Association between obligatory anaerobes and empyema caused by Streptococcus anginosus group bacteria

Noguchi, Shingo; Yatera, Kazuhiro; Kawanami, Toshinori; Ikegami, Hiroaki; Hata, Ryosuke; Yamasaki, Kei; Fukuda, Kazumasa; Mukae, Hiroshi

doi:10.1016/j.resinv.2021.04.009

Cited by 4 publications

(6 citation statements)

References 10 publications

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“…initiation of empiric antibiotics, cultures can result negative. Also, it has been seen that SAG infection is commonly associated with concomitant anaerobic infection, increasing SAG virulence [10]. The typical treatment for these infections is ampicillin or vancomycin plus drainage of any concomitant abscess.…”

Section: Discussionmentioning

confidence: 99%

Streptococcus anginosus Lung Abscess With Complicated Parapneumonic Empyema

Gonzalez¹,

Nessa²,

Sanivarapu³

et al. 2023

Cureus

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A 55-year-old female with hypertension presented to our facility with complicated pneumonia. She complained of progressively worsening shortness of breath and pleuritic chest pain. She was in her usual state of health except for an upper respiratory infection treated with oral antibiotics a month prior. At the presentation, she was febrile, tachycardic, and hypoxic on room air. A chest computed tomography (CT) showed near-complete opacification of the right lung, a cavitation with the fluid level in the right middle lobe, and moderate-to-large effusion. Broad-spectrum antibiotics were started. Sputum culture was later positive for methicillin-resistant Staphylococcus aureus, which prompted antibiotic de-escalation to vancomycin. A chest tube was placed into the right pleural space draining 700 mL of exudative fluid, which cultures grew Streptococcus anginosus group (SAG) bacteria. Due to persistent respiratory distress and residual effusion, right thoracotomy and decortication were performed. A right upper lobe abscess ruptured into the pleural space was noted during the procedure. Pathology revealed necrotic tissue, and the microbiological workup was negative. The patient clinically improved postoperatively and was discharged home with oral Linezolid.

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Section: Discussionmentioning

confidence: 99%

Streptococcus anginosus Lung Abscess With Complicated Parapneumonic Empyema

Gonzalez¹,

Nessa²,

Sanivarapu³

et al. 2023

Cureus

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“…Ornidazole effectively treats anaerobic infection ( Pradeep et al., 2012 ). Anaerobes often coexist with aerobes, so effective antibiotics against both infectious pathogens were used, such as carbapenem antibiotics and quinolone antibiotics ( Brook, 2011 ; Noguchi et al., 2021 ). It is worth noting that patients who do not receive ornidazole have a higher rate of surgery, but more data are needed to validate this finding.…”

Section: Discussionmentioning

confidence: 99%

Significance of pleural effusion detected by metagenomic next-generation sequencing in the diagnosis of aspiration pneumonia

Zhu

Hao

et al. 2022

Front. Cell. Infect. Microbiol.

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ObjectiveUsing metagenomic next-generation sequencing (mNGS) to profile the bacterial pathogen of pleural infection in aspiration pneumonia for therapeutic decision-making.MethodsCollection and analysis of the clinical and laboratory data of aspiration pneumonia patients who underwent mNGS detection of pleural effusion at the Second Hospital of Jilin University from November 2020 and March 2022.ResultsNine males and one female were included, aged 33 to 69 years. All patients had chest pain, fever, cough, and hypoxemia symptoms; 90% had expectoration. The laboratory tests revealed that all patients had elevated white blood cell, neutrophil, and C-reactive protein (CRP) levels. Furthermore, erythrocyte sedimentation rate (ESR) increased in 8 patients, and procalcitonin increased in only one patient. Chest CT indicated different degrees of lobar pneumonia and pleural effusion in all patients, and biochemical results implied exudative effusion according to Light criteria. Most routine culture results were negative. Among bacteria identified by mNGS, Fusobacterium nucleatum (n=9) was the most common, followed by Parvimonas micra (n=7) and Filifactor alocis (n=6). Three patients underwent surgical treatment after applying targeted antibiotics, thoracic puncture and drainage, and fibrinolytic septum treatment. After the adjusted treatment, the number of white blood cells, neutrophils, and lymphocytes decreased significantly, indicating the eradication of the infection.ConclusionsImproving the vigilance of atypical people suffering from aspiration pneumonia is essential. The mNGS detection of pleural effusion clarified the microbial spectrum of aspiration pneumonia, allowing targeted antibiotic administration.

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“…The SAG tends to co-infect with other anaerobes. Co-infection with the SAG and obligate anaerobes is commonly detected in patients with odontogenic infections [13] . This concomitancy leads to increased virulence.…”

Section: Discussionmentioning

confidence: 99%

An empyema caused by Streptococcus constellatus in an older immunocompetent patient

Lee

Lee²,

Kwon

et al. 2021

Medicine

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Rationale:Empyema caused by Streptococcus constellatus is rare in patients without underlying diseases. However, the importance of the Streptococcus anginosus group, which consists of S constellatus, S anginosus, and Streptococcus intermedius, as causative organisms of empyema has been increasing.Patient concerns:A 78-year-old man initially presented with dyspnea and chills for 4 days. He had no medical history.Diagnosis:Chest X-ray and chest computed tomography showed a large and multiloculated pleural effusion with an air bubble on the right side. Cultivation of the pleural effusion using clone library analysis of the 16S rRNA gene revealed S constellatus positivity.Interventions:The patient was treated by drainage of the pleural effusion and intravenous ceftriaxone and clindamycin for the possibility of anaerobes, followed by 10 weeks of oral antibiotics.Outcomes:On the 11th day of admission, the thoracic drainage tube was removed. After 1 year of treatment, there were no sequelae of empyema.Lessons:Although S constellatus can cause serious infections in patients with underlying diseases and immunosuppression, physicians need to consider S constellatus infection in community-acquired empyema in elderly individuals. It should be treated with early pleural drainage and antibiotics to avoid surgical decortication and prolonged hospitalization.

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Association between obligatory anaerobes and empyema caused by Streptococcus anginosus group bacteria

Cited by 4 publications

References 10 publications

Streptococcus anginosus Lung Abscess With Complicated Parapneumonic Empyema

Streptococcus anginosus Lung Abscess With Complicated Parapneumonic Empyema

Significance of pleural effusion detected by metagenomic next-generation sequencing in the diagnosis of aspiration pneumonia

An empyema caused by Streptococcus constellatus in an older immunocompetent patient

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