TABLE 1.

Cases of Streptococcus equi subsp. ruminatorum human infections^a

Case reference	Age (yr)	Past medical history	Route of acquisition	Infection type(s)	Serum WBC count/mm3	Fever (°C)	Type(s) of positive samples	Molecular testing	Treatment	Outcome
19	53	HIV infection	Animal source not identified; probable inhalation (no other portal of entry found)	Bacteremia, meningitis, pulmonary infiltrates	9,600 (133 CD4 cells)	38.9	Blood, CSF, bronchial aspirate	16S rRNA gene sequencing	Cefotaxime (12 g/J) + vancomycin (30 mg/kg of body wt/J) + dexamethasone (40 mg/J)	Died within 2 days
20	70	Lumbar spinal stenosis treated by laminectomy, hypertension, IgG(κ) monoclonal gammopathy	Occasional contact with horses; inoculation (skin lesion)	Mitral valve endocarditis complicated by spondylodiskitis	Normal count	39	Blood	rrs gene sequencing	Amoxicillin (200 mg/kg/J) + rifampin (20 mg/kg/J) + gentamicin (3 mg/kg/J)	Recovered
Present case	63	Pituitary adenoma, aortic valve replacement	Occasional contact with horses; probable inhalation (no other portal of entry found)	Prosthetic aortic valve endocarditis	10,100	38.2	Blood	16S rRNA, sodA, rpoB, and szp gene sequencing	Amoxicillin (12 g/J) + gentamicin (240 mg/J) + cardiac surgery	Recovered

^aCSF, cerebrospinal fluid; WBC, white blood cell. All subjects were male.