The most common complication of Erysipelothrix endocarditis, congestive heart failure, was present in approximately 80% of patients ( 15).
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The clinical picture with respect to fever, emboli, peripheral skin stigmata of endocarditis, splenomegaly, hematuria, and mycotic aneurysm are similar for cases of Erysipelothrix endocarditis, and for those of endocarditis caused by other bacteria. In nearly 60% of patients, Erysipelothrix endocarditis apparently developed on previously normal heart valves. Approximately a third of patients have had a history of an antecedent skin lesion or a concurrent characteristic skin lesion of erysipeloid ( 15). Erysipelothrix endocarditis correlates highly with occupation (animal exposure), effects more males than females (which probably reflects occupational exposure), exhibits a peculiar aortic valve trophism, and is associated with significant mortality. Although most reported cases of endocarditis have involved native valves, prosthetic valve endocarditis has been reported( 16). It tends to occur in immunocompromised patients, whereas endocarditis usually occurs in immunocompromised patients. Bacteremia, without endocarditis, is being reported more frequently. rhusiopathiae have been reported, with a very high incidence of endocarditis among them ( 15, 33). It rarely develops from localized infection. Systemic infection with Erysipelothrix is uncommon.
The clinical course is much more protracted than in erysipeloid, and recurrences are not unusual. There are often systemic manifestations such as fever and arthralgias, but blood cultures are usually negative. In this situation, the cutaneous lesion progresses proximally from the site of inoculation or appears at remote areas. Features which help to distinguish erysipeloid from staphylococcal or streptococcal cellulitis include the absence of suppuration, the violaceous color, the lack of pitting edema, and the disproportionate pain seen with erysipeloid ( 28) Systemic symptoms are uncommon, with low grade fevers and arthralgias occurring in only 10% of cases ( 47). Lymphadenopathy and lymphangitis occur in approximately 20% cases. As it spreads peripherally, the central area clears. The lesion is violaceous in color and slightly elevated with well-defined borders ( 3). The incubation period is approximately five to seven days. Erysipeloid is painful and may have a throbbing or burning quality. Because of its mode of acquisition (i.e., contact with infected animals, fish, or their products, with organisms gaining entrance via cuts or abrasions on the skin), lesions are usually confined to the hands and fingers ( 7). Erysipeloid is the most common form of infection ( 18). There are 3 well-defined clinical entities described in humans: 1) A localized cutaneous form known as erysipeloid 2) A generalized cutaneous form 3) A bacteremic form which is often associated with endocarditis ( 17, 34). rhusiopathiae may rarely be part of the oral flora of these household pets ( 43). Recent reports of erysipeloid following cat and dog bites suggest that E. The occurrence of systemic infection that doesn't have an occupational link (predominantly in immunocompromised hosts) suggests that oropharyngeal or gastrointestinal colonization may occur. There are a few reports of bacteremia that have occurred after ingestion of undercooked pork.
The organism is communicable from animals to humans generally by direct cutaneous contact ( 5). Those at greatest risk include fishermen, butchers, slaughterhouse workers, veterinarians and housewives ( 27, 48, 49). Most human cases are related to occupational exposure ( 25). rhusiopathiae is closely related to the opportunity for exposure to the organism. It has been isolated from flies, mites, lice and ticks. It has been reported as a commensal or a pathogen in a wide variety of vertebrate and invertebrate species including swine, sheep, turkeys, ducks, and fish but also dogs, cats, chickens and rodents. EPIDEMIOLOGYĮrysipelothrix rhusiopathiae is found worldwide. Erysipelothrix rhusiopathiae is a slender, pleomorphic, non-sporulating, gram-positive rod.
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