Streptococcus suis infection in Hong Kong.

Twenty-five patients were admitted to two hospitals in Hong Kong for Streptococcus suis infection between 1984 and 1993. Among them, 15 (60%) had an occupational exposure to pigs or pork, and four had a clear history of skin injury up to 16 days before admission. Examination of the cerebrospinal fluid of 21 patients confirmed the presence of meningitis in every case; the remaining four patients who did not have lumbar punctures had each presented with arthritis, bronchopneumonia, endocarditis and pyrexia without neck stiffness. The only fatality was a patient admitted in septicaemic shock with evidence of meningitis and disseminated intravascular coagulation. Of the 24 survivors, 16 (67%) acquired varying degrees of hearing loss as a result of meningitic involvement. All the isolates of S. suis were sensitive to penicillin or ampicillin, which was used alone or in combination with other antibiotics for every patient. Two patients had a relapse of symptoms when penicillin was stopped, but were successfully treated after the antibiotic was resumed for a total of 6 weeks. Over 100 cases of S. suis infection have been described previously, with a geographic distribution heavily biased towards Northern Europe and Southeast Asia. Lack of awareness of this unique zoonosis may be a reason why it is not diagnosed more readily elsewhere.