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Published on: March 23, 2019
A Case of Recurrent Erysipelas Caused by Streptococcus mitis Group
David Nygren1, Bo Nilson2,3, Magnus Rasmussen1
1Division of Infection Medicine, Department for Clinical Sciences Lund, Medical Faculty, Lund University, Lund, Sweden.
Abstract:
The aetiology of erysipelas remains poorly defined though beta-haemolytic streptococci are considered as the main causative pathogens. We describe a case of a 70-year-old woman with recurrent erysipelas in her left arm due to infection with streptococci of the mitis group. Her past medical history includes lymphoedema of the left arm secondary to lymph node dissection due to breast cancer surgery. On seven different occasions during a decade, she has presented a clinical picture of erysipelas and in three of them with Streptococcus mitis group bacteraemia. The results indicate that two cases were caused by Streptococcus mitis and one case was caused by Streptococcus oralis. This is, to our knowledge, the first reported cases of S. mitis and of S. oralis as the causative agents of erysipelas.
Insights
Recurrent erysipelas in a patient with lymphoedema was linked to Streptococcus mitis group bacteria. This study reports Streptococcus mitis and Streptococcus oralis as novel causes of erysipelas.
Area of Science:
- Infectious Diseases
- Microbiology
Background:
- Erysipelas etiology is often unclear, with beta-hemolytic streptococci typically implicated.
- Patient history includes lymphoedema of the left arm post-breast cancer surgery and lymph node dissection.
Observation:
- A 70-year-old woman experienced recurrent erysipelas on her left arm over a decade.
- Seven distinct erysipelas episodes were documented, with three concurrent cases of Streptococcus mitis group bacteremia.
Findings:
- This case series identifies Streptococcus mitis and Streptococcus oralis as causative agents of erysipelas.
- These findings represent the first reported instances of these specific bacteria causing erysipelas.
Implications:
- Expands the known spectrum of pathogens responsible for erysipelas.
- Highlights the importance of considering non-beta-hemolytic streptococci in recurrent or atypical erysipelas cases, especially in immunocompromised or lymphoedematous patients.
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