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Ned Tijdschr Geneeskd ; 160: D240, 2016.
Artigo em Holandês | MEDLINE | ID: mdl-27581861

RESUMO

Post-splenectomy sepsis is a serious condition with high mortality rates. We present a case of a 64-year-old patient with a medical history of splenectomy who was referred to the Emergency Department with a fever, shivers, and an altered mental state. The symptoms had started twelve hours before. Upon arrival in the hospital the patient was tachypnoeic, hypotensive and febrile. Blood cultures were taken and broad-spectrum antibiotics were started. He was directly admitted to the Intensive Care Unit with severe sepsis of unknown aetiology. CT imaging did not reveal the source of the infection. A second medical history assessment revealed that the patient had engaged in play fighting with a dog two days previously, which left a superficial lesion on his arm. A Capnocytophaga canimorsus infection was deemed likely and antibiotics were switched to intravenous amoxicillin-clavulanic acid. Despite maximal support the patient's clinical condition deteriorated rapidly. The patient died from multi-organ failure fourteen hours after admission to the hospital.


Assuntos
Capnocytophaga , Infecções por Bactérias Gram-Negativas/diagnóstico , Sepse/microbiologia , Esplenectomia , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Animais , Antibacterianos/uso terapêutico , Cães , Serviço Hospitalar de Emergência , Evolução Fatal , Infecções por Bactérias Gram-Negativas/etiologia , Infecções por Bactérias Gram-Negativas/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Sepse/diagnóstico , Sepse/tratamento farmacológico
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