Teen Hospitalised for Six Weeks After Rare Disease from Horses

A 17-year-old girl in Limerick, Ireland, required a six-week hospital stay after contracting a rare bacterial infection from horses. The teenager was admitted to the emergency department of University Hospital Limerick (UHL) with a series of painful symptoms, ultimately diagnosed with Streptococcus equi, a pathogen typically associated with equine strangles. While zoonotic transmission is rare, the infection can have severe consequences in humans.

The girl initially experienced symptoms including a sore throat, cough, and fever for about a week. Although her condition seemed to improve, she participated in a horse grooming show. Following the event, she developed a rash on her left leg and painful swelling that caused her to limp. After testing positive for the influenza B virus, she was advised to self-isolate and rest. However, subsequent blood tests revealed the presence of Streptococcus equi, leading to her readmission to the hospital.

Severe Consequences of Bacteremia

Upon her second admission, the teenager was diagnosed with bacteremia, a condition where bacteria enter the bloodstream, which can lead to septic shock. She also suffered from left lower limb cellulitis and myositis, a rare muscle disease. Treatment involved six weeks of intravenous antibiotics. An MRI conducted two months later indicated significant improvement, although mild residual myofascial edema—swelling of the muscles and surrounding tissues—remained.

Medical professionals at UHL highlighted the necessity of comprehensive history-taking to expedite diagnosis and treatment of Streptococcus equi. In a case report published in the latest issue of the Irish Medical Journal, they noted that the initial influenza B infection may have caused transient immunosuppression, increasing the risk of bacterial transmission from the horses she was grooming.

“We believe this case underscores the impact of transient immunosuppression potentially induced by the influenza B virus infection on the severity of S. equi infection,” the report stated. Furthermore, the doctors emphasised the importance of obtaining a thorough clinical history to prevent diagnostic delays and suboptimal patient outcomes.

This incident serves as a cautionary tale regarding the rare but serious risks of zoonotic diseases, especially for individuals with compromised immune systems. The case illustrates the critical need for awareness and prompt medical attention in similar situations, particularly for those who interact closely with animals.