RESUMO
The microbiology of infective endocarditis (IE) varies in different populations and depends on public health conditions and socioeconomic status. In low-income countries, oral Streptococci affect hearts with rheumatic valve disease in patients with poor dentition. In high-income countries, Staphylococci are the most common cause, affecting elderly and immunocompromised patients, or those with invasive devices. Gram - positive bacili as IE pathogens are unusual. Erysipelothrix rhusiopathiae is a Gram positive bacili. It causes skin diseases in domestic and farm animals, but in humans, is a very unusual pathogen. This infection is considered a zoonosis, since most cases are linked to direct contact with vector animals. We report a 62 year-old male patient with a history of exposure to animals, who developed an infective endocarditis with severe bivalve regurgitation and septic shock, requiring antimicrobials and surgical resolution. Erysipelothrix rhusiopathiae was isolated from blood and valve vegetation cultures. The patient had a successful evolution and was discharged from the hospital.
Assuntos
Humanos , Animais , Masculino , Pessoa de Meia-Idade , Idoso , Endocardite , Endocardite Bacteriana/microbiologia , Erysipelothrix , Infecções por Erysipelothrix/diagnóstico , Infecções por Erysipelothrix/microbiologia , ZoonosesRESUMO
The microbiology of infective endocarditis (IE) varies in different populations and depends on public health conditions and socioeconomic status. In low-income countries, oral Streptococci affect hearts with rheumatic valve disease in patients with poor dentition. In high-income countries, Staphylococci are the most common cause, affecting elderly and immunocompromised patients, or those with invasive devices. Gram - positive bacili as IE pathogens are unusual. Erysipelothrix rhusiopathiae is a Gram positive bacili. It causes skin diseases in domestic and farm animals, but in humans, is a very unusual pathogen. This infection is considered a zoonosis, since most cases are linked to direct contact with vector animals. We report a 62 year-old male patient with a history of exposure to animals, who developed an infective endocarditis with severe bivalve regurgitation and septic shock, requiring antimicrobials and surgical resolution. Erysipelothrix rhusiopathiae was isolated from blood and valve vegetation cultures. The patient had a successful evolution and was discharged from the hospital.
Assuntos
Endocardite Bacteriana , Endocardite , Infecções por Erysipelothrix , Erysipelothrix , Masculino , Animais , Humanos , Idoso , Pessoa de Meia-Idade , Infecções por Erysipelothrix/diagnóstico , Infecções por Erysipelothrix/microbiologia , Endocardite Bacteriana/microbiologia , ZoonosesRESUMO
We report here an atypical case of acute sacroiliitis caused by Erysipelothrix rhusiopathiae revealing tricuspid endocarditis in a 53-year-old woman without medical history. She was admitted to Cayenne hospital because of intense right hip and thigh pain, associated with fever. A right sacroiliitis was visible on the computed tomography (CT) scan, confirmed on MRI. Transesophageal echocardiography revealed a large mobile tricuspid vegetation. Blood cultures were positive for E. rhusiopathiae. CT scan showed pulmonary alveolar opacities, consistent with septic emboli. Clinical improvement was obtained under ceftriaxone followed by ciprofloxacin for 6 weeks of treatment. We present a review of bone and joint infections caused by E. rhusiopathiae. So far, not a single case has been reported in Latin America.
