A case of bacteremia and pneumonia caused by Streptococcus equi subspecies equi infection in a 70-year-old female following horse exposure in rural Wyoming.
Abstract: The occurrence of zoonotic infections following an animal exposure continues to be an important consideration for all patients, especially those within agricultural communities. Streptococcus equi subspecies equi (S. equi subsp. equi) is a bacteria known to cause a common infection called 'Strangles' in horses. This article highlights a new case of pneumonia and bacteremia in a patient caused by S. equi subsp. equi following strangles exposure in a horse. Rarely has there been reported horse to human transmission of subsp. equi. Methods: A 70-year-old woman attended a rural emergency department with complaints of dry heaving, fever, chills, shakes, and nausea and presented with a cough. She had undergone a screening colonoscopy two days prior with no other significant medical history. The patient had computed tomography (CT) evidence of a pneumonia and positive blood cultures growing S. equi subsp. equi consistent with bacteremia. The patient later disclosed the recent passing of her horse following its sudden illness six days prior to her emergency department presentation. She had cuddled and kissed the horse prior to its death. The patient was treated with IV lactated ringers during the initial evaluation and admission and also received IV piperacillin-tazobactam 4.5 g every eight hours intravenously during her hospital stay. She was transitioned to an oral antibiotic on discharge. Subsequent blood cultures drawn the day after discharge were negative for S. equi subsp. equi, indicating successful treatment of her bacteremia. Conclusions: This report discusses an atypical presentation of S. equi subsp. equi infection in an otherwise healthy individual, manifesting as early sepsis, pneumonia, and bacteremia. The patient likely developed this infection following direct contact exposure to her horse who had died from presumed strangles a few days prior to her symptom onset. This case highlights the importance of investigating potential exposures to S. equi subsp. equi in rural areas, areas where farming and ranching are prevalent, particularly among individuals working with horses. It is especially important to acknowledge high risk populations such as immunocompromised individuals with signs and symptoms of meningitis or bacteremia.
© 2023. The Author(s).
Publication Date: 2023-08-02 PubMed ID: 37533031PubMed Central: PMC10399059DOI: 10.1186/s12941-023-00602-1Google Scholar: Lookup
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Summary
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Background:
- Zoonotic infections are diseases that can be transmitted from animals to humans.
- Streptococcus equi subspecies equi (S. equi subsp. equi) is a type of bacteria that commonly causes an infection known as ‘Strangles’ in horses.
- The article reports a rare case where a human contracted a disease from a horse infected with Strangles. Typically, this bacteria doesn’t often transfer from horses to humans.
Case Presentation:
- A 70-year-old woman went to an emergency department in a rural area because she was feeling ill. Her symptoms included fever, chills, nausea, shaking, dry heaving, and a cough.
- Two days before this, she had undergone a colonoscopy (a procedure to examine the colon), but she had no other notable medical history.
- Medical imaging (a CT scan) showed she had pneumonia, and blood tests (cultures) confirmed the presence of S. equi subsp. equi, indicating bacteremia (bacteria in the bloodstream).
- The woman then revealed that her horse had suddenly become ill and died six days before her visit to the hospital. She had been very close to the horse, even kissing it, before it passed away.
- In the hospital, she was treated with intravenous (IV) fluids (lactated ringers) and a specific antibiotic (IV piperacillin-tazobactam) given every eight hours. When she was discharged from the hospital, she was given oral antibiotics to continue her treatment.
- A day after she left the hospital, further blood tests showed no signs of the bacteria, indicating that the treatment had been successful.
Conclusions:
- The report describes an unusual case where a person got infected with S. equi subsp. equi, showing symptoms of early sepsis (a severe reaction to bacteria), pneumonia, and bacteremia.
- It’s believed the woman contracted the disease after close contact with her horse, which had presumably died from Strangles.
- This case emphasizes the need to be cautious of potential exposures to this bacteria, especially in rural or farming areas where people often interact with horses.
- It’s especially crucial to be vigilant with high-risk groups, like those with weakened immune systems, as they might develop severe conditions like meningitis (inflammation of the membranes surrounding the brain and spinal cord) or bacteremia.
In simpler terms, while it’s rare for humans to get infected by the bacteria that causes Strangles in horses, this case shows it’s possible, especially after close contact. People in rural or farming areas, especially those frequently interacting with horses, need to be aware of this risk.
Cite This Article
APA
Bohlman T, Waddell H, Schumaker B.
(2023).
A case of bacteremia and pneumonia caused by Streptococcus equi subspecies equi infection in a 70-year-old female following horse exposure in rural Wyoming.
Ann Clin Microbiol Antimicrob, 22(1), 65.
https://doi.org/10.1186/s12941-023-00602-1 Publication
Researcher Affiliations
- University of Washington School of Medicine, Seattle, Washington, USA.
- University of Washington School of Medicine, Seattle, United States. heith.waddell@CCMSD.net.
- Wyoming WWAMI University of Washington School of Medicine, University of Wyoming, Laramie, Wyoming, USA.
MeSH Terms
- Pneumonia
- Streptococcus
- Horse Diseases / diagnosis
- Horse Diseases / drug therapy
- Horse Diseases / microbiology
- Female
- Wyoming
- Humans
- Streptococcus equi / genetics
- Animals
- Streptococcal Infections / diagnosis
- Streptococcal Infections / drug therapy
- Streptococcal Infections / veterinary
- Bacteremia / drug therapy
- Bacteremia / veterinary
- Horses
- Aged
Conflict of Interest Statement
The authors declare no competing interests.
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This article includes 16 references
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Citations
This article has been cited 1 times.- Zu H, Sun R, Li J, Guo X, Wang M, Guo W, Wang X. Development of a Real-Time Recombinase-Aided Amplification Method for the Rapid Detection of Streptococcus equi subsp. equi. Microorganisms 2024 Apr 11;12(4).
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