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.

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.

Evaluation of safety and immunogenicity of a new octavalent inactivated vaccine containing porcine parvovirus, erysipelas, and leptospira

Porcine parvovirus, Erysipelothrix (E.) rhusiopathiae, and Leptospira (L.) interrogans are considered major etiologic agents of reproductive failure in pigs, causing economic loss in the swine industry. In this study, the safety and immunogenicity of a new octavalent inactivated vaccine were evaluated. The vaccine contained inactivated porcine parvovirus, E. rhusiopathiae, and six L. interrogans serovars (Bratislava, Canicola, Grippotyphosa, Hardjo, Icterohaemorrhagiae, and Pomona). Safety test results showed no notable side effects or clinical signs after vaccination in mice, guinea pigs, and sows. In addition, we assessed immunogenicity of the vaccine in 25 sows under field conditions. The vaccinated group (n = 20) had a significantly higher antibody level than the non-vaccinated group (n = 5). Moreover, the stillbirth rate decreased in piglets born from vaccinated sows, resulting in an increased fertility rate. The results of this study demonstrate that the new octavalent inactivated vaccine can be applied safely and effectively to improve reproductive performance in sows.

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.

Meningitis por Erysipelothrix Rhusiopathiae: Reporte de caso / Erysipelothrix rhusiopathiae meningitis: case report

Presentamos el caso de una paciente con meningitis por un germen inusual, Erysipelothrix rhusiopathiae, es frecuentemente asociado a lesiones cutáneas, raramente de presentación sistémica, causante de infección en manipuladores de animales o de productos cárnicos, en los casos en los que existe compromiso meníngeo es usual la presencia de endocarditis o inmunocompromiso de base sin lesión valvular. Nosotros describimos el caso de una paciente femenina de 43 años de edad, quien presentó meningitis por Erysipelothrix rhusiopathiae sin endocarditis asociada y como único factor de riesgo el uso de drogas ilícitas intravenosas...

Identification of Erysipelothrix rhusiopathiae by DNA Sequencing in a Culture-Negative Intra-Abdominal Abscess / 대한임상미생물학회지

Erysipelothrix rhusiopathiae is a Gram-positive bacillus that causes infections primarily in animals. In humans, the bacteria usually cause localized or generalized cutaneous infections. A 75-year-old man with chronic alcoholism presented with abdominal pain. Abdominal computed tomography and laboratory findings suggested an intra-abdominal abscess in the periaortic soft tissue. While no definitive infectious source was identified, E. rhusiopathiae was identified by 16S rRNA-based gene sequencing from culture-negative, periaortic necrotic tissue, subsequent to empiric antibiotic treatment. It is suggested that E. rhusiopathiae has the potential to cause intra-abdominal abscesses. This case report highlights the usefulness of DNA sequencing to identify pathogens in patients pretreated with antibiotics.

Characteristic of bacterial flora from the uterus in HanWoo cattle / 대한수의학회지

Uterine sterilization is important for improving fertility in cattle. This study compared bacterial flora in the uterus between healthy and repeat breeder cows (RBCs). The uterine flushing of six heifers, 13 healthy HanWoo cows and eight RBCs (HanWoo) were sampled, and 15 frozen semen samples were selected. Overall, 35 bacteria were identified from in HanWoo uterine flushing and semen. The bacterial genera identified from HanWoo uterine flushing were Alloiococcus, Bacillus, Enterobacter, Enterococcus, Erysipelothrix, Gardnerella, Granulicatella, Kocuria, Pantoea, Pasteurella, Rothia, Serratia, Sphingomonas, Staphylococcus, Stenotrophomonas and Streptococcus. The bacterial genera identified from HanWoo semen were Bacillus, Escherichia, Kocuria, Oligella, Pseudomonas, Serratia, Sphingomonas, Staphylococcus, Stenotrophomonas and Streptococcus. The prevalence and presence of the identified bacteria between healthy cows and RBCs differed significantly. Further studies are needed to determine the role of these bacteria in the uterus of HanWoo cattle with reproductive disorder.

Primer informe de celulitis cutánea por Erysipelothrix rhusiopathiae en dos trabajadores rurales / First report of cutaneous cellulitis caused by Erysipelothrix rhusiopathiae in two rural workers

Se informan dos casos de celulitis cutánea en trabajadores de un mismo criadero de aves a corral del área rural de la ciudad de Tandil, Argentina. En ambos pacientes fue identificado E. rhusiopathiae a partir de cultivos de muestras obtenidas por biopsia. La investigación del reservorio evidenció que en todas las muestras de las excretas de aves y en dos muestras de los residuos del alimento, se aisló E. rhusiopathiae con idéntico perfil bioquímico y de resistencia antimicrobiana al de las cepas aisladas de los dos casos clínicos. Si bien son necesarios estudios moleculares para establecer la relación epidemiológica entre las cepas aisladas de los pacientes y las del criadero, se puede inferir que la fuente de infección humana fue el criadero extensivo de aves de corral.

