Sepsis, Endocarditis, and Purulent Arthritis due to a Rare Zoonotic Infection with Streptococcus equi Subspecies zooepidemicus

Abstract EN

Streptococcus equi subspecies zooepidemicus (S.

zooepidemicus) is mostly known as an opportunistic pathogen found in horses and as a rare human zoonosis.

An 82-year-old male, who had daily contact with horses, was admitted in a septic condition.

The patient presented with dyspnea, hemoptysis, impaired general condition, and severe pain in a swollen left shoulder.

Synovial fluid from the affected joint and blood cultures showed growth of S.

equi subsp.

zooepidemicus.

Transesophageal echocardiography showed a vegetation on the aortic valve consistent with endocarditis.

Arthroscopic revision revealed synovitis and erosion of the rotator cuff.

Technetium-99m scintigraphy showed intense increased activity in the left shoulder, suspicious of osteitis.

The infection was treated with intravenous antibiotics over a period of five weeks, followed by oral antibiotics for another two months.

The patient recovered without permanent sequelae.