Risk of Animal Contact in Immunocompromised Hosts

We would like to congratulate Tan¹ on his outstanding review article recently published in the ARCHIVES. As Tan points out, his article does not intend to be comprehensive and inclusive. We would like to emphasize the importance of exposure to domestic dogs and/or cats in immunocompromised patients. Even individuals without a dog or cat bite or scratch may develop a potentially fatal infection. The fatality rate associated with Capnocytophaga canimorsus infection is approximately 25%. Asplenic or immunocompromised patients should be cautioned about the risks of owning pets, since these patients represent approximately 80% of those infected with C canimorsus.² Patients with cirrhosis, solid organ tumors, or hematologic malignancies are predisposed to develop Pasteurella multocida infection, which has an overall mortality rate of 31%.³ The mortality rate associated with spontaneous bacterial peritonitis is about 30% and is even higher when due to P multocida.⁴ The treatment of choice for infections with C canimorsus and/or P multocida is penicillin. The organisms are also sensitive to cephalosporins and quinolones, such as ciprofloxacin hydrochloride. Primary preventive strategies for immunocompromised patients may include minimization of animal contact.