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Introduction: Polyarthritis caused by Erysipelothrix rhusiopathiae is a well-known disease in pigs, and ovine erysipelas infection also commonly affects two-to-six month-old lambs. This report describes case histories of three sheep flocks where lambs exhibited swollen joints and lameness. Special emphasis was given to clinical and diagnostic imaging findings, synovia sampling and the treatment regime. Lambs with only mild lameness, liquid serofibrinous joint effusion and lambs showing no bone involvement, as revealed by ultrasonography or radiography, were treated with systemically administered antibiotics selected from results of antimicrobial susceptibility testing of E. rhusiopathiae isolated from synovial samples, and non-steroidal anti-inflammatory drugs. Lambs with severe lameness and severely swollen joints were euthanized, and routine necropsy was undertaken with a focus on the joints. Further, a herd-specific autogenous vaccine was produced by a specialized laboratory. In conclusion, E. rhusiopathiae infection should be considered as a differential diagnosis in herds associated with lameness and polyarthritis in lambs aged between two up to 17 months.

Erysipelothrix rhusiopathiae is a Gram-positive bacillus that is rarely reported as a causative agent of infections in humans. Human cases in most instances present as localized or generalized skin infections. Invasive infections are exceptionally described and septic forms are usually associated with endocarditis. We report a case of invasive infection caused by Erysipelothrix rhusiopathiae without skin or endocardium involvement in a patient with systemic lupus erythematosus (SLE). To our knowledge, this is the first report of an isolated bacteraemia due to this pathogen in a patient with SLE without skin or endocardium involvement.

The authors report a patient with a rare manifestation of invasive septic Erysipelothrix rhusiopathiae infection without endocardial involvement. Our patient presented with progressive paraparesis and subacute fever for ten days. He had underlying diabetes mellitus and alcoholic cirrhosis. Magnetic resonance imaging (MRI) of the lumbosacral spine showed a psoas abscess with vertebral osteomyelitis and discitis at level of L23 of the lumbar spine. His blood culture grew E. rhusiopathiae. Transthoracic echocardiography demonstrated normal endocardium. Surgical drainage and debridement with concomitant intravenous antibiotics administration resulted in clinical improvement, including neurological status. MRI showed resolution of the psoas abscess and osteomyelitis. Erysipelothrix infection should be considered as a causative pathogen of musculoskeletal infection in immunocompromised patients. To our knowledge, this is the first case report of psoas abscess caused by E. rhusiopathiae in Thailand.

Invasive infection with animal-associated bacteria, Erysipelotrix rhusiopathiae, is unusual and has, to our knowledge, never been described as the cause of infected total hip arthroplasty. We describe how an infected total hip arthroplasty caused by these bacteria is eradicated using standard surgical and antibiotic treatment. Before 2-stage revision surgery, the patient had persistent groin pain, elevated C-reactive protein, radiographic periprosthetic osteolysis, excessive intra-articular fluid, and periprosthetic activity accumulation on the white cell scan. The patient was treated with benzylpenicillin after confirmed sensitivity of E rhusiopathiae diagnosed by culture of five tissue samples and polymerase chain reaction of the prosthetic sonicate sample. Sixteen weeks after the last stage of revision surgery, there were no signs of reoccurring infection., ((c) 2010 Elsevier Inc. All rights reserved.)

A 14-month-old, male German Shepherd dog was admitted with a six-week history of lameness and swelling of the right hindlimb. Clinical examination revealed polyarthritis, fever, petechiae and ecchymoses of the abdominal skin and prepuce. The haematology and blood chemistry were indicative of sepsis. Mediolateral radiographic views of both of the stifle joints revealed signs of bilateral articular capsule swelling. The radiographical, bacteriological and necropsy findings confirmed a diagnosis of septic polyarthritis due to infection with Erysipelothrix rhusiopathiae.

Erysipelothrix rhusiopathiae is a Gram-positive bacillus that is infrequently responsible for infections in humans. Most human cases present as localized or generalized cutaneous infections. An invasive septic form, usually associated with endocarditis, has rarely been described. We report here an invasive infection caused by E. rhusiopathiae without endocardium involvement. To our knowledge, this is the first report of an intra-abdominal abscess due to this pathogen., (Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

A 47-year-old fishmonger presented with a history of weight loss and lethargy. On investigation he was found to have myeloma. He presented again before follow up, with a 3-day history of fever and a maculopapular rash. He was admitted to the haematology ward and treated with broad-spectrum antibiotics. Blood cultures were found to be positive for Erysipelothrix rhusiopathiae. Penicillin treatment was given, and he made a good recovery. The importance of occupational illness in an already immunocompromised patient and of taking a proper social and occupational history from patients on admission is illustrated through this case.

