Archive for January 2, 2016

Streptococcus anginosus pyogenic liver abscess following a screening colonoscopy.

Can J Infect Dis Med Microbiol. 2013 Summer;24(2):e45-6.

Bonenfant F1, Rousseau E1, Farand P1.

Author information

1Internal medicine division, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec.

Abstractin English, French

A previously healthy 58-year-old man presented with a septic thrombosis of the right hepatic vein and a pyogenic liver abscess (PLA) one week after undergoing a screening colonoscopy. Blood cultures and a radiological drainage specimen were both positive for Streptococcus anginosus. Evolution was favourable after six weeks of antibiotherapy. To the authors’ knowledge, the present report is the first to describe a PLA following a screening colonoscopy with no intervention. The authors hypothesize that silent microperforations during colonoscopy contributed to the infection. Although 20% to 40% of reported PLA cases are cryptogenic in the literature, it may be because of failure to recognize and report a precipitating factor such as colonoscopy. As more cases similar to the present case are reported, the number of cryptogenic cases may decrease.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3720014/pdf/jidmm24e045.pdf

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January 2, 2016 at 5:04 pm

Streptococcus intermedius Bacteremia and Liver Abscess following a Routine Dental Cleaning.

Case Rep Infect Dis. 2014;2014:954046.                            

Livingston LV1, Perez-Colon E1.

Author information

1Department of Internal Medicine, Morsani College of Medicine, University of South Florida, 17 Davis Boulevard, Suite 308, Tampa, FL 33606, USA.

Abstract

Streptococcus intermedius is a member of the Streptococcus anginosus group of bacteria. This group is part of the normal flora of the oropharynx, genitourinary, and gastrointestinal tracts; however, they have been known to cause a variety of purulent infections including meningitis, endocarditis, and abscesses, even in immunocompetent hosts. In particular, S. intermedius has been associated with the development of liver and brain abscesses. There have been several case reports of S. intermedius liver abscesses with active periodontal infection. To our knowledge, however, there has not been a case following a routine dental procedure. In fact, the development of liver abscesses secondary to dental procedures is very rare in general, and there are only a few case reports in the literature describing this in relation to any pathogen. We present a rare case of S. intermedius bacteremia and liver abscess following a dental cleaning. This case serves to further emphasize that even routine dental procedures can place a patient at risk of the development of bacteremia and liver abscesses. For this reason, the clinician must be sure to perform a detailed history and careful examination. Timely diagnosis of pyogenic liver abscesses is vital, as they are typically fatal if left untreated.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147201/pdf/CRIID2014-954046.pdf

January 2, 2016 at 5:02 pm

Streptococcus constellatus Causing Septic Thrombophlebitis of the Right Ovarian Vein with Extension into the Inferior Vena Cava.

Case Rep Infect Dis. 2015;2015:495898. .

Haidar A1, Haddad A1, Naqvi A1, Onyesoh NU1, Malik R2, Williams M1.

Author information

1Department of Internal Medicine, Providence Hospital and Medical Center, 16001 W. Nile Mile Road, Southfield, MI 48075, USA.

2Department of Infectious Disease, Providence Hospital and Medical Center, 16001 W. Nile Mile Road, Southfield, MI 48075, USA.

Abstract

Introduction. Streptococcus constellatus collectively with Streptococcus anginosus and Streptococcus intermedius constitute the Streptococcus anginosus (formerly Streptococcus milleri) group. Though they are commonly associated with abscesses, bacteremia with subsequent septic thrombophlebitis is extremely rare, and resulting mortality is infrequent.

Case Presentation. We report a case of a previously healthy 60-year-old African American female who presented with Streptococcus constellatus bacteremia associated with septic thrombophlebitis to the right ovarian vein extending into the inferior vena cava. She was urgently treated with antibiotics and anticoagulation.

Conclusion. Septic thrombophlebitis has a clinical presentation that is often misleading. Therefore, a high clinical index of suspicion and the use of appropriate imaging modalities (computed tomography) are essential in recognizing and confirming this diagnosis. Prompt treatment is warranted. Surgical thrombectomies have been successfully replaced by a combination of antibiotics and anticoagulation therapy.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480241/pdf/CRIID2015-495898.pdf

January 2, 2016 at 5:00 pm

The clinical features of respiratory infections caused by the Streptococcus anginosus group.

BMC Pulm Med. 2015 Oct 26;15:133.

1Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan, 1-17-1, Hamamachi, Wakamatsuku, Kitakyushu city, 808-0024, Fukuoka, Japan. sn0920@med.uoeh-u.ac.jp.

2Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan. yatera@med.uoeh-u.ac.jp.

3Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan. namihei@med.uoeh-u.ac.jp.

4Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan. yamasaki@med.uoeh-u.ac.jp.

5Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan. k-naito@med.uoeh-u.ac.jp.

6Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan. kentarouakata@med.uoeh-u.ac.jp.

7Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan, 1-17-1, Hamamachi, Wakamatsuku, Kitakyushu city, 808-0024, Fukuoka, Japan. shimabukuro@med.uoeh-u.ac.jp.

8Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan. h-ishimoto@med.uoeh-u.ac.jp.

9Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan, 1-17-1, Hamamachi, Wakamatsuku, Kitakyushu city, 808-0024, Fukuoka, Japan. nyan@med.uoeh-u.ac.jp.

10Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan. hmukae@med.uoeh-u.ac.jp.

BACKGROUND:

The Streptococcus anginosus group (SAG) play important roles in respiratory infections. It is ordinarily difficult to distinguish them from contaminations as the causative pathogens of respiratory infections because they are often cultured in respiratory specimens. Therefore, it is important to understand the clinical characteristics and laboratory findings of respiratory infections caused by the SAG members. The aim of this study is to clarify the role of the SAG bacteria in respiratory infections.

METHODS:

A total of 30 patients who were diagnosed with respiratory infections which were caused by the SAG bacteria between January 2005 and February 2015 were retrospectively evaluated.

RESULTS:

Respiratory infections caused by the SAG were mostly seen in male patients with comorbid diseases and were typically complicated with pleural effusion. Pleural effusion was observed in 22 (73.3%) patients. Empyema was observed in half of the 22 patients with pleural effusion. S. intermedius, S. constellatus and S. anginosus were detected in 16 (53.3 %), 11 (36.7 %) and 3 (10.0 %) patients, respectively. Six patients had mixed-infections. The duration from the onset of symptoms to the hospital visit was significantly longer in “lung abscess” patients than in “pneumonia” patients among the 24 patients with single infections, but not among the six patients with mixed-infection. The peripheral white blood cell counts of the “pneumonia” patients were higher than those of the “lung abscess” patients and S. intermedius was identified significantly more frequently in patients with pulmonary and pleural infections (pneumonia and lung abscess) than in patients with bacterial pleurisy only. In addition, the patients in whom S. intermedius was cultured were significantly older than those in whom S. constellatus was cultured.

CONCLUSIONS:

Respiratory infections caused by the SAG bacteria tended to be observed more frequently in male patients with comorbid diseases and to more frequently involve purulent formation. In addition, S. intermedius was mainly identified in elderly patients with having pulmonary infection complicated with pleural effusion, and the aspiration of oral secretions may be a risk factor in the formation of empyema thoracis associated with pneumonia due to S. intermedius.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624190/pdf/12890_2015_Article_128.pdf

January 2, 2016 at 4:57 pm


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