Characterization of pig tonsils as niches for the generation of Streptococcus suis diversity.

Streptococcus suis is a gram-positive bacterium that causes meningitis, septicemia, endocarditis, and other disorders in pigs and humans. We obtained 42 and 50 S. suis isolates from lesions of porcine endocarditis and palatine tonsils, respectively, of clinically healthy pigs in Japan; we then determined their sequence types (STs) by multilocus sequence typing (MLST), cps genotypes, serotypes, and presence of classical major virulence-associated marker genes (mrp, epf, and sly). The 42 isolates from endocarditis lesions were assigned to a limited number of STs and clonal complexes (CCs). On the other hand, the 50 isolates from tonsils were diverse in these traits and seemingly in the degree of virulence, suggesting that tonsils can accommodate a variety of S. suis isolates. The goeBURST full algorithm using tonsil isolates obtained in this study and those retrieved from the database showed that major CCs as well as many other clusters were composed of isolates originating from different countries, and some of the STs were very similar to each other despite the difference in country of origin. These findings indicate that S. suis with not only different but also similar mutations in the genome have survived in tonsils independently across different geographical locations. Therefore, unlike the lesions of endocarditis, the tonsils of pigs seemingly accommodate various S. suis lineages. The present study suggests that S. suis acquired its diversity by natural mutations during colonization and persistence in the tonsils of pigs.

Detection and disease diagnosis trends (2017-2022) for Streptococcus suis, Glaesserella parasuis, Mycoplasma hyorhinis, Actinobacillus suis and Mycoplasma hyosynoviae at Iowa State University Veterinary Diagnostic Laboratory.

BACKGROUND: Accurate measurement of disease associated with endemic bacterial agents in pig populations is challenging due to their commensal ecology, the lack of disease-specific antemortem diagnostic tests, and the polymicrobial nature of swine diagnostic cases. The main objective of this retrospective study was to estimate temporal patterns of agent detection and disease diagnosis for five endemic bacteria that can cause systemic disease in porcine tissue specimens submitted to the Iowa State University Veterinary Diagnostic Laboratory (ISU VDL) from 2017 to 2022. The study also explored the diagnostic value of specific tissue specimens for disease diagnosis, estimated the frequency of polymicrobial diagnosis, and evaluated the association between phase of pig production and disease diagnosis. RESULTS: S. suis and G. parasuis bronchopneumonia increased on average 6 and 4.3%, while S. suis endocarditis increased by 23% per year, respectively. M. hyorhinis and A. suis associated serositis increased yearly by 4.2 and 12.8%, respectively. A significant upward trend in M. hyorhinis arthritis cases was also observed. In contrast, M. hyosynoviae arthritis cases decreased by 33% average/year. Investigation into the diagnostic value of tissues showed that lungs were the most frequently submitted sample, However, the use of lung for systemic disease diagnosis requires caution due to the commensal nature of these agents in the respiratory system, compared to systemic sites that diagnosticians typically target. This study also explored associations between phase of production and specific diseases caused by each agent, showcasing the role of S. suis arthritis in suckling pigs, meningitis in early nursery and endocarditis in growing pigs, and the role of G. parasuis, A. suis, M. hyorhinis and M. hyosynoviae disease mainly in post-weaning phases. Finally, this study highlighted the high frequency of co-detection and -disease diagnosis with other infectious etiologies, such as PRRSV and IAV, demonstrating that to minimize the health impact of these endemic bacterial agents it is imperative to establish effective viral control programs. CONCLUSIONS: Results from this retrospective study demonstrated significant increases in disease diagnosis for S. suis, G. parasuis, M. hyorhinis, and A. suis, and a significant decrease in detection and disease diagnosis of M. hyosynoviae. High frequencies of interactions between these endemic agents and with viral pathogens was also demonstrated. Consequently, improved control programs are needed to mitigate the adverse effect of these endemic bacterial agents on swine health and wellbeing. This includes improving diagnostic procedures, developing more effective vaccine products, fine-tuning antimicrobial approaches, and managing viral co-infections.

Cook Inlet beluga whale Delphinapterus leucas with valvular endocarditis, encephalitis, rhabdomyolysis, heavy parasitism and fungal dermatitis.

