Streptococcus equi subsp. zooepidemicus and ‘Neighbourhood syndrome’ –extra-orbitocranial rhinosinusitis with reversible sudden loss of vision- a case report

Abstract

Background Rhinosinusitis is a common condition which may present with complications commonly involving the orbit and the intracranial space. Loss of vision in the absence of clinical or radiological signs of involvement of the orbit and intracranium is rare and carries a high morbidity rate. Streptococcus equi subspecies zooepidemicus is not a well-documented cause of paranasal sinus infection. Case presentation We present a case of a 16 year old female patient who had unilateral loss of vision with signs of retrobulbar optic neuritis and no other neurological signs. We isolated an unusual organism- Streptococcus equi subspecies zooepidemicus from the maxillary sinus. Emergency endoscopic sinus surgery and antibiotic treatment resulted in complete reversal of the loss of vision. Conclusion The presence of paranasal sinus disease in association with loss of vision even in the absence of a clear link between the two should be treated as an emergency with surgical drainage and or appropriate antibiotic therapy. In patients presenting with suspected inflammatory orbital involvement, imaging of the orbit and paranasal sinuses should be considered early.

Pathogenicity and drug resistance of animal streptococci responsible for human infections

“…The infection occurs by eating unpasteurized dairy products, cheese, pork meat or direct contact with horses. The clinical forms described thus far include meningitis, septic arthritis, endocarditis, glomerulonephritis, streptococcal toxic shock syndrome, pneumonia, pharyngitis, lymphadenitis, osteomyelitis, rheumatic fever, and skin and soft tissue infections [68,84,90,91]. Table 6 presents details of selected cases of SEZ infections in humans.…”

Diagnosis, Surveillance and Management of Streptococcus equi subspecies zooepidemicus Infections in Chinchillas (Chinchilla lanigera)

“…35 In humans, severe infections causing glomerulonephritis, endocarditis, pneumonia, pericarditis, septic arthritis, osteomyelitis, meningitis, and death have been reported. 1,13,18,31,35 Case Study Clinical case 1. A 5-mo old, 415 g intact female chinchilla (Chinchilla lanigera) was received at our institution on June 29, 2017 for use in an acoustic and physiologic measurement research project.…”