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MSphere Apr 2023Streptococcus anginosus is a prevalent member of the human flora. While it has been found in the microbiota of "healthy" asymptomatic individuals, it has also been...
Streptococcus anginosus is a prevalent member of the human flora. While it has been found in the microbiota of "healthy" asymptomatic individuals, it has also been associated with genitourinary tract infections and bacteremia. Based upon multilocus sequence analysis, two subspecies and two genomosubspecies have been characterized for the species. We previously conducted whole-genome sequencing of 85 isolates from the urinary tract. Here, we present genomic analysis of this species, including isolates from the urinary tract as well as gut and fecal, vaginal, oral, respiratory, and blood and heart samples. Average nucleotide identity and core genome analysis revealed that these strains form two distinct groups. Group 1 is comprised of the type strain and other previously identified subspecies and genomosubspecies, including isolates from throughout the human body. In contrast, group 2 consists of predominantly urinary streptococci ( = 77; 85.6%). Both of these groups are distinct from other members of the Streptococcus anginosus group (SAG) species S. intermedius and S. constellatus. Genes conserved among all strains of one group but not in any strains in the other group were next identified. Group 1 strains included genes found in S. intermedius and , suggesting that they were lost within the ancestor of the group 2 strains. In contrast, genes unique to the group 2 strains were homologous to more distant streptococci, indicative of acquisition via horizontal gene transfer. These genes are ideal candidates for use as marker genes to distinguish between the two groups in the human microbiota. Whole-genome analysis of strains provides greater insight into the diversity of this species than from marker genes alone. Our investigation of 166 publicly available genomes via average nucleotide identity and core genome analysis revealed two phylogenomically distinct groups of this species, with one group almost exclusively consisting of isolates from the urinary tract. In contrast, only 8 urinary strains were identified within the other group, which contained the type strain, as well as all identified subspecies and genomosubspecies. While genomic analysis suggested that this urinary group of is genomically different from the previously characterized subspecies, phenotypic characterization is still needed. Given prior reports of the prevalence of in the urinary tract of both continent and incontinent females, future studies are needed to investigate if the symptom state of the urinary tract is associated with these two different groups.
Topics: Female; Humans; Streptococcus anginosus; Streptococcus; Genomics; Urinary Tract Infections; Multilocus Sequence Typing
PubMed: 36744899
DOI: 10.1128/msphere.00687-22 -
Gut Pathogens Jan 2024Pyogenic Liver Abscesses (PLA) are the most common type of visceral abscess. They generally develop in a context of biliary disease or hematogenous seeding, but a...
BACKGROUND
Pyogenic Liver Abscesses (PLA) are the most common type of visceral abscess. They generally develop in a context of biliary disease or hematogenous seeding, but a complete diagnostic work-up is always required in order not to miss other important causes, including above all malignancies of the gastro-intestinal tract.
CASE PRESENTATION
Herein, we report a particular case of a 80 years-old immunocompetent woman hospitalized for sepsis. At the end of the diagnostic process, Streptococcus constellatus (Sc) was identified as the cause of sepsis, multiple PLA were found together with a previous unknown ileal malignancy. We speculated about a possible correlation among these three entities (i.e. sepsis from Sc, PLA and tumors).
CONCLUSIONS
Detection of Sc in blood should raise red flags in clinicians as aggressive clinical presentation are possible.
PubMed: 38178146
DOI: 10.1186/s13099-023-00593-6 -
Anesthesia and Pain Medicine Apr 2020Herpes zoster ophthalmicus (HZO) is an infectious disease that results from the reactivation of latent varicella zoster virus in the ophthalmic branch of the trigeminal...
BACKGROUND
Herpes zoster ophthalmicus (HZO) is an infectious disease that results from the reactivation of latent varicella zoster virus in the ophthalmic branch of the trigeminal ganglia. HZO manifests with herpes zoster-like symptoms such as rash with or without signs of ocular involvement. Cavernous sinus thrombosis (CST) is a life-threatening condition accompanied by signs and symptoms involving the eyes and the cranial nerves.
