A Case of Meningitis Due to "Streptococcus zooepidemicus"

Latorre, Miguel; Álvarez, M. Villar; Fernández, José Manuel; Berdonces, Pilar; Llanos, Adelina; Cisterna, R

doi:10.1093/clinids/17.5.932

Cited by 13 publications

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“…Human disease caused by S. zooepidemicus has been reported to result in serious infections, including meningitis, pneumonia, septic arthritis, endocarditis and epidemic outbreaks of PSGN [3][4][5][6][7][8][9]. In epidemics of PSGN due to S. equi, the vehicle of transmission has been identified as infected milk and cheese.…”

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confidence: 99%

Post streptococcal acute glomerulonephritis secondary to sporadic Streptococcus equi infection

et al. 2007

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Streptococcus equi subspecies zooepidemicus infection is rare in humans, but a well-known cause of pyogenic disease in cows and horses. S. zooepidemicus uncommonly causes post-strep glomerulonephritis (PSGN) in humans via epidemic outbreaks. We present a sporadic case of post S. zooepidemicus glomerulonephritis in a child most probably contracted from a horse. The 14-year-old girl presented with the typical signs of PSGN, with S. equi zooepidemicus isolated from a blood culture, together with a low C3 and raised anti-DNAse B. This is the first known report of a sporadic case of PSGN in a child caused by this organism.

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Post streptococcal acute glomerulonephritis secondary to sporadic Streptococcus equi infection

et al. 2007

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“…Meningitis caused by group C streptococci is very rare, with approximately 50 previously reported cases in the world literature [1–17]. Published reports of group C streptococcal meningitis in any language were identified by performing an extensive Medline electronic database search, in addition to a detailed analysis of the individual reference lists of each retrieved article.…”

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“…Treatment of patients with group C streptococcal meningitis has been problematic. The mortality rate of reported cases has been approximately 50% [1–17]. Furthermore, patients who recover from such infections may be left with residual neurologic impairment, despite rapid institution of appropriate antimicrobial therapy [2,8,16], although there have been reports of cure without neurologic sequelae [14,15,17].…”

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“…Isolates of S. equi subsp. equi and other group C streptococci are uniformly sensitive to penicillin G [1–18]. However, strains tolerant to the bactericidal action of penicillin G have been described, and some authors advocate that, for serious group C streptococcal infections, treatment should consist of penicillin G plus an aminoglycoside based on in vitro synergy data [1,2,18].…”

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Streptococcus equi subspecies equi (Lancefield group C) meningitis in a child

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Massey

et al. 2003

Clinical Microbiology and Infection

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“…zooepidemicus causes disease in several animal species and is a frequently isolated pathogen in horses, where it exists as normal flora (10). This organism has been known to cause a variety of serious infections in humans, including meningitis (13), pneumonia (20), septic arthritis (5), endocarditis (15), and poststreptococcal acute glomerulonephritis (PSGN) (1,2,4,7). Transmission to humans has been associated with equine contact (14,20) or dairy product consumption (2,4,7).…”

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Analysis of Immunoreactivity to aStreptococcus equisubsp.zooepidemicusM-Like Protein To Confirm an Outbreak of Poststreptococcal Glomerulonephritis, and Sequences of M-Like Proteins from Isolates Obtained from Different Host Species

et al. 2000

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The etiologic agent of a large 1998 outbreak of poststreptococcal acute glomerulonephritis (PSGN) in Nova Serrana, Brazil, was found likely to be a specific strain of Streptococcus equi subsp.zooepidemicus from contaminated cheese (S. Balter et al., Lancet 355:1776–1780, 2000). In the present study, we used a serologic screen for a known surface-exposed virulence factor to confirm the epidemiologic findings. Using primers flanking a previously characterized M-like protein gene (J. F. Timoney et al., Infect. Immun. 63:1440–1445, 1995), we amplified and sequenced the M-like protein (designated Szp5058) gene and found it to be identical among four independent acute-phase PSGN patient isolates. Convalescent-phase sera from 33 of 44 patients in the PSGN outbreak were found to contain antibodies highly reactive to a purified Szp5058 fusion protein, compared with 1 of 17 control sera (P < 0.0001), suggesting that Szp5058 was expressed during infection and further implicating this strain as the cause of the PSGN outbreak. The predicted signal sequence and cell wall association motif of Szp5058 were highly conserved with the corresponding sequence from S. equi subsp. zooepidemicus SzpW60, while the predicted surface-exposed portions differed markedly between these two proteins. The 5′ end of the szp5058 gene, including its variable region, was identical to the szp gene from another strain associated with a previous PSGN outbreak in England (M. Barham et al., Lancet i:945–948, 1983), and the corresponding szpsequence found from the Lancefield group C type strain isolated from a guinea pig. In addition, the hypervariable (HV) portion ofszp5058 was identical to a previously published HV sequence from a horse isolate (J. A. Walker and J. F. Timoney, Am. J. Vet. Res. 59:1129–1133, 1998). Three other strains ofS. equi subsp. zooepidemicus, including another strain previously associated with a PSGN outbreak, were each found to contain a distinct szp gene. Two of these szpgenes had HV regions identical to szp regions from isolates recovered from different host species.

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A Case of Meningitis Due to "Streptococcus zooepidemicus"

Cited by 13 publications

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Post streptococcal acute glomerulonephritis secondary to sporadic Streptococcus equi infection

Post streptococcal acute glomerulonephritis secondary to sporadic Streptococcus equi infection

Streptococcus equi subspecies equi (Lancefield group C) meningitis in a child

Analysis of Immunoreactivity to aStreptococcus equisubsp.zooepidemicusM-Like Protein To Confirm an Outbreak of Poststreptococcal Glomerulonephritis, and Sequences of M-Like Proteins from Isolates Obtained from Different Host Species

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