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Annals of clinical microbiology and antimicrobials2023; 22(1); 65; doi: 10.1186/s12941-023-00602-1

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.

Bohlman, T
·
Waddell, H
·
Schumaker, B

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.

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Publication Date: 2023-08-02 PubMed ID: 37533031PubMed Central: PMC10399059DOI: 10.1186/s12941-023-00602-1Google Scholar: Lookup

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Case Reports
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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.

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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

Annals of clinical microbiology and antimicrobials

ISSN: 1476-0711

NlmUniqueID: 101152152

Country: England

Language: English

Volume: 22

Issue: 1

Pages: 65

Researcher Affiliations

Bohlman, Tristan

University of Washington School of Medicine, Seattle, Washington, USA.

Waddell, Heith

University of Washington School of Medicine, Seattle, United States. heith.waddell@CCMSD.net.

Schumaker, Brant

Wyoming WWAMI University of Washington School of Medicine, University of Wyoming, Laramie, Wyoming, USA.

MeSH Terms

Humans
Female
Animals
Horses
Aged
Streptococcus equi / genetics
Wyoming
Horse Diseases / diagnosis
Horse Diseases / drug therapy
Horse Diseases / microbiology
Streptococcal Infections / diagnosis
Streptococcal Infections / drug therapy
Streptococcal Infections / veterinary
Bacteremia / drug therapy
Bacteremia / veterinary
Pneumonia

Conflict of Interest Statement

The authors declare no competing interests.

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