Assuntos
Endocardite , Infecções por Erysipelothrix , Erysipelothrix , Sacroileíte , Animais , Feminino , Humanos , Pessoa de Meia-Idade , Infecções por Erysipelothrix/diagnóstico , Ceftriaxona/uso terapêutico , Sacroileíte/complicações , Endocardite/complicações , Ciprofloxacina/uso terapêuticoRESUMO
Erysipelothrix sp. isolates obtained from a deadly outbreak in farmed turkeys were sequenced and compared to representatives of the genus. Phylogenetic trees-supported by digital DNA:DNA hybridization and Average Nucleotide Identity-revealed a novel monophyletic clade comprising isolates from pigs, turkeys, and fish, including isolates previously described as E. sp. Strain 2. Genes coding for the SpaC protein, typically found in E. sp. Strain 2, were detected in all isolates of the clade. Therefore, we confirm E. sp. Strain 2 represents a unique species that may be isolated from a broad host range, and the name "Erysipelothrix takahashiae" is suggested. Core genome analysis showed that the pathogenic species of this genus, E. rhusiopathiae and the clade E. sp. Strain 2, are enriched in core functionalities related to nutrient uptake and transport, but not necessarily homologous pathways. For instance, whereas the aerobic DctA transporter may uptake C4-dicarboxylates in both species, the anaerobic DcuC transporter is exclusive of the E. sp. Strain 2. Remarkably, the pan-genome analysis uncovered that genes related to transport and metabolism, recombination and repair, translation and transcription in the fish isolate, within the novel clade, have undergone a genomic reduction through pseudogenization. This reflects distinct selective pressures shaping the genome of species and strains within the genus Erysipelothrix while adapting to their respective niches.
Assuntos
DNA Bacteriano/genética , Erysipelothrix/genética , Genoma Bacteriano , Filogenia , Análise de Sequência de DNA , Animais , Erysipelothrix/classificação , Erysipelothrix/isolamento & purificação , Infecções por Erysipelothrix/epidemiologia , Infecções por Erysipelothrix/genética , Genômica , Doenças das Aves Domésticas/epidemiologia , Doenças das Aves Domésticas/genética , TurquiaRESUMO
RESUMEN Erysipelothrix rhusiopathiae es un bacilo grampositivo, inmóvil, no esporulado, considerado una zoonosis, para la cual el hombre es un hospedero accidental. Esta bacteria es reconocida como agente causal de endocarditis infecciosa; la identificación inmediata de este microorganismo es vital, debido a su naturaleza fulminante. Se presentó el caso de un paciente masculino de 60 años de edad, alcohólico crónico y dedicado a la cría de cerdos, con un cuadro de: fiebre, disnea a grandes esfuerzos, petequias en miembros inferiores y edemas perimaleolares. El ecocardiograma reveló la presencia de vegetaciones en la válvula tricúspidea, lo que generaba insuficiencia tricúspidea grave. En los hemocultivos se aisló Erysipelothrix rhusiopathiae. Se realizó el tratamiento con penicilina y se constató una mejoría clínica evidente del paciente. Desafortunadamente, este falleció por una parada cardíaca en el segundo día del recambio valvular.
ABSTRACT Erysipelothrix rhusiopathiae is a gram-positive, immobile, non-sporulated bacillus, considered a zoonosis, for which man is an accidental host. This bacterium is recognized as a causal agent of infectious endocarditis; immediate identification of this microorganism is vital, due to its fulminant nature. We present a 60-year-old male patient, chronic alcoholic and pig breeder, with a history of fever, dyspnea on great exertion, petechiae in the lower limbs and perimalleolar edema. The echocardiogram revealed the presence of tricuspid valve vegetations, which generated severe tricuspid regurgitation. Erysipelothrix rhusiopathiae was isolated from blood cultures. Treatment with penicillin was carried out and an evident clinical improvement of the patient was verified. Unfortunately, he died of a cardiac arrest on the second day after valve replacement.
Assuntos
Zoonoses , Endocardite Bacteriana , Infecções por ErysipelothrixRESUMO
Na suinocultura perdas econômicas ainda são elevadas devido aos baixos padrões de qualidade e sanidade dos animais. Dentre as afecções que afetam a produção, a erisipela é uma doença considerada importante em função dos prejuízos econômicos que causa, e pela questão de saúde pública visto ser uma zoonose. Ela é uma enfermidade do tipo hemorrágica comumente causada pela bactéria ubíqua Erysipelotrix rhusiopathiae. O objetivo deste trabalho foi relatar um caso desta afecção em uma matriz da raça Large White, de dois anos de idade, recém desmamada, não vacinada, de uma pequena granja de ciclo completo no munícipio de Cachoeiras de Macacu, estado do Rio de Janeiro. Ela amanheceu prostrada, com dificuldade de locomoção, sem febre e com manchas avermelhadas sobre toda a superfície corporal. As lesões cutâneas, ligeiramente elevadas, apresentavam um formato losangular (diamante) característico e sugestivo de Erisipela. Após a identificação do problema, o animal foi isolado e tratado. O tratamento iniciou-se na manhã do mesmo dia, observando-se a regressão da maioria das lesões à tarde e na manhã seguinte. A suspeita clínica foi confirmada através do diagnóstico terapêutico, sendo a associação de penicilina e estreptomicina eficiente no tratamento.
