Open AccessSepsis, Endocarditis, and Purulent Arthritis due to a Rare Zoonotic Infection with Streptococcus equi Subspecies zooepidemicus
Author(s) -
Anne Kirstine Høyer-Nielsen,
Shahin Gaïni,
Anne Kjerulf,
Rudi Kollslíð,
Torkil á Steig,
Marc Stegger,
Jan Jóanesarson
Publication year - 2018
Publication title -
case reports in infectious diseases
Language(s) - English
Resource type - Journals
eISSN - 2090-6625
pISSN - 2090-6633
DOI - 10.1155/2018/3265701
Subject(s) - medicine , streptococcus equi , endocarditis , septic arthritis , synovitis , blood culture , monoarthritis , sepsis , surgery , osteitis , infective endocarditis , synovial fluid , antibiotics , arthritis , osteomyelitis , pathology , microbiology and biotechnology , osteoarthritis , genetics , bacteria , biology , alternative medicine
Streptococcus equi subspecies zooepidemicus ( S. zooepidemicus ) 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 S. equi subsp. zooepidemicus . 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.