Summary
Group C Streptococci comprises of Streptococcus dysgalatiae
that is further divided into two subspecies, namely S. dysgalactiae
subspecies equisimilis and S. dysgalactiae subspecies dysgalactiae.
S. dysgalactiae subspecies dysgalactiae is mainly an animal
pathogen but few cases of human infections have been described
in the literature. A 40 year old patient presented to the hospital with
complaints of pain in pelvis and suprapubic area. Urine sample of
the patient was subjected to microscopy and culture for isolation
and identification of the etiological agent. S. dysgalactiae
subspecies dysgalactiae was identified from the clinical specimen
of the patient by conventional and automated methods. The patient
was successfully treated with third generation cephalosporin. With
newer or rarely reported pathogens causing human diseases and
increase in number of immunocompromised individuals in the
population, the pathogenic potential of such isolates should not be
undermined and a careful correlation with the clinical profile should
help guide a clinician in optimum treatment of the patient.
Introduction
Group C Streptococci comprises of Streptococcus dysgalatiae
that is further divided into two subspecies, namely S. dysgalactiae
subsp. equisimilis (SDSE) and S. dysgalactiae subsp. dysgalactiae
(SDSD) (1). SDSE exhibits distinct Lancefield group antigens C
and G whereas SDSD exhibits antigen C and L (2). SDSD is mainly
a pathogen of animals but human infections have been reported on
rare occasions in the literature. A literature search on PubMed using
the search term “((Streptococcus dysgalactiae) AND (subspecies
dysgalactiae)) NOT (subspecies equisimilis)” helped us identify
five reports of SDSD infections in humans (1-5). Here, we present
a rare case of a patient that was diagnosed with SDSD urinary tract
infection (UTI) and treated for the same at our hospital.
Case description
A 40-years-old female visited the out patient department of our
tertiary care center with complaints of pain in pelvic and suprapubic
region, over the past few weeks, which was insidious in onset, not
associated with vaginal discharge. The patient also experienced
occasional episodes of pain in abdomen. Her menstrual history was
insignificant and ruled out pregnancy. The patient was married,
having kids and had no history of contact with multiple partners.
There was no past medical history or history of instrumentation or
surgical intervention. On examination, the patient reported slight
tenderness in the suprapubic area but there was no guarding or
rigidity in the abdomen. No organomegaly was detected upon
physical examination. Her body temperature was 38.3°C, total
leucocyte count was elevated (17300/µL).
The radiological investigations included Ultrasonography
(USG) of the abdomen and X-ray of the pelvis and lumbar spine.
While the x-rays were normal, there was evidence of hepatomegaly
with coarsened texture of liver parenchyma and periportal
echogenicity around the left portal vein. Kidneys and urinary tract
showed no abnormality on USG. Liver function tests were
Correspondence: Vibhor Tak, Associate Professor, Department of
Microbiology, All India Institute of Medical Sciences (AIIMS),
Jodhpur, Rajasthan 342005, India.
Tel.: +91.8003991307.
E-mail: vibhor_tak@yahoo.com
Key words: Urinary tract infection, Streptococcus dysgalactiae, Group
C Streptococci, zoonotic disease.
Contributions: V.T. and Y.B. were involved in conception and design.
Y.B., V.T. and V.L.N. conducted the work and analyzed the data. Y.B.
prepared the first draft of the manuscript. V.T. and V.L.N. reviewed and
made corrections to the manuscript. All authors have read, approved the
final draft and account for all aspect of the work.
Conflict of interest: The authors declare no conflict of interest.
Funding: None.
Ethical considerations: Informed consent was taken from the patient
regarding the use of anonymised data for publishing that does not iden-
tify the patient. The study conforms to ethical guidelines for biomedical
research on human subjects as given by the Central Ethics Committee
on Human Research (CECHR) of Indian Council of Medical Research
(ICMR), New Delhi in 2006 and as given in the ‘Declaration of
Helsinki’ 1975 as revised in 2013.
Received for publication: 12 June 2020.
Revision received: 18 August 2020.
Accepted for publication: 19 September 2020.
©
Copyright: the Author(s), 2020
Licensee PAGEPress, Italy
Microbiologia Medica 2020; 35:9176
doi:10.4081/mm.2020.9176
This article is distributed under the terms of the Creative Commons
Attribution Noncommercial License (by-nc 4.0) which permits any non-
commercial use, distribution, and reproduction in any medium, provid-
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Streptococcus dysgalactiae subspecies dysgalactiae as a cause of urinary
tract infection in a diabetic woman: A case report and review of literature
Yashik Bansal, Vibhor Tak, Vijaya Lakshmi Nag
Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
[page 42] [Microbiologia Medica 2020; 35:9176]
Microbiologia Medica 2020; volume 35:9176
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