In swine industry, economic losses are still high due to low standards of quality and health of animals. Among the diseases that affect production, erysipelas is a disease considered important due to the economic losses it causes, and because of the public health issue as it is a zoonosis. It is a hemorrhagic type disease commonly caused by the ubiquitous bacteria Erysipelotrix rhusiopathiae. The aim of this study was to report a case of this condition in a Large White breed sow, two years old, recently weaned, not vaccinated, from a small pig farm (farrow to finish operation) in the municipality of Cachoeiras de Macacu, state of Rio de Janeiro. The sow was prostrate and with limited mobility, without fever and with reddish spots on the entire body surface. The cutaneous lesions were elevated, with a characteristic diamond shape suggestive of erysipelas. After identifying the problem, the animal was isolated and treated. The treatment started in the morning of the same day, observing the regression of most lesions in the afternoon and the following morning. The clinical diagnosis was confirmed through therapeutic diagnosis, and the association of penicillin and streptomycin was efficient in the treatment.
Assuntos
Animais , Erysipelothrix/classificação , Infecções por Erysipelothrix/diagnóstico , Suínos/microbiologia , ZoonosesRESUMO
Na suinocultura perdas econômicas ainda são elevadas devido aos baixos padrões de qualidade e sanidade dos animais. Dentre as afecções que afetam a produção, a erisipela é uma doença considerada importante em função dos prejuízos econômicos que causa, e pela questão de saúde pública visto ser uma zoonose. Ela é uma enfermidade do tipo hemorrágica comumente causada pela bactéria ubíqua Erysipelotrix rhusiopathiae. O objetivo deste trabalho foi relatar um caso desta afecção em uma matriz da raça Large White, de dois anos de idade, recém desmamada, não vacinada, de uma pequena granja de ciclo completo no munícipio de Cachoeiras de Macacu, estado do Rio de Janeiro. Ela amanheceu prostrada, com dificuldade de locomoção, sem febre e com manchas avermelhadas sobre toda a superfície corporal. As lesões cutâneas, ligeiramente elevadas, apresentavam um formato losangular (diamante) característico e sugestivo de Erisipela. Após a identificação do problema, o animal foi isolado e tratado. O tratamento iniciou-se na manhã do mesmo dia, observando-se a regressão da maioria das lesões à tarde e na manhã seguinte. A suspeita clínica foi confirmada através do diagnóstico terapêutico, sendo a associação de penicilina e estreptomicina eficiente no tratamento.
In swine industry, economic losses are still high due to low standards of quality and health of animals. Among the diseases that affect production, erysipelas is a disease considered important due to the economic losses it causes, and because of the public health issue as it is a zoonosis. It is a hemorrhagic type disease commonly caused by the ubiquitous bacteria Erysipelotrix rhusiopathiae. The aim of this study was to report a case of this condition in a Large White breed sow, two years old, recently weaned, not vaccinated, from a small pig farm (farrow to finish operation) in the municipality of Cachoeiras de Macacu, state of Rio de Janeiro. The sow was prostrate and with limited mobility, without fever and with reddish spots on the entire body surface. The cutaneous lesions were elevated, with a characteristic diamond shape suggestive of erysipelas. After identifying the problem, the animal was isolated and treated. The treatment started in the morning of the same day, observing the regression of most lesions in the afternoon and the following morning. The clinical diagnosis was confirmed through therapeutic diagnosis, and the association of penicillin and streptomycin was efficient in the treatment.
