A human case of strangles (equine distemper) with skin lesions.

The research paper discusses a rare instance of a human contracting Strangles, a disease generally found in horses, resulting in skin lesions. The patient successfully recovered after a course of trimethoprim/sulfamethoxazole therapy.

About Strangles

• Strangles, also known as adenitis equorum, equine distemper, or Coryza contagiosa equorum, is essentially a highly contagious upper respiratory tract infection found in horses and other equids, primarily caused by the Streptococcus equi var. equi bacterium.
• This bacterium is part of the pyogenic group of streptococci, identified as group C in the Lancefield classification.
• Strangles is the consequence of three subspecies of zoonotic agents, namely, S. equi subsp. equi, S. equi subsp. zooepidemicus, and S. equi subsp. ruminatorum, all of which rarely infect humans.
• The incubation period for the disease is generally 4-8 days. Once infected, the horse may develop a fever, start discharging heavy nasal fluids, and exhibit swelling in lymph nodes in the neck and throat latch. The appearance may also become dull, and the horse might stop eating.
• Transmission of the disease happens through nasal discharge or material from draining abscesses, which contaminates surrounding environments such as pastures, barns, feed troughs, and stables.

The Case Study

• The paper presents a unique case of a 38-year-old man who contracted the disease, exhibiting only skin lesions as symptoms of strangles.
• The patient referred presented multiple, oval and confluent, erythematous, scaly and crusted plaques over face, neck, and chin. There were subcutaneous abscesses and exudation on the chin.
• The submandibular and parotid lymph nodes were enlarged, with the patient experiencing limited neck mobility and difficulty in swallowing. However, he was not running a fever.
• All mycological tests, such as scrapings for potassium hydroxide examination, returned normal results.
• The case was rare in terms of Strangles infection in a human, caused by Group C Streptococci, most likely the Streptococcus equi subspecies and it manifested only through skin lesions.
• The patient was treated with trimethoprim/sulfamethoxazole therapy and recovered well.