Erysipelothrix rhusiopathiae: an unusual pathogen of infective endocarditis

Native valve endocarditis caused by Erysipelothrix rhusiopathiae in an immunocompetent individual

Infective endocarditis is a very rare clinical form caused by Erysipelothrix rhusiopathiae. It is rarely seen in immunocompetent individuals. Even after surgery it may entail mortality rates as high as 30–40 %. This report describes a case of native valve endocarditis caused by E. rhusiopathiae and cured with crystallized penicillin G and surgery.

An autopsy case of Erysipelothrix rhusiopathiae endocarditis

A 58-year-old man was admitted to our hospital with fever. The vegetation was confirmed by echocardiography on the tricuspid valve and Erysipelothrix rhusiopathiae was isolated by blood culture. The patient died due to heart failure, and tricuspid valve vegetation was confirmed on autopsy and the sample of Gram's staining showed gram-positive microcolonies. Although about 60 cases of E. rhusiopathiae endocarditis have been reported, Japanese cases are extremely rare.

Deferment of slaughtering in swine affected by cutaneous erysipelas

According to the European Union rules for meat inspection (Regulation (EC) No. 854/2004 of the European Parliament and of the Council of 29 April 2004, that will be enforced in January 2006 in place of Council Directive 91/497/EEC of 29 July 1991 and Council Directive 91/498/EEC of 29 July 1991), any swine carcase affected by erysipelas must be destroyed. When pigs show erysipelas during antemortem inspection, the slaughtering must be deferred. Legislation however does not specify how long should be this period. In our research, 24 swine showing cutaneous erysipelas during antemortem inspection, have been tested: 8 of them were slaughtered after 10 days, 8 after 15 days and 8 after 20 days from the observation of the disease. Skin with scars of "diamond lesions", spleen, liver, kidney, inguinal lymph nodes, tonsils and muscle samples were tested in each carcase for the presence of Erysipelothrix rhusiopathiae. The results suggest that the slaughtering of swine affected by cutaneous erysipelas must be deferred for at least 15 days from disappearance of typical lesions, in order to guarantee a good level of safety of the meat and to reduce the hazard of occupational disease for veterinarians, abattoir workers and meat processors.