Erysipelothrix endocarditis with cutaneous lesion.
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Erysipelothrix rhusiopathiae was isolated from the swollen finger of a 55 year old man. The swelling was due to a peck by an infected chicken. Tracing the infection to the chicken-raising premises has proven that the bacterium was present in some of the chicken and manure samples.
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.
On the model of the septic mouse infected with mice pathogenic Erysipelothrix strain NaSCN had a protective effect (lower and delayed lethality in the doses of 64 and 256 mg/kg, given once a day intraperitoneally prophylactically or simultaneously to the infection.
In an attempt to characterize the immuno response of the animal organism to experimental infection, ELISA and immunoblotting were used to test the antibody levels of erysipelas hyperimmune sera (HIS) which had been induced by Erysipelothrix rhusiopathiae. Also, 5 pigs were accidentally chosen to check on individual curves of antibody formation, following periodical inoculation up to HIS collection. All HIS verified and confirmed by the mouse protective test responded by high titres. Yet, the results so far obtained from HIS titration have failed to be conclusive as to valency. The animals selected for these experiments exhibited differentiated antibody levels during the phase of immunisation, although they were at one and the same level, when measured by the final titre, following last boostering. The desired rise in antibody levels was achieved only by the 4th to 9th boostering in almost all cases. Extinction values determined by ELISA were confirmed or supplemented by the results obtained from immunoblotting.
We report case of a 67-year-old alcoholic fisherman who developed infective endocarditis caused by Erysipelothrix rhusiopathiae. The initial manifestations were fever and back pain of approximately three months' duration. Auscultation of the heart revealed a loud systolic murmur at the apex and a diastolic murmur over the aortic valve area. Echocardiographic studies showed vegetations on both the aortic valve and mitral valve. Blood cultures grew Erysipelothrix rhusiopathiae, and it was sensitive to aminobenzyl penicillin. No other bacteria grew aut. A diagnosis of infective endocarditis caused by the Erysipelothnx rhusiopatniae was made, and the patient was treated with aminobenzyl penicillin 12g/day for 6 weeks. His clinical course was complicated by heart failure, multiple cerebral embolism, and renal infarctions. However, he recovered without valve replacement. Although the exact route of infection remains unknown, erosions of the skin, of his palms at the time of tho initial examination appeared to be one possible source of the systemic infection in this case. The serotype of the bacteria was Ib. To our knowledge this is the first case of serotyping of bacterium that caused endocarditis in humans.
On the basis of circumstantial evidence, a number of human diseases have been postulated to result from the presence of occult infection. To investigate this problem amethod of specifically detecting and semiquantitaing trace quantities of bacterial DNA in infected tissue has been devised. It is based on RNA-DNA hybridization using radiolabeled RNAcomplementary to the DNA of the organism being sought. The characteristics of the reaction are shown to conform to those expected for RNA-DNA hybridization and the sensitivity of the method is shown to correspond to approximately one organism per 50 mammalian cells. Specificity at this level of sensitivity is sufficient to clearly distinguish between infections with Listeria monocytogenes and Erysipelothrix insidiosa. This approach may have general applicability forthe study of diseases putatively caused by chronic infection not readily demonstrable bythe usual cultural or immunologic techniques. It may also be useful for helping distinguish contaminants from pathogens when isolates are obtained from diseases tissue. Unique to this approach is the value of negative information in excluding the presenceof an organism within its limits of sensitivity.
Erysipelas is a bacterial disease caused by Erysipelothrix rhusiopathiae, which may infect swine as well as several other species of mammals and birds, including domestic fowl. In poultry, erysipelas may cause sudden high mortality due to septicemia. This communication describes the first isolation of E. rhusiopathiae from the haematophagous poultry red mite, Dermanyssus gallinae DeGeer (Acari: Dermanyssidae), that was collected on three farms where hen erysipelas was diagnosed. The bacteria were isolated from the integument as well as from the interior of the mites. Serotypes 1a and 1b of E. rhusiopathiae found in the mites corresponded with those isolated from the diseased birds. These findings imply that D. gallinae is a potential vector of E. rhusiopathiae. The current lack of effective measures to control D. gallinae causes recurring mite problems in poultry facilities once afflicted by this parasite. Consequently, mites containing E. rhusiopathiae may act as reservoir hosts of this bacterium, allowing it to persist in the poultry house between flock cycles as a source of infection for the replacement pullets. The zoonotic potentials of both E. rhusiopathiae and D. gallinae should also be considered.
