Differentiating Streptococcus pseudoporcinus from GBS: could this have implications in pregnancy?

Endocarditis with Streptococcus pseudoporcinus Associated with Mastocytosis and Spondylodiscitis-A Coincidental Association? A Case Report

Streptococcus pseudoporcinus is a nonmotile Gram-positive, catalase, and benzidine negative, arranged in short chains, isolated from the genitourinary tract group B Streptococcus. S. pseudoporcinus was also identified from blood, urine, skin, cervical area, wounds, rectum, and placenta samples. Two cases of infective endocarditis have been reported in the literature. Based on these data, the identification of a case of S. pseudoporcinus infective endocarditis associated with spondylodiscitis in a patient with undiagnosed systemic mastocytosis until the age of 63 years is unusual. Two sets of blood specimens were collected, and both sets were positive for S. pseudoporcinus. Transesophageal echocardiography revealed, multiple vegetations on the mitral valve. A lumbar spine MRI revealed L5-S1 spondylodiscitis that associates prevertebral and right paramedian epidural abscesses with compressive stenosis. The performed bone marrow biopsy, and cellularity examination revealed 5-10% mast cells in the areas of medullary tissue, an aspect that is suggestive of mastocytosis. Antibiotic therapy was initiated, under which the patient presented intermittent fever. A second transesophageal echocardiography revealed a mitral valve abscess. A mitral valve replacement with a mechanical heart valve device through a minimally invasive approach was performed, with a favorable evolution under treatment. S. pseudoporcinus can be responsible for infectious endocarditis in certain immunodepressed cases, but also in a profibrotic, proatherogenic field, as shown by the association with mastocytosis in the presented case.

Case report: Multidrug-resistant Streptococcus pseudoporcinus isolated from an infected surgical wound of a 9-year-old spayed female Great Dane dog

Streptococcus pseudoporcinus (S. pseudoporcinus) is a β-hemolytic, Gram-positive novel bacterium first identified in 2006. It is a catalase-negative, non-motile coccus arranged in short chains. Furthermore, it has a broad beta-hemolytic reaction on sheep blood agar and cross-reacts with Lancefield group B antigen agglutination reagent. In this study, we report a case of S. pseudoporcinus infection of a surgical wound on the left metatarsus of a dog. The patient is a 9-year-old spayed female Great Dane dog with a brief history of multiple cutaneous masses being removed. Post-surgery, the post-surgical site on the left metatarsus became infected and discharged purulent material with a fetid odor. Upon preliminary diagnostic testing, we detected catalase-negative Gram-positive cocci exhibiting beta-hemolytic growth on sheep blood agar. A VITEK^® 2 Compact machine from bioMérieux identified the bacterium as S. pseudoporcinus. Furthermore, antibiotic testing revealed multidrug resistance. Therefore, we document a multidrug-resistant S. pseudoporcinus isolate as a cause of canine post-surgical wound infection. Furthermore, it was the only isolate detected from the sample; hence, it is the cause of the infection. To our knowledge, this case is the first report of S. pseudoporcinus in a dog.

Case Report: Corneal perforation secondary to orbital cellulitis caused by Streptococcus pseudoporcinus infection

INTRODUCTION

This report described a rare case of corneal perforation secondary to orbital cellulitis caused by Streptococcus pseudoporcinus (S. pseudoporcinus) infection. To the best of our knowledge, only six cases of S. pseudoporcinus infection have been reported. This case report suggested that S. pseudoporcinus infection was contagious and potentially life threatening. The report emphasized the value of managing infections early to avoid serious consequences.

CASE DESCRIPTION

A patient with orbital cellulitis, which progressed to corneal perforation was admitted to the hospital for right facial swelling, pain, and decreased vision in his right eye. S. pseudoporcinus infection was found after bacterial culture of pus puncture. After aggressive anti-infection and surgical treatment, the infection was eliminated, and the patient was discharged. However, the patient had sustained permanent vision loss.

