Erysipelothrix Rhusiopathiae Septicemia: Diagnosis and Treatment

Klauder, Joseph V.

doi:10.1001/jama.1943.02840310030008

Cited by 37 publications

(9 citation statements)

References 13 publications

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“…Erysipeloid and cutaneous anthrax in meat handlers may be acquired in various ways including bone-inflicted injury (Hunter, 1978;Barber, 1948;Klauder, Kramer & Nicholas, 1943;Brachman, 1977). In a large outbreak of erysipeloid in a factory producing buttons from bone there was a very high attack rate amongst injured workers sawing and cutting bones; conjunctivitis and respiratory infection associated with bone dust was also seen (McGinnes & Spindle, 1934).…”

Section: Discussionmentioning

confidence: 99%

Skin sepsis in meat handlers: observations on the causes of injury with special reference to bone

Barnham

Kerby

1981

J. Hyg.

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Outbreaks of wound infection with Streptococcus pyogenes and Staphylococcus aureus occurred in a abattoir and a pork-processing factory in Autumn 1980. Investigations showed that staff handling the meat before de-boning were particularly affected and that bone was the cause of 48% of the wounds which became clinicially infected. Of the total isolates of Strep. pyogenes and Staph. aureus from wounds of known cause 75% were from lesions caused by bone. In one outbreak streptococcal infection was seen principally in newly-employed staff. Group L streptococci were found in several sites in the pork factory and were isolated from infected lesions in two workers. Strep. pyogenes and Staph. aureus were cultured from tap handles in the lavatories. Sixty-six workers were examined in a non-epidemic period and 59% were found to have current wounds on the hand or wrists; 13% of wounds were infected but Strep. pyogenes was not isolated. Bone was the commonest of the many causes of injury, accounting for 31% of all wounds. Butchers had the highest rates of wounding and most bone-inflicted injury was seen in this group. Packers were the only group to wear protective gloves regularly. Damaged fingernails were found in 50% of workers, including a high proportion of nail-biters (33% of all workers). The epidemic strain of Staph. aureus was cultured from bitten fingernails. Three of four infected workers carrying epidemic organisms in the throat were examined and all were nail-biters. Sharp-edged bone was produced by rotary saws early in the production line and bone dust contaminated the carcasses and adjacent surfaces. It is suggested that bone fragments could contaminate wounds and that this might have implications for the initiation of infection and the development of outbreaks.

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Section: Discussionmentioning

confidence: 99%

Skin sepsis in meat handlers: observations on the causes of injury with special reference to bone

Barnham

Kerby

1981

J. Hyg.

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“…of infarction, and the spleen became palpable. Three successive blood cultures grew Erysipelothrix rhusiopathiae, the isolates being morphologically, culturally, and biochemically indistinguishable from this organism as described in standard reference works (Wilson and Miles, 1964;Cowan and Steel, 1965) and in individual reports (Klauder et al, 1943;Procter, 1965). Sputum culture was negative.…”

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confidence: 80%

Erysipelothrix septicaemia without endocarditis.

Townshend¹,

Jephcott²,

Yekta³

1973

BMJ

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“…Septicemia and endocarditis have been reported in humans. [33][34][35][36][37] The organism may cause extensive destruction of previously normal heart valves, abscess formation, uremia, and intractable heart failure requiring emergency valve replacement. 37 This organism is a rare cause of apparently culture-negative endocarditis.…”

Section: P Resentation Of C Asementioning

confidence: 99%

Case 11-1995

Abraham¹,

Hansen²

1995

N Engl J Med

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A 39-year-old man was admitted to the hospital because of calcifications around the aortic root, a recent myocardial infarction, and subsequent congestive heart failure, with increasing aortic regurgitation.The patient had been well until six years earlier, when progressive renal insufficiency with hypertension was found. A low-protein diet and enalapril were begun. He was subsequently well until four months before admission, when chest pain developed and he entered another hospital. The urea nitrogen concentration was 143 mg per deciliter (51.1 mmol per liter), and the creatinine concentration was 9.4 mg per deciliter (830 m mol per liter). An electrocardiogram showed an acute myocardial infarct. A transthoracic cardiac ultrasonographic examination revealed a mass around the aortic root that was suspected to represent an aneurysm of the sinus of Valsalva. A transesophageal cardiac ultrasonographic examination at another hospital showed a multilobulated mass with a highly reflective surface and a sonolucent center encircling the anterior aspect of the aortic root and right coronary artery. Dense echogenic material extended onto the base of the anterior mitral leaflet. The aortic valve was tricuspid, with mild stenosis and regurgitation. The peak systolic aortic gradient by continuous-wave Doppler study was 40 mm Hg. The left ventricular size and ejection fraction were normal; the inferior segments of the left ventricle appeared slightly hypokinetic. A magnetic resonance imaging (MRI) scan of the heart also disclosed an extensive mass that involved the aortic root and the myocardial surface of the right ventricle, without obvious invasion of the ventricle. Serologic tests for brucella and coxiella microorganisms were negative. The patient was afebrile, and multiple blood-culture specimens were ster-ile. It was decided not to perform a surgical procedure. The urea nitrogen concentration declined to 88 mg per deciliter (31 mmol per liter), and the creatinine concentration to 8.8 mg per deciliter (780 m mol per liter). The patient was discharged, with arrangements made for extracorporeal hemodialysis.The patient felt well until two weeks before admission, when he began to have bouts of dyspnea, usually after dialysis. Four days before admission he was treated for congestive heart failure at another hospital. There was evidence of increasing aortic regurgitation. Episodes of intermittent atrioventricular dissociation, with a ventricular rate of 40 to 50, were observed, and on the fourth hospital day a sequential dual-chamber electronic pacemaker was implanted. The patient was transferred to this hospital.The patient was unmarried and lived alone. He was a veterinarian who treated dogs and cats predominantly. He traveled to England in the summer and frequently took cruises to the Caribbean and South America. His father had died at the age of 41 years of a ruptured intracranial mycotic aneurysm due to bacterial endocarditis on a bicuspid aortic valve. There was no family history of renal disease. The patient's medicatio...

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Erysipelothrix Rhusiopathiae Septicemia: Diagnosis and Treatment

Cited by 37 publications

References 13 publications

Skin sepsis in meat handlers: observations on the causes of injury with special reference to bone

Skin sepsis in meat handlers: observations on the causes of injury with special reference to bone

Erysipelothrix septicaemia without endocarditis.

Case 11-1995

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