Polyarthritis was induced in lambs via the i/v infection with 2 cm3 of 24-hour Erysipelothrix rhusiopathiae broth culture, which led to distinctive morphologic and biochemical changes in the peripheral blood. The hemoglobin content, the erythrocyte count, and the hematocrit value dropped, while ESR rose with the development of the infection process. The white blood picture presented transient and slight drop of the leukocyte count followed by leukocytosis with shifting to the left, aneosinophilia, lympho- and monopenia in the acute stage, and well manifested eosinophilia in the chronic stage of the infection. The changes in the total protein and the protein fractions consisted in hypoproteinemia in the first days following infection, hypoalbuminemia during the entire period, and hyperproteinemia and hypergammaglobulinemia in the chronic stage. The changes in the blood electrolites consisted in the rise of Ca and K, the drop of Na, and transient changes in the level of P, tending toward a rise in the chronic stage. It was also established that the values of sialic acid were raised in the entire period of polyarthritis development, while those of aspartate aminotransferase and alanine aminotransferase were higher in the first seven-day period only.
Severe polyarthritis was induced in 42 SPF piglets by subcutaneous and intraarticular infection in one joint of the bacterium Erysipelothrix rhusiopathiae (Serotype B, strain T 28), which in its chronic stage morphologically resembles human c.P. The light and electron microscopic examination of the articular cartilage and synovial membrane reveals a parallel evolution of hyaline cartilage degeneration, and activation and proliferation of synovial lining cells. The initial cartilage alteration with demasking of collagen fibrils and focal degeneration of chondrocytes in the erysipelas model is caused by direct action of the microbial agent, fibrin and few granulocytes Erysipelothrix bacteria and neutrophilic granulocytes are able to invade the superficial and intermediate cartilage layers. This model is not considered a suppurative infectious arthritis. In chronic villous erysipelas polyarthritis, which develops without the presence of neutrophils in the cartilage, the invasively growing synovial pannus dominates, which deeply destroys the pre-damaged cartilage, resulting in macroscopic focal or wide-spread cartilage erosion. We consider the poorly vascularized cartilage and the particular fibrosis suitable sites for the extremely long (up to three years) persistence of this microbial agent. The persistence of the agent is considered necessary for the persisting immunological reactions and the perpetuation of erysipelas polyarthritis. With longer duration (1-3 years) of experimental erysipelas polyarthritis the number of bacteriologically positive arthritic joint decreases. Microscopically, the causative bacteria may only sporadically identified.
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A woman with diabetes mellitus type 2 had a thigh infection that drained foul-smelling pus. Necrotizing fasciitis was diagnosed surgically and histopathologically, with Erysipelothrix rhusiopathiae being the predominant organism. A pet goldfish might have been the source.
We describe herein the case of a man with Erysipelothrix rhusiopathiae septic arthritis and possible infective endocarditis. This is the first report in the English-language medical literature of septic arthritis caused by this organism.
Botryomycosis is a rare bacterial infection of the skin and, rarely, viscera that is characterized by the formation of characteristic hyaline grains. We encountered a patient with Erysipelothrix rhusiopathiae endocarditis who developed visceral botryomycosis. He was a 54-year-old black man who presented in sepsis with a history of progressive weakness and severe weight loss. He died 10 hours after admission. At autopsy, endocarditis was identified, along with infarcts of the spleen and kidneys. Microscopically, visceral botryomycosis was seen. With these bacteria, an animal source is usually identified, although one was not found in this man. Erysipelothrix rhusiopathiae is an organism that is becoming identified in a range of infections in humans, the manifestations and pathophysiology of which are still being discovered.
Arthritic joints obtained from 50 freshly slaughtered pig carcasses condemned for polyarthritis were studied microbiologically. A routine technique was developed for aseptically opening joints to obtain material for microbiological examination. A standard series of culture media for the primary isolation of arthritogenic agents were used in the examination of each affected joint. The microbiological study cultured for isolation of the following microorganisms: Erysipelothrix rhusiopathiae, Corynebacterium pyogenes, Staphylococcus aureus, Escherichia coli, Streptococcus spp., Haemophilus spp., Mycoplasma spp., Salmonella spp., Chlamydia, and viruses.E. rhusiopathiae was found to be responsible for 48% of the cases of arthritis and Streptococcus spp., C. pyogenes and S. aureus for 20%, 4%, and 2% respectively; no microorganisms were cultured from 26% of the arthritic joints.