[Infectious endocarditis caused by Erysipelothrix rhusiopathiae].
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Erysipelothrix rhusiopathiae only seldom causes cases of endocarditis. Contact with infectious animals leads to endocarditis of the left heart with high lethality. Vancomycin and aminoglycosides, which are often used in gram-positive endocarditis, show no effect.
The authors describe an unusual case of bacterial endocarditis. A very rare etiologic agent, Erysipelothrix rhusiopathiae, was isolated. The patient was not fisherman or butcher and he did ot other risky job. Moreover the disease had an atypical course.
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A case of erysipeloid with bacteraemia caused by Erysipelothrix rhusiopathiae (ER) in a previously healthy 41-year old man is presented. The bacterium was probably introduced by the bite of a dog. He was treated successfully with penicillin V. The ER bacteraemia occurred without complications of endocarditis.
Erysipelothrix rhusiopathiae is becoming more commonly recognized in humans and has the potential for significant morbidity and mortality. In this article, we describe one patient's clinical symptoms after occupational exposure to E rhusiopathiae and its sequela. We discuss the natural history of the organism, three major categories of human disease, and treatment options.
Arthritic and histologically normal joints from swine in which arthritis had been produced by the intravenous inoculation of Erysipelothrix rhusiopathiae were used as a source of fluids for lysosomal enzyme determinations. Mean lysozyme activities in synovias from arthritic and histologically normal joints were 16.60 and 5.79 mug/ml, respectively. Acid phosphatase (ACP) was increased more than 8 times the activity in histologically normal joints, but there was no relationship between lysozyme and ACP, indicating the probability that 1 of these enzymes came from another source. The cytoplasmic enzyme, lactic dehydrogenase (LDH), was increased in proportion to ACP, indicating that cell death and not selective extrusion of lysosomal enzymes during phagocytosis was an important mechanism of enzyme release in arthritic joints. Lysozyme activities in synovias from histologically normal joints were often increased above companion serum concentrations, indicating the enzyme has a special role in the joint. Also, the ratio of activities of lysozyme to ACP in pig buffy coat lysates was different from the ratio of the 2 enzymes in synovias from arthritic joints.
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One male of a group of seven Pacific white-sided dolphins (Lagenorhynchus obliquidens) died after a brief period of nonspecific clinical signs. Four beluga whales (Delphinapterus leucas) and four harbor seals (Phoca vitulina) were managed in the same water system. Gross examination of the dolphin revealed only moderately enlarged mesenteric lymph nodes. Histopathology revealed small to massive numbers of gram-positive bacilli, usually intravascular, in all tissues. Bacteria were both extracellular and present in macrophages, monocytes, and neutrophils. Aerobic bacterial culture of lung, liver, kidney, and spleen yielded pure cultures of Erysipelothrix rhusiopathiae. Based on clinical course, histopathology, and bacteriology, a diagnosis of acute erysipelas septicemia was made. None of the other cetaceans or pinnipeds exhibited clinical signs.
Erysipelothrix rhusiopathiae strains isolated from duck carcasses and pigs were examined by sodium dodecyl sulphate--polyacrylamide gel electrophoresis (SDS-PAGE) and the results were evaluated by a computerised method in order to compare the strains for protein composition according to molecular mass. To characterise the similarity of the strains, Pearson's correlation coefficient was calculated. The degree of similarity between duck strains originating from the same flock was 980-991, while that of strains isolated from ducks and pigs varied between 836 and 991 on a scale of 0 to 1000. The method gives highly reproducible results and can be utilised in epidemiological investigations. Its use may provide new data on E. rhusiopathiae strains, complementing the results of methods recommended for this purpose earlier and increasing the efficiency of epidemiological investigations.
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