Finn M, Dale B, Isles C
Beware of dog! A syndrome resembling thrombotic thrombocytopenic
purpura associated with Capnocytophaga canimorsus
septicemia
Nephrol Dial Transplant
(Sep) 11:1839-1840 1996

A syndrome resembling TTP associated with Capnocytophaga
canimorsus was first described by Scarlett et al in Am J
Med, 1991 (90:127-128). For you non-Latin scholars, "canimorsus"
means dogbite. In this paper, Finn et al recount the tale of an
elderly woman who presented with fever, headache, and neck stiffness,
purpuric rash, high fever, and hypotension. She was found to be
septic with a Gram-negative bacillus that turned out to be
Capnocytophaga canimorsus, an organism that has been associated
with dog bites. Initial treatment was with benzylpenicillin and
netilmicin. Subsequently the patient developed altered mental status,
gangrenous changes of nose and toes, and renal and respiratory
failure, low platelet count, and schistocytes on blood smear. She
recoverd slowly after treatment with antibiotics, high dose steroids
and plasma exchange. She denied being bitten by a dog, but had a dog
that frequently licked her face, and the inference drawn was, that
perhaps this particular bacterium, or related organisms carried in
dogs' oral secretions, may cause a TTP-like illness.
Comment: One problem is that features characteristic of TTP
developed somewhat late in this patient's course. Nevertheless, it
suggests a possible etiology for some otherwise unexplained TTP-like
illnesses. (John T. Daugirdas, M.D., University of Illinois at
Chicago)