This is a case report of a Cook Inlet beluga whale Delphinapterus leucas found dead stranded on September 28, 2020 in Turnagain Arm, Alaska. This subadult male had valvular endocarditis, encephalitis, rhabdomyolysis, myoglobinuric nephropathy, severe parasitism and fungal dermatitis. Erysipelothrix rhusiopathiae was detected in the heart lesion, eye and external swabs. The level of infection and parasitism in this individual is markedly higher than what has been found in other Cook Inlet belugas, suggesting immunosuppression.

Brevundimonas vesicularis isolation from a Labrador Retriever with Bacteremia, Endocarditis, Spinal Epidural Empyema, and Polyarthritis.

A 7 yr old spayed female Labrador retriever was evaluated for progressive nonambulatory tetraparesis, obtundation, joint pain, and pyrexia. The dog was diagnosed with spinal epidural empyema, bacteremia, endocarditis, and polyarthritis based on magnetic resonance imaging, echocardiography, joint fluid analysis, and blood culture. Blood culture isolated a rare and atypical pathogen, Brevundimonas vesicularis in conjunction with Escherchia coli. The patient was treated with a 10 mo antibiotic course, and clinical signs quickly resolved. This is the first report of B vesicularis in association with bacteremia, endocarditis, spinal empyema, and polyarthritis in a dog.

Postmortem Evaluation of Cardiac Valvular Disease in Bald Eagles (Haliaeetus leucocephalus) and a Golden Eagle (Aquila chrysaetos).

Limited data are available regarding cardiac diseases in birds of prey despite their prevalence in these avian species. Literature regarding valvular lesions in birds of prey is scarce and includes single reports of left atrioventricular valvular endocarditis in an adult, free-ranging, male bald eagle (Haliaeetus leucocephalus) and aortic valvular endocarditis in an adult, free-ranging, female red-tailed hawk (Buteo jamaicensis). The purpose of this study was to evaluate the prevalence, signalment, gross necropsy findings, and histologic lesions of valvular lesions in eagles. In this retrospective study, necropsy reports for 24 free-ranging and captive eagles were evaluated over a 15-year period (July 3, 2006-February 28, 2021). Six (25%; 95% confidence interval: 8.9-58.9) birds, 5 bald eagles and 1 golden eagle (Aquila chrysaetos), met the inclusion criteria. Five (83.3%) of the 6 birds had valvular degeneration, 2 (33.3%) had endocarditis, and Staphylococcus aureus was cultured from 1 (16.7%) of the endocarditis cases. The 6 eagles with valvular lesions were all captive adults. Four of the birds were female (66.7%), and the aortic and left atrioventricular valves were equally affected. Acute or chronic cerebral infarcts were present in all 6 birds. Valvular cardiac disease should be considered as a differential diagnosis in eagles exhibiting respiratory distress, neurologic signs, syncope, or in cases of sudden death.

Streptococcus gallolyticus and Bacterial Endocarditis in Swine, United States, 2015-2020.

To evaluate trends in bacterial causes of valvular endocarditis in swine, we retrospectively analyzed 321 cases diagnosed at Iowa State University Veterinary Diagnostic Laboratory (Ames, IA, USA) during May 2015--April 2020. Streptococcus gallolyticus was the causative agent for 7.59% of cases. This emerging infection in swine could aid study of endocarditis in humans.

Case report and successful management of canine aortic endocarditis caused by Actinomyces neuii subsp. anitratus (Winkia neuii subsp. anitrata).

BACKGROUND: Canine aortic valve endocarditis carries a poor prognosis. In the current literature there are only two reports of infectious endocarditis associated with Actinomyces; Actinomyces turicensis and an Actinomyces-like organism. Endocarditis due to Actinomyces neuii subsp. anitratus (now known as Winkia neuii subsp. anitrata) has rarely been reported in humans, and to the best of our knowledge, has never been reported in dogs. CASE PRESENTATION: A 4 year-3 months old female neutered Great Dane presented with lethargy, hyporexia, 'praying position' stance, acute onset of cherry eye and pyrexia. A subtle diastolic heart murmur was detected on thoracic auscultation and echocardiology revealed an irregular lesion adhered to the ventricular aspect of the aortic valve, suggestive of aortic valve endocarditis. Peripheral blood was collected for blood culture. Following 10 days of incubation, blood cultures yielded a growth of aerobic gram-positive filamentous rods which were further biochemically (BioMerieux API Coryne profiling strip) identified as Actinomyces neuii subsp. anitratus. The patient was treated with marbofloxacin and amoxicillin/clavulanic acid for five consecutive months. On repeat echogram, following treatment completion, there was no evidence of aortic valve endocarditis. To the best of our knowledge this is the first case report documenting successful treatment of aortic valve endocarditis caused by Actinomyces neuii subsp. anitratus in a dog. CONCLUSIONS: Despite the poor prognosis of canine infectious aortic valve endocarditis, patients with Actinomyces neuii subsp. anitratus infection might have a favourable outcome. It is therefore important identifying the underling infectious cause, as it may have a significant impact on prognosis and treatment outcome when it is caused by Actinomyces neuii subsp. anitratus.

