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Background <p><i>Capnocytophaga sputigena</i>, a fastidious Gram-negative commensal of the human oral flora, rarely causes bloodstream infections but poses significant risks to immunocompromised hosts, particularly those with hematologic malignancies or mucosal barrier injury.</p> Case presentation <p>We report a rare case of <i>C. sputigena</i> bacteremia in a 51-year-old man with epidermal growth factor receptor (EGFR)-positive nasopharyngeal carcinoma (NPC) Stage IV (cT3N2M1), as confirmed by immunohistochemistry. The patient, who was undergoing chemotherapy, presented with severe neutropenia (absolute neutrophil count 0.04 × 10<sup>9</sup>/L), fever (38.9°C), and oral mucositis. Blood cultures identified slender Gram-negative bacilli, which were confirmed as <i>C. sputigena</i> using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) and 16S rDNA sequencing. Initial empirical therapy with meropenem led to clinical improvement, and antimicrobial therapy was subsequently de-escalated to ceftazidime. The patient was eventually discharged in stable condition.</p> Conclusions <p>This case underscores that <i>C. sputigena</i> can act as an opportunistic pathogen in solid tumor patients with therapy-induced mucosal damage and highlights the critical importance of meticulous oral care and advanced microbiological diagnostics in managing immunocompromised individuals.</p>

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Capnocytophaga sputigena bacteremia in a nasopharyngeal carcinoma patient with severe neutropenia: a case report

  • 期刊论文

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  • 发表日期：

    2025年12月13日

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  • Zhi-Ying Deng,
  • Li-Hua Tong,
  • Zhan-Tao Lu,
  • Chun-Lin Liu,
  • Jie Yao

摘要

Background

Capnocytophaga sputigena, a fastidious Gram-negative commensal of the human oral flora, rarely causes bloodstream infections but poses significant risks to immunocompromised hosts, particularly those with hematologic malignancies or mucosal barrier injury.

Case presentation

We report a rare case of C. sputigena bacteremia in a 51-year-old man with epidermal growth factor receptor (EGFR)-positive nasopharyngeal carcinoma (NPC) Stage IV (cT3N2M1), as confirmed by immunohistochemistry. The patient, who was undergoing chemotherapy, presented with severe neutropenia (absolute neutrophil count 0.04 × 109/L), fever (38.9°C), and oral mucositis. Blood cultures identified slender Gram-negative bacilli, which were confirmed as C. sputigena using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) and 16S rDNA sequencing. Initial empirical therapy with meropenem led to clinical improvement, and antimicrobial therapy was subsequently de-escalated to ceftazidime. The patient was eventually discharged in stable condition.

Conclusions

This case underscores that C. sputigena can act as an opportunistic pathogen in solid tumor patients with therapy-induced mucosal damage and highlights the critical importance of meticulous oral care and advanced microbiological diagnostics in managing immunocompromised individuals.