title: Streptococcus suis meningitis with ventriculoperitoneal shunt infection and spondylodiscitis.
abstract: Streptococcus suis is a zoonotic pathogen which causes meningitis, bacteremia, and endocarditis in pigs. Human infection is rare and often presents as meningitis with the sequela of permanent deafness and endocarditis. Previous cases were reported from pig-rearing countries such as Holland and Hong Kong. We report a 55-year-old bedridden man with S. suis meningitis complicated with ventriculoperitoneal shunt infection and lumbar spine spondylodiscitis. He presented with fever, delirium, neck stiffness, lower leg weakness and sudden onset hearing loss for several days. He was successfully treated with intravenous antibiotics, ventriculoperitoneal shunt replacement, lumbar spinal laminotomy and discectomy. Cerebrospinal fluid culture initially misidentified the organism as Streptococcus acidominimus, and S. suis was later identified by 16S rRNA sequencing. Misidentification of the microbiological findings may lead to a failure to correctly diagnose this disease. S. suis meningitis should be included in the differential diagnosis of patients with meningitis and sudden hearing loss.
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung and National Yang-Ming University, Taipei, Taiwan.
authors.forename: Hung-Chin
authors.initials: HC
authors.lastname: Tsai
authors.forename: Susan Shin-Jung
authors.initials: SS
authors.lastname: Lee
authors.forename: Shue-Ren
authors.initials: SR
authors.lastname: Wann
authors.forename: Tsi-Shu
authors.initials: TS
authors.lastname: Huang
authors.forename: Yao-Shen
authors.initials: YS
authors.lastname: Chen
authors.forename: Yung-Ching
authors.initials: YC
authors.lastname: Liu
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D015299:Discitis / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000382:microbiology*; D013290:Streptococcal Infections / Q000188:drug therapy / Q000382:microbiology* / Q000628:therapy; D017011:Streptococcus suis / Q000302:isolation & purification*; D017287:Ventriculoperitoneal Shunt
chemical_list: D000900:Anti-Bacterial Agents