Erysipelothrix rhusiopathiae bacteremia without endocarditis associated with psoas abscess: the first case report in Thailand.

The authors report a patient with a rare manifestation of invasive septic Erysipelothrix rhusiopathiae infection without endocardial involvement. Our patient presented with progressive paraparesis and subacute fever for ten days. He had underlying diabetes mellitus and alcoholic cirrhosis. Magnetic resonance imaging (MRI) of the lumbosacral spine showed a psoas abscess with vertebral osteomyelitis and discitis at level of L23 of the lumbar spine. His blood culture grew E. rhusiopathiae. Transthoracic echocardiography demonstrated normal endocardium. Surgical drainage and debridement with concomitant intravenous antibiotics administration resulted in clinical improvement, including neurological status. MRI showed resolution of the psoas abscess and osteomyelitis. Erysipelothrix infection should be considered as a causative pathogen of musculoskeletal infection in immunocompromised patients. To our knowledge, this is the first case report of psoas abscess caused by E. rhusiopathiae in Thailand.

Animal-associated bacteria, Erysipelotrix rhusiopathiae, as the cause of infection in a total hip arthroplasty.

Invasive infection with animal-associated bacteria, Erysipelotrix rhusiopathiae, is unusual and has, to our knowledge, never been described as the cause of infected total hip arthroplasty. We describe how an infected total hip arthroplasty caused by these bacteria is eradicated using standard surgical and antibiotic treatment. Before 2-stage revision surgery, the patient had persistent groin pain, elevated C-reactive protein, radiographic periprosthetic osteolysis, excessive intra-articular fluid, and periprosthetic activity accumulation on the white cell scan. The patient was treated with benzylpenicillin after confirmed sensitivity of E rhusiopathiae diagnosed by culture of five tissue samples and polymerase chain reaction of the prosthetic sonicate sample. Sixteen weeks after the last stage of revision surgery, there were no signs of reoccurring infection.

Septic polyarthritis caused by Erysipelothrix rhusiopathiae in a dog.

A 14-month-old, male German Shepherd dog was admitted with a six-week history of lameness and swelling of the right hindlimb. Clinical examination revealed polyarthritis, fever, petechiae and ecchymoses of the abdominal skin and prepuce. The haematology and blood chemistry were indicative of sepsis. Mediolateral radiographic views of both of the stifle joints revealed signs of bilateral articular capsule swelling. The radiographical, bacteriological and necropsy findings confirmed a diagnosis of septic polyarthritis due to infection with Erysipelothrix rhusiopathiae.

Polyarthritis caused by Erysipelothrix rhusiopathiae in three Austrian sheep flocks - diagnosis, treatment and management measures.

INTRODUCTION: Polyarthritis caused by Erysipelothrix rhusiopathiae is a well-known disease in pigs, and ovine erysipelas infection also commonly affects two-to-six month-old lambs. This report describes case histories of three sheep flocks where lambs exhibited swollen joints and lameness. Special emphasis was given to clinical and diagnostic imaging findings, synovia sampling and the treatment regime. Lambs with only mild lameness, liquid serofibrinous joint effusion and lambs showing no bone involvement, as revealed by ultrasonography or radiography, were treated with systemically administered antibiotics selected from results of antimicrobial susceptibility testing of E. rhusiopathiae isolated from synovial samples, and non-steroidal anti-inflammatory drugs. Lambs with severe lameness and severely swollen joints were euthanized, and routine necropsy was undertaken with a focus on the joints. Further, a herd-specific autogenous vaccine was produced by a specialized laboratory. In conclusion, E. rhusiopathiae infection should be considered as a differential diagnosis in herds associated with lameness and polyarthritis in lambs aged between two up to 17 months.

