Streptococcus Suis is an avoidable infection in humans with exposure/contact of contaminated pigs/pig products causing meningitis and septicemia; loss of hearing is a more frequent complication (Gill, C.O. et al). We present here 2 cases of bacterial meningitis from streptococcus suis infection.

A 57-year old male with fever, biparieto-occipital headache, non-rotatory dizziness, vomiting, left ear hearing loss, and decreasing sensorium. He recently ate at a local Samgyupsal place. He was febrile, drowsy, disoriented, had left ear sensorineural hearing loss, and signs of meningeal irritation. On brain MRI, splenium restricted diffusion with bilateral frontal flair hyperintensity without enhancement seen. Blood culture showed streptococcus suis. Cerebrospinal fluid (CSF) was turbid, leukocyte 60 cells/uL, elevated protein and glucose, other CSF studies were unremarkable. He was started on Penicilin G and steroid therapy.

A 51-year old female with fever, bi-parietal headache, non-rotatory dizziness, vomiting, hearing loss, and signs of meningeal irritation. She recently ate at a local Samgyupsal place. She was febrile, awake, had right ear sensorineural hearing loss, and signs of meningeal irritation. On brain MRI, there was bilateral cerebral sulci and cerebellar interfoliar spaces diffuse flair hyperintensities with ventral brainstem and leptomeningeal enhancement. CSF was clear with leukocyte 16 cells/uL, elevated protein, and low glucose. Blood and CSF culture showed streptococcus suis; other CSF studies were unremarkable. The patient was started on Penicilin G and steroid therapy.

Streptococcus suis in humans is acquired from occupational or household exposure to contaminated pigs/pig meat (Huang, Y.T. et al). It is recognized that suboptimal pork preparation/consumption may increase the risk of acquiring this disease, as our cases above.

The treatment principles in bacterial meningitis are mostly the same regardless of the isolate. The treatment with steroids is still controversial however there are studies that show improvement in the patient’s hearing and dizziness.