Valvular endocarditis in the horse: 20 cases (1993-2020).

Medical records of 20 horses with a confirmed diagnosis of valvular endocarditis at the Ontario Veterinary College between January 1, 1993 and February 3, 2020 were reviewed. The diagnosis was based on physical examination findings, complete blood (cell) count (CBC), serum biochemistry, echocardiography, blood culture, and post-mortem findings. Common presenting signs included tachycardia, pyrexia, weight loss, lameness/joint distension, and a heart murmur. Clinicopathological findings included leukocytosis, anemia, hypoalbuminemia, hyperglobulinemia, and elevated inflammatory markers. Culture from 5 horses yielded Actinobacillus equuli in 2 cases and Actinobacillus suis in 1 case. Of the 20 horses included in this study, 17 were euthanized and 3 were treated. Only 1 case had follow-up more than 1 year after discharge.

Endocardite valvulaire chez le cheval : 20 cas (1993­2020). Les dossiers médicaux de 20 chevaux avec un diagnostic confirmé d'endocardite valvulaire au Ontario Veterinary College entre le 1er janvier 1993 et le 3 février 2020 furent revus. Le diagnostic était basé sur les trouvailles de l'examen physique, un comptage sanguin complet (CBC), une biochimie sérique, une échocardiographie, une hémoculture et les trouvailles post-mortem. Les signes fréquents de présentation incluaient tachycardie, pyrexie, perte de poids, boiterie/enflure articulaire et murmure cardiaque. Les trouvailles clinico-pathologiques incluaient leucocytose, anémie, hypoalbuminémie, hyperglobulinémie et augmentation des marqueurs inflammatoires. La culture provenant de cinq chevaux permis d'isoler Actinobacillus equuli dans deux cas et Actinobacillus suis d'un cas. Parmi les 20 chevaux inclus dans cette étude, 17 furent euthanasiés et trois furent traités. Seulement un cas avait un suivi de plus d'un an après le congé.(Traduit par Dr Serge Messier).

The application of the loop-mediated isothermal amplification (LAMP) method for diagnosing Enterococcus hirae-associated endocarditis outbreaks in chickens.

BACKGROUND: Enterococcus hirae is considered a part of the normal intestinal biota of several domestic animals, including poultry. However, this species is also associated with infective endocarditis in chickens, a disease that leads to unexpected deaths and serious economical losses. Enterococcus hirae is identified predominantly with the use of conventional bacteriological methods, biochemical tests and PCR. Rapid, sensitive and specific methods for detecting E. hirae in clinical samples are required in poultry production. The aim of this study was to use the Loop-Mediated Isothermal Amplification (LAMP) for the identification and quantification of E. hirae in heart samples from broiler chickens. RESULTS: The specificity of the LAMP method was confirmed for 7 enterococcal strains and 3 non-enterococcal strains. E. hirae was detected in all of the 22 analyzed clinical bacterial isolates and in all of the 9 heart samples. Three sets of primers supported the detection of E. hirae with high sensitivity and specificity within one hour. The highest detection rate of a LAMP product was approximately 7 min for an E. hirae strain and 12 min for a positive heart sample. The detection limit for the E. hirae ATCC 10541 standard was 1.3 × 102 CFU (43.4 fg) or 13.8 copies of the E. hirae genome equivalent per reaction. The reaction was 10-fold more sensitive than conventional species-specific PCR. The LAMP assay supported the determination of the E. hirae load in chicken hearts with endocarditis in field cases. The average number of E. hirae cells in hearts was 5.19 × 107 CFU/g of tissue, and the average number of E. hirae genome equivalents in hearts was 5.51× 106 copies/g of tissue. Bacterial counts were significantly higher in the LAMP assay than in the standard plate count. CONCLUSIONS: The LAMP assay is a useful diagnostic tool and an effective alternative to conventional methods for the detection of this enterococcal species. The sodA-based LAMP assay supported direct identification of E. hirae from pure cultures and heart samples without previous bacterial cultivation. This is the first study to apply the LAMP method for the purpose of diagnosing E. hirae-associated endocarditis in poultry.

