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. 2025 Oct 29.
doi: 10.1007/s12024-025-01101-9. Online ahead of print.

Capnocytophaga canimorsus: meningitis and Waterhouse-Friderichsen syndrome in an immunocompetent patient

A Fort  1   2 , J Liance  3 , J Borges  4 , C Recule  5 , M Peoc'h  6 , V Scolan  4   7   8
Affiliations

Capnocytophaga canimorsus: meningitis and Waterhouse-Friderichsen syndrome in an immunocompetent patient

A Fort et al. Forensic Sci Med Pathol. .

Abstract

Diagnosing sudden, unexplained death in healthy individuals is challenging. This case report details a rare case of fatal Waterhouse-Friderichsen Syndrome (WFS) in a previously healthy 27-year-old man. Post-mortem examination revealed vomit stains, widespread purpura, and haemorrhagic adrenal glands. Microbiological analysis confirmed a systemic infection with Capnocytophaga canimorsus. While C. canimorsus infections are uncommon, their association with WFS is exceedingly rare. To our knowledge, this is the first documented case of fatal C. canimorsus sepsis causing WFS in an immunocompetent patient with no history of a dog bite. This case highlights the critical importance of post-mortem microbiological analyses in sudden, unexplained deaths, even when typical risk factors are absent.

Keywords: Adrenal haemorrhage; Capnocytophaga canimorsus; Forensic pathology; Immunocompetent; Meningitis.

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Conflict of interest statement

Declarations. Informed consent: As this report is based on a judicial autopsy, and is fully anonymized to protect the patient’s identity, informed consent from the next of kin was not required for publication under French law and institutional policy. Ethical approval: This case report is based on a judicial autopsy performed as part of a legal investigation. Following French law and institutional guidelines, ethical approval was not required. Conflict of interest: The authors declare no competing interests.

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