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Frontiers in Microbiology 2022Three distinct streptococcal species: , and , belonging to the group (SAG), also known as group, have been attracting clinicians and microbiologists, not only as oral... (Review)
Review
Three distinct streptococcal species: , and , belonging to the group (SAG), also known as group, have been attracting clinicians and microbiologists, not only as oral commensals but also as opportunistic pathogens. For years they have been simply classified as so called viridans streptococci, and distinct species were not associated with particular clinical manifestations. Therefore, description of SAG members are clearly underrepresented in the literature, compared to other medically relevant streptococci. However, the increasing number of reports of life-threatening infections caused by SAG indicates their emerging pathogenicity. The improved clinical data generated with the application of modern molecular diagnostic techniques allow for precise identification of individual species belonging to SAG. This review summarizes clinical reports on SAG infections and systematizes data on the occurrence of individual species at the site of infection. We also discuss the issue of proper microbiological diagnostics, which is crucial for further clinical treatment.
PubMed: 35898914
DOI: 10.3389/fmicb.2022.956677 -
Infection and Drug Resistance 2022, a commensal, plays an important role in purulent infections. It has been reported as aggressive pathogen causing pleural empyema. But the role of in empyema has not...
BACKGROUND
, a commensal, plays an important role in purulent infections. It has been reported as aggressive pathogen causing pleural empyema. But the role of in empyema has not been taken seriously. There are no studies about clinical characteristics of empyema caused by domestically and abroad. This study aimed to explore the clinical features and management of empyema caused by .
METHODS
A retrospective review of 9 patients diagnosed with empyema caused by in a hospital between January 2010 and August 2021 was performed.
RESULTS
empyema were mostly seen in old males (66.7%) with comorbid diseases. The high-risk factors include diabetes mellitus, oral infection, and oral surgery. All were unilateral encapsulated empyema (right-side, 55.6%), diagnosed with pneumonia (bilateral pneumonia, 88.9%; ipsilateral lung abscess, 44.4%). 33.3% of patients had and anaerobes co-isolated. were sensitive to penicillin G, linezolid, levofloxacin, vancomycin, ceftriaxone, and chloramphenicol, resistant to erythromycin, tetracycline, and clindamycin. 33.3% of the patients needed ventilator support. The primary treatment to empyema was timely pus drainage, intravenous antibiotics, and enough nutrition support, intrapleural fibrinolytics and surgery (VAST recommended first) in necessity.
CONCLUSION
may cause pneumonia and lung abscess first and then spread to cause empyema mainly in old males with comorbid diseases. often co-isolated with anaerobes in empyema. Antibiotics should cover simultaneously both and anaerobes.
PubMed: 36329986
DOI: 10.2147/IDR.S382484 -
Cureus Apr 2021The group (SAG) consists of three bacteria (, , and ) that are known commensals of the upper respiratory, digestive, and reproductive tracts. While a rare occurrence,...
The group (SAG) consists of three bacteria (, , and ) that are known commensals of the upper respiratory, digestive, and reproductive tracts. While a rare occurrence, these bacteria have the capability of causing devastating pyogenic infections and ensuing abscess formations. It is often difficult to distinguish this group as a contaminant or the offending organism (as it is often cultured in respiratory specimens); therefore, it is important to understand the risk factors, clinical presentation, and diagnostic findings that can provide a more accurate picture to identify the organism. Published literature pertaining to the SAG group has rarely documented any invasive surgical intervention that was undertaken for treatment. We describe a case of a 59-year-old male who presented for persistent chest pain and profuse productive cough weeks after he was diagnosed with a left lower extremity deep vein thrombosis and right-sided pulmonary embolism. The patient was found to have a rapidly evolving right middle lobe lung abscess complicated by a right hemithorax empyema. Management included an exploration of the right chest, decortication, parietal pleurectomy, and partial excision of the right middle lobe. Subsequently, the patient completed four weeks of antibiotics with ertapenem.
PubMed: 34017651
DOI: 10.7759/cureus.14534 -
BMC Infectious Diseases Dec 2021Streptococcus constellatus is a member of Streptococcus anginosus group (SAG) that tends to cause pyogenic infections in various sites. However, Streptococcus... (Review)
Review
BACKGROUND
Streptococcus constellatus is a member of Streptococcus anginosus group (SAG) that tends to cause pyogenic infections in various sites. However, Streptococcus constellatus is easily ignored by routine clinical laboratory tests for its prolonged anaerobic culture environment.
