Streptococcus suis: Bacteremia presenting with fever, rashes, arthritis and neurologic deficits

ABSTRACT

Introduction@#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. @*Case Presentation@#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 five days prior to admission. Blood culture was positive for S. suis II and clinical improvement was achieved with antibiotic treatment and administration of Dexamethasone. On follow-up check; however, patient had residual deafness on bilateral ears, which prompted referral to ENT service for further work-up and management. Our patient is the second Filipino and the first documented case to be diagnosed in the Philippines.@*Conclusion@#Despite a booming hog industry in the Philippines and increasing prevalence in its neighboring countries, S. suis infection remains unreported in our country due to either lack of available diagnostics or misdiagnoses; therefore, a good clinical skills and high index of suspicion are warranted in the initial diagnosis of patients infected with S. suis. In order to prevent epidemic outbreak in the future, simple preventive measures like handwashing and wearing gloves after handling raw pork meat should always be practiced. With an increased awareness among clinicians and microbiologists and vigilance among high-risk individuals, we will promote early diagnosis of this pathogen and prevention of its sequelae