What The Health?! Can you really die after being licked by a dog?

An old dog licking a little boy's face. Isolated on white.
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In a rare and tragic medical case, a man died from multi-organ failure after being licked by his pet dog.

The 63-year-old German man went to hospital with severe flu-like symptoms including pain in his legs, fever, and laboured breathing, according to the European Journal of Case Reports in Internal Medicine. He also had tiny red spots on his face and discolouration in his lower extremities.

According the report, the unnamed man was otherwise healthy; he had no headaches, neck stiffness, nor other symptoms of meningitis.

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Initial tests, however, showed signs of acute kidney damage and liver dysfunction. He was transferred to the intensive care unit, where he was diagnosed with severe sepsis with purpura fulminans, a rapidly-progressive necrosis of the skin.

In the Hospital Sick Male Patient Sleeps on the Bed. Heart Rate Monitor Equipment is on His Finger.
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Doctors started him on antibiotics, but over the ensuing 30 hours, his condition deteriorated. He experienced cardiac arrest but was resuscitated, then intubated and mechanically ventilated.

On the man’s fourth day of hospitalization, blood cultures revealed Capnocytophaga canimorsus, a type of bacteria commonly found in the mouths of people, dogs, and cats. He had been touched and licked by his dog, his only pet, in previous weeks.

He was given more antibiotics.

The man went on to develop encephalopathy (brain damage or malfunction) and renal and liver failure. From there, things just got worse. The man developed blistering of the skin, gangrene, and brain swelling, among other symptoms.

His family decided to take him off life support, and he died 16 days after starting treatment.

virus 3d illustration
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According to the Centers for Disease Control and Prevention, Capnocytophaga canimorsus can enter the blood stream, which can lead to infections throughout body. Those can cause septicemia (blood infection), endocarditis (inflammation of the lining of the heart), abscesses that cause redness and swelling in body tissues, and inflammation of the eyes, face, lymph nodes, or brain membranes.

Infections typically occur in people with a compromised immune system, including those who drink alcohol excessively, have HIV or cancer, or who have had their spleens removed.

The man in this particular case, however, was not immunocompromised.

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It’s not the only documented case of a human being infected with Capnocytophaga canimorsus.

A 49-year-old woman from Ottawa lost three limbs after a bite from her dog led to infection due to the bacterium in 2013.

Infection from Capnocytophaga canimorsus is rare; exact numbers, however, don’t exist since it’s not a reportable disease, says. Dr. Scott J. Weese, a professor of infectious diseases and director of the Centre for Public Health and Zoonoses at the University of Guelph.

Two months old Jack Russell terrier puppy biting hand of old lady who tires to play with her.
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“It’s almost always from dogs,” says Weese, coauthor of the Worms and Germs blog, which promotes safe pet ownership. “Cats would be a very rare source. The bacterium is carried in the mouths of pretty much all dogs.”

“It’s very rare to see a case with no known risk factors,” he says. “In a case like the German man, it’s impossible to rule out an immune system problem. Otherwise, it’s just an exceptionally rare example. We can rarely say ’never’ with infectious diseases, and this may be an example of a strange and rare incident.”

To prevent infection and illness, Weese says it’s critical that high-risk people know they’re high risk. People without a spleen don’t always realize the risk.

Human Spleen Anatomy Illustration. 3D render
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“Add that to a situation where healthcare personnel don’t often ask about pet contact, and risk gets elevated,” Weese says. “Very minor bites can be enough to infect someone, and those sometimes don’t get reported. High-risk people need to get antibiotics after any bite. Low risk people need to make sure they healthcare provider knows they have animal contact, and if there was a bite, they need to speak up about that, regardless of how minor it might have seemed.”

Dr. Maureen E.C. Anderson, lead veterinarian of animal health and welfare with the veterinary science unit of the Ontario Ministry of Agriculture, Food and Rural Affairs, says that if you have contact with a pet that breaks the skin, it’s important to practise proper hygiene immediately.

“Washing with soap and water right away is an essential part of wound care, and should be done anytime you have a bite or scratch from an animal, even if it seems minor,” says Anderson, Weese’s Worms and Germs’ coauthor. “While it can’t eliminate the risk of infection, it can help significantly reduce the risk of infection with any of the myriad of bacteria found in a pet’s mouth, including C. canimorsus.”

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Both Weese and Anderson stress that most people don’t need to worry about this potential source of infection.

“People shouldn’t panic,” Weese says. “Millions of Canadians have contact with pets on a daily basis. A large number of those have contact with saliva. Yet, infections like this are rare in high-risk people and exceptionally rare in others.”

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