A rare case of hemolytic-uremic syndrome due to a Capnocytophaga canimorsus sepsis: Case report.

RATIONALE: Capnocytophaga canimorsus infection is a rare complication of pet exposure, often resulting from a bite or lick. Its prolonged bacterial culture time can delay diagnosis and treatment, potentially leading to life-threatening situations, such as thrombotic microangiopathy (TMA), especially in immunocompromised patients.

PATIENT CONCERNS: A 62-year-old immunocompetent man was admitted with septic shock.

DIAGNOSES: During hospitalization, he developed hemolytic-uremic syndrome with anuric acute kidney injury. Blood cultures later confirmed C canimorsus bacteremia. On reassessment, he recalled a recent index-finger skin injury that had been licked by his dog.

INTERVENTIONS: The patient received hemodialysis and antibiotic therapy with amoxicillin-clavulanate.

OUTCOMES: He achieved full clinical recovery.

LESSONS: TMA secondary to C canimorsus bacteremia is exceptionally rare (<20 cases reported). Because the organism grows slowly, clinicians should maintain a high index of suspicion in septic patients with recent dog exposure - especially when TMA is present on admission - and start appropriate empiric therapy while cultures are pending. Early distinction between primary thrombotic thrombocytopenic purpura/hemolytic-uremic syndrome and infection-associated TMA is essential to guide management.