CASE
We report a case of septic cavernous sinus thrombosis (caused by subsp. ) which was masked by the simultaneous occurrence of HZO in this patient, resulting in delayed diagnosis.
CONCLUSIONS
CST may be obscured by HZO, prompt diagnosis and treatment is necessary when such case arrive.
PubMed: 33329815
DOI: 10.17085/apm.2020.15.2.205 -
Metagenomic next-generation sequencing for the diagnosis of oral and maxillofacial space infections.Journal of Dental Sciences Jul 2023Metagenomic next-generation sequencing (mNGS) has been widely used for the detection of pathogens causing infectious diseases. This study aimed to evaluate the potential...
BACKGROUND/PURPOSE
Metagenomic next-generation sequencing (mNGS) has been widely used for the detection of pathogens causing infectious diseases. This study aimed to evaluate the potential ability of mNGS to detect pathogens causing oral and maxillofacial space infection (OMSI) and compare the results with those of the traditional diagnostic microbial culture method.
MATERIALS AND METHODS
We retrospectively reviewed the data of 218 patients diagnosed with OMSI who underwent microbial culture and mNGS at the Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, from July 2020 to January 2022.
RESULTS
The positivity rate of mNGS (216 cases) was significantly higher than that of microbial culture (123 cases). The most frequently detected bacteria were different between these two detection methods. (16.05%, 35), (15.69%, 34) and (6.88%, 15) were the most commonly isolated bacteria by culture. However, (61.47%, 134), (68.35%, 149) and (57.34%, 125) were the most commonly detected bacteria by mNGS. mNGS also has advantages in diagnosing viral infections. The optimal numbers of diagnostic reads were 1162 and 588 for the diagnosis of and infections, respectively. Read numbers were significantly correlated with C-reactive protein (CRP), procalcitonin (PCT), and blood glucose levels and neutrophil percentage (NEUT%).
CONCLUSION
For pathogens causing OMSI, mNGS had a higher rate of microbial pathogen detection and remarkable advantages in identifying coinfections involving viruses and fungi. The read numbers for mNGS are important for diagnostic accuracy and disease severity evaluation.
PubMed: 37404664
DOI: 10.1016/j.jds.2022.09.002 -
The Journal of International Medical... Nov 2023Empyema is a common complication of pneumonia, caused by the accumulation of purulent exudate due to pathogenic bacteria invading the pleural cavity. and are pathogens...
Empyema is a common complication of pneumonia, caused by the accumulation of purulent exudate due to pathogenic bacteria invading the pleural cavity. and are pathogens that rarely cause pneumonia with empyema. Herein, a case of severe empyema caused by these two pathogens, confirmed by metagenomic next-generation sequencing (mNGS) of pleural effusion cultures, is reported. A male Chinese patient in his late sixties presented with wheezing, cough, sputum expectoration, and fever. Blood and sputum cultures were negative for pathogens, but the pleural effusion culture was positive for , and was also found to contain , confirmed by mNGS. The patient's symptoms improved after treatment with cefoperazone/sulbactam and moxifloxacin. Pneumonia caused by and is rare; however, coinfection with these pathogens may cause severe pneumonia, with or without empyema.
Topics: Humans; Male; Streptococcus constellatus; Empyema, Pleural; Coinfection; Pneumonia; Pleural Effusion
PubMed: 37994021
DOI: 10.1177/03000605231210657 -
Optometry and Vision Science : Official... Oct 2023We present a rare case of Streptococcus constellatus -induced odontogenic orbital cellulitis.
PURPOSE
We present a rare case of Streptococcus constellatus -induced odontogenic orbital cellulitis.
METHODS
An 8-year-old boy presented to an outpatient clinic with complaints of right-sided toothache, right eye swelling, and decreased visual acuity. He was referred to a pediatric critical care department for further management. Comprehensive diagnostic assessments, such as ophthalmic examination, blood tests, computed tomography, and MRI, were performed.