This report describes two cases of cutaneous cellulitis in workers at the same poultry farm in the rural area of Tandil, Argentina. In both patients E. rhusiopathiae was identified from culture samples obtained through biopsy. Investigation of the reservoir showed that, in all samples of fowl waste and in 2 samples of feed, E. rhusiopathiae was isolated with identical biochemical and antibiotic resistance profiles to those of the isolated strains in the case reports. Even though molecular analyses are required to establish an epidemiologic relation between the strains found in the patients and those on the farm, it can be inferred that the source of human infection was the extensive poultry farm.

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.

Annual Report on External Quality Assessment in Clinical Microbiology Laboratory in Korea (2008) / 임상검사와정도관리

Two trials of external quality assessment for clinical microbiology laboratories were performed in 2008. A total of 16 specimens were distributed. Eight specimens were distributed to 330 laboratories with 319 (96.7%) returns in Trial I, and 8 specimens to 335 laboratories with 319 returns (95.2%) in Trial II. Two slide specimens for mycobacterium stain (AFB) were distributed in Trial I and II. The acceptable percentages of Gram stain were relatively good for both stainability and morphology except for Acinetobacter baumannii. The acceptable percentages of bacterial identification (correct answers to species level) on Klebsiella pneumoniae, Staphylococcus aureus, Neisseria meningitidis, Serratia marcescens, Erysipelothrix rhusiopathiae and Candida albicans (Trial I) were 97.4%, 99.2%, 55.6%, 97.0%, 79.2%, and 92.0%, respectively. The acceptable percentages of bacterial identification on A. baumannii, Enterococcus faecalis, Streptococcus pyogenes, Haemophilus parainfluenzae, Elizabethkingia meningoseptica, and Yersinia pseudotuberculosis (Trial II) were 92.0%, 90.8%, 4.5%, 53.1%, 74.8% and 94.3%, respectively. The acceptable percentages for antimicrobial susceptibility tests on K. pneumoniae and S. aureus (Trial I), and A. baumannii and E. faecalis, (Trial II) were relatively good compared to data of the last year. The acceptable percentages for AFB stain in Trial I and II were relatively high. In summary, the acceptable percentages of bacterial stain and identification were relatively good except some cases with poor specimen quality. However, it is still necessary that the quality assurance of the individual laboratories should be improved for antimicrobial susceptibility tests, and the selection of the most appropriate antimicrobial agents to test should be also considered.

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.

A case of Erysipelothrix rhusiopathiae endocarditis cured with antibiotic treatment / 대한내과학회지

Erysipelothrix rhusiopathiae is an uncommon pathogen in humans, and it is caused by zoonotic infection. It usually induces localized skin infection (erysipeloid) in most cases of human infection. Endocarditis due to E. rhusiopathie is very rare, but it causes various cardiac valve complications including valve replacement. We reported here on a case of E. rhusiopathiae endocarditis in a 71 years old man who had liver cirrhosis and no underlying cardiac disease. This case was treated with intravenous penicillin G for 30 days and he improved without any surgical intervention.

Annual Report on External Quality Assessment of Clinical Microbiology Laboratory in Korea (2004) / 임상검사와정도관리

Two trials of external quality assessment for clinical microbiology laboratory were performed in 2004. A total of 12 specimens were distributed. Six specimens were distributed to 293 laboratories with 277 returns in Trial I and six specimens to 293 laboratories with 274 returns in Trial II. The acceptable percentages of Gram-stain on Streptococcus pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Enterococcus faecalis were 96.0%, 98.5%, 97.4% and 98.2%, respectively. The acceptable percentages of bacterial identification on Streptococcus pneumoniae, Escherichia coli, Enterococcus faecalis, Staphylococcus saprophyticus, Shigella flexneri, Gemella spp., Pseudomonas aeruginosa, Enterococcus faecalis (Trial II), Streptococcus agalactiae, Listeria monocytogenes, Erysipelothrix rhusiopathiae, and Eikenella corrodens were 97.5% (including 33.7% of no growth), 99.6%, 93.2%, 82.3%, 95.4%, 50.7%, 98.4%, 92.3%, 87.0%, 78.9%, 92.5% (including 53.4% of no growth), respectively. The acceptable percentages for antimicrobial susceptibility tests on Escherichia coli and Pseudomonas aeruginosa were relatively high, but those on Streptococcus pneumoniae and Enterococcus faecalis were not high. In conclusion, the acceptable percentages of bacterial stain and identification were relatively good. However, it is necessary that the quality assurance of the individual laboratories should be improved for antimicrobial susceptibility tests on Streptococcus pneumoniae and Enterococcus faecalis, and the selection of the most appropriate antimicrobial agents to test should be also considered.

