The first case of invasive S. suis infection in a human in Lithuania: Case report and literature review.

Streptococcus suis is an emerging zoonotic pathogen that can cause infections in pigs and humans, usually after ingestion of raw pork meat or wound contamination. We report the first S. suis meningitis and sepsis case in a human in Lithuania. 51 y.o. man with no relevant comorbidities, but with a history of alcohol abuse was admitted to the emergency department due to new-onset tonic-clonic seizures. The patient became agitated, aggressive and hypotensive, later sensible contact was lost (GCS of 8 points). Blood tests and cerebrospinal fluid (CSF) analysis were consistent with bacterial meningitis, thus ceftriaxone and ampicillin were empirically started. S. suis, susceptible to penicillin and ceftriaxone, was identified in blood and CSF cultures. The patient recovered without any immediate significant sequels, but later developed cognitive impairment. The route of infection for our patient was not clear because he had no contact with pigs or raw pork, although he lived in the countryside, helped farmers with non-pig related work, had some scabs on his shins and ate home-cooked pork. The paper presents the case report and review of the literature.