INTRODUCTION: La polyarthrite causée par Erysipelothrix rhusiopathiae est une maladie bien connue chez le porc. Chez les ovins, l'infection touche le plus souvent les agneaux âgés de deux à six mois. Ce rapport de cas décrit trois troupeaux de moutons où des agneaux présentaient des articulations enflées et une boiterie. Un accent particulier a été mis sur la clinique, les résultats de l'imagerie diagnostique, les prélèvements de synovie et le mode de traitement. Les agneaux présentant uniquement une légère boiterie, des épanchements articulaires séro-fibrineux et ceux ne présentant pas d'atteinte osseuse, révélée par échographie ou radiographie, ont été traités avec des antibiotiques administrés par voie systémique, sélectionnés à partir des résultats de la sensibilité d'E. Rhusiopathiae isolé sur les échantillons synoviaux, ainsi qu'avec des anti-inflammatoires non stéroïdiens. Les agneaux présentant une boiterie sévère et des articulations gravement enflées ont été euthanasiés et une autopsie de routine a été réalisée avec un accent particulier mis sur les articulations. De plus, un vaccin autogène spécifique au troupeau a été produit par un laboratoire. En conclusion, l'infection à E. rhusiopathiae doit être considérée comme un diagnostic différentiel dans les troupeaux où l'on constate des boiteries et des polyarthrites chez les agneaux âgés de 2 à 17 mois.

Erysipelothrix rhusiopathiae septicaemia in systemic lupus erythematosus.

Erysipelothrix rhusiopathiae is a Gram-positive bacillus that is rarely reported as a causative agent of infections in humans. Human cases in most instances present as localized or generalized skin infections. Invasive infections are exceptionally described and septic forms are usually associated with endocarditis. We report a case of invasive infection caused by Erysipelothrix rhusiopathiae without skin or endocardium involvement in a patient with systemic lupus erythematosus (SLE). To our knowledge, this is the first report of an isolated bacteraemia due to this pathogen in a patient with SLE without skin or endocardium involvement.

Occupational injury in a fishmonger with a macular rash, hepatosplenomegaly and pancytopenia.

A 47-year-old fishmonger presented with a history of weight loss and lethargy. On investigation he was found to have myeloma. He presented again before follow up, with a 3-day history of fever and a maculopapular rash. He was admitted to the haematology ward and treated with broad-spectrum antibiotics. Blood cultures were found to be positive for Erysipelothrix rhusiopathiae. Penicillin treatment was given, and he made a good recovery. The importance of occupational illness in an already immunocompromised patient and of taking a proper social and occupational history from patients on admission is illustrated through this case.

Visceral botryomycosis in a case of Erysipelothrix rhusiopathiae endocarditis.

Botryomycosis is a rare bacterial infection of the skin and, rarely, viscera that is characterized by the formation of characteristic hyaline grains. We encountered a patient with Erysipelothrix rhusiopathiae endocarditis who developed visceral botryomycosis. He was a 54-year-old black man who presented in sepsis with a history of progressive weakness and severe weight loss. He died 10 hours after admission. At autopsy, endocarditis was identified, along with infarcts of the spleen and kidneys. Microscopically, visceral botryomycosis was seen. With these bacteria, an animal source is usually identified, although one was not found in this man. Erysipelothrix rhusiopathiae is an organism that is becoming identified in a range of infections in humans, the manifestations and pathophysiology of which are still being discovered.

A case of multiple brain infarctions associated with Erysipelothrix rhusiopathiae endocarditis.

A 63-year-old woman was admitted to our hospital because of fever and altered mentality. Brain magnetic resonance imaging showed multiple infarctions at the basal ganglia, cerebellum, and subcortical white matter with petechial hemorrhage, which was more easily seen on gradient echo images. Erysipelothrix rhusiopathiae was cultured from her blood, and echocardiography showed septic vegetations in the mitral valve. She recovered fully after 6 weeks of appropriate antibiotic treatment.

Erysipeloid infection in a sheep farmer with coexisting orf.

Erysipeloid is a rarely reported zoonotic infection caused by Erysipelothrix rhusiopathiae. We report a case of coexisting erysipeloid and orf infections in a sheep farmer, an association not previously recorded to our knowledge.

Possible role of neuraminidase in the pathogenesis of arteritis and thrombocytopenia induced in rats by Erysipelothrix rhusiopathiae.