CONCLUSIONS

This case suggested the potential risk of corneal perforation and orbital cellulitis caused by S. pseudoporcinus infection in humans. The specific biological changes and mode of action of S. pseudoporcinus are unclear and need further investigation.

Extensive Cellulitis and Bacteremia Due to Streptococcus Pseudoporcinus in a Child With Klippel-Trenaunay Syndrome

Streptococcus pseudoporcinus is a newly recognized β-hemolytic streptococcus, that is considered a rare pathogen in adults. Infections in children have not been reported. We describe a child with Klippel-Trenaunay syndrome that developed of S. pseudoporcinus cellulitis and bacteremia, which was difficult-to-treat, relapsed and required prolonged antibiotic courses. S. pseudoporcinus can cause invasive infection in children, especially in the presence of predisposing conditions.

Fatal Streptococcus pseudoporcinus disseminated infection in decompensated liver cirrhosis: a case report

Background

Streptococcus pseudoporcinus (S. pseudoporcinus) was first identified in 2006. It cross-reacts with Lancefield group B antigen agglutination reagents and has been misidentified as S. agalactiae. Sites of S. pseudoporcinus isolation include the female genitourinary tract, urine, wounds, and dairy products. The prevalence of vaginal colonization is reportedly between 1 and 5.4%. Two uneventful cases of soft tissue infection caused by S. pseudoporcinus were reported in the past. However, since late 2019, six cases of invasive S. pseudoporcinus infections have emerged in the literature, one of which was fatal.

Case presentation

We describe a fatal case of a Caucasian male with spontaneous bacterial peritonitis associated with bacteremia due to a multidrug-resistant S. pseudoporcinus strain in a patient with decompensated liver cirrhosis. Despite the patient’s good general condition and stable blood test results when he had visited the outpatient clinic for large-volume paracentesis a few days before admission, this time he presented to the emergency department with a rapidly worsening clinical condition and with laboratory features consistent with multiple-organ dysfunction syndrome, and succumbed within a short period.

Conclusions

Contrary to what was thought until recently, multidrug-resistant S. pseudoporcinus may cause invasive, disseminated, fatal disease in humans. According to current limited data, vancomycin, linezolid, daptomycin, levofloxacin, clindamycin, and tetracycline seem to be the most effective antimicrobial agents against multidrug-resistant strains, and should be the empirical choice in cases of disseminated S. pseudoporcinus infection until laboratory antimicrobial susceptibility results are available. Improvements and new approaches for bacterial identification in routine clinical microbiology laboratories may reveal the real spectrum of S. pseudoporcinus infections in humans, which is currently believed to be underestimated. SS. pseudoporcinus could emerge as a serious medical problem in the near future, similar to other β-hemolytic streptococci.

First report of infective endocarditis caused by Streptococcus pseudoporcinus in Vietnam

We report a first case of Streptococcus pseudoporcinus bacteraemia causing infective endocarditis in a 40-year-old man in Vietnam. This is the second case of Streptococcus pseudoporcinus infective endocarditis in the literature. The patient was successfully treated by antibiotics, combined with aortic valve replacement. Streptococcus pseudoporcinus may be an emerging infectious agent causing endocarditis.

A Case of Maternal Sepsis and Fetal Demise Associated with Streptococcus pseudoporcinus

Streptococcus pseudoporcinus has recently been described in relation to its colonization of the female genitourinary tract. Since prior reports have linked S. pseudoporcinus only with minor morbidities, the organism previously has not been considered to be a cause of serious puerperal infections. A 41-year-old gravida 2, para 1-0-0-1 presented with abdominal pain and intrauterine fetal demise. A beta hemolytic Streptococcus was isolated from her placenta, endometrium, urine, and two blood culture sets. The isolate was a Streptococcus pseudoporcinus, which colonizes the female genital tract and can resemble Streptococcus agalactiae. This case demonstrates that S. pseudoporcinus is a potential cause of severe maternal and fetal morbidity and mortality.