Concurrent spinal epidural empyema and endocarditis in a dog.

A 9-year-old neutered male Rhodesian ridgeback cross dog was evaluated for progressive non-ambulatory paraparesis, fever, and leukocytosis. The dog was diagnosed with spinal epidural empyema (SEE) and infectious endocarditis (IE) of the mitral valve based on the findings of contrast-enhanced computed tomography (CT), CT myelography, echocardiography, and bacterial culture. The report herein describes the clinical presentation, CT findings, clinical and surgical management of this case, together with the electrocardiography, and echocardiography findings. To the authors' knowledge, this is the first reported case of spinal epidural empyema likely to be caused by infectious endocarditis of the mitral valve in a dog.

Empyème épidural spinal concomitant à une endocardite chez un chien. Un chien mâle castré croisé Rhodesian Ridgeback âgé de 9 ans a été évalué pour une paraparésie progressive non-ambulatoire, de la fièvre et une leucocytose. Un diagnostic d'empyème épidural spinal (SEE) et d'endocardite infectieuse (IE) de la valvule mitrale a été émis basé sur les trouvailles de la tomodensitométrie (CT), d'une myélographie CT, de l'échocardiographie, et de la culture bactérienne. Le présent rapport décrit la présentation clinique, les trouvailles de CT, la gestion clinique et chirurgicale de ce cas, de même que les trouvailles par électrocardiographie et échocardiographie. À la connaissance des auteurs, ceci représente le premier cas rapporté d'empyème épidural spinal à être causé par une endocardite infectieuse de la valvule mitrale chez un chien.(Traduit par Dr Serge Messier).

Validation of IgY for the diagnosis of Streptococcus agalactiae-caused endocarditis and bacterial meningitis in Nile tilapia (Oreochromis niloticus).

Streptococcus agalactiae (Sta), which belongs to Lancefield group B, causes sepsis, endocarditis and bacterial meningitis in human neonates and Nile tilapia. Because the pathophysiology of Sta infection is partially similar in both species, the identification of biomarkers for the diagnosis and study of this disease is of importance for human and animal health. Therefore, in the present study, we produced an immunoglobulin Y (IgY) by immunizing laying hens with Sta proteins and evaluated its ability to detect Sta in paraffinized tilapia brain and cardiac tissue by direct immunofluorescence (IMF) and indirect immunohistochemistry (IHC). The IgY produced was effective in the diagnosis of Sta infection in Nile tilapia, justifying the use of this species as a biomodel for the study of this disease.

SQUAMOUS CELL CARCINOMAS WITH PULMONARY METASTASIS AND ENDOCARDIOSIS IN THE SIBERIAN CHIPMUNK ( EUTAMIAS SIBIRICUS): TWO NECROPSY CASES.

Reports of neoplastic diseases in the Siberian chipmunk ( Eutamias sibiricus) are limited. The authors describe herein two necropsy cases of Siberian chipmunks with squamous cell carcinoma; both of which showed self-biting behaviors on presentation to the clinician. In both cases, the neoplasms comprised trabeculae and islands of polyhedral cells, supported by moderate amounts of fibrous stroma. Anisocytosis and anisokaryosis were moderate to prominent. Neoplastic cells were occasionally keratinized, with a keratin pearl formation. In one case, valvular endocardiosis of the left and right atrioventricular valves with secondary pulmonary and hepatic lesions was incidentally diagnosed. This report provides the first documentation of squamous cell carcinoma and endocardiosis in the Siberian chipmunk.

Staphylococcus simulans associated with endocarditis in broiler chickens.

This report suggests a strong association between coagulase-negative Staphylococcus simulans and endocarditis in broiler chickens of a single flock. Clinical signs included increased mortality and lameness, and some dead chickens were found on their backs. Lesions included cauliflower-like, fibrinous vegetative lesions on the left atrioventricular valve; cream-coloured, necrotic foci of varying size in the liver; and necrosis of the femoral head. Histopathological examination of the heart revealed multifocal conglomerates of bacterial colonies attached to the valvular endocardium, threads of fibrin, and inflammatory cells with the presence of heterophils. S. simulans strains were first identified by API ID32, and then confirmed with Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry and by partial sequencing of the rpoB and dnaJ genes. These bacteria were resistant to methicillin but sensitive to vancomycin and characterized by slime production and protease activity.

