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Case Reports
. 2020 Feb 9;13(2):e233783.
doi: 10.1136/bcr-2019-233783.

First reported case of lead-related infective endocarditis secondary to Capnocytophaga canimorsus: 'Dog Scratch' endocarditis

Gareth Squire  1 , Simon Hetherington  2
Affiliations
Case Reports

First reported case of lead-related infective endocarditis secondary to Capnocytophaga canimorsus: 'Dog Scratch' endocarditis

Gareth Squire et al. BMJ Case Rep. .

Abstract

A 76-year-old woman presented with a 6-week history of malaise, night sweats and recurrent fever. She had a background of dilated cardiomyopathy for which she had a cardiac resynchronisation device in situ. She had several hospital admissions across this time with differing diagnoses offered. She received multiple courses of antibiotics with short-term symptom resolution. Blood cultures grew Gram-negative rods and samples were sent to a specialist centre for subtype analysis. A transthoracic echocardiogram revealed thickening of the distal right ventricular lead. A transoesophageal echocardiogram demonstrated a clearer vegetation on this lead. It transpired that she had been scratched by her dog a fortnight before symptom onset. The causal bacterium was reported as Capnocytophaga canimorsus, a bacterium that exists almost exclusively in the saliva and claws of dogs and cats. She received an extended course of antibiotics with eventual removal of the infected device.

Keywords: cardiovascular system; valvar diseases.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Transthoracic echocardiogram, 4-chamber apical view, close up of right atrium, distal right ventricular lead thickening.
Figure 2
Figure 2
Transoesophageal echocardiogram, mid-oesophageal, right ventricular (RV) inflow outflow view. An amorphous mass envelops the RV lead on the atrial side of the tricuspid valve; there is soft echo-density attached to it, which is independently mobile and consistent with a vegetation.
Figure 3
Figure 3
Transthoracic echocardiogram, 4-chamber apical view, close up of right atrium, clear vegetation on distal right ventricular lead.
See this image and copyright information in PMC

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