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Researchers find genetic link in rare reaction to pet germ

Capnocytophaga (cap-noh-seye-TOEB次元官网网址-fah-gah) is a germ human and dog mouths

ItB次元官网网址檚 hard to regard Ellie as a menace.

When Greg Manteufel is frustrated or feeling down, she sits by him. At night, she sleeps under his covers. At dinner, sheB次元官网网址檚 there next to him, knowing heB次元官网网址檒l throw something her way. She belies the stereotype of the vicious pit bull.

B次元官网网址淲e love her like sheB次元官网网址檚 our daughter,B次元官网网址 he said of the dog.

And yet, Ellie may be the reason Manteufel, 49, nearly died.

Gravely ill, he lost parts of his arms and legs, as well as the skin of his nose and part of his upper lip. The cause was capnocytophaga (cap-noh-seye-TOEB次元官网网址-fah-gah), a germ from EllieB次元官网网址檚 mouth or from another dog he encountered.

Capnocytophaga is commonly found in the saliva of cats and dogs and almost never leads to people getting sick, unless the person has a compromised immune system. But Manteufel was perfectly healthy. In fact, he doesnB次元官网网址檛 think heB次元官网网址檇 ever used his health insurance before he fell ill.

The case is extremely rare and doctors at his hospital, Froedtert & the Medical College of Wisconsin, had no explanation for why he got so sick. But over the last 10 years there have been at least five other healthy people who have had severe reactions to the germ. A team of researchers connected with Harvard Medical School has developed a theory on why B次元官网网址 a gene change in all the victims.

And their finding means doctors canB次元官网网址檛 rule out the capnocytophaga bacteria could strike Manteufel and other victims again.

Greg Manteufel thought he was getting the flu in June of 2018. He had a fever, vomiting and diarrhea. But when he started getting confused, his family took him to the hospital.

Doctors did blood cultures and found capnocytophaga, which caused sepsis, a severe blood infection that led to his blood pressure dropping and many of his organs shutting down.

B次元官网网址淒o what you have to, to keep me alive,B次元官网网址 he told the doctors.

He had so much to live for B次元官网网址 foremost, his wife of 16 years, Dawn, and 26-year-old son, Mike. He was just starting to get really good at his day job, painting houses. He cherished his Harley Davidson Electric Glide. He was in the middle of fixing up his B次元官网网址66 El Camino. And of course there was Ellie, the pup.

And so he persisted, through more than 20 surgeries, including amputations of his left and right arms just below the elbow, and legs through the middle of the knee.

His wife and son stayed optimistic, because he was.

B次元官网网址淕reg said he didnB次元官网网址檛 come this far to lay down and let this beat him,B次元官网网址 Dawn Manteufel said.

He was out of the in-patient rehab unit in about two weeks, learning to move from his wheelchair to the bed, toilet and car. The usual stay is three to four weeks, said Dr. David Del Toro, medical director for the inpatient rehab unit at Froedtert.

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Manteufel made similar quick advances using his arm prosthetics and leg prosthetics.

B次元官网网址淗e does not seem like any other patient IB次元官网网址檝e met before,B次元官网网址 Del Toro said. B次元官网网址淗eB次元官网网址檚 just, you know, full speed ahead.B次元官网网址

Meanwhile, researchers at Brigham and WomenB次元官网网址檚 Hospital in Boston, connected to Harvard Medical School, as well as Dana-Farber Cancer Institute and Beth Israel Deaconess Medical Center had been investigating cases like his.

The team has done genetic testing on five otherwise healthy people who suffered capnocytophaga infections to see if they could find anything in common. They discovered all had a gene connected to the immune system that was working differently B次元官网网址 a genetic variant.

B次元官网网址淚t was a really thrilling moment,B次元官网网址 said Elizabeth Fieg, a genetic counsellor at Brigham and WomenB次元官网网址檚 Hospital. B次元官网网址淭he stakes are so high with these cases and the patients have gone through so much.B次元官网网址

They believe it makes those people more susceptible to developing severe medical problems from capnocytophaga. But they are also trying to determine if there are other risk factors.