CASE PRESENTATION
A 71-year-old man was admitted to our hospital due to productive cough, fever, chest pain and shortness of breath for 3 weeks. Chest computed tomography showed patchy opacities and right-sided pleural effusion, so a chest tube was inserted and purulent and hemorrhagic fluid was aspirated. The routine etiological examinations of the pleural effusion were all negative, and next-generation sequencing (NGS) detected Streptococcus constellatus. Intravenous piperacillin-tazobactam 4.5 g every 8 h was used accordingly. The patient recovered and subsequent chest computed tomography confirmed the improvement.
CONCLUSIONS
We reported a case of empyema secondary to Streptococcus constellatus infection, which was identified by NGS, instead of bacterial culture. This case highlights the utility of NGS in detecting pathogens negative in traditional bacterial tests.
Topics: Aged; Empyema; Fever; Humans; Laboratories, Clinical; Male; Streptococcal Infections; Streptococcus constellatus
PubMed: 34930151
DOI: 10.1186/s12879-021-06955-2 -
Case Reports in Obstetrics and... 2019Previous reports have described cases of abscess formation by involving the oral cavity, gastrointestinal tract, and septic thrombophlebitis of the right ovarian vein...
BACKGROUND
Previous reports have described cases of abscess formation by involving the oral cavity, gastrointestinal tract, and septic thrombophlebitis of the right ovarian vein with subsequent bacteremia and septic shock. Ascending infection from the genital tract to the fallopian tubes resulting in peritonitis from is a rare clinical circumstance where there is minimal information in the literature to guide its diagnosis, management, and expected prognosis.
CASE
A 36-year-old G3P0111 developed a tubo-ovarian abscess two weeks after intrauterine device (IUD) removal and then rapidly decompensated with septic shock from peritonitis due to infection. The patient was also newly diagnosed with diabetes and in diabetic ketoacidosis (DKA) on presentation. She received broad-spectrum antibiotic coverage and required two exploratory surgical procedures to obtain source control. Two Interventional Radiology- (IR-) guided drainage procedures were subsequently performed to drain remaining fluid collections. Her recovery involved a prolonged ICU stay. On hospital day seventy-three, after receiving approximately 8 weeks of antibiotics and the above noted procedures the patient was discharged to a subacute rehabilitation facility.
CONCLUSION
is a highly pathogenic organism once a systemic septic infection has become established that can cause an ascending genital tract infection resulting in tubo-ovarian abscess formation, peritonitis, and septic shock.
PubMed: 31467746
DOI: 10.1155/2019/6491617 -
Frontiers in Microbiology 2022together with and constitute the group (SAG), until recently considered to be benign commensals of the human mucosa isolated predominantly from oral cavity, but also... (Review)
Review
together with and constitute the group (SAG), until recently considered to be benign commensals of the human mucosa isolated predominantly from oral cavity, but also from upper respiratory, intestinal, and urogenital tracts. For years the virulence potential of SAG was underestimated, mainly due to complications in correct species identification and their assignment to the physiological microbiota. Still, SAG representatives have been associated with purulent infections at oral and non-oral sites resulting in abscesses formation and empyema. Also, life threatening blood infections caused by SAG have been reported. However, the understanding of SAG as potential pathogen is only fragmentary, albeit certain aspects of SAG infection seem sufficiently well described to deserve a systematic overview. In this review we summarize the current state of knowledge of the pathogenicity factors and their mechanisms of action.
PubMed: 36386673
DOI: 10.3389/fmicb.2022.1025136 -
Annals of Palliative Medicine Apr 2022Streptococcus constellatus (S. constellatus) is a Gram-positive commensal bacterium that is commonly found in the oral, nasal, pharyngeal, gastrointestinal, and...
