Pyogenic Liver Abscess and Sepsis Caused by Streptococcus constellatus in the Immunocompetent Host

Khan, Muhammad Zatmar; Tahir, Danial; Kichloo, Asim; Haddad, Nicholas; Hanan, Abdul

doi:10.7759/cureus.9802

Cited by 5 publications

(6 citation statements)

References 11 publications

(11 reference statements)

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“…Moreover, qRT-PCR also showed that the mRNA levels of IL-1β, IL-6, TNF-α, and MCP-1 in the liver were higher in the MD+KLA mice. Clinically, ALT, AST, and LDH are commonly used to evaluate liver function, 35 and they are elevated in liver abscess patients. In this study, ALT was significantly elevated in KLA mice, and the difference was even more pronounced in MD+KLA mice.…”

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confidence: 99%

Gut Microbiota Contributes to Host Defense Against Klebsiella pneumoniae-Induced Liver Abscess

Zheng¹,

Ding²,

Xu³

et al. 2021

JIR

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Purpose: Klebsiella pneumoniae-induced liver abscess (KLA) is a type of pyogenic liver abscess (PLA), which is a distinct invasive syndrome that has been increasingly reported worldwide over the past two decades. The intestinal microbiota is increasingly recognized as an important modulator that can promote and maintain host immune homeostasis. However, its precise role in liver abscess is unknown. We aimed to investigate the function of the gut microbiota in the host defense against K. pneumoniae infection. Methods: We constructed C57BL/6J mice with KLA and analyzed the diversity and richness of the intestinal microflora by 16S rRNA sequencing. Next, to create a microbiota-depleted (MD) mouse model, we administered multiple broad-spectrum antibiotics and validated the model using 16S rRNA sequencing. At 48 h after K. pneumoniae infection, we assessed the general health condition, liver injury, bacterial loads, and inflammatory factor levels in MD+KLA mice. Additionally, fecal microbiota transplantation (FMT) was conducted in another group of MD+KLA mice prior to K. pneumoniae infection, and we assessed whether the transplantation changed the outcomes. Results: The diversity of the intestinal flora was significantly changed in KLA mice compared to control mice, with a decrease in beneficial bacteria and an increase in harmful bacteria. The MD+KLA mice exhibited impaired antimicrobial capacity, reduced survival, increased inflammation and liver damage at 48 h after K. pneumoniae infection compared to the KLA mice. However, FMT normalized the inflammatory cytokine levels, reduced liver damage, and increased survival. Conclusion:This study identified the gut microbiota as a protective factor against K. pneumoniae infection. The role of FMT in KLA should be investigated in future clinical studies.

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confidence: 99%

Gut Microbiota Contributes to Host Defense Against Klebsiella pneumoniae-Induced Liver Abscess

Zheng¹,

Ding²,

Xu³

et al. 2021

JIR

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“…It has been observed that bacteremia occurs most often after a tooth or soft tissue infection (4). It is presumed that immunocompromised patients, such as those with diabetes mellitus, chronic kidney disease, hepatobiliary disease, neoplasias, or undergoing chemotherapy, are at higher risk of bacteremia (8). Our patient was not immunocompromised.…”

Section: Discussionmentioning

confidence: 86%

Diş Çürümesine İkincil Olarak Yüzde Gelişen Streptococcus Constellatus'un Neden Olduğu Apse: Olgu Sunumu

Kılıçaslan¹,

İşançlı²,

Fil³

et al. 2021

Düzce Tıp Fakültesi Dergisi

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A six-year-old male patient with no known history of disease was presented due to an unfamiliar Streptococcus constellatus growth that developed alongside a tooth abscess and fistulized. The patient was admitted with redness, swelling, and tenderness in the left-most section of his face. We learned that the patient visited a dentist three weeks prior due to complaints of swelling in the jaw and tooth decay. The patient had a leukocyte count of 22,600/μL (neutrophil: 17,190/μL), C-reactive protein level was 105.2 mg/L. The patient was put on an intravenous treatment of clindamycin and cefoperazone-sulbactam. There was spontaneous discharge in the abscess. S. constellatus grew in abscess culture dish. The current therapy was changed to ampicillin-sulbactam. Observations on the seventh day of hospitalization showed that the lesion had subsided almost entirely. S. constellatus is a rare microorganism that produces abscesses and requires immediate medical attention.

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“…Recent studies have found that S constellatus usually exacerbates inflammation in association with other anerobic organisms and gram-negative pathogens, especially in healthy individuals . [ 7 , 8 ] Treatment with broad-spectrum antibiotics and anti-anaerobic antibiotics is essential. Our patient had neither predisposing factors nor an underlying disease as described above and his blood culture, sputum culture, and pus culture showed no anaerobic bacteria.…”

Section: Discussionmentioning

confidence: 99%

Descending necrotizing mediastinitis caused by Streptococcus constellatus: A case report and review of the literature

et al. 2023

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Rationale: Descending necrotizing mediastinitis (DNM) is a rare but severe mediastinal infection. If not diagnosed and treated promptly, the consequences can be very serious. Here, we shared a successful diagnosis and treatment case of DNM that originates from oral to neck and mediastinum caused by Streptococcus constellatus (S constellatus ). S constellatus is a clinically uncommon gram-positive coccus and is known for its ability to form abscesses. Timely surgical drainage and the correct use of antibiotics are key to successful treatment. Patient concerns: A 53-year-old male admitted to hospital with painful swelling of the right cheek, persistent oral pus and moderate fever lasting 1 week, followed by rapid development of a mediastinal abscess. Diagnoses: He was diagnosed with DNM caused by S constellatus . Interventions: On the evening of admission, an emergency tracheotomy and thoracoscopic exploration and drainage of the right mediastinum, floor of the mouth, parapharynx and neck abscess were performed. Antibiotics were administered immediately. Outcomes: At 28 days post-operatively, the abscess was absorbed, bilateral lung exudate decreased and the patient temperature, aspartate transaminase, alanine transaminase, bilirubin and platelets returned to normal. The patient was discharged after completing 4 weeks of antibiotic therapy. Follow-up at 3 months after discharge revealed no recurrence of the abscess. Lessons: Early surgical drainage and antibiotics treatment are important in mediastinal abscesses and infectious shock due to Streptococcus asteroids.

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Pyogenic Liver Abscess and Sepsis Caused by Streptococcus constellatus in the Immunocompetent Host

Cited by 5 publications

References 11 publications

Gut Microbiota Contributes to Host Defense Against Klebsiella pneumoniae-Induced Liver Abscess

Gut Microbiota Contributes to Host Defense Against Klebsiella pneumoniae-Induced Liver Abscess

Diş Çürümesine İkincil Olarak Yüzde Gelişen Streptococcus Constellatus'un Neden Olduğu Apse: Olgu Sunumu

Descending necrotizing mediastinitis caused by Streptococcus constellatus: A case report and review of the literature

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