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Streptococcus suis infection in Hong Kong
Abstract:
Twenty-five patients were admitted to two hospitals in Hong Kong for Streptococcus suis infection between 1984 and 1993. Among them, 15 (60%) had an occupational exposure to pigs or pork, and four had a clear history of skin injury up to 16 days before admission. Examination of the cerebrospinal fluid of 21 patients confirmed the presence of meningitis in every case; the remaining four patients who did not have lumbar punctures had each presented with arthritis, bronchopneumonia, endocarditis and pyrexia without neck stiffness. The only fatality was a patient admitted in septicaemic shock with evidence of meningitis and disseminated intravascular coagulation. Of the 24 survivors, 16 (67%) acquired varying degrees of hearing loss as a result of meningitic involvement. All the isolates of S. suis were sensitive to penicillin or ampicillin, which was used alone or in combination with other antibiotics for every patient. Two patients had a relapse of symptoms when penicillin was stopped, but were successfully treated after the antibiotic was resumed for a total of 6 weeks. Over 100 cases of S. suis infection have been described previously, with a geographic distribution heavily biased towards Northern Europe and Southeast Asia. Lack of awareness of this unique zoonosis may be a reason why it is not diagnosed more readily elsewhere.
Insights
Streptococcus suis infection, a zoonosis primarily seen in Southeast Asia, frequently causes meningitis and hearing loss. Early diagnosis and antibiotic treatment are crucial for recovery.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Streptococcus suis is a zoonotic pathogen with a known geographic distribution biased towards Northern Europe and Southeast Asia.
- Occupational exposure to pigs or pork is a significant risk factor for Streptococcus suis infection.
Purpose of the Study:
- To describe the clinical features, outcomes, and treatment of Streptococcus suis infections in Hong Kong.
- To highlight the potential for underdiagnosis of this zoonosis in regions outside its typical endemic areas.
Main Methods:
- Retrospective case series of 25 patients admitted to two Hong Kong hospitals between 1984 and 1993.
- Clinical data, including exposure history, symptoms, diagnostic findings (cerebrospinal fluid analysis), and treatment outcomes, were analyzed.
Main Results:
- Sixty percent of patients had occupational exposure to pigs or pork; 16% had a history of skin injury.
- Meningitis was confirmed in all patients who underwent lumbar puncture. Other presentations included arthritis, bronchopneumonia, and endocarditis.
- The fatality rate was low (4%), but 67% of survivors experienced hearing loss. All isolates were sensitive to penicillin and ampicillin.
Conclusions:
- Streptococcus suis infection can occur in Hong Kong, presenting with severe manifestations like meningitis and hearing loss.
- Prompt diagnosis and appropriate antibiotic therapy (penicillin or ampicillin) are essential for managing Streptococcus suis infections.
- Increased awareness of this zoonosis is needed for earlier and more accurate diagnosis in diverse geographic regions.