An Atlantic Canada case of disseminated Streptococcus equi subspecies zooepidemicus infection

Streptococcus equi subspecies zooepidemicus infections in humans can be contracted through contact with domestic animals or unpasteurized dairy products. Although infection in humans is rare, the course can be fulminant. We describe the case of a 75-year-old immunocompetent male who developed disseminated disease with bacteremia, native aortic valve endocarditis, suppurative pericarditis with cardiac tamponade, meningitis, and bilateral endophthalmitis. Despite treatment with pericardial drain placement, intravenous ceftriaxone, and rifampin, the patient unfortunately did not survive. To date, reported cases of disseminated infection by S. equi subsp zooepidemicus are few. Furthermore, with review of the literature, this case demonstrates the broadest organ system involvement reported. Of interest, previous studies have suggested an affinity of this organism for certain organ systems and this case corroborates an emerging association of S. equi subsp zooepidemicus with endophthalmitis. In addition, this is the second Canadian case of documented human infection, with both cases being similar in clinical features, presentation, and geographical location. This case report should serve to warn clinicians about complications and sites of haematogenous seeding in the setting of disseminated S. equi subsp zooepidemicus infections.