NonspecificErysipelothrix rhusiopathiaeBacteremia in a Patient with Subclinical Alcoholic Liver Disease

Abstract

Erysipelothrix rhusiopathiae, a pleomorphic gram-positive bacillus, is found widely in nature or as a commensal pathogen. It infects domestic animals such as swine, which may be the major reservoir of the organism. E. rhusiopathiae is primarily an occupational illness; 89% of the cases are linked to high-risk epidemiological situations. Humans that are infected by this bacillus typically present with one or a combination of the following symptoms: localized skin lesion (erysipeloid), diffuse cutaneous eruptions with systemic symptoms, or bacteremia, which is often followed by endocarditis. We report a case of E. rhusiopathiae bacteremia that was present without severe clinical illness such as endocarditis, arthritis, or skin lesions. The patient was a 64-year-old male with a complicated past medical history including subclinical alcoholic liver disease. Penicillin-G therapy completely resolved the patients bacteremia. The case presented has exceptional clinical merit due to 2 key factors: the patient does not fit the occupational demographic typically affected by this bacterium, and the patient presented with subclinical septicemia, which has a high correlation with fatal endocarditis. This case brings a new prospective to E. rhusiopathiae bacteremia.

Shock caused by multidrug-resistant Erysipelothrix rhusiopathiae bacteremia: a rare case report and literature review

“…The excretion of organisms by infected and colonized animals is considered to result in contamination of the environment and subsequent acquisition of the bacteria by humans [2]. Veterinary surgeons and people engaged in animal breeding, animal slaughtering, and seafood handling are at particular risk of being infected [4].…”

“…Infection in humans occurs mainly due to occupational exposure to animals or other organic matter including swine, chickens, dogs, sheep, horse, cattle, and fish [1]. The infected patients typically present with one or a combination of the following symptoms: localized skin lesion (erysipeloid), diffuse cutaneous eruptions with systemic symptoms, or bacteremia [2]. However, less than 1% of cases with E. rhusiopathiae infection can progress to bacteremia with life-threatening risk [3].…”

Erysipelothrix rhusiopathiae bloodstream infection – A 22‐year experience at Mayo Clinic, Minnesota

“…Erysipelothrix rhusiopathiae is a non‐motile, non‐spore‐forming, facultatively anaerobic Gram‐positive bacillus found worldwide in animals and fish (Romney, Cheung, & Montessori, ). The major reservoir is swine, but it is also found in fish, sheep, horse, cattle, chicken, crabs, dogs and cats (Kichloo, Hallac, Mousavi, & Hirekhan, ). Transmission to humans occurs via direct cutaneous contact through cuts or abrasions in the skin (Vallianatos, Tilentzoglou, & Koutsoukou, ).…”

“…Transmission to humans occurs via direct cutaneous contact through cuts or abrasions in the skin (Vallianatos, Tilentzoglou, & Koutsoukou, ). Human infection is associated with occupational exposure, such as butchers, abattoir workers and fish handlers (Kichloo et al., ; Romney et al., ). Other risk factors include immunocompromising conditions such as chronic kidney and liver disease, diabetes mellitus, chronic lymphocytic leukaemia, systemic lupus erythematosus and rheumatoid arthritis (Kichloo et al., ; Mukhopadhyay, Shah, Vandana, Munim, & Vijayan, ).…”

“…Human infection is associated with occupational exposure, such as butchers, abattoir workers and fish handlers (Kichloo et al., ; Romney et al., ). Other risk factors include immunocompromising conditions such as chronic kidney and liver disease, diabetes mellitus, chronic lymphocytic leukaemia, systemic lupus erythematosus and rheumatoid arthritis (Kichloo et al., ; Mukhopadhyay, Shah, Vandana, Munim, & Vijayan, ). Although the cutaneous form (erysipeloid) of E. rhusiopathiae infection is common (Ruiz, Richards, Kerr, & Kan, ), invasive infection is rare, with approximately 60 published cases as of 2001 (Romney et al., ).…”