Pastor's heart implant infection caused by feral pig meat gift, Florida doctors say
The man went to the Malcom Randall Veteran Affairs Medical Center in Gainesville in fall 2020 seeking help for chest pain, but his health problems started much earlier, doctors said in a case report published March 12 in the peer-reviewed journal Emerging Infectious Diseases.
The man, who worked as a pastor, was being treated for type 2 diabetes and heart failure, and previously had a biventricular automated implantable cardiac defibrillator placed on his heart, according to the report.
He first sought help for the unusual pain in his chest in spring 2019, doctors said, and he had hardened tissue on the left side of his chest, as well as swelling from excess fluid.
Doctors suspected an infection of his heart implant and started courses of antibiotics, according to the report. The pastor continued the course of treatment for six months before the side effects became too great and he stopped treatment.
For a few months, he was fine, doctors said. But, eventually the chest pain returned, this time accompanied by a fever and his implant had migrated within his chest. The pastor went to a hospital in Alabama for treatment, but blood testing for infection was negative, and the man was discharged.
By fall of 2020, he was in the hospital in Gainesville for most testing, doctors said, and this time blood tests revealed a bacterial infection.
Doctors removed his heart implant and sent it, along with the fluid found in its pocket, to the Florida Department of Health and Centers for Disease Control and Prevention for testing, according to the report.
The results came back as a Brucella suis infection, which causes a rare bacterial disease in humans and is spread by animals, according to the CDC.
The pastor lived on a farm in rural Florida that kept dogs outside and had a group of goats, according to the report, but the man wasn't involved in their care.
Previous cases of B. suis infections have been identified in Florida wild pig hunters, so doctors asked the pastor if he hunted pigs.
'He confirmed no hunting activities but recalled receiving feral swine meat as a gift from a local hunter around 2017 on several occasions,' doctors said. 'He did not remember who specifically gave him the meat but recalled handing the raw meat and blood with bare hands before cooking and consuming it. This encounter likely served as his exposure to B. suis.'
Brucella bacteria have a long 'incubation period,' which is the time between when someone might be exposed to the bacteria and when they may start exhibiting symptoms of infection, according to the CDC. In some cases, symptoms of a Brucella infection may not appear for weeks or months after someone has been exposed.
Brucellosis, the disease caused by Brucella bacteria, can manifest as fever, headaches, joint pain, muscle pain, fatigue, anorexia and weight loss, meningitis or specific organ conditions, according to the CDC.
The condition can be treated with antibiotics.
'Depending on the timing of treatment and severity of illness, recovery may take a few weeks to several months,' according to the CDC. 'Though the infection can last a long time, brucellosis rarely causes death. It's estimated that no more than 2% of all people with brucellosis die from their infection.'
The pastor was treated with an antibiotic regimen for 6 weeks, then his heart implant was replaced four months after it was initially removed, according to the report. Three years later, there was no sign of brucellosis in his follow-up appointment.
'More than 1 million feral swine live in Florida and can carry zoonoses that include leptospirosis, trichinella and toxoplasmosis,' doctors said. 'Feral swine hunters are at risk of contracting B. suis, and measures to reduce that risk include the use of personal protective equipment and thoroughly cooking animal products before consumption.'
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