Case report: Spinal meningitis associated with streptococcus suis infection in a cat

A 7-year-old, castrated male, Persian cat was presented to the hospital with acute onset of extreme reluctance to move. The cat lived strictly indoors, with no contact with other animals. It was fed exclusively a commercial kibble. Severe mid lumbar back pain and extreme reluctance to move were the only abnormalities on physical and neurological examinations. Blood test abnormalities included mild lymphopenia and mildly increased serum creatinine kinase activity. Thoracic and lumbar survey radiography and magnetic resonance imaging (MRI) were unremarkable. Cerebrospinal fluid (CSF) analysis showed marked neutrophilic pleocytosis. CSF culture yielded pure growth of Streptococcus suis, sensitive to all antibiotics tested, excluding azithromycin. Pending CSF culture results, the initial treatment included intravenous clindamycin and ceftriaxone. After four days, the cat showed hypersalivation, vomiting and inappetence. Based on bacterial culture and sensitivity results, oral amoxicillin-clavulanic acid and cefpodoxime were prescribed. Three weeks after presentation, the cat had only mild inappetence, but was neurologically normal. A repeat CSF analysis two months post-discharge was normal. At that point antibiotic treatment was discontinued. S. suis is an uncommon causative infective agent of meningitis in cats, however, it should be considered as such, even when there is no historical evidence of exposure to pork or swine-related remains. The favorable outcome of this case was probably due to the very short lag of time from onset of clinical signs to the administration of aggressive antibiotic treatment, the overall good health status of this cat, and possibly low bacterial virulence.