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Home / Equine Research Bank / Case Rep Infect Dis / Sepsis, Endocarditis, and Purulent Arthritis due to a Rare Z...
Case reports in infectious diseases2018; 2018; 3265701; doi: 10.1155/2018/3265701

Sepsis, Endocarditis, and Purulent Arthritis due to a Rare Zoonotic Infection with Streptococcus equi Subspecies zooepidemicus.

Abstract: subspecies () is mostly known as an opportunistic pathogen found in horses and as a rare human zoonosis. An 82-year-old male, who had daily contact with horses, was admitted in a septic condition. The patient presented with dyspnea, hemoptysis, impaired general condition, and severe pain in a swollen left shoulder. Synovial fluid from the affected joint and blood cultures showed growth of subsp. . Transesophageal echocardiography showed a vegetation on the aortic valve consistent with endocarditis. Arthroscopic revision revealed synovitis and erosion of the rotator cuff. Technetium-99m scintigraphy showed intense increased activity in the left shoulder, suspicious of osteitis. The infection was treated with intravenous antibiotics over a period of five weeks, followed by oral antibiotics for another two months. The patient recovered without permanent sequelae.
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Publication Date: 2018-06-14 PubMed ID: 30013802PubMed Central: PMC6022317DOI: 10.1155/2018/3265701Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research discusses a case of sepsis, endocarditis, and purulent arthritis in an 82-year-old man caused by a rare zoonotic infection from the bacteria Streptococcus equi subspecies zooepidemicus, typically found in horses with whom the patient had daily contact.

Case Study

  • The study focused on an 82-year-old male patient with daily exposure to horses, who was brought to the hospital in a septic condition. The symptoms he displayed included difficulty in breathing, coughing up blood, a generally weakened state, and intense pain in a swollen left shoulder.
  • Tests on the synovial fluid from his swollen joint and his blood cultures exhibited signs of Streptococcus equi subspecies zooepidemicus, a bacterial subspecies normally found in horses but occasionally causing zoonotic infections in humans.

Symptoms and Diagnosis

  • A further procedure known as transesophageal echocardiography (an ultrasound test that examines the interior of the heart) showed the presence of a growth on the patient’s aortic valve, indicative of endocarditis (inflammation of the heart valves).
  • An arthroscopic revision (a minimally invasive surgery used to examine and treat problems inside a joint) of his left shoulder revealed synovitis (an inflammation of the joint’s lining) and erosion of the rotator cuff.
  • Technetium-99m scintigraphy, a type of bone scan, showed increased activity in the left shoulder. This is suspicious for osteitis (inflammation of the bones).

Treatment and Outcome

  • The patient’s infection was treated with a course of intravenous antibiotics over five weeks, followed by oral antibiotics for an additional two months.
  • The treatment was successful, and the patient recovered without suffering any permanent aftereffects, demonstrating that even severe infections from this rare zoonotic disease can be effectively treated with a proper and thorough antibiotic regimen.

Cite This Article

APA
Høyer-Nielsen AK, Gaini S, Kjerulf A, Kollslíð R, Steig TÁ, Stegger M, Jóanesarson J. (2018). Sepsis, Endocarditis, and Purulent Arthritis due to a Rare Zoonotic Infection with Streptococcus equi Subspecies zooepidemicus. Case Rep Infect Dis, 2018, 3265701. https://doi.org/10.1155/2018/3265701

Publication

Case reports in infectious diseases
ISSN: 2090-6625
NlmUniqueID: 101573243
Country: Egypt
Language: English
Volume: 2018
Pages: 3265701
PII: 3265701

