Kichloo Asim Ahmed, Hallac Alexander, Mousavi Ben, Hirekhan Omkar
Department of Internal Medicine, Wyckoff Heights Medical Center, Brooklyn, NY 11237, USA.
Case Rep Infect Dis. 2013;2013:474593. doi: 10.1155/2013/474593. Epub 2013 May 30.
Erysipelothrix rhusiopathiae, a pleomorphic gram-positive bacillus, is found widely in nature or as a commensal pathogen. It infects domestic animals such as swine, which may be the major reservoir of the organism. E. rhusiopathiae is primarily an occupational illness; 89% of the cases are linked to high-risk epidemiological situations. Humans that are infected by this bacillus typically present with one or a combination of the following symptoms: localized skin lesion (erysipeloid), diffuse cutaneous eruptions with systemic symptoms, or bacteremia, which is often followed by endocarditis. We report a case of E. rhusiopathiae bacteremia that was present without severe clinical illness such as endocarditis, arthritis, or skin lesions. The patient was a 64-year-old male with a complicated past medical history including subclinical alcoholic liver disease. Penicillin-G therapy completely resolved the patients bacteremia. The case presented has exceptional clinical merit due to 2 key factors: the patient does not fit the occupational demographic typically affected by this bacterium, and the patient presented with subclinical septicemia, which has a high correlation with fatal endocarditis. This case brings a new prospective to E. rhusiopathiae bacteremia.
猪红斑丹毒丝菌是一种多形性革兰氏阳性杆菌，广泛存在于自然界，也可作为共生病原体存在。它可感染家畜，如猪，猪可能是该病原体的主要宿主。猪红斑丹毒丝菌感染主要是一种职业病；89%的病例与高风险的流行病学情况有关。感染这种杆菌的人类通常会出现以下一种或多种症状：局部皮肤病变（类丹毒）、伴有全身症状的弥漫性皮肤疹或菌血症，菌血症常继发心内膜炎。我们报告一例猪红斑丹毒丝菌菌血症病例，该病例没有出现心内膜炎、关节炎或皮肤病变等严重临床疾病。患者是一名64岁男性，有复杂的既往病史，包括亚临床酒精性肝病。青霉素G治疗完全消除了患者的菌血症。该病例具有特殊的临床价值，原因有两个关键因素：该患者不符合通常受这种细菌影响的职业人群特征，且该患者表现为亚临床败血症，这与致命的心内膜炎高度相关。该病例为猪红斑丹毒丝菌菌血症带来了新的研究前景。
