PMC10238923_01
Left hand showing puncture wound in the middle finger and index finger.
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A puncture wound was present at the palmer aspect of the left middle finger while another one was found at the dorsum of index finger (Fig. 1).
Chest X-ray on admission.
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Chest x-ray on admission showed either patchy infiltrates bilaterally or atelectasis in the retrocardiac region in the left lower lobe along with bilateral shoulder arthroplasty (Fig. 2).
(A) shows non-contrast CT abdomen with bilateral pleural effusions. Fig (B) and (C) include non-contrast CT abdomen indicating the presence of ileocolitis.
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CT scan of the abdomen was obtained (Fig. 3A-C) which showed small bilateral pleural effusions, and findings suggestive of inflammation of distal ileum and entire colon, concerning for ileocolitis.
(A) shows light-microscopic view of numerous bacilli in patient blood specimen. (B) indicates multiple gram-negative rods upon Gram-staining of patient's blood culture specimen, later confirmed as Capnocytophaga species. (C) Encapsulated, non-hemolytic Capnocytophaga spp. growth on blood agar plate.
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The surgical team recommended to continue empiric antibiotics without surgical intervention as there was an intact arterial circulation. 48 h later, the patient's blood culture came back positive for Capnocytophaga species and the patient's antibiotics were tailored to IV ampicillin/sulbactam (Unasyn) (Fig. 4A-C).