{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:39:44Z","timestamp":1789738784168,"version":"4.0.1"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,16]],"date-time":"2021-05-16T00:00:00Z","timestamp":1621123200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,16]],"date-time":"2021-05-16T00:00:00Z","timestamp":1621123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p><jats:italic>Streptococcus pseudoporcinus<\/jats:italic> (<jats:italic>S. pseudoporcinus<\/jats:italic>) was first identified in 2006. It cross-reacts with Lancefield group B antigen agglutination reagents and has been misidentified as <jats:italic>S. agalactiae<\/jats:italic>. Sites of <jats:italic>S. pseudoporcinus<\/jats:italic> isolation include the female genitourinary tract, urine, wounds, and dairy products. The prevalence of vaginal colonization is reportedly between 1 and 5.4%. Two uneventful cases of soft tissue infection caused by <jats:italic>S. pseudoporcinus<\/jats:italic> were reported in the past. However, since late 2019, six cases of invasive <jats:italic>S. pseudoporcinus<\/jats:italic> infections have emerged in the literature, one of which was fatal.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We describe a fatal case of a Caucasian male with spontaneous bacterial peritonitis associated with bacteremia due to a multidrug-resistant <jats:italic>S. pseudoporcinus<\/jats:italic> strain in a patient with decompensated liver cirrhosis. Despite the patient\u2019s good general condition and stable blood test results when he had visited the outpatient clinic for large-volume paracentesis a few days before admission, this time he presented to the emergency department with a rapidly worsening clinical condition and with laboratory features consistent with multiple-organ dysfunction syndrome, and succumbed within a short period.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Contrary to what was thought until recently, multidrug-resistant <jats:italic>S. pseudoporcinus<\/jats:italic> may cause invasive, disseminated, fatal disease in humans. According to current limited data, vancomycin, linezolid, daptomycin, levofloxacin, clindamycin, and tetracycline seem to be the most effective antimicrobial agents against multidrug-resistant strains, and should be the empirical choice in cases of disseminated <jats:italic>S. pseudoporcinus<\/jats:italic> infection until laboratory antimicrobial susceptibility results are available. Improvements and new approaches for bacterial identification in routine clinical microbiology laboratories may reveal the real spectrum of <jats:italic>S. pseudoporcinus<\/jats:italic> infections in humans, which is currently believed to be underestimated. <jats:italic>SS. pseudoporcinus<\/jats:italic> could emerge as a serious medical problem in the near future, similar to other \u03b2-hemolytic streptococci.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-021-02832-3","type":"journal-article","created":{"date-parts":[[2021,5,15]],"date-time":"2021-05-15T23:05:17Z","timestamp":1621119917000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Fatal Streptococcus pseudoporcinus disseminated infection in decompensated liver cirrhosis: a case report"],"prefix":"10.1186","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8203-2748","authenticated-orcid":false,"given":"George D.","family":"Liatsos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasia","family":"Tsiriga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spyridon P.","family":"Dourakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,16]]},"reference":[{"key":"2832_CR1","doi-asserted-by":"publisher","first-page":"2584","DOI":"10.1128\/JCM.02707-05","volume":"44","author":"S Bekal","year":"2006","unstructured":"Bekal S, Gaudreau C, Laurence RA, Simoneau E, Raynal L. Streptococcus pseudoporcinus sp. nov., a novel species isolated from the genitourinary tract of women. J Clin Microbiol. 2006;44:2584\u20136.","journal-title":"J Clin Microbiol."},{"key":"2832_CR2","doi-asserted-by":"publisher","first-page":"3591","DOI":"10.1128\/JCM.01481-12","volume":"50","author":"PL Shewmaker","year":"2012","unstructured":"Shewmaker PL, Steigerwalt AG, Whitney AM, Morey RE, Graziano JC, Facklam RR, et al. Evaluation of methods for identification and determination of the taxonomic status of strains belonging to the Streptococcus porcinus-Streptococcus pseudoporcinus complex isolated from animal, human, and dairy sources. J Clin Microbiol. 2012;50:3591\u20137.","journal-title":"J Clin Microbiol."},{"key":"2832_CR3","doi-asserted-by":"publisher","first-page":"3926","DOI":"10.1128\/JCM.02363-15","volume":"53","author":"N Suwantarat","year":"2015","unstructured":"Suwantarat N, Grundy M, Rubin M, Harris R, Miller JA, Romagnoli M, et al. Recognition of Streptococcus pseudoporcinus colonization in women as a consequence of using matrix-assisted laser desorption ionization-time of flight mass spectrometry for Group B Streptococcus identification. J Clin Microbiol. 2015;53:3926\u201330.","journal-title":"J Clin Microbiol."