1. Sepsis, Endocarditis, and Purulent Arthritis due to a Rare Zoonotic Infection with Streptococcus equi Subspecies zooepidemicus
- Author
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Anne Kirstine Høyer-Nielsen, Rudi Kollslíð, Shahin Gaini, Anne Kjerulf, Jan Jóanesarson, Torkil á Steig, and Marc Stegger
- Subjects
0301 basic medicine ,Aortic valve ,medicine.medical_specialty ,medicine.drug_class ,animal diseases ,030106 microbiology ,Antibiotics ,Case Report ,lcsh:Infectious and parasitic diseases ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,Synovitis ,medicine ,Endocarditis ,Synovial fluid ,lcsh:RC109-216 ,030212 general & internal medicine ,Zoonotic Infection ,business.industry ,General Medicine ,medicine.disease ,bacterial infections and mycoses ,Surgery ,medicine.anatomical_structure ,Osteitis ,business - Abstract
Streptococcus equi subspecies zooepidemicus (S. zooepidemicus) is mostly known as an opportunistic pathogen found in horses and as a rare human zoonosis. An 82-year-old male, who had daily contact with horses, was admitted in a septic condition. The patient presented with dyspnea, hemoptysis, impaired general condition, and severe pain in a swollen left shoulder. Synovial fluid from the affected joint and blood cultures showed growth of S. equi subsp. zooepidemicus. Transesophageal echocardiography showed a vegetation on the aortic valve consistent with endocarditis. Arthroscopic revision revealed synovitis and erosion of the rotator cuff. Technetium-99m scintigraphy showed intense increased activity in the left shoulder, suspicious of osteitis. The infection was treated with intravenous antibiotics over a period of five weeks, followed by oral antibiotics for another two months. The patient recovered without permanent sequelae.
- Published
- 2018
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