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Potential errors in recognition of Erysipelothrix rhusiopathiae.
1Department of Pathology, Baylor College of Medicine, Houston, Texas, USA.
Journal of Clinical Microbiology
|March 4, 2000
Summary
Erysipelothrix rhusiopathiae can cause severe infections like polyarthralgia and renal failure. Clinical microbiologists may face challenges identifying this bacterium due to unusual presentations and potential misidentification with other bacteria.
Area of Science:
- Medical Microbiology
- Infectious Diseases
Background:
- Erysipelothrix rhusiopathiae is a facultative anaerobic gram-positive bacterium.
- It is known to cause erysipeloid skin infections in humans and a variety of diseases in animals.
Observation:
- Four cases of Erysipelothrix rhusiopathiae infections are presented, manifesting as polyarthralgia with renal failure, septic arthritis, classic erysipeloid, and peritonitis.
- The bacterium was challenging to identify in three cases due to atypical clinical presentations.
- In two cases, growth was only observed in broth, potentially leading to underappreciation of the infection's significance.
- One case was initially misdiagnosed as a polymicrobial infection.
Findings:
- Biochemical identification of Erysipelothrix rhusiopathiae was straightforward.
- Clinical recognition was challenging due to unusual presentations and limited growth.
- Misidentification as Lactobacillus spp. or Enterococcus spp. is possible if hydrogen sulfide (H2S) production is not tested, especially in atypical infections.
Implications:
- Clinical microbiologists must consider Erysipelothrix rhusiopathiae in the differential diagnosis of severe infections, even with unusual presentations.
- Accurate identification requires careful consideration of Gram stain morphology and specific biochemical tests, including H2S production.
- Awareness of potential misidentification is crucial for appropriate patient management and treatment of Erysipelothrix rhusiopathiae infections.