},{"key":"2832_CR4","doi-asserted-by":"publisher","first-page":"3041","DOI":"10.1128\/JCM.00802-09","volume":"47","author":"SD Mahlen","year":"2009","unstructured":"Mahlen SD, Clarridge JE 3rd. Thumb infection caused by Streptococcus pseudoporcinus. J Clin Microbiol. 2009;47:3041\u20132.","journal-title":"J Clin Microbiol."},{"key":"2832_CR5","doi-asserted-by":"publisher","first-page":"280","DOI":"10.5582\/irdr.2018.01110","volume":"7","author":"S Sawamura","year":"2018","unstructured":"Sawamura S, Niimori D, Ihn H. A case of leg cellulitis caused by multidrug-resistant Streptococcus pseudoporcinus. Intractable Rare Dis Res. 2018;7:280\u20132.","journal-title":"Intractable Rare Dis Res."},{"key":"2832_CR6","doi-asserted-by":"publisher","first-page":"1620","DOI":"10.1099\/jmm.0.47295-0","volume":"56","author":"C Gaudreau","year":"2007","unstructured":"Gaudreau C, Simoneau E, Labrecque O, Laurence RA, Laferri\u00e8re C, Miller M, et al. Epidemiological, biochemical and antimicrobial susceptibility characteristics of Streptococcus pseudoporcinus isolated in Quebec, Canada, from 1997 to 2006. J Med Microbiol. 2007;56:1620\u20134.","journal-title":"J Med Microbiol."},{"key":"2832_CR7","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1128\/JCM.01965-10","volume":"49","author":"KA Stoner","year":"2011","unstructured":"Stoner KA, Rabe LK, Austin MN, Meyn LA, Hillier SL. Incidence and epidemiology of Streptococcus pseudoporcinus in the genital tract. J Clin Microbiol. 2011;49:883\u20136.","journal-title":"J Clin Microbiol."},{"key":"2832_CR8","doi-asserted-by":"publisher","first-page":"e00446","DOI":"10.1128\/JCM.00446-19","volume":"57","author":"H Salimnia","year":"2019","unstructured":"Salimnia H, Robinson-Dunn B, Gundel A, Campbell A, Mitchell R, Taylor M, et al. Suggested modifications to improve the sensitivity and specificity of the 2010 CDC-recommended routine Streptococcus agalactiae screening culture for pregnant women. J Clin Microbiol. 2019;57:e00446-e519.","journal-title":"J Clin Microbiol."},{"key":"2832_CR9","doi-asserted-by":"publisher","first-page":"490.e1","DOI":"10.1016\/j.ajog.2019.01.219","volume":"220","author":"M Grundy","year":"2019","unstructured":"Grundy M, Suwantarat N, Rubin M, Harris R, Hanlon A, Tekle T, et al. Differentiating Streptococcus Pseudoporcinus from GBS: could this have implications in pregnancy? 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Case Rep Infect Dis. 2020;2020:4135246.","journal-title":"Case Rep Infect Dis."},{"key":"2832_CR12","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1536\/ihj.19-446","volume":"61","author":"M Akagi","year":"2020","unstructured":"Akagi M, Iwanaga N, Torisu Y, Fujita H, Kawahara C, Horai Y, et al. IgA vasculitis triggered by infective endocarditis of pulmonary artery with congenitally corrected transposition of the great arteries. Int Heart J. 2020;61:404\u20138.","journal-title":"Int Heart J."},{"key":"2832_CR13","doi-asserted-by":"publisher","first-page":"100643","DOI":"10.1016\/j.nmni.2019.100643","volume":"34","author":"PD Hai","year":"2020","unstructured":"Hai PD, Dung NM, Son PN, Phuong LL, Thuyet BT, Hoa LV. First report of infective endocarditis caused by Streptococcus pseudoporcinus in Vietnam. New Microbes New Infect. 2020;34:100643.","journal-title":"New Microbes New Infect."},{"key":"2832_CR14","doi-asserted-by":"publisher","first-page":"2119","DOI":"10.4103\/jfmpc.jfmpc_663_19","volume":"9","author":"K Gupta","year":"2020","unstructured":"Gupta K, Mohanty M, Rath S. Bacteremia because of Streptococcus pseudoporcinus in a Syphilis-HIV co-infected patient: a case report. J Family Med Prim Care. 2020;9:2119\u201320.","journal-title":"J Family Med Prim Care."},{"key":"2832_CR15","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/4309191","author":"SL Pierce","year":"2019","unstructured":"Pierce SL, Shibib DR, Robison D, Edwards RK. A case of maternal sepsis and fetal demise associated with Streptococcus pseudoporcinus. Case Rep Obstet Gynecol. 2019. https:\/\/doi.org\/10.1155\/2019\/4309191.","journal-title":"Case Rep Obstet Gynecol."}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-02832-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-021-02832-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-02832-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,15]],"date-time":"2021-05-15T23:09:45Z","timestamp":1621120185000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-021-02832-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,16]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2832"],"URL":"https:\/\/doi.org\/10.1186\/s13256-021-02832-3","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,16]]},"assertion":[{"value":"22 May 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 March 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient\u2018s son, given that the patient had died, for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that there is no conflict of interest to disclose.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"240"}}