ABSTRACT
<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.
ABSTRACT
Objective/background: the prevalence of pulmonary nontuberculous mycobacterial [pNTM] disease, including Mycobacterium avium complex [MAC], varies widely according to geographic region. However, the factors that influence regional variations in pNTM disease prevalence remain unknown. This study was undertaken to examine whether environmental or occupational factors or host traits could influence regional variations in pNTM disease prevalence
Methods: we collected laboratory data on pulmonary tuberculosis [pTB] and pNTM from two hospitals in the West Harima area of Japan and five hospitals in Kyoto City, Japan from 2012 to 2013. We estimated microbiological pNTM disease prevalence by multiplying all pTB cases in each area with the ratio of pNTM cases and pTB cases at the survey hospitals in each area. We administered a standardized questionnaire to 52 patients and 120 patients with pulmonary MAC [pMAC] disease at Ako City Hospital and Kyoto University Hospital, respectively
Results: the estimated prevalence of microbiological pNTM disease in the West Harima area [85.4/ 100,000 population-years] was significantly higher than that observed in Kyoto City [23.6/100,000 population-years; p < .001]. According to multiple logistic regression analysis, in Ako City Hospital, primary [activities directly related to natural resources] and secondary industries [construction, mining, and manufacturing primary industry produce; odds ratio [OR] = 4.79; 95% confidence interval [CI]= 1.49 - 14.0; p = .007] and soil exposure [OR= 13.6; 95% CJ= 4.94 - 45.26; p < .001] were associated with pMAC disease
Conclusion: environmental factors, both industrial structures associated with occupational dust and environmental soil exposure, could influence the regional variations in pNTM disease prevalence