Assuntos
Animais , Suínos/microbiologia , Erisipela Suína/diagnóstico , Artrite Infecciosa/veterinária , Erysipelothrix/patogenicidade , Infecções por Erysipelothrix/terapia , Economia Rural , Zoonoses Bacterianas/prevenção & controle , Hemorragia/veterináriaRESUMO
Na suinocultura perdas econômicas ainda são elevadas devido aos baixos padrões de qualidade e sanidade dos animais. Dentre as afecções que afetam a produção, a erisipela é uma doença considerada importante em função dos prejuízos econômicos que causa, e pela questão de saúde pública visto ser uma zoonose. Ela é uma enfermidade do tipo hemorrágica comumente causada pela bactéria ubíqua Erysipelotrix rhusiopathiae. O objetivo deste trabalho foi relatar um caso desta afecção em uma matriz da raça Large White, de dois anos de idade, recém desmamada, não vacinada, de uma pequena granja de ciclo completo no munícipio de Cachoeiras de Macacu, estado do Rio de Janeiro. Ela amanheceu prostrada, com dificuldade de locomoção, sem febre e com manchas avermelhadas sobre toda a superfície corporal. As lesões cutâneas, ligeiramente elevadas, apresentavam um formato losangular (diamante) característico e sugestivo de Erisipela. Após a identificação do problema, o animal foi isolado e tratado. O tratamento iniciou-se na manhã do mesmo dia, observando-se a regressão da maioria das lesões à tarde e na manhã seguinte. A suspeita clínica foi confirmada através do diagnóstico terapêutico, sendo a associação de penicilina e estreptomicina eficiente no tratamento.
In swine industry, economic losses are still high due to low standards of quality and health of animals. Among the diseases that affect production, erysipelas is a disease considered important due to the economic losses it causes, and because of the public health issue as it is a zoonosis. It is a hemorrhagic type disease commonly caused by the ubiquitous bacteria Erysipelotrix rhusiopathiae. The aim of this study was to report a case of this condition in a Large White breed sow, two years old, recently weaned, not vaccinated, from a small pig farm (farrow to finish operation) in the municipality of Cachoeiras de Macacu, state of Rio de Janeiro. The sow was prostrate and with limited mobility, without fever and with reddish spots on the entire body surface. The cutaneous lesions were elevated, with a characteristic diamond shape suggestive of erysipelas. After identifying the problem, the animal was isolated and treated. The treatment started in the morning of the same day, observing the regression of most lesions in the afternoon and the following morning. The clinical diagnosis was confirmed through therapeutic diagnosis, and the association of penicillin and streptomycin was efficient in the treatment.(AU)
Assuntos
Animais , Suínos/microbiologia , Erysipelothrix/classificação , Infecções por Erysipelothrix/diagnóstico , ZoonosesRESUMO
Southern right whales Eubalaena australis from Peninsula Valdés, Argentina, show wounds produced by kelp gulls Larus dominicanus that feed on the whales' dorsal skin and blubber. During the 2013 whale season, several calves were reported showing kelp gull injuries with a swollen area surrounded by rhomboid-shaped raised edges. Samples from 9 calves were taken in order to establish the etiology of these rhomboid-shaped wounds; 2 calves (one living, one dead) showed gull-inflicted injuries with rhomboid-shaped edges. Samples from the dead calf were histologically characterized by the presence of dermal congestion, suppurative dermatitis and panniculitis, necrotizing vasculitis and vascular thrombosis. Erysipelothrix rhusiopathiae was detected by culture and PCR in samples from both calves. In this study we report, for the first time to our knowledge, the isolation of E. rhusiopathiae from wounds produced by gull attacks on southern right whale calves, supplying evidence that these wounds may act as an entry route for pathogens. This work provides new information about the consequences of gull-inflicted injuries for whale health.
Assuntos
Charadriiformes , Infecções por Erysipelothrix/microbiologia , Erysipelothrix/isolamento & purificação , Baleias , Infecção dos Ferimentos/veterinária , Ferimentos e Lesões/veterinária , Animais , Infecção dos Ferimentos/microbiologia , Ferimentos e Lesões/etiologiaRESUMO
Erysipelothrix rhusiopathie is an immobile, not sporulated, gram positive bacillus. Man is an accidental host. Infection is acquired through wounds on contact with sick animals or carriers, their products or objects contaminated with their waste. We report a 40 years old tannery male worker, presenting in the emergency room with fever lasting one month. An echocardiogram showed a vegetation and perforation of the aortic valve with severe aortic regurgitation. Blood cultures gave growth to E. rhusiopathiae. The patient was treated with penicillin. After three weeks of treatment an aortic valve replacement with a mechanical valve was performed. At six weeks, he was discharged from the hospital.
