Misidentification of as a Zoonotic Agent.

BACKGROUND

is an emerging zoonotic pathogen. This bacterium commonly causes meningitis in human and is often associated with hearing and vestibular dysfunction. tends to be misidentified, leading to under-diagnosis.

CASE PRESENTATION

A previously healthy 50-year-old man was admitted to one of the district hospitals in Bali Province, Indonesia, due to meningitis. He had a history of consuming homemade raw pork product two days before the onset of illness. Streptococcus mitis was identified from the cerebrospinal fluid culture by using VITEX 2 COMPACT (Biomeriuex) with a 99% probability score. This patient had clinical symptoms and risk factor identical to infection. Therefore, we performed confirmation tests for the cerebrospinal fluid by PCR (using primer specific for and ) and sequencing of those PCR products. Both of the confirmation tests showed a positive result for .

CONCLUSION

There are few reports of infections in Indonesia, but we believe that the cases in Indonesia, especially Bali, are not uncommon. The under-reported cases are perhaps due to the difficulties in differentiating from other Streptococcus species by culture method, particularly . Therefore, confirmation by PCR is necessary.