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Reminder of important clinical lesson
Case report
Unexpected pathogen presenting with purulent meningitis
  1. Jamie Bering1,
  2. Carlos Hartmann2,
  3. Kara Asbury2 and
  4. Holenarasipur R Vikram2
  1. 1Department of Internal Medicine, Mayo Clinic, Phoenix, Arizona, USA
  2. 2Division of Infectious Diseases, Mayo Clinic, Phoenix, Arizona, USA
  1. Correspondence to Dr Holenarasipur R Vikram; vikram.hr{at}mayo.edu

  • Present affiliation The present affiliation of Carlos Hartmann is: †Valleywise Community Health Center-McDowell, Phoenix, Arizona, USA

  • Present affiliation The present affiliation of Kara Asbury is: ‡Apex Physicians, Infectious Diseases Specialists & Travel Clinic, Scottsdale, Arizona, USA

Abstract

Herein we report a case of a 67-year-old man with chronic lymphocytic leukaemia who developed acute onset of fever and altered mental status while receiving ibrutinib therapy. He was eventually found to have Capnocytophaga canimorsus meningitis. Timely diagnosis and appropriate antimicrobial therapy was associated with a favourable outcome. We describe challenges associated with appropriate identification of, and briefly review infections caused by Capnocytophaga sp. To our knowledge, this is the first case of invasive C. canimorsus infection in the setting of ibrutinib therapy, and adds to the growing list of serious infections that have been associated with this agent.

  • meningitis
  • infections
  • tyrosine Kinase Inhibitor
  • haematology (incl blood transfusion)
  • haematology (drugs and medicines)

https://doi.org/10.1136/bcr-2019-231825

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    Footnotes

    • Contributors JB: manuscript drafting and editing, submission application; CH: manuscript drafting and editing; KA: manuscript editing; HV: manuscript drafting, editing, microbiology figures.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.