Endocarditis infecciosa con compromiso bivalvular por Erysipelothrix rhusiopathiae / Infective endocarditis with bivalvular involvement due to Erysipelothrix rhusiopathiae. Report of one case

The microbiology of infective endocarditis (IE) varies in different populations and depends on public health conditions and socioeconomic status. In low-income countries, oral Streptococci affect hearts with rheumatic valve disease in patients with poor dentition. In high-income countries, Staphylococci are the most common cause, affecting elderly and immunocompromised patients, or those with invasive devices. Gram - positive bacili as IE pathogens are unusual. Erysipelothrix rhusiopathiae is a Gram positive bacili. It causes skin diseases in domestic and farm animals, but in humans, is a very unusual pathogen. This infection is considered a zoonosis, since most cases are linked to direct contact with vector animals. We report a 62 year-old male patient with a history of exposure to animals, who developed an infective endocarditis with severe bivalve regurgitation and septic shock, requiring antimicrobials and surgical resolution. Erysipelothrix rhusiopathiae was isolated from blood and valve vegetation cultures. The patient had a successful evolution and was discharged from the hospital.

Endocarditis por Erysipelothrix rhusiopathiae / Endocarditis due to Erysipelothrix rhusiopathiae

RESUMEN Erysipelothrix rhusiopathiae es un bacilo grampositivo, inmóvil, no esporulado, considerado una zoonosis, para la cual el hombre es un hospedero accidental. Esta bacteria es reconocida como agente causal de endocarditis infecciosa; la identificación inmediata de este microorganismo es vital, debido a su naturaleza fulminante. Se presentó el caso de un paciente masculino de 60 años de edad, alcohólico crónico y dedicado a la cría de cerdos, con un cuadro de: fiebre, disnea a grandes esfuerzos, petequias en miembros inferiores y edemas perimaleolares. El ecocardiograma reveló la presencia de vegetaciones en la válvula tricúspidea, lo que generaba insuficiencia tricúspidea grave. En los hemocultivos se aisló Erysipelothrix rhusiopathiae. Se realizó el tratamiento con penicilina y se constató una mejoría clínica evidente del paciente. Desafortunadamente, este falleció por una parada cardíaca en el segundo día del recambio valvular.

ABSTRACT Erysipelothrix rhusiopathiae is a gram-positive, immobile, non-sporulated bacillus, considered a zoonosis, for which man is an accidental host. This bacterium is recognized as a causal agent of infectious endocarditis; immediate identification of this microorganism is vital, due to its fulminant nature. We present a 60-year-old male patient, chronic alcoholic and pig breeder, with a history of fever, dyspnea on great exertion, petechiae in the lower limbs and perimalleolar edema. The echocardiogram revealed the presence of tricuspid valve vegetations, which generated severe tricuspid regurgitation. Erysipelothrix rhusiopathiae was isolated from blood cultures. Treatment with penicillin was carried out and an evident clinical improvement of the patient was verified. Unfortunately, he died of a cardiac arrest on the second day after valve replacement.

Erisipela suína: Relato de caso no município de Cachoeiras de Macacu-RJ / Swine erysipelas: case report in the city of Cachoeiras de Macacu-RJ

Na suinocultura perdas econômicas ainda são elevadas devido aos baixos padrões de qualidade e sanidade dos animais. Dentre as afecções que afetam a produção, a erisipela é uma doença considerada importante em função dos prejuízos econômicos que causa, e pela questão de saúde pública visto ser uma zoonose. Ela é uma enfermidade do tipo hemorrágica comumente causada pela bactéria ubíqua Erysipelotrix rhusiopathiae. O objetivo deste trabalho foi relatar um caso desta afecção em uma matriz da raça Large White, de dois anos de idade, recém desmamada, não vacinada, de uma pequena granja de ciclo completo no munícipio de Cachoeiras de Macacu, estado do Rio de Janeiro. Ela amanheceu prostrada, com dificuldade de locomoção, sem febre e com manchas avermelhadas sobre toda a superfície corporal. As lesões cutâneas, ligeiramente elevadas, apresentavam um formato losangular (diamante) característico e sugestivo de Erisipela. Após a identificação do problema, o animal foi isolado e tratado. O tratamento iniciou-se na manhã do mesmo dia, observando-se a regressão da maioria das lesões à tarde e na manhã seguinte. A suspeita clínica foi confirmada através do diagnóstico terapêutico, sendo a associação de penicilina e estreptomicina eficiente no tratamento.

