Streptococcus equi subspecies zooepidemicus Meningitis, Septicemia, and Brain Infarcts in a Costa Rican Infant

Abstract

Streptococcus equi , an equine commensal bacterium, is a rare etiology of septicemia and meningoencephalitis in humans and is extremely infrequent in children. Scarce literature has been published about its clinical presentation, treatment and outcomes in infants. Here, we describe a case of S. equi subsp. zooepidemicus septicemia and meningoencephalitis in a five-month-old Costa Rican infant that was confirmed by peripheral blood and cerebrospinal fluid (CSF) cultures in a regional hospital of the Pacific coast of Costa Rica who developed multiple ischemic cerebral infarcts secondary to infectious vasculitis, a subdural empyema and serious neurological sequelae. We also reviewed the literature on S. equi meningitis in infants under one year of age. This is the first reported case in our country, the fourth reported in infants under one year of age and the second describing multiple cerebral infarcts and subdural empyema in an infant.

Characterization of Streptococcus equi subsp. zooepidemicus isolates containing lnuB gene responsible for the L phenotype

“…Regarding antibiotic susceptibility, a comparative analysis with previous published descriptions of human SEZ isolates that included antibiotic resistance profiles (around 20 reports) was carried out. Our results agree with previous descriptions: isolates were sensitive to penicillin G, erythromycin, chloramphenicol, levofloxacin and vancomycin [5,7,13,[40][41][42]46]. As for…”

“…These findings correlate with previous observations pointing out SEZ as an uncommon but serious cause of human infections, particularly in elderly with underlying medical conditions or immunosuppression, and persons exposed to animals or animal products [3][4][5]36,37]. Group C streptococci meningitis is a rare type of infection, with approximately 50 cases reported, where SEZ appears as the most frequent causative agent [38][39][40]. Particularly in Latin-America, only three descriptions of meningitis caused by SEZ have been reported, one of them with a fatal outcome [40][41][42].…”

“…Group C streptococci meningitis is a rare type of infection, with approximately 50 cases reported, where SEZ appears as the most frequent causative agent [38][39][40]. Particularly in Latin-America, only three descriptions of meningitis caused by SEZ have been reported, one of them with a fatal outcome [40][41][42]. Thus, the meningitis caused by SEZ 559 is the fourth case identified in this region.…”

Occurrence and Antimicrobial Susceptibility Profiles of Streptococcus equi subsp. zooepidemicus Strains Isolated from Mares with Fertility Problems

“…In addition, S. zooepidemicus is not only a relevant veterinary pathogen but also of zoonotic importance, with horses acting as main reservoirs for humans, particularly horse personnel and veterinarians [ 47 , 48 ]. Thus, S. zooepidemicus -associated infections could be considered as zoonoses [ 49 , 50 ], since its transmission has been documented also by the consumption of unpasteurized milk and dairy products [ 21 , 22 ], but also from other ill animals, such as domestic dogs [ 19 , 20 ] and guinea pigs [ 9 ]. Thus, further studies on risk factors on its zoonotic transmission are needed.…”

Streptococcus equi subsp. equi in Retropharyngeal Abscess: Case Report and Review of Literature

“…S. equi subsp. zooepidemicus in humans may lead to bacteriemia, meningitis, spondylodiskitis, pneumonia, septic arthritis, toxic shock-like syndrome, nephritis, and endocarditis [ 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. S. equi subsp.…”