Department of Emergency Intensive Care Unit, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China.
Genoxor Medical Science and Technology Inc., Shanghai, China.
J Infect Dev Ctries. 2024 Apr 30;18(4):645-650. doi: 10.3855/jidc.18805.
Streptococcus suis (S. suis) disease is a zoonotic infection caused by invasive S. suis and can lead to meningitis, septic shock, arthritis, and endocarditis. Early treatment is the key to reducing mortality. However, clinical manifestations of most cases are atypical, severely limiting rapid diagnosis and treatment.
Here, we report a 74-year-old female patient diagnosed with S. suis infection. The main symptoms were hearing loss, lumbago, and scattered ecchymosis of the lower extremities and trunk. Blood non-specific infection indexes were significantly increased and platelets were significantly decreased; however, no pathogens were obtained from routine blood culture. Finally, the S. suis infection was confirmed by metagenomic next-generation sequencing (mNGS) of blood and cerebrospinal fluid. After antibiotic treatment, the limb and trunk scattered ecchymosis and lumbago symptoms were significantly relieved, but the hearing did not recover.
Human infection with S. suis is rare in central cities, and it is easy to misdiagnose, especially in cases with atypical early symptoms. mNGS technology, combined with clinical observation, is helpful to clarify the direction of diagnosis and treatment, which is conducive to patient recovery.
猪链球菌病（S. suis）是一种由侵袭性 S. suis 引起的人畜共患病感染，可导致脑膜炎、败血症性休克、关节炎和心内膜炎。早期治疗是降低死亡率的关键。然而，大多数病例的临床表现是非典型的，严重限制了快速诊断和治疗。
本研究报告了一例 74 岁女性患者，诊断为猪链球菌感染。主要症状为听力丧失、腰痛和下肢及躯干散在瘀斑。血液非特异性感染指标明显升高，血小板明显减少；然而，常规血培养未获得病原体。最终，通过血液和脑脊液的宏基因组下一代测序（mNGS）证实了猪链球菌感染。抗生素治疗后，四肢和躯干散在瘀斑和腰痛症状明显缓解，但听力未恢复。
猪链球菌在中心城市的人类感染较为罕见，易误诊，尤其是在症状不典型的早期。mNGS 技术结合临床观察，有助于明确诊断和治疗方向，有利于患者康复。