Researcher Affiliations

Høyer-Nielsen, Anne Kirstine
  • Division of Cardiology, Medical Department, National Hospital Faroe Islands, Tórshavn, Faroe Islands.
Gaini, Shahin
  • Infectious Diseases Division, Medical Department, National Hospital Faroe Islands, Tórshavn, Faroe Islands.
  • Infectious Diseases Research Unit, Odense University Hospital and University of Southern Denmark, Odense, Denmark.
  • Centre of Health Research and Department of Science and Technology, University of the Faroe Islands, Tórshavn, Faroe Islands.
Kjerulf, Anne
  • Infectious Disease Epidemiology & Prevention, Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark.
Kollslíð, Rudi
  • Division of Cardiology, Medical Department, National Hospital Faroe Islands, Tórshavn, Faroe Islands.
Steig, Torkil Á
  • Division of Nephrology, Medical Department, National Hospital Faroe Islands, Tórshavn, Faroe Islands.
Stegger, Marc
  • Bacteria, Parasites and Fungi, Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark.
Jóanesarson, Jan
  • Division of Cardiology, Medical Department, National Hospital Faroe Islands, Tórshavn, Faroe Islands.

References

This article includes 25 references
  1. Pelkonen S, Lindahl SB, Suomala P, Karhukorpi J, Vuorinen S, Koivula I, Väisänen T, Pentikäinen J, Autio T, Tuuminen T. Transmission of Streptococcus equi subspecies zooepidemicus infection from horses to humans.. Emerg Infect Dis 2013 Jul;19(7):1041-8.
    doi: 10.3201/eid1907.121365pmc: PMC3713971pubmed: 23777752google scholar: lookup
  2. Lindahl S. Streptococcus equi subsp. equi and Streptococcus equi subsp. zooepidemicus-upper respiratory disease in horses and zoonotic transmission to humans. Uppsala, Sweden: Swedish University of Agricultural Sciences Uppsala; 2013.
  3. Bordes-Benítez A, Sánchez-Oñoro M, Suárez-Bordón P, García-Rojas AJ, Saéz-Nieto JA, González-García A, Alamo-Antúnez I, Sánchez-Maroto A, Bolaños-Rivero M. Outbreak of Streptococcus equi subsp. zooepidemicus infections on the island of Gran Canaria associated with the consumption of inadequately pasteurized cheese.. Eur J Clin Microbiol Infect Dis 2006 Apr;25(4):242-6.
    doi: 10.1007/s10096-006-0119-xpubmed: 16550347google scholar: lookup
  4. Poulin MF, Boivin G. A case of disseminated infection caused by Streptococcus equi subspecies zooepidemicus.. Can J Infect Dis Med Microbiol 2009 Summer;20(2):59-61.
    doi: 10.1155/2009/538967pmc: PMC2706407pubmed: 20514161google scholar: lookup
  5. Barnham M, Kerby J, Chandler RS, Millar MR. Group C streptococci in human infection: a study of 308 isolates with clinical correlations.. Epidemiol Infect 1989 Jun;102(3):379-90.
    doi: 10.1017/s0950268800030090pmc: PMC2249458pubmed: 2737252google scholar: lookup
  6. Villamil I, Serrano M, Prieto E. [Streptococcus equi subsp. Zooepidemicus endocarditis].. Rev Chilena Infectol 2015 Apr;32(2):240-1.
    doi: 10.4067/s0716-10182015000300017pubmed: 26065461google scholar: lookup
  7. Daubié AS, Defrance C, Renvoisé A, Barreda E, D'Alessandro C, Brossier F, Jarlier V, Aubry A. Illustration of the difficulty of identifying Streptococcus equi strains at the subspecies level through a case of endocarditis in an immunocompetent man.. J Clin Microbiol 2014 Feb;52(2):688-91.
    doi: 10.1128/jcm.01447-13pmc: PMC3911343pubmed: 24478515google scholar: lookup
  8. Eyre DW, Kenkre JS, Bowler IC, McBride SJ. Streptococcus equi subspecies zooepidemicus meningitis--a case report and review of the literature.. Eur J Clin Microbiol Infect Dis 2010 Dec;29(12):1459-63.
    doi: 10.1007/s10096-010-1037-5pubmed: 20820836google scholar: lookup
  9. Yuen KY, Seto WH, Choi CH, Ng W, Ho SW, Chau PY. Streptococcus zooepidemicus (Lancefield group C) septicaemia in Hong Kong.. J Infect 1990 Nov;21(3):241-50.
    doi: 10.1016/0163-4453(90)93885-vpubmed: 2273271google scholar: lookup
  10. Martinez-Luengas F, Inclan GM, Pastor A, Montejo M, Barron J, Baroja A, Aguirre C. Endocarditis due to Streptococcus zooepidemicus.. Can Med Assoc J 1982 Jul 1;127(1):13.
