A case of leg cellulitis caused by multidrug-resistant &lt;i&gt;Streptococcus pseudoporcinus &lt;/i&gt;

Sawamura, Soichiro; Niimori, Daisuke; Ihn, Hironobu

doi:10.5582/irdr.2018.01110

Cited by 10 publications

(15 citation statements)

References 12 publications

(11 reference statements)

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“…New techniques for bacterial identification in routine clinical microbiology may affect its known prevalence, revealing its true significance as a human pathogen. S. pseudoporcinus resistance to penicillin, to third-generation cephalosporins, and even to carbapenems was reported in a previous case [5], and is consistent with the antibiotic susceptibility of our isolate. To date, multidrug-resistant S. pseudoporcinus has been found to be susceptible to vancomycin, daptomycin, linezolid, levofloxacin, clindamycin, and tetracycline.…”

Section: Discussionsupporting

confidence: 93%

Fatal Streptococcus pseudoporcinus disseminated infection in decompensated liver cirrhosis: a case report

2021

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Background Streptococcus pseudoporcinus (S. pseudoporcinus) was first identified in 2006. It cross-reacts with Lancefield group B antigen agglutination reagents and has been misidentified as S. agalactiae. Sites of S. pseudoporcinus isolation include the female genitourinary tract, urine, wounds, and dairy products. The prevalence of vaginal colonization is reportedly between 1 and 5.4%. Two uneventful cases of soft tissue infection caused by S. pseudoporcinus were reported in the past. However, since late 2019, six cases of invasive S. pseudoporcinus infections have emerged in the literature, one of which was fatal. Case presentation We describe a fatal case of a Caucasian male with spontaneous bacterial peritonitis associated with bacteremia due to a multidrug-resistant S. pseudoporcinus strain in a patient with decompensated liver cirrhosis. Despite the patient’s good general condition and stable blood test results when he had visited the outpatient clinic for large-volume paracentesis a few days before admission, this time he presented to the emergency department with a rapidly worsening clinical condition and with laboratory features consistent with multiple-organ dysfunction syndrome, and succumbed within a short period. Conclusions Contrary to what was thought until recently, multidrug-resistant S. pseudoporcinus may cause invasive, disseminated, fatal disease in humans. According to current limited data, vancomycin, linezolid, daptomycin, levofloxacin, clindamycin, and tetracycline seem to be the most effective antimicrobial agents against multidrug-resistant strains, and should be the empirical choice in cases of disseminated S. pseudoporcinus infection until laboratory antimicrobial susceptibility results are available. Improvements and new approaches for bacterial identification in routine clinical microbiology laboratories may reveal the real spectrum of S. pseudoporcinus infections in humans, which is currently believed to be underestimated. SS. pseudoporcinus could emerge as a serious medical problem in the near future, similar to other β-hemolytic streptococci.

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Section: Discussionsupporting

confidence: 93%

Fatal Streptococcus pseudoporcinus disseminated infection in decompensated liver cirrhosis: a case report

2021

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“…In our case, identification was made using the VT2 GP ID ™ card which is S. pseudoporcinus isolates are usually susceptible to beta-lactams, erythromycin, clindamycin, vancomycin, and trimethoprim-sulfamethoxazole; most of them are resistant to tetracycline, as was observed in our cases [6]. However, one case report documented a multidrug-resistant S. pseudoporcinus isolate [3]. An IgG-degrading enzyme designated as IgdE was recently discovered that is highly specific for members of some of the Streptococcus species [7].…”

Section: Discussionmentioning

confidence: 71%

“…Although it was phenotypically identified as Streptococcus porcinus, sequencing data differentiated it as a novel species [1]. Only two reported human infections implicated this bacterium including a wound infection of a finger as a result of trauma and another with left lower leg cellulitis associated with stasis dermatitis [2,3]. We describe two additional cases, one causing endocarditis and a second with pneumonia and empyema.…”

Section: Introductionmentioning

confidence: 88%

Streptococcus pseudoporcinus: Case Reports and Review of the Literature

Khan

Wong

Prasad

et al. 2020

Case Reports in Infectious Diseases

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Streptococcus pseudoporcinus is a beta-hemolytic Gram-positive, catalase-negative, nonmotile coccus arranged in short chains, usually found in the female genitourinary tract and differentiated from Streptococcus porcinus in 2006. Only two human infections associated with this organism have been reported to date: one in a patient with a first digit wound infection and another with lower extremity cellulitis. We describe two novel cases of Streptococcus pseudoporcinus causing endocarditis in one and pneumonia with empyema in another, illustrating the potential of these bacteria to cause severe invasive and life-threatening disease.

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“…Previous reports have demonstrated clinical infections associated with S. pseudoporcinus [4, 7, 8], but to our knowledge there have been no reports of this organism in association with severe obstetric morbidity. One recent report describes a patient with a vaginorectal culture at 39 weeks that grew a beta-hemolytic organism that was identified as S. pseudoporcinus , however there were no associated adverse maternal or neonatal outcomes in that pregnancy [9].…”

Section: Discussionmentioning

confidence: 87%

A Case of Maternal Sepsis and Fetal Demise Associated with Streptococcus pseudoporcinus

Pierce

Shibib

Robison³

et al. 2019

Case Reports in Obstetrics and Gynecology

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Streptococcus pseudoporcinus has recently been described in relation to its colonization of the female genitourinary tract. Since prior reports have linked S. pseudoporcinus only with minor morbidities, the organism previously has not been considered to be a cause of serious puerperal infections. A 41-year-old gravida 2, para 1-0-0-1 presented with abdominal pain and intrauterine fetal demise. A beta hemolytic Streptococcus was isolated from her placenta, endometrium, urine, and two blood culture sets. The isolate was a Streptococcus pseudoporcinus, which colonizes the female genital tract and can resemble Streptococcus agalactiae. This case demonstrates that S. pseudoporcinus is a potential cause of severe maternal and fetal morbidity and mortality.

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A case of leg cellulitis caused by multidrug-resistant <i>Streptococcus pseudoporcinus </i>

Cited by 10 publications

References 12 publications

Fatal Streptococcus pseudoporcinus disseminated infection in decompensated liver cirrhosis: a case report

Fatal Streptococcus pseudoporcinus disseminated infection in decompensated liver cirrhosis: a case report

Streptococcus pseudoporcinus: Case Reports and Review of the Literature

A Case of Maternal Sepsis and Fetal Demise Associated with Streptococcus pseudoporcinus

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