In swine industry, economic losses are still high due to low standards of quality and health of animals. Among the diseases that affect production, erysipelas is a disease considered important due to the economic losses it causes, and because of the public health issue as it is a zoonosis. It is a hemorrhagic type disease commonly caused by the ubiquitous bacteria Erysipelotrix rhusiopathiae. The aim of this study was to report a case of this condition in a Large White breed sow, two years old, recently weaned, not vaccinated, from a small pig farm (farrow to finish operation) in the municipality of Cachoeiras de Macacu, state of Rio de Janeiro. The sow was prostrate and with limited mobility, without fever and with reddish spots on the entire body surface. The cutaneous lesions were elevated, with a characteristic diamond shape suggestive of erysipelas. After identifying the problem, the animal was isolated and treated. The treatment started in the morning of the same day, observing the regression of most lesions in the afternoon and the following morning. The clinical diagnosis was confirmed through therapeutic diagnosis, and the association of penicillin and streptomycin was efficient in the treatment.

Erisipela suína: relato de caso no município de Cachoeiras de Macacu-RJ / Swine erysipelas: case report in the city of Cachoeiras de Macacu-RJ

Na suinocultura perdas econômicas ainda são elevadas devido aos baixos padrões de qualidade e sanidade dos animais. Dentre as afecções que afetam a produção, a erisipela é uma doença considerada importante em função dos prejuízos econômicos que causa, e pela questão de saúde pública visto ser uma zoonose. Ela é uma enfermidade do tipo hemorrágica comumente causada pela bactéria ubíqua Erysipelotrix rhusiopathiae. O objetivo deste trabalho foi relatar um caso desta afecção em uma matriz da raça Large White, de dois anos de idade, recém desmamada, não vacinada, de uma pequena granja de ciclo completo no munícipio de Cachoeiras de Macacu, estado do Rio de Janeiro. Ela amanheceu prostrada, com dificuldade de locomoção, sem febre e com manchas avermelhadas sobre toda a superfície corporal. As lesões cutâneas, ligeiramente elevadas, apresentavam um formato losangular (diamante) característico e sugestivo de Erisipela. Após a identificação do problema, o animal foi isolado e tratado. O tratamento iniciou-se na manhã do mesmo dia, observando-se a regressão da maioria das lesões à tarde e na manhã seguinte. A suspeita clínica foi confirmada através do diagnóstico terapêutico, sendo a associação de penicilina e estreptomicina eficiente no tratamento.

In swine industry, economic losses are still high due to low standards of quality and health of animals. Among the diseases that affect production, erysipelas is a disease considered important due to the economic losses it causes, and because of the public health issue as it is a zoonosis. It is a hemorrhagic type disease commonly caused by the ubiquitous bacteria Erysipelotrix rhusiopathiae. The aim of this study was to report a case of this condition in a Large White breed sow, two years old, recently weaned, not vaccinated, from a small pig farm (farrow to finish operation) in the municipality of Cachoeiras de Macacu, state of Rio de Janeiro. The sow was prostrate and with limited mobility, without fever and with reddish spots on the entire body surface. The cutaneous lesions were elevated, with a characteristic diamond shape suggestive of erysipelas. After identifying the problem, the animal was isolated and treated. The treatment started in the morning of the same day, observing the regression of most lesions in the afternoon and the following morning. The clinical diagnosis was confirmed through therapeutic diagnosis, and the association of penicillin and streptomycin was efficient in the treatment.

Endocarditis infecciosa por Erysipelothrix rhusiopathiae: Report of one case / Infective endocarditis caused by Erysipelothrix rhusiopathie

Erysipelothrix rhusiopathie is an immobile, not sporulated, gram positive bacillus. Man is an accidental host. Infection is acquired through wounds on contact with sick animals or carriers, their products or objects contaminated with their waste. We report a 40 years old tannery male worker, presenting in the emergency room with fever lasting one month. An echocardiogram showed a vegetation and perforation of the aortic valve with severe aortic regurgitation. Blood cultures gave growth to E. rhusiopathiae. The patient was treated with penicillin. After three weeks of treatment an aortic valve replacement with a mechanical valve was performed. At six weeks, he was discharged from the hospital.

Mitral regurgitation jet around neoannulus: Mitral valve replacement in erysipelothrix rhusiopathiae endocarditis.

A 50-year-old male presented with erysipelothrix rhusiopathiae (ER) endocarditis of the mitral valve, severe mitral regurgitation, and heart failure. The ER endocarditis destroyed the native mitral annulus therefore a new annulus was created for the suspension of the mitral bioprosthesis. Postoperative neoannulus dehiscence and leak prompted to redo surgery where transesophageal echocardiography (TEE) played an important role in pointing out the exact location of perineoannular leaks for repair.

