<i>Streptococcus suis</i> meningitis: An emerging zoonotic disease in Brazil

Ramos, Geisa Santos Souza; Rego, Renata Ferreira da Silva; Oliveira, Maria Fernanda Feltrin de; Rocha, Verônica de França Diniz; Oliveira, Ernesto Pereira de; Reis, Joice Neves

doi:10.1590/0037-8682-0610-2023

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Case Report • Rev. Soc. Bras. Med. Trop. 57 • 2024 • https://doi.org/10.1590/0037-8682-0610-2023 copy

Streptococcus suis meningitis: An emerging zoonotic disease in Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Streptococcus suis has been widely reported as a pathogen in animals, especially pigs. In terms of human health implications, it has been characterized as a zoonosis associated with the consumption of pork products and occupational exposure, particularly in Southeast Asian countries. Here, we present a rare case of human S. suis infection in Brazil, diagnosed in an older adult swine farmer, a small rural producer residing in the semi-arid region of Bahia, Brazil.

Keywords:
Streptococcus suis; Meningitis; Bacterial meningitis

	09/27/2019	09/29/2019	09/30/2019	10/03/2019	10/23/2019
Blood parameters
Hemoglobin	-	14.9 g/dL	-	10/03/2019	10/23/2019	-	-
WBC count	12,400 WBCs/μL	14,170 WBC/μL	10,690 WBC/μL	9,790 WBC/μL	4,740 WBC/μL
Band PMNs	-	2%	0%	0%	-
Targeted PMNs	78%	81%	80%	60%	-
Platelets	-	288,000/μL	-	-	-
CRP	-	72.3 mg/L	-	-	-
Urea	-	68 mg/dL	-	-	-
Creatinine	-	1.10 mg/dL	-	-	-
Gamma-GT	-	48 UI/L	-	-	-
AST	-	21 UI/L	-	-	-
ALT	-	25 UI/L	-	-	-
Sodium	-	140 mEq/L	-	-	-
Potassium	-	4.5 mEq/L	-	-	-
HIV serology	-	Negative	-	-	-
Syphilis serology	-	Negative	-	-	-
HBV and HCV serologies	-	Negative	-	-	-
CSF parameters
Leukocytes	350 leukocytes	150 leukocytes	-	-	-	-	-
PMNs	89%	Mononuclear cells predominant	-	-	-
CSF protein	119 mg/dL	92 mg/dL	-	-	-
CSF glucose	32 mg/dL	39 mg/dL	-	-	-
Lactate	8.4 mmol/L	-	-	-	-
Pandy test	-	Negative	-	-	-

Characteristics	Case 1 (da Silva et al.⁶6. da Silva NCZ, Varaschin PA, Castanho CR, dos Santos RS, Camargos VS, Garcia RAM, et al. Streptococcus suis Meningitis in Humans: the Cause of Emerging Bacterial Infectious Diseases in Brazil? Case Report. SN Compr Clin Med. 2020;2:2933-4.)	Case 2 (Ponte de Matos et al.⁷7. Ponte de Matos FB, Farias LABG, Negreiro Dias C, Pinho Mendes L, Pinheiro de Negreiros Bessa P. Meningitis due to Streptococcus suis in Two Patients with Occupational Exposure from Northeastern Brazil. Case Rep Infect Dis. 2021;2021:5512303.)	Case 3 (Ponte de Matos et al. ⁷7. Ponte de Matos FB, Farias LABG, Negreiro Dias C, Pinho Mendes L, Pinheiro de Negreiros Bessa P. Meningitis due to Streptococcus suis in Two Patients with Occupational Exposure from Northeastern Brazil. Case Rep Infect Dis. 2021;2021:5512303.)	Case 4 (this study)
Location	Rio de Janeiro	Ceará	Ceará	Bahia
Age (years)	82	60	68	68
Sex	Male	Male	Male	Male
Risk exposure	Consumption of porcine meat	Butcher	Farming (pig)	Farming (pig)
Comorbidities	Not reported	COPD/alcoholism	No	No
Clinical findings
Fever	Yes	Yes	Yes	Yes
Neck stiffness	Not reported	Yes	Yes	Yes
Brudzinski	Not reported	Yes	No	No
Kernig	Not reported	No	No	No
Lasegue	Not reported	No	No	No
Treatment
Antibiotic	Ceftriaxone + vancomycin + acyclovir (5 days)	Ceftriaxone (14 days)	Piperacillin/tazobactam (7 days)	Ceftriaxone + ampicillin (1 day)
	ceftriaxone alone (9 days)		Meropenem (14 days)	ceftriaxone alone (9 days)
			Polymyxin B (7 days)
Corticosteroids	No	Yes	Yes	Yes
Sequalae	Not reported	Hearing loss	Not evident	Hearing loss
Outcome	Discharge	Discharge	Discharge	Discharge

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E-mail: rsbmt@uftm.edu.br

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[1] ✉ Joice Neves Reis. e-mail: joice@ufba.br