RESULTS
On presentation, the best-corrected visual acuities were 20/250 and 20/20 in the right and left eyes, respectively. Examination revealed grade 2+ eyelid edema and erythema and grade 4+ chemosis and exophthalmos in the right eye. The patient displayed restricted eye movements in all directions. Blood tests revealed a total white blood cell count of 12,100 cells/μL. Axial and coronal computed tomography revealed right-sided maxillary sinus, ethmoidal sinus, and orbital abscesses. Therefore, the patient was diagnosed with septicemia, orbital cellulitis, and orbital apex syndrome in the right eye. Intravenous antibiotics were administered; paracentesis of the orbital abscess was performed under local anesthesia. However, the patient's condition worsened, resulting in a complete loss of light perception in the right eye. Accordingly, surgery was performed under general anesthesia within 24 hours of admission; the surgery involved drainage of the orbital abscess through an inferior intraorbital incision, as well as drainage of the ethmoid sinus and maxillary sinus abscesses via nasal endoscopy. A culture obtained from the orbital abscess yielded S. constellatus . The infection was managed by a combination of surgical intervention, antibiotics, steroids, and hyperbaric oxygen therapy. However, because of optic nerve injury, vision in the affected eye partially recovered to 20/200.
CONCLUSIONS
Streptococcus constellatus -induced pediatric orbital cellulitis can result in significant morbidity. The significant improvement in vision, from no light perception to 20/200, emphasizes the importance of timely diagnosis and treatment in patients who present with acute orbital cellulitis and vision loss symptoms.
Topics: Male; Humans; Child; Orbital Cellulitis; Abscess; Streptococcus constellatus; Vision Disorders; Exophthalmos; Anti-Bacterial Agents
PubMed: 37639550
DOI: 10.1097/OPX.0000000000002062 -
Journal of Medical Case Reports Oct 2020Pyopneumothorax secondary to Streptococcus constellatus infection is a clinically rare event, and few cases have been reported. (Review)
Review
BACKGROUND
Pyopneumothorax secondary to Streptococcus constellatus infection is a clinically rare event, and few cases have been reported.
CASE PRESENTATION
We report the case of a 55-year-old Han Chinese man with underlying diabetes who presented with fever of 17 days duration. A pulmonary computed tomography scan revealed right-sided massive pyopneumothorax. A culture of the pleural effusion and blood grew S. constellatus. A drug sensitivity test showed that the isolate was sensitive to linezolid, penicillin G, cefotaxime, vancomycin, and cefuroxime. Our patient was treated with linezolid for a total of 6 weeks. Subsequently, his chest computed tomography scan showed improved lung condition.
CONCLUSION
To the best of our knowledge, this is the first case of pyopneumothorax secondary to S. constellatus to be treated with linezolid. Pyopneumothorax may be caused by streptococcal infection, and linezolid is another good choice for treatment.
Topics: Empyema, Pleural; Humans; Linezolid; Male; Middle Aged; Pneumothorax; Streptococcal Infections; Streptococcus constellatus
PubMed: 33023642
DOI: 10.1186/s13256-020-02475-w -
World Journal of Clinical Cases Jun 2024This case series investigated the clinical manifestations, diagnoses, and treatment of cerebral abscesses caused by . We retrospectively analyzed the clinical...
BACKGROUND
This case series investigated the clinical manifestations, diagnoses, and treatment of cerebral abscesses caused by . We retrospectively analyzed the clinical characteristics and outcomes of three cases of cerebral abscesses caused by and conducted a comprehensive review of relevant literature.
