Novel case of penicillin resistant E. rhusiopathiae septicemia: Case report with review of the literature

Erysipelothrix Rhusiopathiae is a fastidious pathogen that was first isolated by Koch in 1878 and later identified as a pathogen by Rosenbach in 1909. Is a facultative anaerobic, non-spore forming, and non-motile gram positive bacillus which causes infection in several species of mammals and other animals. E. rhusiopathiae is an occupational illness; 89% of the cases are linked to high-risk epidemiological situations [1]. It causes infections in humans through exposure with contaminated animals or animal products [2]. In humans, the infections can take three forms: a localized cutaneous form (erysipeloid) caused by traumatic penetration of E. rhusiopathiae, a generalized cutaneous form, and a septicemic form. Systemic infection with bacteremia is relatively uncommon and mainly encountered in immunocompromised patients or patients with chronic alcoholism or other risk factors. Diffuse cutaneous and septic forms occur rarely, and the septic form has been previously associated with endocarditis [3]. A previous study reviewing invasive infection cases since 1912 reported that about 90% of cases of E. rhusiopathiae bacteremia result in endocarditis [4]. This association has been recently questioned, since some cases of E. rhusiopathiae bacteremia without subsequent endocarditis have been reported in the most recent literature [3,5–9]. Here our case adds up to the latter literature, and describes a case of E. rhusiopathiae bacteremia which started as a localized erysipeloid form and lead to septicemia without endocarditis.