1033 A Rare Case of a Dog Bite Leading to Bilateral Lower Limb Amputation

Abstract Introduction Capnocytophaga canimorsus is a Gram- negative bacteria which is present in the normal gingival flora of both cats and dogs. C. canimorsus is a rare cause of bacteraemia in humans, occurring usually after animal bites, and can have devastating consequences for patients. Report This report describes the case of a 65-year-old female patient who presented acutely unwell six days after being bitten on the hand by a dog. Her blood culture flagged positive and further analysis by 16S rRNA PCR confirmed the organism as C. canimorsus. She suffered consequences of overwhelming sepsis, disseminated intravascular coagulation (DIC) and bilateral acute limb ischaemia requiring bilateral major lower limb amputations. Discussion A Dutch national surveillance study found the incidence of C. canimorsus to be 0.67 cases per million, however, with the incidence of dog bites doubling between 1998-2018; the incidence of C. canimorsus is likely to increase more than previously reported. A retrospective review of patients in a Helsinki ICU cohort between 2005 and 2014 found 65 patients with C. canimorsus; only three of these required lower limb amputation. Early prophylactic treatment with antibiotics after suffering a dog or cat bite could prevent serious complications associated with this bacterium.