Assuntos
Adulto , Humanos , Masculino , Endocardite Bacteriana/microbiologia , Infecções por Erysipelothrix/diagnóstico , Erysipelothrix/isolamento & purificação , Endocardite Bacteriana/diagnósticoRESUMO
Erysipelothrix rhusiopathie is an immobile, not sporulated, gram positive bacillus. Man is an accidental host. Infection is acquired through wounds on contact with sick animals or carriers, their products or objects contaminated with their waste. We report a 40 years old tannery male worker, presenting in the emergency room with fever lasting one month. An echocardiogram showed a vegetation and perforation of the aortic valve with severe aortic regurgitation. Blood cultures gave growth to E. rhusiopathiae. The patient was treated with penicillin. After three weeks of treatment an aortic valve replacement with a mechanical valve was performed. At six weeks, he was discharged from the hospital.
Assuntos
Endocardite Bacteriana/microbiologia , Infecções por Erysipelothrix/diagnóstico , Erysipelothrix/isolamento & purificação , Adulto , Endocardite Bacteriana/diagnóstico , Humanos , MasculinoRESUMO
Erysipelothrix rhusiopathiae causes a variety of diseases in many animal species, including human beings. Most human infections caused by this pathogen are related to occupational exposure, and swine are considered to be the most important reservoir of E. rhusiopathiae. The white-lipped peccary (Tayassu pecari) is an ungulate that has some genetic relationship to swine, and since the demand for T. pecari meat has recently increased in Brazil and nothing is known about the relationship of this peccary with the occupational zoonotic agent, E. rhusiopathiae, an investigation on the matter was conducted. Tonsils from 21 T. pecari slaughtered in southern Brazil were examined, and one animal was positive for E. rhusiopathiae isolation. Five colonies of this positive specimen had their species identity confirmed by PCR, and were characterized by serotyping, broth microdilution susceptibility test, and pulsed field gel electrophoresis (PFGE). All colonies belonged to serotype 2b, and presented identical susceptibility profiles. Nevertheless, the five colonies showed three different PFGE profiles, demonstrating the occurrence of infection by different E. rhusiopathiae genotypes. This is the first report of E. rhusiopathiae infection in T. pecari as well as the first description of animals carrying different E. rhusiopathiae genotypes.
Assuntos
Artiodáctilos , Infecções por Erysipelothrix/microbiologia , Erysipelothrix/classificação , Erysipelothrix/isolamento & purificação , Criação de Animais Domésticos , Animais , Brasil , DNA Bacteriano/genética , Farmacorresistência Bacteriana Múltipla , Eletroforese em Gel de Campo Pulsado , Erysipelothrix/genética , Genótipo , Filogenia , Reação em Cadeia da Polimerase , SorotipagemRESUMO
One hundred fifty-one Erysipelothrix spp. isolates from Brazilian swine were characterized by serotyping, determination of antimicrobial susceptibility, amplified fragment length polymorphism (AFLP), and pulsed-field gel electrophoresis (PFGE). Among all isolates, 139 were classified in 18 different serotypes and serotype 2b was the most frequent. The susceptibility profiles of the isolates were very similar among each other, which did not permit subtyping Erysipelothrix spp. isolates by the antimicrobial susceptibility testing. Despite the fact that AFLP and PFGE provided the same discriminatory index (0.98), PFGE was more discriminatory than AFLP, given the types of groups it generates. Regardless the technique employed (AFLP or PFGE), no discrimination between recent and historical isolates was established, neither a fixed epidemiologic pattern for their grouping was observed. Nevertheless, AFLP could be an interesting alternative for discriminating the Erysipelothrix species, while PFGE could be an indication for discerning this bacterium according to the serotypes.