Valvular and Mural Endocardiosis in Aging Zebrafish (Danio rerio).

Endocardiosis or myxomatous degeneration of the cardiac valves is a well-described age-related change in humans and dogs. Lesions consist of polypoid nodular proliferations of loose extracellular matrix and valvular interstitial cells, most commonly affecting the mitral valve. This entity has not been previously described in fish. Herein we report the appearance, location, and occurrence of valvular and mural endocardiosis in a retrospective survey of aging laboratory zebrafish. Endocardiosis was present in 59 of 777 fish (7.59%), most commonly affecting the sinoatrial (34 fish; 57.6%) and atrioventricular (33 fish; 55.9%) valves. Lesions were more common in fish raised in recirculating water systems and fed commercial diets (52/230 fish; 22.6%) versus flow-through systems with fish fed semi-purified diets (4/234; 1.71%). Lesions were overrepresented in fish heterozygous for a mutant smoothened allele (34/61 fish, 55.7% vs 17/168, 10.1% wild type). There was no association between endocardiosis and intestinal carcinoids. Valvular endocardiosis is a significant age- and husbandry-related background finding in zebrafish and should be considered in the design and interpretation of research studies.

Echocardiographic and pathologic identification of an aorto-left atrial fistula secondary to infective endocarditis in a canine patient.

A dog was presented for lameness, fever, and extreme lethargy. On physical exam, a new heart murmur, arrhythmia, and joint effusion were detected. These findings were not detected two months prior. A diagnostic work-up confirmed septic suppurative inflammation in multiple joints. Echocardiogram revealed aortic valvular endocarditis along with a communication, as a consequence of a fistula, that extended from just below the aortic sinotubular junction to the left atrial lumen. Due to a poor prognosis, humane euthanasia was elected. Necropsy and histopathology confirmed infective endocarditis of the aortic valve and an aorto-left atrial fistulous tract extending from the left coronary sinus of the aortic valve to the lumen of left atrium.

Pathogenicity of wild-type and small-colony variants of Streptococcus equi subsp. zooepidemicus in layer chickens.

Wild-type (WT) and small-colony-variant (SCV) strains of Streptococcus equi subsp. zooepidemicus have recently been isolated from a layer flock in Denmark experiencing high mortality. To investigate the disease-causing potential of SCV compared with WT, a 2-week long infection study was performed in 45-week-old brown layer chickens. Four groups of 11 chickens each were inoculated with a WT or SCV strain by the intravenous or intra-tracheal route: WT-IV, SCV-IV or WT-IT, SCV-IT, respectively. Clinical signs were observed in most chickens in the WT-IV group (9/11). Mortality was observed in the SCV-IV (4/11) and WT-IV (2/11) groups. Ten chickens in the WT-IV and WT-IT groups, respectively, developed gross lesions including oophoritis/peritonitis, hepatitis and airsacculitis cervicalis. Bronchopneumonia was common in the SCV-IT group (6/11), and valvular endocarditis in the SCV-IV group (4/11). Histological lesions in liver tissue were frequently observed in the chickens of the SCV-IV group (9/11), followed by the WT-IT (7/11), WT-IV (6/11), and SCV-IT (2/11) groups. The lesions in the SCV-IV group were dominated by deposition of eosinophilic material with infiltration of inflammatory cells (6/9). Bacteriological re-isolation of either strain type was achieved from all chickens of the WT-IV and WT-IT groups, and from nine and seven out of 11 chickens for each of the SCV-IV and SCV-IT groups, respectively. In summary, we were able to reproduce clinical signs and lesions as observed during the natural outbreak, which included an overall initial onset in WT-infected chickens as opposed to a late onset and possible recurring infection seen in the SCV-infected chickens.

Infective endocarditis with systemic bacterial embolism caused by Staphylococcus aureus in a free-ranging Amami rabbit (Pentalagus furnessi).

The Amami rabbit (Pentalagus furnessi) is found only on the two islands of Amami-Oshima and Tokunoshima in southwest Japan. It has a primitive appearance and ecology, is an evolutionarily valuable animal and has been assigned to the International Union for Conservation of Nature Red List of Threatened Species. We describe a case with mild purulent wounds on the distal digital skin of both forelimbs and multiple nodular lesions in various organs, including the heart and kidney. Microscopically, the heart lesions were characterized by disruption of the mitral valve and multifocal myocardial necrosis and abscesses due to infection with gram-positive cocci. Similar bacterial infarctions were also found in other organs, including the kidneys. The bacteria were identified as Staphylococcus aureus by immunohistochemical and molecular biological examinations. This first report of infective endocarditis and systemic infarctions caused by S. aureus in an Amami rabbit indicates the importance of monitoring purulent injuries, even if mild, to prevent secondary infections in this species.

