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.

Antibacterial activity of the essential oils of myrtle leaves against Erysipelothrix rhusiopathiae

<p><b>OBJECTIVE</b>To evaluate the antibacterial activity of the essential oil of Myrtus communis (M. communis) L. against Erysipelothrix rhusiopathiae (E. rhusiopathiae) in vitro.</p><p><b>METHODS</b>Wild populations of M. communis collected from Khuzestan and Lorestan provinces, Southwest Iran, were examined for antibacterial activity and chemical variability in leaves. The in vitro antibacterial activity against E. rhusiopathiae was performed by agar disc diffusion and micro-dilution assays.</p><p><b>RESULTS</b>The essential oils of M. communis have strong antibacterial against E. rhusiopathiae in both assays. The results showed that the major components of the oil were α-pinene (22.3%-55.2%), 1,8-cineole (8.7%-43.8%) and linalool (6.4%-14.5%). The inhibition zones and MIC values for bacteria which were sensitive to the essential oils of M. communis were in the range of 14.7-27.0 mm and 0.031-0.25 mg/mL, respectively.</p><p><b>CONCLUSIONS</b>This study demonstrates that products with valuable antibacterial activity can be produced from leaves of M. communis against E. rhusiopathiae.</p>

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.

Antibacterial activity of the essential oils of myrtle leaves against Erysipelothrix rhusiopathiae

Objective: To evaluate the antibacterial activity of the essential oil of Myrtus communis (M.communis Methods: Wild populations of M. communis collected from Khuzestan and Lorestan provinces, Southwest Iran, were examined for antibacterial activity and chemical variability in leaves. Thein vitro antibacterial activity against E. rhusiopathiae was performed by agar disc diffusion and micro-dilution assays.Results:) L. against Erysipelothrix rhusiopathiae (E. rhusiopathiae) in vitro. in both assays. The results showed that the major components of the oil were α-pinene (22.3%-55.2%), 1,8-cineole (8.7%-43.8%) and linalool (6.4%-14.5%). The inhibition zones and MIC values for bacteria which were sensitive to the essential oils of M. communis were in the range of 14.7-27.0 mm and 0.031-0.25 mg/mL, respectively.Conclusions:This study demonstrates that products with valuable antibacterial activity can be The essential oils of M. communis have strong antibacterial against E. rhusiopathiae produced from leaves of M. communis against E. rhusiopathiae.

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.

A child with Erysipelothrix arthritis-beware of the little known

Erysipelothrix rhusiopathiae is an established animal pathogen while the zoonotic infections in humans are rarely reported. Infections occur after exposure to animals or animal products that are mostly occupational in adults. Here we report in a child for the first time septic arthritis and osteomyelitis without an identifiable risk factor. A 5-year-old male child was admitted with pain in the left hip joint and inability to bear weight on the limb. Clinical examination followed by radiological and magnetic resonance imaging was suggestive of septic arthritis. Erysipelothrix rhusiopathiae grew from peroperative joint specimen. The infection was resolved following arthrotomy, joint lavage and antibiotic therapy.

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.

Enhancement of antibodies to protective domain of surface protective antigen A of Erysipelothrix rhusiopathiae by DNA immunization with plasmids expressing spaA-chimeras / 细胞与分子免疫学杂志

AIM: DNA vaccines expressing protective domain of surface protective antigen A（spaA）of Erysipelothrix rhusiopathiae have been relatively ineffective at generating high-titer, long-lasting, neutralizing antibodies in murine models. METHODS: This paper report using a DNA vaccine expressing a fusion of the spaA protein and various elements, such as a secretion leader sequence from the highly expressed human gene encoding α1-antitrypsin (AAT), a highly soluble and stably folded domain from the rat cartilage oligomerization matrix protein (COMP), and three copies of the complement component, C3d3, to enhance the titers of neutralizing spaＡ-specific antibody. RESULTS: Analysis of titers of the antibody raised in vaccinated mice at different time points indicated that immunizations with the DNA expressing pcDNA3-AAT-COMP-spaAN-3C3d((pcD-ACSC)) had higher titers than pcDNA3-spaA_N(pcD-S) at weeks 4. Furthermore, the immune protective efficacy of the spaA-chimeras was demonstrated by lethal challenge with a virulent homologous strain 1249 against immunized mice. CONCLUSION: These results suggest that using a plasmid vector containing a strong heterologous signal sequence that mediate efficient antigen secretion in vivo and a fused piece of sequence improving antigens solubility, as well as C3d3, genetic adjuvant, could enhance the antibody responses level. This approach might be an efficient way to improve the antibody level of spaA_N DNA vaccination.

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.

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.

Erysipelothrix rhusiopathiae Endocarditis: A Case Report

Erysipelothrix rhusiopathiae endocarditis in man is a very rare disease. The bacteria can be easily misiden- tified as nonpathogenic gram-positive bacilli or streptococci. This organism was isolated from blood samples taken from a 39-year-old male farmer with subacute bacterial endocarditis. The patient had cirrhosis of the liver; diabetes, and tuberculosis. The isolate showed typical cultural and biochemical characteristics such as facultative growth, formation of small greenish colonies on blood agar, positive hydrogen sulfide, negative catalase, and nonmotility. The isolate was susceptible to penicillin G and the cephalosporins.