CASE SUMMARY
Case 1 presented with a history of left otitis media and exhibited high fever, confusion, and vomiting as primary symptoms. Postoperative pus culture indicated a brain abscess caused by infection. Case 2 experienced dizziness for two days as the primary symptom. Postoperative pus culture suggested an intermediate streptococcal brain abscess. Case 3: Enhanced head magnetic resonance imaging (MRI) and diffusion-weighted imaging revealed occupancy of the left temporal lobe, initially suspected to be a metastatic tumor. However, a postoperative pus culture confirmed the presence of a brain abscess caused by infection. The three cases presented in this case series were all patients with community-acquired brain abscesses resulting from angina caused by Streptococcus group infection. All three patients demonstrated sensitivity to penicillin, ceftriaxone, vancomycin, linezolid, chloramphenicol, and levofloxacin. Successful treatment was achieved through stereotaxic puncture, drainage, and ceftriaxone administration with a six -week course of antibiotics.
CONCLUSION
Preoperative enhanced head MRI plays a critical role in distinguishing brain tumors from abscesses. Selecting the correct early diagnostic methods for brain abscesses and providing timely intervention are very important. This case series was in accordance with the CARE guidelines.
PubMed: 38898852
DOI: 10.12998/wjcc.v12.i17.3243 -
Open Life Sciences 2023A lung abscess is a necrotizing infection caused by microbiomes that lead to the loss of healthy lung tissue. The routine culture is a waste of time and yields...
A lung abscess is a necrotizing infection caused by microbiomes that lead to the loss of healthy lung tissue. The routine culture is a waste of time and yields false-negative results, and clinicians could only choose empiric therapy or use broad-spectrum antibiotics, which could significantly contribute to the problem of resistance or aggravate the condition. We report three patients with a routine-culture-negative lung abscess. The presenting symptoms included fever, cough, dyspnea, and chest pain, and a computed tomography scan revealed a lesion in the lungs. The bronchoalveolar lavage fluid and pleural fluid were tested for pathogens using metagenome next-generation sequencing (mNGS), and the results revealed and spp. (, ) as the most represented microbial pathogens. Our data demonstrated that mNGS could be a promising alternative diagnostic tool for pathogen detection, and the pathogen lists indicate that it will be important to focus on the genus rather than the dominant spp. in terms of co-infection of pathogen determined by shotgun mNGS.
PubMed: 37483431
DOI: 10.1515/biol-2022-0651 -
Microorganisms Nov 2021Deep neck infections (DNIs) such as parotid abscesses are medical emergencies with a seemingly different etiology and treatment course from other DNIs. We sought to...
Deep neck infections (DNIs) such as parotid abscesses are medical emergencies with a seemingly different etiology and treatment course from other DNIs. We sought to confirm this in the present retrospective population-based cohort study. Between August 2016 and January 2020, 412 patients with DNIs seen at a tertiary medical center were enrolled in this study. Infections of the parotid space were compared with those of other deep neck spaces, according to patient characteristics. All patients were divided into parotid space (PS; = 91, 22.08%) and non-parotid space (NPS; = 321, 77.92%) subgroups. We further divided the patients into single parotid space (PS-single; = 50, 12.13%), single non-parotid space (NPS-single; = 149, 36.16%), multiple parotid space (PS-multiple; = 41, 9.95%), and multiple non-parotid space (NPS-multiple; = 172, 41.76%) DNI subgroups. In the PS-single and PS-multiple subgroups, a longer duration of symptoms ( = 0.001), lower white blood cell count ( = 0.001), lower C-reactive protein level ( = 0.010), higher rate of ultrasonography-guided drainage ( < 0.001), and lower rates of surgical incision and drainage ( < 0.001) were observed compared with the NPS-single and NPS-multiple subgroups. The PS group had a higher positive culture rate ( < 0.001), and lower positive ( = 0.002), and ( = 0.025) culture rates than the NPS group. In a multivariate analysis, was independently associated with parotoid space involvement in comparisons of the PS and NPS groups, PS-single and NPS-single subgroups, and PS-multiple and NPS-multiple subgroups. The clinical presentation of a parotid space infection differs from that of other deep neck space infections.
PubMed: 34835486
DOI: 10.3390/microorganisms9112361