Infective endocarditis in dogs in the UK: 77 cases (2009-2019).

OBJECTIVES: To determine the causative organisms, clinical features and outcome of canine infective endocarditis in the UK. MATERIALS AND METHODS: Medical records of three veterinary referral hospitals were searched for dogs with infective endocarditis between December 2009 and December 2019. Signalment, clinical signs, causative organism, valve affected, treatment and survival data were recorded. RESULTS: Seventy-seven cases with possible or definite infective endocarditis (according to the modified Duke criteria) were included. The majority were large breed (40/77 - 51.9%). There were 47 of 77 (61%) male dogs and the mean age was 7.3 ±3 years. A causative organism was identified in 26 of 77 (33.8%) cases. The most common organisms were Escherichia coli (7/27 - 25.9%), Pasteurella spp. (5/27 - 18.5%), Staphylococcus spp. (4/27 - 14.8%) and Corynebacterium spp. (4/27 - 14.8%). Bartonella spp. were not detected in any patients. The mitral valve was most commonly affected (48/77 - 62.3%). Clinical features were non-specific, with lethargy being the most common clinical sign observed (53/77 - 68.8%). Fifty-three dogs (68.8%) survived to discharge. The median survival time post discharge was 425 days (2 to 3650 days). The development of congestive heart failure was associated with a poorer outcome. Cardiac troponin concentration, antithrombotic use and the development of thromboembolism or arrhythmias were not significantly associated with outcome. CLINICAL SIGNIFICANCE: Some dogs with infective endocarditis that survive to discharge can have a long lifespan. The inability to detect an underlying organism is common and Bartonella spp. may be a less prevalent cause of canine infective endocarditis in the UK than in the USA.

Streptococcus canis prostatitis and endocarditis with thromboembolism in a dog with sertoli cell tumour in a cryptic testis and prostatic squamous metaplasia.

We describe an unusual case of prostatitis caused by Streptococcus canis evolving to endocarditis and splenic, renal, and cerebral thromboembolism in a dog, associated with a Sertoli cell tumour in a cryptic testis and diffuse prostatic squamous metaplasia. A nine-year-old, intact male, mixed-breed dog was presented to a veterinary teaching hospital with abdominal pain and prostration. Physical examination and abdominal ultrasonography revealed an atrophic right testicle located in the subcutaneous tissue. The left testicle was in the abdominal cavity with increased dimensions and irregular contours. Complete blood count analysis showed marked neutrophilic leukocytosis and thrombocytopenia. After clinical worsening, euthanasia was performed, and the dog was submitted to post-mortem examination. The main gross findings included testicular malposition with one cryptic and one ectopic testis, enlarged prostate with purulent content, distension of the urinary bladder with cloudy urine, vegetative valvular endocarditis in the mitral valve, and spleen and renal infarcts. Histological examination showed a Sertoli cell tumour in the abdominal testis, diffuse prostatic squamous metaplasia with marked keratinization associated with bacterial prostatitis, fibrinonecrotic cystitis, bacterial endocarditis with marked myxomatous degeneration in the mitral valve, and splenic, renal, and cerebral thromboembolism. Microbiological analysis identified Streptococcus canis in the prostate and mitral valve. Sertoli cell tumour of cryptic testis increases oestrogen production and leads to squamous metaplasia of the prostate, which should be considered as predisposing factors for ascending S. canis infection from the urogenital tract to the prostate. Then, haematogenous spread of S. canis from the prostate to mitral valve cause endocarditis and subsequent thromboembolism and infarcts, all decisive to poor prognosis in this case.

Genotypic characterization of Streptococcus infantarius subsp. coli isolates from sea otters with infective endocarditis and/or septicemia and from environmental mussel samples.

Pulsed-field gel electrophoresis (PFGE) was used to type 128 Streptococcus infantarius subsp. coli isolates from sea otters and mussels. Six SmaI PFGE groups were detected, with one predominant group representing 57% of the isolates collected over a wide geographic region. Several sea otter and mussel isolates were highly related, suggesting that an environmental infection source is possible.