The role of the neuraminidase produced by Erysipelothrix rhusiopathiae (E. rhusiopathiae) in the pathogenesis of arteritis and induced thrombocytopenia was examined using young and adult rats. There was a close correlation between bacterial invasion, desialation and cell infiltration in the common iliac artery. E. rhusiopathiae induced arteritis from the second and third day after inoculation with 3 X 10(8) viable bacteria in the young and adult rats, respectively. This delay with age was closely related to the increase of free sialic acid in the plasma. The sites invaded by E. rhusiopathiae coincided with the desialated lesions, and the bacteria invaded the periarterial region which was always accompanied by desialation when examined with FITC-conjugated peanut lectin. The free sialic acid in the plasma was, at least partly, considered to originate from the desialation of the arterial wall caused by E. rhusiopathiae. The platelet number decreased significantly after inoculation. The sialic acid content of the platelets prepared from circulating blood at 12 and 18 hours after inoculation showed a slight decrease and decreased further when the platelets were incubated with the bacteria. Platelets obtained from circulating blood within 24 hours after inoculation or incubated with the bacteria had demonstrated desialated sites as detected by immunofluorescent staining with FITC-conjugated peanut lectin. In conclusion, free sialic acid in the plasma was considered to be a good marker of the desialation of the arteries caused by E. rhusiopathiae, and the neuraminidase produced by the bacteria would be a key to solve the pathogenesis of the arteritis and thrombocytopenia.

Adhesion of Erysipelothrix rhusiopathiae to cultured rat aortic endothelial cells. Role of bacterial neuraminidase in the induction of arteritis.

The adhesion of Erysipelothrix rhusiopathiae (E. rhusiopathiae) to the cultured confluent monolayer of rat aortic endothelial cells (EC) and the role of neuraminidase in the interaction between EC and E. rhusiopathiae were examined. One EC line was obtained by collagenase treatment of rat aorta. The EC showed a typical cobblestone appearance and possessed the factor VIII related antigen. When cultured more than two weeks after reaching confluence, the EC formed a vascular plexus-like appearance. E. rhusiopathiae began to adhere to EC within 2 minutes after the beginning of culture and adhered at a constant rate for 20 minutes. The adhesion of bacteria to EC was closely related to the release of sialic acid from the EC. Significantly more bacteria adhered to neuraminidase treated EC, and bacterial adhesion was inhibited dose-dependently by N-acetylneuraminic-lactose, which is the substrate of bacterial neuraminidase. It is concluded that bacterial neuraminidase plays an essential role in initiating the interaction between EC and E. rhusiopathiae, which would contribute to the genesis of arteritis.

Erysipelothrix endocarditis with previous cutaneous lesion: report of a case and review of the literature.

This report describes the first documented case of Erysipelothrix rhusiopathiae endocarditis in Latin America. The patient was a 51-years-old male, moderate alcoholic, with a previous history of aortic failure. He was used to fishing and cooking as a hobby and had his left hand wounded by a fish-bone. The disease began with erysipeloid form and developed to septicemia and endocarditis. He was treated with antibiotics and surgery for aortic valve replacement. There are only 46 cases of E. rhusiopathiae endocarditis reported to date. The authors wonder if several other cases might go unreported for lack of microbiological laboratorial diagnosis.

Endocarditis caused by Erysipelothrix rhusiopathiae in a dog.

Bacterial endocarditis was diagnosed in a 4-year-old male German shorthaired Pointer with a 4-month history of shifting lameness and intermittent fever. The dog died in spite of treatment for progressive depression and dehydration. Blood cultures were positive for Erysipelothrix rhusiopathiae strain 7, which is known to be pathogenic for dogs. The clinical diagnosis was confirmed at necropsy.20

[Infective endocarditis with perivalvular abscess in a patient with Erysipelothrix rhusiopathiae bacteremia]. / Endocarditis infecciosa con absceso perivalvular en un paciente con bacteriemia por Erysipelothrix rhusiopathiae.

The bacterial species Erysipelothrix rhusiopathiae is found worldwide as a commensal or a pathogen in a variety of animals. One well-defined pattern of human infection is an uncommon bacteremic form, with or without cutaneous involvement, usually complicated by endocarditis. We report the case of a 38-year-old male butcher with E. rhusiopathiae bacteremia, native aortic valve endocarditis and perivalvular abscess. The patient was released after six weeks of intravenous ceftriaxone and aortic valve replacement because of severe regurgitation.

Erysipelothrix rhusiopathiae intra-abdominal abscess.

Erysipelothrix rhusiopathiae is a Gram-positive bacillus that is infrequently responsible for infections in humans. Most human cases present as localized or generalized cutaneous infections. An invasive septic form, usually associated with endocarditis, has rarely been described. We report here an invasive infection caused by E. rhusiopathiae without endocardium involvement. To our knowledge, this is the first report of an intra-abdominal abscess due to this pathogen.