    pmc: PMC1863187pubmed: 7083102
  11. Edwards AT, Roulson M, Ironside MJ. A milk-borne outbreak of serious infection due to Streptococcus zooepidemicus (Lancefield Group C).. Epidemiol Infect 1988 Aug;101(1):43-51.
    doi: 10.1017/s0950268800029204pmc: PMC2249326pubmed: 3402548google scholar: lookup
  12. Ghoneim AT, Cooke EM. Serious infection caused by group C streptococci.. J Clin Pathol 1980 Feb;33(2):188-90.
    doi: 10.1136/jcp.33.2.188pmc: PMC1146019pubmed: 7364954google scholar: lookup
  13. Friederichs J, Hungerer S, Werle R, Militz M, Bühren V. Human bacterial arthritis caused by Streptococcus zooepidemicus: report of a case.. Int J Infect Dis 2010 Sep;14 Suppl 3:e233-5.
    doi: 10.1016/j.ijid.2009.08.009pubmed: 20004124google scholar: lookup
  14. Barnham M, Ljunggren A, McIntyre M. Human infection with Streptococcus zooepidemicus (Lancefield group C): three case reports.. Epidemiol Infect 1987 Apr;98(2):183-90.
    doi: 10.1017/s0950268800061896pmc: PMC2235243pubmed: 3556445google scholar: lookup
  15. Trell K, Nilson B, Petersson AC, Rasmussen M. Clinical and microbiological features of bacteremia with Streptococcus equi.. Diagn Microbiol Infect Dis 2017 Feb;87(2):196-198.
    doi: 10.1016/j.diagmicrobio.2016.10.018pubmed: 27829495google scholar: lookup
  16. Collazos J, Echevarria MJ, Ayarza R, de Miguel J. Streptococcus zooepidemicus septic arthritis: case report and review of group C streptococcal arthritis.. Clin Infect Dis 1992 Oct;15(4):744-6.
    doi: 10.1093/clind/15.4.744-apubmed: 1420701google scholar: lookup
  17. Bhatia R, Bhanot N. Spondylodiskitis secondary to Streptococcus equi subspecies zooepidemicus.. Am J Med Sci 2012 Jan;343(1):94-7.
    doi: 10.1097/maj.0b013e31822cf8a8pubmed: 21825960google scholar: lookup
  18. Kuusi M, Lahti E, Virolainen A, Hatakka M, Vuento R, Rantala L, Vuopio-Varkila J, Seuna E, Karppelin M, Hakkinen M, Takkinen J, Gindonis V, Siponen K, Huotari K. An outbreak of Streptococcus equi subspecies zooepidemicus associated with consumption of fresh goat cheese.. BMC Infect Dis 2006 Feb 27;6:36.
    doi: 10.1186/1471-2334-6-36pmc: PMC1413536pubmed: 16504158google scholar: lookup
  19. Sesso R, Wyton S, Pinto L. Epidemic glomerulonephritis due to Streptococcus zooepidemicus in Nova Serrana, Brazil.. Kidney Int Suppl 2005 Aug;(97):S132-6.
    doi: 10.1111/j.1523-1755.2005.09722.xpubmed: 16014091google scholar: lookup
  20. Waller AS. Strangles: taking steps towards eradication.. Vet Microbiol 2013 Nov 29;167(1-2):50-60.
    doi: 10.1016/j.vetmic.2013.03.033pubmed: 23642414google scholar: lookup
  21. Li JS, Sexton DJ, Mick N, Nettles R, Fowler VG Jr, Ryan T, Bashore T, Corey GR. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis.. Clin Infect Dis 2000 Apr;30(4):633-8.
    doi: 10.1086/313753pubmed: 10770721google scholar: lookup
  22. Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Tleyjeh IM, Rybak MJ, Barsic B, Lockhart PB, Gewitz MH, Levison ME, Bolger AF, Steckelberg JM, Baltimore RS, Fink AM, O'Gara P, Taubert KA. Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association.. Circulation 2015 Oct 13;132(15):1435-86.
    doi: 10.1161/cir.0000000000000296pubmed: 26373316google scholar: lookup
  23. Bradley SF, Gordon JJ, Baumgartner DD, Marasco WA, Kauffman CA. Group C streptococcal bacteremia: analysis of 88 cases.. Rev Infect Dis 1991 Mar-Apr;13(2):270-80.
    doi: 10.1093/clinids/13.2.270pubmed: 2041960google scholar: lookup
  24. Salata RA, Lerner PI, Shlaes DM, Gopalakrishna KV, Wolinsky E. Infections due to Lancefield group C streptococci.. Medicine (Baltimore) 1989 Jul;68(4):225-39.
    doi: 10.1097/00005792-198907000-00005pubmed: 2661962google scholar: lookup
  25. Peres LR, Marchitto RO, Pereira GS, Yoshino FS, de Castro Fernandes M, Matsumoto MH. Arthrotomy versus arthroscopy in the treatment of septic arthritis of the knee in adults: a randomized clinical trial.. Knee Surg Sports Traumatol Arthrosc 2016 Oct;24(10):3155-3162.
    doi: 10.1007/s00167-015-3918-8pubmed: 26704806google scholar: lookup

