Cases reported "Bites and Stings"

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1/19. capnocytophaga cynodegmi cellulitis, bacteremia, and pneumonitis in a diabetic man.

    capnocytophaga cynodegmi (formerly "DF-2 like organism"), a commensal organism of the canine oral cavity, is a capnophilic, gram-negative, facultative bacillus. C. cynodegmi has rarely been encountered in human diseases. We report the first known case of cellulitis, bacteremia, and pneumonitis caused by C. cynodegmi in a diabetic man from central india following a dog bite.
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2/19. A previously undescribed gram-negative bacillus causing septicemia and meningitis.

    This report describes a case of septicemia and meningitis secondary to dog bites by two different dogs on two consecutive days. The case is noteworthy because of the unusual characteristics of the etiologic agent and the inability to place the etiologic agent into any currently defined genus or to identify it by the existing systems of classification. The organism is a small, thin, Gram-negative bacillus after 24 hours of incubation on blood agar; after prolonged incubation, it becomes filamentous. The organism is catalase- and oxidase-positive, hydrolyzes esculin, and forms acid in glucose, xylose, and maltose after 21 days' incubation. The organism does not manifest lysis on sheep blood agar, and does not grow on MacConkey, salmonella-shigella, Centrimide, nutrient, or Kligler iron agars. The tests for urea, nitrate reduction, and indol are negative. The unidentified Gram-negative bacillus showed susceptibility to all antimicrobials tested except gentamicin.
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keywords = bacillus
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3/19. Rat bite fever without fever.

    Rat bite fever is a rarely reported acute febrile bacterial illness caused by streptobacillus moniliformis or spirillum minus following a rat bite. It is classically characterised by abrupt onset of fever with rigors, myalgias, headache, and the appearance of a generalised maculopapular petechial skin rash. Polyarthritis complicates the course of the disease in up to 50% of infected patients, and numerous hurdles can make the diagnosis particularly difficult in the absence of fever or rash, as in the present case. A high degree of awareness is necessary to make the correct diagnosis in such cases. diagnosis has important prognostic implications as the disease is potentially lethal, but easily treatable.
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4/19. streptobacillus moniliformis endocarditis: case report and review.

    A 46-year-old man with rat-bite fever due to streptobacillus moniliformis that was complicated by endocarditis is reported. Other unusual features of this case include septic arthritis with prominent involvement of the sternoclavicular joint and the absence of a rash. Sixteen cases of streptobacillary endocarditis have previously been described. This condition occurs most often in the setting of previously damaged heart valves, usually as a result of rheumatic heart disease. echocardiography demonstrated valvular vegetations in two of the four cases in which it was performed. Embolic phenomena are rare, and therapy with adequate doses of penicillin is usually curative.
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ranking = 5
keywords = bacillus
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5/19. Fatal rat-bite fever--florida and washington, 2003.

    rat-bite fever (RBF) is a rare, systemic illness caused by infection with streptobacillus moniliformis. RBF has a case-fatality rate of 7%-10% among untreated patients. S. moniliformis is commonly found in the nasal and oropharyngeal flora of rats. Human infection can result from a bite or scratch from an infected or colonized rat, handling of an infected rat, or ingestion of food or water contaminated with infected rat excreta. An abrupt onset of fever, myalgias, arthralgias, vomiting, and headache typically occurs within 2-10 days of exposure and is usually followed by a maculopapular rash on the extremities. This report summarizes the clinical course and exposure history of two rapidly fatal cases of RBF identified by the CDC Unexplained Deaths and Critical Illnesses (UNEX) Project in 2003. These cases underscore the importance of 1) including RBF in the differential diagnoses of acutely ill patients with reported rat exposures and 2) preventing zoonotic infections among persons with occupational or recreational exposure to rats.
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6/19. capnocytophaga canimorsus endocarditis.

    We report a case of aortic valve endocarditis, caused by capnocytophaga canimorsus (previously known as CDC Group DF-2) secondary to a dog bite. Vegetations were documented by cross-sectional echocardiography and bacteraemia by positive haemocultures for this unusual gram-negative bacillus.
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7/19. rat-bite fever septic arthritis: illustrative case and literature review.

    rat-bite fever is a rare zoonotic infection caused by streptobacillus moniliformis or spirillum minus, which is characterised by fever, rash and arthritis. The arthritis has previously been described as non-suppurative and isolation of the organism from synovial fluid as very uncommon. This article reports a case of septic arthritis diagnosed as rat-bite fever when the organism was cultured from synovial fluid and reviews another 15 cases of S. moniliformis septic arthritis reported in the worldwide literature since 1985. Articles were included in this review if S. moniliformis was cultured from synovial fluid. Of the published cases, 88% presented with polyarthritis, affecting small and large joints although two had monoarticular hip sepsis. Fever was present in 88%, rash in 25% and 56% had extra-articular features. synovial fluid analysis revealed high cell counts in all cases (mean 51,000 x 10(9)/l) with a predominance of polymorphonuclear leucocytes, and organisms were found on Gram stain in only 50%. Penicillin was used for treatment in 56% of cases and surgery was required in 30%. All patients recovered. rat-bite fever arthritis can be suppurative and attempts should be made to isolate the organism from synovial fluid. The diagnosis should be considered when there is arthritis and a high synovial fluid cell count but no apparent organism, especially when the patient has had contact with rats.
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8/19. capnocytophaga canimorsus septicemia caused by a dog bite in a hairy cell leukemia patient.

    Fatal septicemia developed in a splenectomized patient with hairy cell leukemia following a dog bite. capnocytophaga canimorsus, a slowly growing gram-negative bacillus, was isolated from the patient's blood. Although a rare complication of dog bites in the normal population, this bacterium should be suspected and promptly treated in immunologically compromised dog bite victims. Furthermore, immunocompromised patients should be made aware of the dangers of dog ownership.
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ranking = 1
keywords = bacillus
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9/19. actinobacillus spp. and related bacteria in infected wounds of humans bitten by horses and sheep.

    We describe the isolation of actinobacillus lignieresii and an A. equuli-like bacterium from an infected horse-bite wound in a 22-year-old stable foreman and A. suis from a bite injury in a 35-year-old man who had been attacked by a horse. A. lignieresii was also isolated in pure culture from an infected sheep-bite wound in a rural worker. These species of the genus actinobacillus are primarily associated with animals and animal diseases and are rarely isolated from humans. The purpose of this report is to raise awareness of the possible occurrence of actinobacillus spp. in bite wounds inflicted by farm animals and to discuss the difficulties encountered in the identification of species of actinobacillus and related bacteria.
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ranking = 8
keywords = bacillus
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10/19. Dysgonic fermenter 2 septicemia.

    Dysgonic fermenter 2 (DF-2) is a slow-growing gram-negative bacillus causing a zoonotic infection that is acquired through dog bites or other contact with dogs. Splenectomized patients and those with alcoholic liver disease are most susceptible to DF-2 infection. The clinical picture can be one of fulminant septicemia and disseminated intravascular coagulation in the splenectomized patient; the presentation is milder in the alcoholic patient. The overall mortality from DF-2 septicemia among the 41 cases reported in the literature is 27%. The organism is sensitive to penicillin, resistant to aminoglycosides, and not easily grown on common media. It appears to be serum-sensitive in tests with normal human serum. Penicillin prophylaxis of dog bite wounds is especially important in high-risk patients. DF-2 infection should be considered when any splenectomized patient develops fulminant septicemia, disseminated intravascular coagulation, and peripheral gangrene. Examination of a gram stain of the peripheral blood or buffy coat is of value in such cases.
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