Unusual infections and novel therapy in the immunocompromised host

Facial cellulitis because of Aggregatibacter (Actinobacillus) actinomycetemcomitans and Capnocytophaga species in an immunocompetent patient

The species of Capnocytophaga and Aggregatibacter are normal flora and mostly cause periodontal diseases. The soft tissue infection caused by Aggregatibacter often is associated with Actinomyces species. Beside, most Capnocytophaga infections are described in immunocompromised patients. We identified facial cellulitis caused by Capnocytophaga spp and Aggregatibacter (Actinobacillus) actinomycetemcomitans in a 16-year-old immunocompetent female.

A series of infections due to Capnocytophaga spp in immunosuppressed and immunocompetent patients

OBJECTIVE

To investigate the epidemiology, microbiology and outcome of infections caused by Capnocytophaga spp. at a single center.

METHODS

We report on ten documented infectious episodes caused by Capnocytophaga observed between 1994 and 1999 at the Innsbruck University Hospital.

RESULTS

In seven of ten patients, Capnocytophaga septicemia was diagnosed during periods of neutropenia. In contrast, the remaining three patients had normal white blood cell counts when acquiring Capnocytophaga septicemia (one) and pleural empyema (two). Blood cultures containing long, slender, Gram-negative rods, which grew slowly under anaerobic conditions and lacked susceptibility to metronidazole, were subcultivated in a CO2-enriched atmosphere (5%). Subcultivation yielded Capnocytophaga in all ten cases within 2-12 days. The patients were then placed on appropriate antibiotic therapy, with or without additional surgical intervention, and the organism was eradicated.

CONCLUSION

Identification of Capnocytophaga facilitates appropriate, and in most cases effective, antimicrobial therapy.