Erysipelothrix rhusiopathiae Peritonitis in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis

Erysipelothrix rhusiopathiae is known as a pathogen of occupational diseases or a zoonosis. We report a case of E. rhusiopathiae peritonitis in a 50-yr-old male undergoing continuous ambulatory peritoneal dialysis (CAPD). He was suffered from mild abdominal pain with a distinctive erysipeloid skin lesion. E. rhusiopathiae was considered to be introduced through a lacerated wound on his hand when he was exposed to contaminated materials. He was treated successfully with a first generation cephalosporin. To our knowledge, CAPD peritonitis due to E. rhusiopathiae is very rare, and this is a report of the first case in Asia.

Invasive Erysipelothrix rhusiopathiae infection in northeast Thailand.

Three cases of invasive Erysipelothrix rhusipathiae infection, which is considered rare, presented to a hospital in Ubon Ratchathani, northeast Thailand during 2006. Patients presented with variable clinical manifestations including diffused cutaneous lesions, bacteremia and endocarditis. Erysipelothrix infection may be an emerging infection in immunocompromized individuals in Thailand.

Endocarditis infecciosa con absceso perivalvular en un paciente con bacteriemia por Erysipelothrix rhusiopathiae / Infective endocarditis with perivalvular abscess in a patient with Erysipelothrix rhusiopathiae bacteremia

The bacterial species Erysipelothrix rhusiopathiae is found worldwide as a commensal or a pathogen in a variety of animals. One well-defined pattern of human infection is an uncommon bacteremic form, with or without cutaneous involvement, usually complicated by endocarditis. We report the case of a 38-year-old male butcher with E. rhusiopathiae bacteremia, native aortic valve endocarditis and perivalvular abscess. The patient was released after six weeks of intravenous ceftriaxone and aortic valve replacement because of severe regurgitation

Aspectos clínicos y bacteriológicos de la infección por erysipelothrix rhusiopathiae en el hombre: presentación de dos casos clínicos; endocarditis subaguda y meningitis / Clinical and bacteriological aspects of erysipelothrix rhusiopathiae infection in man: presentation of 2 clinical cases; subacute endocarditis and meningitis

Se revisan los aspectos clínicos y el diagnóstico bacteriológico de la infección por Erysipelothrix rhusiopathiae (ER). Presentación de dos casos clínicos: el primero corresponde a una endocarditis subaguda con complicaciones neurológicas sugerentes de embolias cerebromeníngeas en un enfermo portador de insuficiencia aórtica, que evoluciona en forma progresiva. Por error diagnóstico el tratamiento específico se inicia tardíamente. La endocarditis por ER, a pesar de la sensibilidad del organismo a la penicilina, tiene una mayor letalidad que las endocarditis de otras etiologías. Este paciente fallece por ruptura de velos aórticos. En el segundo caso, se trata de un enfermo con meningitis por ER que tiene una buena respuesta al tratamiento antibiótico. Aunque la infección por ER es rara en el hombre, en su forma septicémica o de compromiso meníngeo, debe considerarse como posibilidad diagnóstica, si se aísla un difteromorfo de sangre o de LCR

Erysipelothrix endocarditis with previous cutaneous lesion: report of a case and review of the literature

Este relato descreve o primeiro caso documentado de endocardite por E. rhusiopathiae na América Latina. O paciente tinha 51 anos de idade, era alcoólatra moderado, com uma história prévia de insuficiência aórtica. Ele costumava pescar e cozinhar como hobby e feriu sua mäo esquerda com uma espinha-de-peixe. A doença começou com a forma erisipelóide e evoluiu para septicemia e endocardite. Ele foi tratado com antibióticos e cirurgia para troca da válvula aórtica. Até hoje foram relatados apenas 46 casos de endocardite por E. rhusiopathiae. Os autores questionam se muitos outros casos sem que sejam relatados por falta de correto diagnóstico microbiológico laboratorial

Classificacao sorologica de amostras de Erysipelothrix rhusiopathiae, isoladas de suinos, no Estado do Rio Grande do Sul, Brasil. / Serologic classification of Erysipelothrix rhusiopathiae, isolated from swines, in the State of Rio Grande do Sul, Brasil

Classificacao sorologica de 133 amostras de Erysipelothrix rhusiopathiae, pela tecnica de imunodifusao dupla em gel, contra uma bacteria de 16 antisoros, produzidos a partir de amostras padroes. Houve reacao entre os antigenos usados e sete antisoros Foram analisadas bacterias de 21 animais, com quadro clinico de doenca septicemica e de 112 animais portadores sadios.Foram encontrados, com maior frequencia, nas duas situacoes, os sorotipos 1a, 1b e 2b. O sorotipo 11 e descrito pela primeira vez, em associacao com quadro clinico de doenca septicemica, em suino