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The Cost of Swine Dining: Streptococcus Suis as a cause of meningitis, permanent hearing loss, idiopathic thrombocyto-penia, and multi-level spinal facet septic arthritis

Abstract

Amanda L. Kelly, PA-C, Briana Ophoff, PA-C, Svetoslav Saev, MD and Gordana Simeunovic, MD*

S. suis is a zoonotic pathogen found primarily in swine that has been described to cause human infection with various presentations and a high incidence of long-term neurologic sequelae. Most published literature cases have been reported in Southeast Asia, with only a paucity of reports in North America, particularly in the United States. It is unclear if the disease is absent in this area or has been misdiagnosed. Here, we report the case of a 48-year-old female swine worker who suffered immune-mediated thrombocytopenia, facet joint arthritis, and bilateral sensorineural hearing loss precipitated by occupationally acquired meningitis caused by S. suis. Following therapy with antibiotics and corticosteroids, the patient fully recovered except for hearing loss, which was permanent necessitating cochlear implant placement. We hope to raise clinicians' awareness of this rare, potentially devastating, but treatable disease by describing this case. S. suis should be suspected in patients with unexplained symptoms, particularly headache and meningeal signs, who have a history of pig exposure or pork consumption.

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