Clinical Review

Lesson of the week: Man's best friend: life threatening sepsis after minor dog bite

BMJ 1997; 314 doi: http://dx.doi.org/10.1136/bmj.314.7074.129 (Published 11 January 1997) Cite this as: BMJ 1997;314:129
  1. D J Mellor, senior registrar in anaesthetics and intensive careb,
  2. Sunil Bhandari, clinical research fellowa,
  3. K Kerr, senior lecturer in microbiologya,
  4. A R Bodenham, director of intensive carea
  1. aLeeds General Infirmary, Leeds LS1 3EX
  2. bBradford Royal Infirmary, Bradford BD9 6RJ
  1. Correspondence to: Dr Mellor
  • Accepted 10 September 1996

Introduction

Minor bites from domestic pets are common, usually causing no more than a superficial lesion. In an American series, however,1 animal bites were the presenting complaint in about 1% of all referrals to emergency rooms. Although severe bite injuries usually present early, for management of soft tissue injury as well as prophylaxis against tetanus and rabies infection, apparently trivial injuries may present later due to insidiously developing, local or systemic infection. Catastrophic sepsis following late presentation after apparently trivial animal bites has been described before.2 3 We describe a case of cardiovascular collapse, purpura fulminans, and acute renal failure in response to infection with capnocytophaga after an apparently trivial bite from a dog.

Case report

A 55 year old man who had been in good health was admitted to hospital with a 36 hour history of fever, rash, diarrhoea, and vomiting. Four days earlier he had been bitten by his pet …

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