INFEKCIJA UZROKOVANA SA STREPTOCOCCUS SUIS, ZOONOZA NA KOJU TREBA MISLITI – Prikaz dvaju bolesnika

Jasminka Kopić, Maja Tomić Paradžik, Nenad Pandak

Sažetak. Streptococcus suis u prvome je redu patogen svinje, ali i uzročnik bolesti ljudi izloženih kontaktu sa svinjama (mesari, radnici u klaonicama, uzgajivači stoke). U ljudi najčešće izaziva gnojni meningitis s gluhoćom i ataksijom, a opisani su i rijetki slučajevi septičkog šoka s višeorganskim zatajenjem i smrtnim ishodom. U radu su prikazana dva bolesnika, liječena u Općoj bolnici »Dr. Josip Benčević«, Slavonski Brod, kod kojih je kao uzročnik bolesti identificiran Streptococcus suis tip 1. Jedan je bolesnik imao tešku bolest sa septičkim šokom, višeorganskim zatajenjem i smrtnim ishodom. Drugi je bolesnik imao gnojni meningitis s gluhoćom. Oba bolesnika su odranije imala oštećenje imunosti. Vjerojatno su zaraženi tijekom »svinjokolje« U naših je bolesnika izoliran tip 1 Streptococcus suis, za razliku od većine izvješća o bolesti u ljudi izazvanih tipom 2. U našoj je zemlji nužno učiniti epidemiološku obradu zaraženosti ljudi, osobito profesionalno izloženih kontaktu sa svinjama ili svinj skim mesom.

Summary. Streptococcus suis is primarily pig’s pathogen, but can cause disease in a man exposed to contact with pigs (butchers, abbatoir workers, farmers). Infection in man is most frequently manifested as purulent meningitis, with deafness and ataxia, but there are rare reports on septic shock with multiple organ failure and death. We report two patients with Streptococcus suis type 1 infection, treated in »Dr Josip Ben~evi}« General Hospital, Slavonski Brod. The first patient suffered a very abrupt and severe illness, with septic shock, multiple organ failure and lethal outcome. The second patient had purulent meningitis with deafness. Both of them had a defect in immunologic function before infection. They were probably infected during manipula- tion with pork meat at home. Our patients had infection with Streptococcus suis type 1, contrary to reports on prevalent human infection with type 2. It is necessary to make epidemiologic survey on human infection with that pathogen, especially in those professionally exposed to pigs and pork meat.