Kidney Week

Abstract: SA-PO1151

A Rare Case of Streptococcus canis Bacteremia in a Kidney Transplant Recipient

Session Information

• Transplantation: Clinical - Infectious Diseases
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Gianni, Tito, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States

Tito Gianni

• Najar, Hatem, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States

Hatem Najar, MD

• Gupta, Maitreyee M., Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States

Maitreyee M. Gupta, MD

Introduction

Bloodstream infections are a major cause of morbidity and mortality in kidney transplant recipients. Streptococcus canis, a group G β-hemolytic streptococcus commonly found in dogs, rarely infects humans but can cause severe disease in immunocompromised transplant recipients. We report a case of Streptococcus canis bacteremia in an immunosuppressed patient five years after deceased-donor renal transplantation, presumably from his pet dogs, highlighting the clinical presentation and the treatment outcomes.

Case Description

A 70-year-old Caucasian male was admitted after being found on the floor by his neighbor. After taking his dogs out for a walk the night before, he had experienced acute pain in his back and right hip and had fallen. He remained on the ground until his neighbor assisted him the following day. His medical history was relevant for end-stage renal disease secondary to diabetic nephropathy and oxalate nephropathy, status post deceased-donor kidney transplant in December 2019 (cPRA 0%, KDPI 84%; low risk CMV and moderate risk EBV status), type 2 diabetes mellitus, essential hypertension, and Roux-en-Y gastric-bypass surgery. His immunosuppressive regimen included tacrolimus and mycophenolate. At presentation, his temperature was 39.8°C. Physical examination revealed left lower extremity edema and erythema extending to the medial lower thigh. He had a WBC count of 3.6 x 10⁹/L, hemoglobin of 13.0 g/dL, creatinine of 1.57 mg/dL, BUN of 25 mg/dL, lactate of 2.8 mmol/L, and creatine kinase of 2226 IU/L. No dog bite wounds were evident. Blood cultures grew Streptococcus canis. MRI spine was negative for a spinal abscess. He was started on ceftriaxone 2 g IV daily; his mycophenolate was held. Prednisone 10 mg daily was also started. Blood cultures quickly cleared. He was discharged on levofloxacin 750 mg PO daily for two weeks from the date of the first negative blood culture, and his immunosuppressive regimen was restarted. At follow-up, he demonstrated stable graft function and an overall return to baseline clinical status.

Discussion

This case highlights a considerably rare cause of zoonotic infection with Gram-positive bacteremia in immunosuppressed individuals, underscores the importance of obtaining a thorough history, presents a clear therapeutic strategy for this patient population, and emphasizes that such incidents, while exceptionally rare, must be included in the differential diagnosis.