ABSTRACT
Meningitis and septicaemia due to Capnocytophaga canimorsus are extremely rare and described as emerging zoonoses because of their low incidence and prevalence, but also because of the challenges in bacterial identification, thus, the real number of cases is probably underestimated. We report the case of a 61-year-old man, with a history a chronic alcoholism, who developed, following a recent dog bite, meningitis with normoglycorachia and concomitant sepsis, and had a favorable outcome after intravenous probabilistic antibiotherapy combining ceftazidime and metronidazole. This association aimed to cover the risks represented by Pseudomonas spp and anaerobic bacteria, once the microorganisms commonly associated with meningitis were excluded using molecular biology tools. In addition to the unusual biological results (normoglycorachia and bacterial morphology after Gram staining), we present the biological diagnostic approach (molecular, biochemical and physical tools successively used to lead, by exclusion and confirmation, to this diagnosis), closely linked to the clinical expertise. This is, to our knowledge, the first described case of meningitis with normoglycorachia and septicaemia due to Capnocytophaga canimorsus successfully treated with ceftazidime and confirmed by identification by MALDI-TOF mass spectrometry.
Subject(s)
Capnocytophaga , Gram-Negative Bacterial Infections/diagnosis , Meningitis, Bacterial/diagnosis , Animals , Bites and Stings , Blood Chemical Analysis/methods , Capnocytophaga/isolation & purification , Dogs , Gram-Negative Bacterial Infections/microbiology , Humans , Male , Meningitis, Bacterial/microbiology , Middle Aged , Sepsis/diagnosis , Sepsis/microbiology , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Zoonoses/diagnosisABSTRACT
We have assessed turnaround time (TAT) for urgent laboratory analysis. Twelve hospital laboratories participated to this study. All laboratories have organized a classification of a management system of urgent analyses. The TAT reporting were relatively homogeneous for 12 laboratories. We have defined TAT as time of specimen receipt in the laboratory to time of results reporting. This TAT divides into 4 groups: close to 50 minutes for analyses as TP, D-dimeres, CRP (C Protein Reactive), HCG, troponin, alcoholhemia, K, lipase; 35 minutes for the cytology of cerebrospinal fluid; 25 minutes for complete blood cell count and 15 minutes for blood gases. All laboratories have accepted to TAT as a quality indicator. Quality indicator data should be collected in time to identify and correct problems to implemente effective interventions and to standardize processes among clinical laboratories.