Aislamiento e identificación serológica de Erysipelothrix rhusiopathie de cerdos con lesiones sistémicas compatibles con las del mal rojo en la República Argentina / Isolation and serological identification of Erysipelothrix rhusiopathiae from systemic lesions resembling erysipelas in Argentina

Objetivos. Investigar la presencia Erysipelothrix rhusiopathiae en cerdos de las categorías crecimiento y engorde con lesiones sistémicas no cutáneas compatibles con las de mal rojo (MR) provenientes de dos granjas, situadas en la provincia de Buenos Aires, Argentina. Materiales y Métodos. Muestras de tonsilas, corazón (endocardio), bazo, riñón y líquido articular con lesiones compatibles con las del mal rojo se inocularon en caldo ESB y se repicaron en medio sólido MBA. A partir de colonias similares a las del género Erisipelothrix, se realizaron tinción de Gram y pruebas fisiológicas y bioquímicas. La identificación serológica se llevó a cabo por la prueba de inmunodifusión doble en gel de agarosa enfrentando antígenos extractados de las cepas en estudio contra sueros hiperinmunes de los 28 serotipos de referencia de E. rhusiopathiae.Resultados. Se aisló E. rhusiopathiae de dos cerdos a partir de tonsilas (sin lesiones aparentes), bazo (con esplenomegalia), endocardio valvular (con lesiones de endocarditis) y exudado articular (no purulento). En otro animal sólo se lo aisló de exudado articular. Las tres cepas de E. rhusiopathiae correspondieron al serotipo 10. El aislamiento de E. rhusiopathiae se dificultó debido al crecimiento de bacterias de los géneros Lactobacillus spp y Enterococcus spp que enmascararon o compitieron en el desarrollo de las colonias. Discusión. El E. rhusiopathiae serotipo 10 es raramente aislado de cerdos y no se lo ha asociado a cuadros clínicos de erisipela. El aislamiento E. rhusiopathiae serotipo 10 de lesiones sistémicas no cutáneas compatibles con las del MR del cerdo, constituye la primera referencia de la infección del cerdo por E. rhusiopathiae en el país así como de la patogenicidad de dicho serotipo.

A Case of Infective Endocarditis with Erysipelothrix rhusiopathiae / 감염

Erysipelothrix rhusiopathiae is an uncommon pathogen in human, which causes zoonotic infection. The most common type of human disease with E. rhusiopathiae is a localized skin infection (erysipeloed). E. rhusiopathiae endocarditis is very rare, which usually develops in normal heart valves and causes a variety of complications leading to valve replacement. We described a case of E. rhusiopathiae endocarditis which developed in a 56-year-old man without a predisposing valvular heart disease. In this case, aortic valve and mitral valve were involved and emergency valve replacement was required, which improved patient's condition markedly. Intravenous therapy with penicillin G and subsequent ceftriaxone were given for 8 weeks after surgery and he was recovered without relapse.

Erysipelothrix rhusiopathiae Bacteremia in a Hemodialysis Patient / 대한임상병리학회지

Erysipelothrix rhusiopathiae, a facultatively anaerobic, gram-positive rod, has long been an important pathogen in veterinary medicine. Recently E. rhusiopathiae has become more commonly recognized as a cause of serious diseases in humans, such as endocarditis- associated ones. Identifying E. rhusiopathiae is difficult as this organism may be mistaken for Streptococcus or just dismissed as a contaminant. E. rhusiopathiae was isolated from a blood specimen obtained from a 65-year-old man, who had chronic renal failure. His recent contact history with animal was not available. The isolate showed typical cultural and biochemical characteristics such as growth on both aerobic and anaerobic media, formation of small, greenish colonies on blood agar, positive hydrogen sulfide in TSI agar, and absence of motility and catalase reaction. The isolate was resistant to vancomycin in disk diffusion test and in Etest. In conclusion, in case of unidentified gram-positive bacterial sepsis, one should be aware of E. rhusiopathiae as a possible pathogen.

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