Key Instruction Point
- Physician review is advised prior to work with animals, particularly for people with impaired defense mechanisms
A 26-year-old woman underwent a splenectomy (spleen removal). Two years later, while working as a dog groomer at a veterinary hospital she was bitten by a dog. The wound was washed with surgical iodine solution and bandaged. Three days later, the woman left work because had pain at the site of the bite and felt ill. Within 12 hours she had two grand mal seizures and collapsed She was hospitalized and treated for septicemia (blood infection) and kidney failure. She eventually recovered without complications.
This patient became infected with a bacterium formerly called DF2, which is now classified as Capnocytophaga canimorsus. This bacterium is commonly found in the mouths of normal dogs. It is probably a common contaminant of dog bite wounds. Most people do not experience problems. However, the organism can cause a serious, potentially fatal systemic infection in immunocompromised people. Alcoholism and absence of a spleen have been associated with many cases. Even intensive antibiotic therapy may not be able to control the infection in such cases. The rapid onset of symptoms seen in this case is typical. Physicians should consider hospitalization for observation of splenectomy patients following a dog bite. Persons who have had their spleen removed should discuss the advisability of working with dogs or cats, with their physician in any setting.