Streptococcus milleri causing treatable infection in perineal hidradenitis suppurativa

Highet, A.S.; Warren, R. E.; Staughton, R.C.D.; Roberts, Sarah

doi:10.1111/j.1365-2133.1980.tb07259.x

Cited by 53 publications

(30 citation statements)

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“…Unfortunately, this combined treatment only transitorily improved severe HS cases, a finding that was confirmed recently in two retrospective studies [5,6]. Since various bacteria of the skin flora such as Propionibacterium acnes and coagulase-negative staphylococci [8], but also streptococci of the Streptococcus milleri group and miscellaneous anaerobes have been cultured from chronic HS lesions [8,9,10,11,12], we moved to a combination of rifampin (10 mg/kg daily) and moxifloxacin (400 mg daily). Indeed, both antibiotics are bactericidal, have a wide antimicrobial spectrum that includes anaerobes and have good diffusion properties [22].…”

Section: Discussionmentioning

confidence: 97%

“…In the absence of any validated therapies, we treated long-lasting HS patients with more intensive compassionate antimicrobial treatments at the Centre d’Infectiologie Necker-Pasteur based on the microbiology of HS lesions [8,9,10,11,12,13]. The aim of this study was to assess the efficacy and safety of a therapeutic strategy based on an oral antimicrobial combination that included rifampin, moxifloxacin and metronidazole in 28 consecutive HS patients.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Rifampin-Moxifloxacin-Metronidazole Combination Therapy in Hidradenitis Suppurativa

et al. 2010

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Background: Antibiotics have been shown to improve hidradenitis suppurativa (HS) patients but complete remission is rare using these treatments. Objective: To assess the efficacy and safety of a combination of oral rifampin, moxifloxacin and metronidazole in long-lasting refractory HS. Methods: We retrospectively studied 28 consecutive HS patients including 6, 10 and 12 Hurley stage 1, 2 and 3 patients, respectively. Complete remission, defined as a clearance of all inflammatory lesions including hypertrophic scars, was the main outcome criterion of the study. Results: Complete remission was obtained in 16 patients, including 6/6, 8/10 and 2/12 patients with Hurley stage 1, 2 and 3, respectively (p = 0.0004). The median duration of treatment to obtain complete remission was 2.4 (range 0.9–6.5) and 3.8 months (range 1.6–7.4) in stage 1 and 2 patients, respectively, and 6.2 and 12 months in the 2 stage 3 patients. Main adverse events of the treatments were gastrointestinal disorders (64% of patients) and vaginal candidiasis (35% of females). Reversible tendinopathy and hepatitis occurred in 4 and 1 patient, respectively. Conclusions: Complete remission of refractory HS can be obtained using broad-spectrum antibiotics and Hurley staging is a prognostic factor of response to the treatment.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Efficacy of Rifampin-Moxifloxacin-Metronidazole Combination Therapy in Hidradenitis Suppurativa

et al. 2010

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“…B. auch der äußerst seltene Keim Streptococcus milleri [16],und Staphylokokken bei der Infektion spielen, ist letztlich noch nicht geklärt.Es existiert offensichtlich auch eine genetisch bedingte Form der Acne inversa [6]. Eine nicht geringe pathogenetische Bedeutung scheint Nikotinabusus zu haben [2,31].…”

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Therapie des Pilonidalsinus und der Acne inversa

Breuninger

2004

Der Hautarzt

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A pilonidal sinus is a invagination of the skin over the sacrum containing a tuft of hair which enlarges by repeated friction causing the hairs to penetrate the skin. It may become symptomatic if an infection occurs. There are similarities with acne inversa, which is present in about 23% of cases. Acne inversa is an inflammation of the sebaceous glands and terminal hair follicles, chiefly in the intertriginous areas. The first manifestation can occur at any time from puberty to advanced age. 90% of patients are smokers. Initially giant comedones and indolent subcutaneous nodules are found; they progress to form draining sinus tracts. Conservative treatment, incision and/or surgical removal of the abscesses and fistulas is futile. The method of choice is the early complete surgical excision of the involved skin extending into normal tissue both laterally and at the base. In most cases healing of the defects by secondary intention is uneventful.

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“…Die Erstmanifestation kann von der Pubertät an bis ins hohe Alter erfolgen. Nach Breitkopf et al [10] [30], ebenso Jemec et al [36] konnten bei Acneinversa-Patienten den äußerst seltenen Keim Streptococcus milleri isolieren und beschrieben eine Befundbesserung nach adäquater Antibiotikatherapie. Kurzen et al [38] fanden präoperativ in den meisten Fällen Staphylococcus aureus.…”

Section: Epidemiologieunclassified

Interdisziplin�re Leitlinie: Acne inversa (Entwicklungsstufe S1)

Wienert¹,

Breuninger²,

Peto³

et al. 2003

Colo-Proctology

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Streptococcus milleri causing treatable infection in perineal hidradenitis suppurativa

Abstract: Streptococcus milleri was isolated from the active lesions of three patients with perineal hidradenitis suppurativa. In each patient, elimination of this organism by appropriate antibiotic therapy was accompanied by marked clinical improvement.

Cited by 53 publications

References 10 publications

Efficacy of Rifampin-Moxifloxacin-Metronidazole Combination Therapy in Hidradenitis Suppurativa

Efficacy of Rifampin-Moxifloxacin-Metronidazole Combination Therapy in Hidradenitis Suppurativa

Therapie des Pilonidalsinus und der Acne inversa

Interdisziplin�re Leitlinie: Acne inversa (Entwicklungsstufe S1)

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