Case Report
Published: Nov 02, 2025 | DOI: 10.24911/ejmcr.9-2331
Atypical Gastrointestinal Presentation and Overcoming Diagnostic and Therapeutic Challenges in Fulminant Capnocytophaga canimorsus Sepsis
Authors: Pushpa Saajan , Ashby Mathew , Anusha Karunasagar , Ehab elghaysha , Fiona Mulyansaka , Shikandhini Visuvanthan
Article Info
Authors
Pushpa Saajan
Princess Alexandra Hospital NHS Trust Harlow United Kingdom
Ashby Mathew
Princess Alexandra Hospital NHS Trust Harlow United Kingdom
Anusha Karunasagar
Princess Alexandra Hospital NHS Trust Harlow United Kingdom
Ehab elghaysha
Princess Alexandra Hospital NHS Trust Harlow United Kingdom
Fiona Mulyansaka
Princess Alexandra Hospital NHS Trust Harlow United Kingdom
Shikandhini Visuvanthan
Princess Alexandra Hospital NHS Trust Harlow United Kingdom
Publication History
Received: August 17, 2025
Accepted: September 19, 2025
Published: November 02, 2025
Abstract
Background:
Capnocytophaga canimorsus is a fastidious, zoonotic Gram-negative bacillus that can cause rapidly fatal septicaemia. Delays in microbiological diagnosis due to slow growth are common, reducing survival chances. This case uniquely highlights both an atypical gastrointestinal presentation and the resolution of a diagnostic impasse through extended CO₂ incubation triggered by astute clinical suspicion.
Case Presentation:
A 57-year-old male, recently tapered off corticosteroids for inflammatory arthritis, presented with diarrhoea, vomiting, and hypotensive collapse. He rapidly developed disseminated intravascular coagulation and multi-organ failure. Empirical piperacillin–tazobactam and gentamicin failed; cultures flagged positive at 72 hours with no initial growth. Only after clinicians alerted the laboratory, extended incubation under CO₂ enabled growth of C. canimorsus by day seven, confirmed via MALDI-TOF. Switching to meropenem led to recovery, although amputations of the necrotic tissues, including both toes and digits from his right hand were necessary due disseminated intravascular coagulation.
Conclusion:
This case demonstrates that C. canimorsus infection may initially mimic gastroenteritis and progress rapidly to fulminant sepsis. Early clinical suspicion, timely communication with microbiology for adapted incubation protocols, and prompt escalation to effective antimicrobial therapy are critical for survival.
Keywords: Capnocytophaga canimorsus, Disseminated intravascular coagulopathy, Septicemia
Pubmed Style
Pushpa Saajan, Ashby Mathew, Anusha Karunasagar, Ehab elghaysha , Fiona Mulyansaka, Shikandhini Visuvanthan . Atypical Gastrointestinal Presentation and Overcoming Diagnostic and Therapeutic Challenges in Fulminant Capnocytophaga canimorsus Sepsis. EJMCR. 2025; 02 (November 2025): -. doi:10.24911/ejmcr.9-2331
Web Style
Pushpa Saajan, Ashby Mathew, Anusha Karunasagar, Ehab elghaysha , Fiona Mulyansaka, Shikandhini Visuvanthan . Atypical Gastrointestinal Presentation and Overcoming Diagnostic and Therapeutic Challenges in Fulminant Capnocytophaga canimorsus Sepsis. https://www.ejmcr.com/index.php/articles/2331 [Access: November 06, 2025]. doi:10.24911/ejmcr.9-2331
AMA (American Medical Association) Style
Pushpa Saajan, Ashby Mathew, Anusha Karunasagar, Ehab elghaysha , Fiona Mulyansaka, Shikandhini Visuvanthan . Atypical Gastrointestinal Presentation and Overcoming Diagnostic and Therapeutic Challenges in Fulminant Capnocytophaga canimorsus Sepsis. EJMCR. 2025; 02 (November 2025): -. doi:10.24911/ejmcr.9-2331
Vancouver/ICMJE Style
Pushpa Saajan, Ashby Mathew, Anusha Karunasagar, Ehab elghaysha , Fiona Mulyansaka, Shikandhini Visuvanthan . Atypical Gastrointestinal Presentation and Overcoming Diagnostic and Therapeutic Challenges in Fulminant Capnocytophaga canimorsus Sepsis. EJMCR. (2025), [cited November 06, 2025]; 02 (November 2025): -. doi:10.24911/ejmcr.9-2331
Harvard Style
Pushpa Saajan, Ashby Mathew, Anusha Karunasagar, Ehab elghaysha , Fiona Mulyansaka, Shikandhini Visuvanthan (2025) Atypical Gastrointestinal Presentation and Overcoming Diagnostic and Therapeutic Challenges in Fulminant Capnocytophaga canimorsus Sepsis. EJMCR, 02 (November 2025): -. doi:10.24911/ejmcr.9-2331
Chicago Style
Pushpa Saajan, Ashby Mathew, Anusha Karunasagar, Ehab elghaysha , Fiona Mulyansaka, Shikandhini Visuvanthan . "Atypical Gastrointestinal Presentation and Overcoming Diagnostic and Therapeutic Challenges in Fulminant Capnocytophaga canimorsus Sepsis." 02 (2025), -. doi:10.24911/ejmcr.9-2331
MLA (The Modern Language Association) Style
Pushpa Saajan, Ashby Mathew, Anusha Karunasagar, Ehab elghaysha , Fiona Mulyansaka, Shikandhini Visuvanthan . "Atypical Gastrointestinal Presentation and Overcoming Diagnostic and Therapeutic Challenges in Fulminant Capnocytophaga canimorsus Sepsis." 02.November 2025 (2025), -. Print. doi:10.24911/ejmcr.9-2331
APA (American Psychological Association) Style
Pushpa Saajan, Ashby Mathew, Anusha Karunasagar, Ehab elghaysha , Fiona Mulyansaka, Shikandhini Visuvanthan (2025) Atypical Gastrointestinal Presentation and Overcoming Diagnostic and Therapeutic Challenges in Fulminant Capnocytophaga canimorsus Sepsis. , 02 (November 2025), -. doi:10.24911/ejmcr.9-2331