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Description
Capnocytophaga species is a slow-growing gram-negative bacilli that colonizes the saliva of canines. Human infections caused by this organism are most commonly seen as sequela of dog bites in immunocompromised or asplenic patients. Meningitis due to capnocytophaga is rarely documented. In a review of literature from 2019, only 37 cases of meningitis due capnocytophaga canimorsus were highlighted. Because of its slow-growing nature, delayed diagnosis is common, and even more delayed if it is not suspected in patients without classic risk factors or a clear history of animal bite. This case highlights an atypical presentation of Capnocytophaga meningitis in an immunocompetent patient and highlights the diagnostic challenges posed by this rare infection.
A 70-year-old female with hypothyroidism and history of tobacco use presented to the emergency room after being found unresponsive in her home. She had been feeling general malaise for three days prior to presentation and fever for one day but did not endorse any other symptoms. On presentation, she was incoherent, not responsive to verbal stimuli but protecting airway, with a GCS of 11. Meningitic coverage antibiotics were started. Lumbar puncture was performed which was suspicious for bacterial infection with cerebral spinal fluid protein of 260 mg/dL with glucose of 39. Imaging was unremarkable. Other initial labs were suggestive of rhabdomyolysis and significant for a procalcitonin of 23.7.
This case is a rare presentation of Capnocytophaga canimorsus meningitis in an immunocompetent patient. Due to the organism's slow growth and frequent delays in species identification, diagnosis may be prolonged and blood cultures initially nondiagnostic. Early initiation and maintenance of broad-spectrum antimicrobial therapy is critical when this pathogen is suspected, particularly in patients with canine exposure and severe sepsis. Increased awareness of this diagnosis may facilitate earlier recognition and improve outcomes.
Publication Date
5-8-2026
Disciplines
Internal Medicine
Recommended Citation
Campbell H, Parent J, Khirfan G. Capnocytophaga meningitis: A rare cause of bacterial central nervous system infection. Presented at: Research Day Corewell Health West; 2026 May 8; Grand Rapids, MI.
Comments
2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 2026