Erysipelothrix rhusiopathiae is a thin, non-sporulating, gram-positive rod found worldwide and hosted by many domestic or savage animals, birds, fish, and shell/fish. It is extremely resistant in the external environment (soil, surface waters). Human infection is prevalently related to occupational exposure to sick or infected contaminated animals (anthropozoonosis). Frequently, the disease manifests itself as an acute cellulitis on the skin around the gate of entry. Systemic infection is uncommon, most commonly involving the endocardium or joints. We present a case of subacute E. rhusiopathiae endocarditis in a male patient at occupational hazard for this infection (animal genitor in a zoo). The patient was treated with cefoperazone, the course being favorable. Later on, he required mitral valvuloplasty.

Erysipelothrix rhusiopathiae is a Gram-positive rod, carried by many domestic and pet animals and very resistant in the environmental habitat, causing an anthropo-zoonosis infection in humans. It can determine, most frequently, a skin infection and may cause also septic arthritis or systemic infection, usually associated with aortic endocarditis. Bacteremia without endocarditis is a very rare presentation, generally seen in immunocompromised patients. We report such an unexpected diagnosis in a 75-years old woman, with mitral regurgitation, who was investigated for a persistent febrile syndrome, with no evidence of vegetation on repeated echo examinations and no evidence of the entry portal and who recovered successfully from an E. rhusiopathiae bacteremia with Ampicillin iv. therapy for 14 days.

Botryomycosis is a rare bacterial infection of the skin and, rarely, viscera that is characterized by the formation of characteristic hyaline grains. We encountered a patient with Erysipelothrix rhusiopathiae endocarditis who developed visceral botryomycosis. He was a 54-year-old black man who presented in sepsis with a history of progressive weakness and severe weight loss. He died 10 hours after admission. At autopsy, endocarditis was identified, along with infarcts of the spleen and kidneys. Microscopically, visceral botryomycosis was seen. With these bacteria, an animal source is usually identified, although one was not found in this man. Erysipelothrix rhusiopathiae is an organism that is becoming identified in a range of infections in humans, the manifestations and pathophysiology of which are still being discovered.

A woman with diabetes mellitus type 2 had a thigh infection that drained foul-smelling pus. Necrotizing fasciitis was diagnosed surgically and histopathologically, with Erysipelothrix rhusiopathiae being the predominant organism. A pet goldfish might have been the source.

Erysipelas is a bacterial disease caused by Erysipelothrix rhusiopathiae, which may infect swine as well as several other species of mammals and birds, including domestic fowl. In poultry, erysipelas may cause sudden high mortality due to septicemia. This communication describes the first isolation of E. rhusiopathiae from the haematophagous poultry red mite, Dermanyssus gallinae DeGeer (Acari: Dermanyssidae), that was collected on three farms where hen erysipelas was diagnosed. The bacteria were isolated from the integument as well as from the interior of the mites. Serotypes 1a and 1b of E. rhusiopathiae found in the mites corresponded with those isolated from the diseased birds. These findings imply that D. gallinae is a potential vector of E. rhusiopathiae. The current lack of effective measures to control D. gallinae causes recurring mite problems in poultry facilities once afflicted by this parasite. Consequently, mites containing E. rhusiopathiae may act as reservoir hosts of this bacterium, allowing it to persist in the poultry house between flock cycles as a source of infection for the replacement pullets. The zoonotic potentials of both E. rhusiopathiae and D. gallinae should also be considered.

We describe herein the case of a man with Erysipelothrix rhusiopathiae septic arthritis and possible infective endocarditis. This is the first report in the English-language medical literature of septic arthritis caused by this organism.

A 63-year-old woman was admitted to our hospital because of fever and altered mentality. Brain magnetic resonance imaging showed multiple infarctions at the basal ganglia, cerebellum, and subcortical white matter with petechial hemorrhage, which was more easily seen on gradient echo images. Erysipelothrix rhusiopathiae was cultured from her blood, and echocardiography showed septic vegetations in the mitral valve. She recovered fully after 6 weeks of appropriate antibiotic treatment.

We describe a middle-aged lady with systemic lupus erythematosus who presented with chronic left knee monoarthritis without constitutional symptoms. The histology of synovial tissue taken at arthroscopy showed acute inflammation and Erysipelothrix rhusiopathiae, identified with some difficulty, was isolated from the enrichment broth only. Blood cultures were negative. Her history revealed significant exposure to pond fish. She responded well to intravenous penicillin and remains well 12 months later.

The bacterial species Erysipelothrix rhusiopathiae is found worldwide as a commensal or a pathogen in a variety of animals. One well-defined pattern of human infection is an uncommon bacteremic form, with or without cutaneous involvement, usually complicated by endocarditis. We report the case of a 38-year-old male butcher with E. rhusiopathiae bacteremia, native aortic valve endocarditis and perivalvular abscess. The patient was released after six weeks of intravenous ceftriaxone and aortic valve replacement because of severe regurgitation.