Of the five in the study, three survived with amputations and two did not. Fieg hopes their research can determine why some did not survive.

She also hopes if their theory is confirmed, it will help diagnose cases faster, and perhaps save lives and limbs.

ThatB次元官网网址檚 why Greg Manteufel jumped at the chance to take part when he was approached in August.

Researchers need to gather more evidence, but hope to publish their study in the next year to 18 months.

ManteufelB次元官网网址檚 life now includes frequent occupational therapy appointments to perfect his use of arm prosthetics B次元官网网址 the kind with metal movable hooks at the end. HeB次元官网网址檚 using a fork regularly and heB次元官网网址檚 now working on picking up the TV remote, opening doorknobs, cutting vegetables and doing the dishes.

HeB次元官网网址檚 using shortened leg prosthetics, called stubbies, to get his body conditioned to eventually use to full-sized ones. Those are expected to arrive any day.

Plastic surgeons plan another surgery to perfect his nose. TheyB次元官网网址檝e already moved skin from his forehead there. It looks oversized now, but it will eventually fit in with the rest of his face.

He plans to get his car revamped so he can drive with prosthetics. He wants to get a special pole so he can go fishing again. He is even considering going back to work painting.

HeB次元官网网址檚 also become less quiet and a lot more outgoing. B次元官网网址淣ow everybody I see wants to hear something or talk to me. I tell them a 15-minute story about what happened. They probably want me to leave, you know,B次元官网网址 he said, chuckling.

EllieB次元官网网址檚 often by his side.

B次元官网网址淪he loves kids. She loves puppies. Other dogs,B次元官网网址 Manteufel said.

As harmless as she seems, she may have capnocytophaga germ.

The results of ManteufelB次元官网网址檚 genetic tests are expected in three to four months. Fieg said people with the gene variant are at increased risk for recurrent capnocytophaga or other infections in the future.

While Manteufel doesnB次元官网网址檛 like the sound of that, he said EllieB次元官网网址檚 accidentally scratched him since heB次元官网网址檚 been home and even licked his mouth. HeB次元官网网址檚 been fine.

And even if he does have the gene variant, he said, it changes nothing.

B次元官网网址淲e didnB次元官网网址檛 even bother testing her,B次元官网网址 said Manteufel. B次元官网网址淲e werenB次元官网网址檛 going to get rid of her if it was her that caused it anyway.B次元官网网址

B次元官网网址淲e just love her to death.B次元官网网址

Carrie Antlfinger, The Associated Press

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In this Aug. 19, 2019 photo, Greg Manteufel tries out a new prosthetic arm during occupational therapy at Froedtert & the Medical College of Wisconsin in Milwaukee, as he talks to Dr. David Del Toro, the medical director for inpatient rehab. Manteufel lost parts of his arms and legs, as well as the skin of his nose and part of his upper lip from capnocytophaga, a bacteria commonly found in the saliva or cats and dogs that almost never leads to people getting sick, unless the person has a compromised immune system. He was perfectly healthy when he got sick in June of 2018. Over the last seven years, a team of researchers at Brigham and WomenB次元官网网址檚 Hospital in Boston, connected to Harvard Medical School, have tested other healthy people who were affected and developed a theory on why they were affected- a gene change in all the victims. (AP Photo/Carrie Antlfinger)
18713033_web1_21836418
In this Aug. 19, 2019 photo, Greg Manteufel tries out a new prosthetic arm during occupational therapy at Froedtert & the Medical College of Wisconsin, in Milwaukee, as his wife Dawn Manteufel reads paperwork in the background. Manteufel lost parts of his arms and legs, as well as the skin of his nose and part of his upper lip from capnocytophaga, a bacteria commonly found in the saliva or cats and dogs that almost never leads to people getting sick, unless the person has a compromised immune system. He was perfectly healthy when he got sick in June of 2018. Over the last seven years, a team of researchers at Brigham and WomenB次元官网网址檚 Hospital in Boston, connected to Harvard Medical School, have tested other healthy people who were affected and developed a theory on why they were affected- a gene change in all the victims. (AP Photo/Carrie Antlfinger)




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