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Title: CASE REPORT: STREPTOCOCCUS BOVIS SEPTIC ARTHRITIS IN A DAIRY FARMER

Author
item GRANT, J - FOX MEMORIAL HOSPITAL
item SHANG, WILLIAM - FOX MEMORIAL HOSPITAL
item Whitehead, Terence

Submitted to: Clinical Infectious Diseases
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/26/1996
Publication Date: N/A
Citation: N/A

Interpretive Summary: Streptococcus bovis is a bacterium that is normally found in the rumen of ruminant animals such as cattle and sheep and has potential as an industrial organism for production of such products as lactate and ethanol. S. bovis is also rarely isolated from humans, but has been reported to cause such diseases as endocarditis and meningitis. Recent reports also suggest a correlation between increased levels of S. bovis and human colonic cancer. Identification of human isolates of S. bovis has been a problem, due to differences in biochemical characteristics between the human and ruminal strains of S. bovis. In order to overcome this problem, we have developed genetic tests to identify human and ruminal strains of S. bovis. These tests were used to identify a strain of S. bovis that caused a rare arthritis disease in a dairy farmer. The results indicated that the S. bovis was probably of human origin and not ruminal origin.

Technical Abstract: In this case report, we describe a dairy farmer in whom Streptococcus bovis was the causal agent of septic arthritis. Skeletal infections by this organism are rare, and septic arthritis, in particular, has only been described once. The discovery of S. bovis outside the alimentary canal, typically bacteremia, usually prompts consideration of a possible colonic malignancy. Because S. bovis is a common inhabitant in the feces of ruminant animals, both occupational origins and colonic malignancy were investigated. Molecular hybridization studies were performed to differentiate between these two etiologies. Greater homology with isolates of human origin rather than ruminal origin indicated that the patient's strain of S. bovis was probably not occupationally related. Additionally, colonoscopy failed to reveal underlying colonic neoplasia. Molecular subspeciation may present an important dimension in determining the clinical significance of extra-intestinal S. bovis isolates.