Streptococcus suis: Bacteremia presenting with fever, rashes, arthritis and neurologic deficits
Ahmad M Domado and Jill Itable
Southern Philippines Medical Center, Philippines
: Androl Gynecol: Curr Res
Abstract
Streptococcus suis (S. suis) is a Gram positive cocci acquired through exposure to infected swine. The most common clinical manifestation is meningitis often accompanied by bacteremia. S. suis is an emerging pathogen with significant complications but remains to be underreported. Only 1,584 cases of S. suis infection have been reported worldwide with most of the cases concentrated in Southeast Asia where swine quantity is high. Despite a booming hog industry in the Philippines and increasing prevalence in its neighboring countries, S. suis infection remain unreported in our country due to either lack of available diagnostics or misdiagnoses. We report a case of a 52-year-old male who came in due to fever, generalized violaceous purpuric rash, headache and nuchal rigidity. Patient was diagnosed with meningitis clinically. Patient consumed a diseased swine 5 days prior to admission. Blood culture was positive for Streptococcus suis II and clinical improvement was achieved with antibiotic treatment. Our patient is the second Filipino and the first documented case to be diagnosed in the Philippines. Patient is also the first documented case of a Filipino with Streptococcus bacteremia presenting with meningitis, hearing loss, skin lesions and arthritis. In S. suis infection, antibiotic treatment should be started without delay because a high mortality rate of up to 68% is observed in patients with septicemia and septic shock. With increased awareness and available diagnostics, a future outbreak can be prevented.