Streptococcus suis infection

Yu-Tsung Huang¹, Lee-Jene Teng^2,3, Shen-Wu Ho^2,3, Po-Ren Hsueh^1,2
Departments of ¹Internal Medicine and ²Laboratory Medicine, National Taiwan University Hospital, Taipei; and ³School of Medical Technology, National Taiwan University College of Medicine, Taipei, Taiwan

Received: August 26, 2005 Revised: September 2, 2005 Accepted: September 6, 2005

Corresponding author: Po-Ren Hsueh, Departments of Internal Medicine and Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, No 7, Chung-Shan South Road, , Taiwan. E-mail:

A recent outbreak of Streptococcus suis infection associated with the slaughter, preparation or consumption of pigs in Sichuan, China has led to concerns that similar outbreaks could occur in other Asian countries. Although the pig farming industry is flourishing in Taiwan, reports of S. suis infection remain rare. We report 2 cases of S. suis meningitis successfully treated with ceftriaxone and penicillin. Previous reports of S. suis infection from the English literature are reviewed and the clinical data of cases reported in Asian and European countries are summarized. In Europe, there was good correlation between clinical disease and porcine contact, while few cases in Asia reported this association. Meningitis remained the most common presentation of infection in both areas (84.6% and 75.2%, respectively), followed by sepsis (15.4% and 18.6%, respectively), which had a higher mortality rate, particularly for splenectomized patients. Other clinical presentations included enteritis, arthritis, endocarditis, pneumonia, spondylodiscitis, endophthalmitis, uveitis and peritonitis. Deafness was a distinct sequelae (50.5% in Europe and 51.9% in Asia) after recovery from S. suis infection, especially in patients with meningitis. Not all commercial identification systems for streptpcocci could offer adequate speciation for S. suis. When viridans group streptococci are isolated from patients with meningitis and sepsis, prompt and correct identification of isolates to the species level should be performed, especially in areas with a high prevalence of S. suis diseases.

Key words: Disease outbreaks, review, risk factors, Streptococcus suis

J Microbiol Immunol Infect 2005;38:306-313.