Lung Abscess Due to Streptococcus mitis: Case Report and Review

Carrascosa, Miguel F; Pérez-Castrillón, José-Luis; Sampedro, Isabel; Valle, Reina; Cillero, Lourdes; Fernández-Méndez, María Ángeles

doi:10.1093/clinids/19.4.781

Cited by 13 publications

(6 citation statements)

References 22 publications

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“…However, the name ‘ Streptococcus milleri group’ has not been used recently [16], therefore each species was counted separately in our study. The finding that S. mitis is an etiologic pathogen of lung abscess was first reported in 1994 [27]. In our study, S. mitis was the most common organism in the 73 patients in whom Streptococcus species were isolated.…”

Section: Discussionsupporting

confidence: 60%

Etiology and Outcome of Community-Acquired Lung Abscess

et al. 2010

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Background: Anaerobes are the first and Streptococcus species the second most common cause of community-acquired lung abscess (CALA) in the West. The etiologic pathogens of this disease have changed in Taiwan, with Klebsiella pneumoniae being reported as the most common cause of CALA. Objective: To determine the etiologies of community-acquired lung abscess. Methods: We retrospectively reviewed the records of 205 Japanese adult patients with CALA to evaluate etiologies and outcomes. We used not only traditional microbiological investigations but also percutaneous ultrasonography-guided transthoracic needle aspiration and protected specimen brushes. Results: Of these 205 patients, 122 had documented bacteriological results, with 189 bacterial species isolated. Pure aerobic, mixed aerobic and anaerobic, and pure anaerobic bacteria were isolated in 90 (73.8%), 17 (13.9%), and 15 (12.3%) patients, respectively. The four most common etiologic pathogens were Streptococcus species (59.8%), anaerobes (26.2%), Gemella species (9.8%), and K. pneumoniae (8.2%). Streptococcus mitis was the most common among the Streptococcus species. Mean duration of antibiotic administration was 26 days. Six patients (2.9%, 3 with actinomycosis and 3 with nocardiosis) were treated with antibiotics for 76–189 days. Two patients with anaerobic lung abscess died. Conclusions: The first and second most common etiologic pathogens of CALA in our hospital were Streptococcus species and anaerobes, respectively. The etiologies in our study differ from those in Taiwan and are similar to those in the West with the exception that Streptococcus species were the most common etiologic pathogens in our study whereas anaerobes are the most frequent etiologic pathogens in Western countries. S. mitis and Gemella species are important etiologic pathogens as well. The identification of Actinomyces and Nocardia is important in order to define the adequate duration of antibiotic administration.

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Section: Discussionsupporting

confidence: 60%

Etiology and Outcome of Community-Acquired Lung Abscess

et al. 2010

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“…Actinomyces and Streptococcus spp., occur in human dental plaque and may contribute to various disease states including gingivitis [16]. Streptococcus mitis is considered among the pathogenic species of viridans streptococci, associated with an extensive range of infections including meningitis, endocarditis, urinary tract infection as well as liver, lung and epidural abscesses [17–22].…”

Section: Discussionmentioning

confidence: 99%

Streptococci andActinomycesinduce antibodies which cross react with epithelial antigens in periodontitis

Harty

Chapple

et al. 2003

Clinical and Experimental Immunology

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SUMMARYPerturbation of epithelial structure is a prominent but poorly understood feature of the immunopathological response to bacterial antigens which characterizes the destructive lesion of periodontitis. Western analysis of sera from 22 patients with periodontitis detected multiple antigens in extracts of epithelial cells whereas sera from 12 periodontally healthy subjects displayed only trace reaction with epithelial antigens. To investigate a possible relationship between the bacterial flora adjacent to diseased sites and the presence of antibodies reactive with epithelium, subgingival plaque samples were taken from deep periodontal pockets and cultured anaerobically. Gram positive bacteria containing antigens cross-reactive with epithelial cells were reproducibly isolated by probing membrane colonylifts with affinity-isolated (epithelium-specific) antibodies and identified by 16S rDNA sequence homology as streptococci ( S. mitis, S. constellatus and two S. intermedius strains) and Actinomyces ( A. georgiae , and A. sp. oral clone ). Conversely, when serum from patients with periodontitis was absorbed with the captured bacterial species the number of epithelial antigens recognized was specifically reduced. It was concluded that development of cross-reactive antibodies related to these organisms may contribute to perturbation of the epithelial attachment to the tooth and the progression of periodontitis. These autoreactive antibodies could also be a contributing factor in other diseases affecting epithelia.

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“…However, when anatomical and physiological barriers against acid reflux and aspiration are compromised by neurodevelopmental, gastrointestinal, and immunological disorders, lung abscess can ensue 1 , 5 , 6. Despite thorough clinical evaluation and extensive investigations, no underlying pathogenetic factor or comorbid condition contributing to the occurrence of bilateral lung abscesses could be identified in the index patient.…”

Section: Discussionmentioning

confidence: 99%