History and Clinical Findings: A 67 year-old country woman was admitted to the hospital because of a four weeks history of continuous catarrh, arthralgia and fever. Recently, she had also developed upper abdominal pain after oral ibuprofen treatment. The clinical examination showed a patient of impaired general condition. The heart and lungs were auscultatory normal and there were no signs of dyspnea, cyanosis or inflammatory skin lesions., Examinations: Physical examination of heart and lung, electrocardiography and transthoracic echocardiography were without pathological findings., Clinical Course: Gastroscopy revealed acute antral gastritis and duodenitis with presence of Helicobacter pylori. Eradication therapy resolved the abdominal symptoms but fever returned after the antibiotic therapy was stopped. The patient developed a severe endocarditis with progressive mitral regurgitation within a few days. Erysipelothrix rhusiopathiae was isolated from blood cultures and identified by conventional and molecular methods. The patient was treated successfully with 3 x 2 g ampicillin daily, applied parenterally for six weeks, and a mitral valve replacement., Conclusion: This was an unusual manifestation of systemic Erysipelothrix rhusiopathiae infection. The bacterium Erysipelothrix rhusiopathiae has still to be considered in the diagnosis and treatment of endocarditis in patients with increased risk of exposure (e.g. farmers, butchers and fishermen).

Erysipeloid is a rarely reported zoonotic infection caused by Erysipelothrix rhusiopathiae. We report a case of coexisting erysipeloid and orf infections in a sheep farmer, an association not previously recorded to our knowledge.

The adhesion of Erysipelothrix rhusiopathiae (E. rhusiopathiae) to the cultured confluent monolayer of rat aortic endothelial cells (EC) and the role of neuraminidase in the interaction between EC and E. rhusiopathiae were examined. One EC line was obtained by collagenase treatment of rat aorta. The EC showed a typical cobblestone appearance and possessed the factor VIII related antigen. When cultured more than two weeks after reaching confluence, the EC formed a vascular plexus-like appearance. E. rhusiopathiae began to adhere to EC within 2 minutes after the beginning of culture and adhered at a constant rate for 20 minutes. The adhesion of bacteria to EC was closely related to the release of sialic acid from the EC. Significantly more bacteria adhered to neuraminidase treated EC, and bacterial adhesion was inhibited dose-dependently by N-acetylneuraminic-lactose, which is the substrate of bacterial neuraminidase. It is concluded that bacterial neuraminidase plays an essential role in initiating the interaction between EC and E. rhusiopathiae, which would contribute to the genesis of arteritis.

The arthritic activity in the initial phase and during manifestation of experimental erysipelas in rats, an animal model for human rheumatoid arthritis, was studied by plethysmometrical methods. The development of body weight and specific pathologic alterations peculiar to the model such as keratitis, thrombosis of the aorta and gangrene of the tip of the tail served as additional parameters. In the volumetric analysis it could be shown that the first arthritic swelling on both hind legs develops symmetrically up to day 6 post infection in rats with about 200 g of body weight-and in contrast-on the 2nd p.i. in younger animals with about 120 g. The first maximal paw volume was measured on day 9 p. i., the greatest decrease in body weight-a reduction of 25%-on day 10 p. i. In addition the reaction of the animal model following the application of steroid and non-steroid symptomatically as well as cytostatically acting antirheumatic drugs was tested. Daily treatment with acetylsalicylic acid, indomethacine or hydrocortisone provoked more or less significant inhibition of arthritic swelling in the paw. Only at the onset of arthritis acetylsalicylic acid was more effective than the other antiphlogistic drugs. No measurable increase of paw volume during cyclophosphamide treatment could be evaluated. None of the antirheumatics used had a positive effect on body weight developement. In hydrocortisone and also in cyclophosphamide treated rats a greater decrease was obtained than in the infected controls. No thrombosis developed after cytostasis with cyclophosphamide. The advantages of this systemic connective tissue disease with regard to its comparability with human rheumatoid arthritis and due to the course of its arthritic manifestation are discussed, together with the disadvantages specific to the model and the experimental conditions.

The role of the neuraminidase produced by Erysipelothrix rhusiopathiae (E. rhusiopathiae) in the pathogenesis of arteritis and induced thrombocytopenia was examined using young and adult rats. There was a close correlation between bacterial invasion, desialation and cell infiltration in the common iliac artery. E. rhusiopathiae induced arteritis from the second and third day after inoculation with 3 X 10(8) viable bacteria in the young and adult rats, respectively. This delay with age was closely related to the increase of free sialic acid in the plasma. The sites invaded by E. rhusiopathiae coincided with the desialated lesions, and the bacteria invaded the periarterial region which was always accompanied by desialation when examined with FITC-conjugated peanut lectin. The free sialic acid in the plasma was, at least partly, considered to originate from the desialation of the arterial wall caused by E. rhusiopathiae. The platelet number decreased significantly after inoculation. The sialic acid content of the platelets prepared from circulating blood at 12 and 18 hours after inoculation showed a slight decrease and decreased further when the platelets were incubated with the bacteria. Platelets obtained from circulating blood within 24 hours after inoculation or incubated with the bacteria had demonstrated desialated sites as detected by immunofluorescent staining with FITC-conjugated peanut lectin. In conclusion, free sialic acid in the plasma was considered to be a good marker of the desialation of the arteries caused by E. rhusiopathiae, and the neuraminidase produced by the bacteria would be a key to solve the pathogenesis of the arteritis and thrombocytopenia.