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Postgraduate Education Corner: PULMONARY AND CRITICAL CARE PEARLS |

Acute Onset of Fever, Chills, and Lethargy in a 36-Year-Old Woman*

Madalina Minciu Macrea, MD, MPH; Michael McNamee, MD, FCCP; Thomas J. Martin, MD, FCCP
Author and Funding Information

*From the Pulmonary and Critical Care Department (Dr. Macrea) and Medical Service (Dr. Martin), Salem VA Medical Center, Salem, VA; and Medical ICU (Dr. McNamee), Division of Pulmonary and Critical Care, Hospital of Central Connecticut, New Britain, CT.

Correspondence to: Madalina Minciu Macrea, MD, MPH, Pulmonary and Critical Care Department, Salem VA Medical Center, Salem, VA 24153; e-mail: Madalina.Macrea1@va.gov



Chest. 2008;133(6):1505-1507. doi:10.1378/chest.07-2566
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Extract

A 36-year-old woman presented to the emergency department with acute onset of fever, chills, and lethargy. She denied headache, cough, chest, or abdominal pain. She was the owner of a dog, but denied any dog bite. Her medical history included asthma and hypothyroidism. Her medications included albuterol/ipratropium and levothyroxine. There was no history of recent travel or sick contact.

1Blanche, P, Bloch, E, Sicard, D (1998)Capnocytophaga canimorusin the oral flora of dogs and cats [letter].J Infect36,1342Bobo, RA, Newton, EJ A previously undescribed Gram-negative bacillus causing septicemia and meningitis.Am J Clin Pathol1976;65,564-5693Ehrbar, H, Gubler, J, Harbarth, S Capnocytophaga canimorsuscomplicated by myocardial infarction in two patients with normal coronary arteries.Clin Infect Dis1996;23,335-3364Janda, JM, Graves, HM, Lindquist, D, et al DiagnosingCapnocytophaga canimorsusinfections.Emerg Infect Dis2006;12,340-3425Le Moal, G, LAndron, C, Grollier, G Meningitis due toCapnocytophaga canimorsusafter receipt of a dog bite: case report and review of the literature.Clin Infect Dis2003;36,e42-e466Mirza, I, Wolk, J, Toth, L Waterhouse-Friderichsen syndrome secondary toCapnocytophaga canimorsussepticemia and demonstration of bacteremia by peripheral blood smear.Arch Pathol Lab Med2000;124,859-8637Ngaage, D, Kotidis, K, Sandoe, J Do not snog the dog: infective endocarditis due toCapnocytophaga canimorsus.Eur J Cardiothorac Surg1999;16,362-3638Pers, C, Gahrn-Hensen, B, Frederiksen, W Capnocytophaga canimorsussepticemia in Denmark, from 1982 to 1995: review of 39 cases.Clin Infect Dis1996;23,71-759Yu, RK, Shepherd, L, Rapson, D Capnocytophaga canimorsus, a potential emerging microorganism in splenectomized patients.Br J Haematol2000;109,679

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