Assuntos
Anti-Infecciosos/farmacologia , Erysipelothrix/efeitos dos fármacos , Erysipelothrix/genética , Fenótipo , Análise do Polimorfismo de Comprimento de Fragmentos Amplificados , Animais , Brasil , DNA Bacteriano/genética , Eletroforese em Gel de Campo Pulsado , Erysipelothrix/classificação , Infecções por Erysipelothrix/microbiologia , Testes de Sensibilidade Microbiana , Filogenia , Sorotipagem , SuínosRESUMO
A fatal case of Erysipelothrix rhusiopathiae mitral valve endocarditis is described in a 45 years old male, with a history of chronic alcohol abuse and without animals contact. He presented intermittent fever, polyarthralgia, weight loss, and low back pain. In blood cultures (2 bottles), gram-positive pleomorphic rods grew after 48 hours of incubation. The subculture on blood agar media showed a small, alpha-hemolytic colony, catalase and oxidase negative, PYR and LAP positive and the production of H2S in triple sugar iron agar, was demonstrated. The isolate was initially identified as E. rhusiopathiae, and confirmed by API Coryne (BioMérieux). On the basis of these findings and a transthoracic echocardiogram, an endocarditis was confirmed. Intravenous ampicillin and gentamicin treatment was initiated. The patient became afever, nevertheless he died on day 19 after admission as a consequence of acute pulmonary edema. Susceptibility testing by E-test showed that the microorganism was resistant to vancomycin and gentamicin, and susceptible to penicillin and cefotaxime. We emphasize the importance to consider the isolates of gram-positive pleomorphic rods, catalase and oxidase negative, and the addition of H2S production test in TSI medium. Vancomycin-resistance helps in the identification, and to establish the correct antimicrobial therapy. Although E. rhusiopathiae is usually reported as an occupational pathogen, the contact with pigs and other farm animals may be underestimated.
Assuntos
Endocardite Bacteriana/microbiologia , Infecções por Erysipelothrix/microbiologia , Erysipelothrix/isolamento & purificação , Valva Mitral/microbiologia , Alcoolismo/complicações , Ampicilina/uso terapêutico , Surdez/complicações , Diabetes Mellitus Tipo 2/complicações , Farmacorresistência Bacteriana Múltipla , Quimioterapia Combinada , Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/tratamento farmacológico , Erysipelothrix/efeitos dos fármacos , Infecções por Erysipelothrix/diagnóstico , Infecções por Erysipelothrix/tratamento farmacológico , Evolução Fatal , Gentamicinas/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Edema Pulmonar/etiologia , UltrassonografiaRESUMO
The bacterial species Erysipelothrix rhusiopathiae is found worldwide as a commensal or a pathogen in a variety of animals. One well-defined pattern of human infection is an uncommon bacteremic form, with or without cutaneous involvement, usually complicated by endocarditis. We report the case of a 38-year-old male butcher with E. rhusiopathiae bacteremia, native aortic valve endocarditis and perivalvular abscess. The patient was released after six weeks of intravenous ceftriaxone and aortic valve replacement because of severe regurgitation.
