Korean J Lab Med.  2011 Jul;31(3):205-211. 10.3343/kjlm.2011.31.3.205.

Streptococcus suis Meningitis with Bilateral Sensorineural Hearing Loss

• Huh HJ
• Park KJ
• Jang JH
• Lee M
• Lee JH
• Ahn YH
• Kang CI
• Ki CS
• Lee NY

• KMID: 1735856
• DOI: http://doi.org/10.3343/kjlm.2011.31.3.205

Abstract

Streptococcus suis infection is an emerging zoonosis in Asia. The most common disease manifestation is meningitis, which is often associated with hearing loss and cochleovestibular signs. S. suis infection in humans mainly occurs among risk groups that have frequent exposure to pigs or raw pork. Here, we report a case of S. suis meningitis in a 67-yr-old pig carcass handler, who presented with dizziness and sensorineural hearing loss followed by headaches. Gram-positive diplococci were isolated from cerebrospinal fluid (CSF) and blood cultures and showed gray-white colonies with alpha-hemolysis. S. suis was identified from CSF and blood cultures by using a Vitek 2 system (bioMerieux, France), API 20 STREP (bioMerieux), and performing 16S rRNA and tuf gene sequencing. Even after receiving antibiotic treatment, patients with S. suis infection frequently show complications such as hearing impairment and vestibular dysfunction. To the best of our knowledge, this is the first case of S. suis meningitis in Korea. Prevention through public health surveillance is recommended, especially for individuals who have occupational exposures to swine and raw pork.

Keyword

Streptococcus suis; Meningitis; Hearing loss; Korea

MeSH Terms

Aged
Animals
Bacterial Proteins/genetics
Blood/microbiology
Cerebrospinal Fluid/microbiology
Hearing Loss, Bilateral/complications/*diagnosis/microbiology
Humans
Male
Meningitis, Bacterial/complications/*diagnosis/microbiology
Phylogeny
RNA, Ribosomal, 16S/genetics
Sequence Analysis, DNA
Streptococcus suis/classification/genetics/*isolation & purification
Swine
Tomography, X-Ray Computed

Figure

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  Fig. 1 Brain MRIs. T1 weighted gadolinium enhanced axial (A) and coronal (B) images reveal diffuse leptomeningeal enhancement in both cerebral hemispheres.

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  Fig. 2 Gram stain of Streptococcus suis of cerebrospinal fluid showed Gram positive diplococci under a light microscope (×1,000).

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  Fig. 3 Gray-whitish, α-hemolytic colonies of Streptococcus suis on sheep blood agar plate at 35℃ in the presence of 5% CO2 after 24 hr incubation.

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  Fig. 4 Molecular phylogenetic tree constructed by neighbor-joining method using the 16s rRNA (A) and tuf gene (B) sequences of our S. suis isolate and various Streptococcus species. Reference sequences were from the type strains of the species and accession numbers are given in parentheses. All names and accession numbers are given as cited in the GenBank database.

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