Citations

This article has been cited 5 times.
  1. Azpiroz MF, Burger N, Mazza M, Rodríguez G, Camou T, García Gabarrot G. Characterization of Streptococcus equi subsp. zooepidemicus isolates containing lnuB gene responsible for the L phenotype.. PLoS One 2023;18(4):e0284869.
    doi: 10.1371/journal.pone.0284869pubmed: 37115801google scholar: lookup
  2. Elde SFT, Guenthart BA, de Biasi A, Dalal AR, Casselman KG, Hiesinger W, Burton ÉC. Type A Aortic Dissection With Concurrent Aortic Valve Endocarditis, Subarachnoid Hemorrhage, and Disseminated Intravascular Coagulation.. JACC Case Rep 2022 Jul 20;4(14):839-843.
    doi: 10.1016/j.jaccas.2021.05.008pubmed: 35912321google scholar: lookup
  3. Nocera FP, D'Eletto E, Ambrosio M, Fiorito F, Pagnini U, De Martino L. Occurrence and Antimicrobial Susceptibility Profiles of Streptococcus equi subsp. zooepidemicus Strains Isolated from Mares with Fertility Problems.. Antibiotics (Basel) 2021 Dec 27;11(1).
    doi: 10.3390/antibiotics11010025pubmed: 35052902google scholar: lookup
  4. Bergmann R, Jentsch MC, Uhlig A, Müller U, van der Linden M, Rasmussen M, Waller A, von Köckritz-Blickwede M, Baums CG. Prominent Binding of Human and Equine Fibrinogen to Streptococcus equi subsp. zooepidemicus Is Mediated by Specific SzM Types and Is a Distinct Phenotype of Zoonotic Isolates.. Infect Immun 2019 Dec 17;88(1).
    doi: 10.1128/IAI.00559-19pubmed: 31636136google scholar: lookup
  5. Zahlanie Y, Almatrafi M, Filkins L, Hsiang MS. Possible canine source of Streptococcus equi subspecies zooepidemicus causing meningitis in an infant.. IDCases 2019;17:e00568.
    doi: 10.1016/j.idcr.2019.e00568pubmed: 31194131google scholar: lookup
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