Assuntos
Abscesso/microbiologia , Bacteriemia/complicações , Endocardite Bacteriana/microbiologia , Infecções por Erysipelothrix/complicações , Doenças das Valvas Cardíacas/microbiologia , Abscesso/tratamento farmacológico , Adulto , Valva Aórtica/microbiologia , Insuficiência da Valva Aórtica/microbiologia , Insuficiência da Valva Aórtica/cirurgia , Bacteriemia/tratamento farmacológico , Ceftriaxona/uso terapêutico , Cefalosporinas/uso terapêutico , Endocardite Bacteriana/tratamento farmacológico , Infecções por Erysipelothrix/tratamento farmacológico , Doenças das Valvas Cardíacas/tratamento farmacológico , Doenças das Valvas Cardíacas/cirurgia , Implante de Prótese de Valva Cardíaca , Humanos , MasculinoRESUMO
The bacterial species Erysipelothrix rhusiopathiae is found worldwide as a commensal or a pathogen in a variety of animals. One well-defined pattern of human infection is an uncommon bacteremic form, with or without cutaneous involvement, usually complicated by endocarditis. We report the case of a 38-year-old male butcher with E. rhusiopathiae bacteremia, native aortic valve endocarditis and perivalvular abscess. The patient was released after six weeks of intravenous ceftriaxone and aortic valve replacement because of severe regurgitation (AU)
Assuntos
Humanos , Masculino , Adulto , Endocardite Bacteriana/microbiologia , Abscesso/microbiologia , Doenças das Valvas Cardíacas/microbiologia , Bacteriemia/complicações , Infecções por Erysipelothrix/complicações , Endocardite Bacteriana/tratamento farmacológico , Abscesso/tratamento farmacológico , Doenças das Valvas Cardíacas/tratamento farmacológico , Doenças das Valvas Cardíacas/cirurgia , Bacteriemia/tratamento farmacológico , Infecções por Erysipelothrix/tratamento farmacológico , Ceftriaxona/uso terapêutico , Cefalosporinas/uso terapêutico , Valva Aórtica/microbiologia , Insuficiência da Valva Aórtica/microbiologia , Insuficiência da Valva Aórtica/cirurgia , Implante de Prótese de Valva CardíacaRESUMO
The bacterial species Erysipelothrix rhusiopathiae is found worldwide as a commensal or a pathogen in a variety of animals. One well-defined pattern of human infection is an uncommon bacteremic form, with or without cutaneous involvement, usually complicated by endocarditis. We report the case of a 38-year-old male butcher with E. rhusiopathiae bacteremia, native aortic valve endocarditis and perivalvular abscess. The patient was released after six weeks of intravenous ceftriaxone and aortic valve replacement because of severe regurgitation
Assuntos
Humanos , Masculino , Adulto , Abscesso , Bacteriemia , Endocardite Bacteriana , Infecções por Erysipelothrix , Doenças das Valvas Cardíacas , Abscesso , Valva Aórtica , Insuficiência da Valva Aórtica , Bacteriemia , Ceftriaxona , Cefalosporinas , Endocardite Bacteriana , Infecções por Erysipelothrix , Doenças das Valvas Cardíacas , Implante de Prótese de Valva CardíacaRESUMO
Se revisan los aspectos clínicos y el diagnóstico bacteriológico de la infección por Erysipelothrix rhusiopathiae (ER). Presentación de dos casos clínicos: el primero corresponde a una endocarditis subaguda con complicaciones neurológicas sugerentes de embolias cerebromeníngeas en un enfermo portador de insuficiencia aórtica, que evoluciona en forma progresiva. Por error diagnóstico el tratamiento específico se inicia tardíamente. La endocarditis por ER, a pesar de la sensibilidad del organismo a la penicilina, tiene una mayor letalidad que las endocarditis de otras etiologías. Este paciente fallece por ruptura de velos aórticos. En el segundo caso, se trata de un enfermo con meningitis por ER que tiene una buena respuesta al tratamiento antibiótico. Aunque la infección por ER es rara en el hombre, en su forma septicémica o de compromiso meníngeo, debe considerarse como posibilidad diagnóstica, si se aísla un difteromorfo de sangre o de LCR
Assuntos
Humanos , Masculino , Adulto , Endocardite Bacteriana Subaguda/microbiologia , Infecções por Erysipelothrix/microbiologia , Meningites Bacterianas/microbiologia , Erysipelothrix/patogenicidadeRESUMO
Este relato descreve o primeiro caso documentado de endocardite por E. rhusiopathiae na América Latina. O paciente tinha 51 anos de idade, era alcoólatra moderado, com uma história prévia de insuficiência aórtica. Ele costumava pescar e cozinhar como hobby e feriu sua mäo esquerda com uma espinha-de-peixe. A doença começou com a forma erisipelóide e evoluiu para septicemia e endocardite. Ele foi tratado com antibióticos e cirurgia para troca da válvula aórtica. Até hoje foram relatados apenas 46 casos de endocardite por E. rhusiopathiae. Os autores questionam se muitos outros casos sem que sejam relatados por falta de correto diagnóstico microbiológico laboratorial