Table 1. Summary of gross necropsy, histological and microbiological findings from cases 1 and 2, and archived case.
Case | Gross findings | Histopathologic diagnoses | Culture site results |
---|---|---|---|
1* | Focal pale tan discoloration at dorsal base of the heart; pale circumferential dark circular lesions on splenic surface; mottled and tan serosal surface of kidney; cortical pitting on surface of left kidney; 3 implantation sites in left horn of uterus | Streptococcal septicaemia Severe multifocal acute necrotizing suppurative myocarditis, epicarditis and valvular endocarditis with intra-lesional cocci Moderate multifocal acute suppurative necrotizing splenitis with intra-lesional cocci Moderate multifocal neutrophilic and histiocytic interstitial pneumonia with vasculitis and fibrin thrombi admixed with bacteria Moderate multifocal acute suppurative necrotizing nephritis with intra-lesional cocci Mild multifocal acute suppurative meningoencephalitis Severe multifocal acute necrotizing suppurative metritis with intra-lesional cocci |
Blood – Streptococcus agalactiae Cardiac lesion – S. agalactiae - 3 isolates Spleen – S. agalactiae, Enterobacter aerogenes, Staphylococcus sciuri, Enterococcus faecalis Vaginal swab – S. agalactiae, S. sciuri, E. aerogenes, Proteus mirabilis, E. coli, E. faecalis Cervical contents – S. agalactiae, E. faecalis - 2 isolates, E. aerogenes, P. mirabilis, Enterococcus avium |
2* | 3–4 tan to pale yellow plaque-like lesions on the pericardium extending into the parenchyma; two pinpoint dark red to haemorrhagic lesions on the lung surface; left kidney with pinpoint tan-white focal lesions extending 1.5 mm into the parenchyma; mildly distended uterus with 1 haemorrhagic and autolysed fetus in each horn | Severe multifocal acute necrotizing myocarditis, epicarditis and endocarditis with atrial and ventricular thrombi admixed with intra-lesional cocci Moderate multifocal subacute neutrophilic and histiocytic interstitial pneumonia Severe multifocal acute necrotizing suppurative metritis with intra-lesional cocci Mild multifocal subacute lymphocytic pancreatitis Streptococcal septicaemia |
Nares wash – S. agalactiae, E. faecalis, Streptococcus mitis, S. sciuri, E. aerogenes - S. agalactiae, E. faecalis, Streptococcus mitis, S. sciuri, E. aerogenes Cardiac lesion – S. agalactiae - S. agalactiae Lung -–S. agalactiae, E. faecalis, E. avium, E. coli - S. agalactiae, E. faecalis, E. avium, E. coli Kidney – S. agalactiae - S. agalactiae Brain – S. agalactiae, E. faecalis, Streptococcus oralis - S. agalactiae, E. faecalis, Streptococcus oralis Vaginal swab – S. agalactiae, E. faecalis, E. avium, E. coli, Morganella morganii, P. mirabilis - S. agalactiae, E. faecalis, E. avium, E. coli, Morganella morganii, P. mirabilis Uterine swab – S. agalactiae, E. faecalis, E. avium, E. coli Fetus – S. agalactiae, E. faecalis - 2 isolates, E. coli |
Archived case† | Ventricular thrombus; autolysed fetus‡ | Septic right ventricular thrombosis with Gram-positive and -negative bacteria Grossly fibrinopurulent inflammation of the placenta, macerated fetus Renal abscess with Gram-positive bacteria Severe submassive and centrilobular hepatic necrosis Pleural effusion Extramedullary splenic myelopoiesis |
Cardiac thrombus – S. agalactiae, P. mirabilis, E. coli Fetus – S. agalactiae, P. mirabilis, E. coli |
*Histopathology reviewed by V. B.
†Histopathology reviewed by L. R.
‡Notes from necropsy of archived case with GBS-related pathology not further detailed.