Streptococcus constellatus (S. constellatus) is a Gram-positive commensal bacterium that is commonly found in the oral, nasal, pharyngeal, gastrointestinal, and urogenital tracts. It can be further consisted by three subspecies: subsp, constellatus, subsp. pharynges, and subsp. viborgensis. As an opportunistic pathogen, S. constellatus can cause abscesses and bacteremia, so infection requires timely and accurate identification in clinical practice. There are a few case reports describing the range of infections caused by S. constellatus, which include intracardiac, thoracic, intracranial, and abdominal infections. Here we report the first case of thigh abscess caused by S. constellatus subsp. constellatus which was rarely insensitive to penicillin in a patient with exacerbation of bronchiectasis. The patient improved significantly after receiving antibiotic therapy with ceftriaxone and vancomycin, as well as percutaneous catheter drainage guided by color ultrasonography. The thigh abscess did not recur during follow-up. This case report demonstrates that although S. constellatus is a rare infectious pathogen, it is important to gain a better understanding of the range of possible infections to ensure timely diagnosis. Furthermore, although the prognosis of most patients with such infections is relatively good, the timely identify the resistant strains and administration of sensitive antibiotics along with abscess drainage may ensure effective treatment.
Topics: Abscess; Anti-Bacterial Agents; Bronchiectasis; Humans; Streptococcal Infections; Streptococcus; Thigh
PubMed: 34328004
DOI: 10.21037/apm-21-740 -
Cureus Aug 2023A 60-year-old male presented to our institution for abdominal pain and was later admitted to the intensive care unit for shock, acute hypoxemic respiratory failure, and...
A 60-year-old male presented to our institution for abdominal pain and was later admitted to the intensive care unit for shock, acute hypoxemic respiratory failure, and acute kidney injury. He was subsequently found to have a large left-sided pleural effusion with empyema secondary to . With the emerging threat and growing prevalence of group pathogens, there is now greater clinical importance in identifying viridans streptococci at the species level. While immunosuppressed individuals are at greater risk of opportunistic pathogens, this case presentation demonstrated that can remain a serious community-acquired pathogen for the non-immunosuppressed. Continued interprofessional team care management and a greater look into the reasons for greater pathogenicity may be indicated.
PubMed: 37711946
DOI: 10.7759/cureus.43468 -
Cureus Aug 2020Streptococcus constellatus is a member of Streptococcus milleri group which is a subgroup of Viridans streptococci, first described by Guthof in 1956 after being...
Streptococcus constellatus is a member of Streptococcus milleri group which is a subgroup of Viridans streptococci, first described by Guthof in 1956 after being isolated from dental abscesses. S. constellatus, a gram positive, non-sporing, non-motile, catalase negative cocci, is the normal flora of the oropharyngeal, gastrointestinal and urogenital tract. It is not a commonly encountered pathogen but has a propensity to form abscesses and cause bacteremia in the immunocompromised patient. Here, we report a 78-year-old man with sepsis due to Streptococcus constellatus liver abscess. The patient had a history of hypertension, stroke, benign prostatic hyperplasia, vascular dementia and myocardial infarction status post coronary artery bypass grafting. There has been no particular link between any of these conditions to S. constellatus. However, immunocompromised status predisposes to fulminant infection and formation of abscesses. The patient was febrile with a temperature of 99.1°F, blood pressure of 143/73 mmHg and the heart rate (HR) of 98. Labs revealed a leukocytosis of 16.90 K/uL, hemoglobin 11.8 g/dL, hematocrit 35.8%, total bilirubin 1.7 mg/dL, direct bilirubin 1.0 mg/dL, aspartate aminotransferase (AST) 44 IU/L, alanine aminotransferase (ALT) 28 IU/L, alkaline phosphatase (ALKP) 176 IU/L and lactate dehydrogenase (LDH) was 290 IU/L. He was started on intravenous Maxipime and Unasyn which was switched to Rocephin and Clindamycin based on the Infectious disease recommendations. Metronidazole was also started and the serologies were sent for Entamoeba histolytica. Computerized tomography (CT) scan showed an abscess in the right lobe of the liver which was finally drained using an interventional radiology (IR)-guided approach. The cultures from the fluid and blood yielded S. constellatus and thus Metronidazole was discontinued. The patient improved after a few days and the drainage catheter was pulled out and the patient discharged in stable condition.
PubMed: 32953314
DOI: 10.7759/cureus.9802