The first report of human primary pyogenic ventriculitis caused by Streptococcus suis: a case report

Streptococcus suis (S. suis), a gram-positive facultative anaerobe, has emerged as a zoonotic pathogen of suppurative infections in various human organs. Never reported is human primary ventriculitis caused by S. suis. A 70-year-old Chinese woman with a history of eating undercooked pork tongue was admitted to our hospital due to vomiting, headache and high fever. Brain magnetic resonance imaging (MRI) revealed intraventricular empyema and hydrocephalus, while cerebrospinal fluid (CSF) analysis showed purulent changes. S. suis was cultured in the CSF and blood samples of the patient, and confirmed as serotype 2 by real-time polymerase chain reaction (PCR). Therefore, the diagnosis of primary ventriculitis caused by S. suis was established. She was treated with intravenous (IV) meropenem for six weeks. To solve hydrocephalus, external ventricular drain (EVD) was performed, followed by ventriculoperitoneal shunt. Finally, the patient achieved a good outcome after a 6-month follow-up. S. suis is a rare pathogen in northern China but can cause severe infection and complications. S. suis infection should be considered when a patient with bacterial infection has a history of eating undercooked pork. MRI can help detect ventriculitis. It is worth noting that rapid and prolongated administration of IV antibiotics and timely neurosurgical intervention can achieve desirable outcomes.