A Case of Scratched Infection by <i>Capnocytophaga canimorsus</i> Diagnosed Early with Microscopic Peripheral Blood Smear Examination / 日本農村医学会雑誌

　　<i>Capnocytophaga canimorsus</i> is a spindle-shaped facultatively anaerobic Gram-negative rod in the oral cavity of dogs and cats. <i>C. canimorsus</i> rarely infects humans through an animal bite or scratch. However, it leads to severe sepsis once infection occurs, and the fatality rate is estimated to be up to 30%. The patient was a 56-year-old man with fatigue and fever. Sepsis with thrombocytopenia was suspected from the blood examination results. We decided to conduct microscopic examination of a non-stained peripheral blood smear and identified bacteria; therefore, Gram stain was immediately performed and spindle-shaped Gram-negative bacilli were detected. Additionally, the patient had a history of a bite and scratch by his cat. We suspected <i>C. canimorsus</i> infection from the microscopic examination findings and history. Moreover, we determined early that the pathogenic bacterium was <i>C. canimorsus</i> by blood culture. With immediate and proper treatment based on these results, we could rescue this septic patient with disseminated intravascular coagulation. Microscopic examination of non-stained peripheral blood smear is helpful for the early diagnosis of <i>C. canimorsus</i> infection.

Survey on the contributions of hospice and palliative care staff to spiritual and life-and-death education at school

We surveyed the involvement of hospice and palliative care staff in spiritual and life-and-death education at school. We sent a questionnaire to a total of 138 hospice and palliative care institutions, receiving 67 responses (response rate 49%). A variety of staff at 15 institutions (22%) practiced life-and-death education. Most often, they realized the necessity of such education when they observed children grieving from the death or dying of a family member. 6 institutions targeted their life-and-death education to primary schools, 8 to junior high schools, and 6 to senior high schools. The number of teaching sessions ranged from once to 97 times per year, with hours of class contact less than one hour in 2 institutions, and 1-3 hours in the other 12 institutions. Even those institutions not conducting school education almost all responded that school education on life and death by healthcare workers would be meaningful. Respondents concurred that children would be moved by both "life-and-death education" and "spiritual education." Further comments almost all noted the importance of life-and-death education, not only for children but also for adults. In this sense, the expertise and experiences of hospice and palliative care institutions will become valuable educational resources.