The Streptococcus milleri Group as a Cause of Pulmonary Infections

Shinzato, Takashi; Saitô, Atsushi

doi:10.1093/clind/21.supplement_3.s238

Cited by 131 publications

(94 citation statements)

References 20 publications

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“…This is probably related to the fact that all polymicrobial infections in this series, except for one (mediastinitis in Ludwig's angina), were linked to respiratory or gastrointestinal tract procedures, indicating that the procedure is a decisive factor for the concomitant presence of other pathogens. Similarly, the apparent synergy between SM and strict anaerobic bacteria [7] could explain the frequency of polymicrobial infections. Finally, a higher rate of hospital-acquired infections (60%) was found than that described in the literature [23,28].…”

Section: Discussionmentioning

confidence: 99%

“…WHILEY and coworkers [2,3], through phenotypic and deoxyribonucleic acid (DNA)-DNA hybridization studies, affirmed the existence of at least three well-differentiated species: S. constellatus, S. intermedius and S. anginosus. Many authors prefer to continue using the term SM for the three species for two reasons: firstly, because the term is useful to the clinician, since it warns of the presence of a suppurative process [4,5] and secondly, because the three species appear to be equally represented as a cause of thoracic infection [6,7].…”

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confidence: 99%

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Thoracic infection caused by Streptococcus milleri

Porta

Rodríguez-Carballeira²,

Gómez³

et al. 1998

Eur Respir J

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The group Streptococcus milleri (SM) includes several species of pathogenic streptococci associated with pyogenic infections. In 1956 O. Guthof was the first to use the name SM when referring to nonhaemolytic species of streptococci found in the oral cavity [1]. WHILEY and coworkers [2,3], through phenotypic and deoxyribonucleic acid (DNA)-DNA hybridization studies, affirmed the existence of at least three well-differentiated species: S. constellatus, S. intermedius and S. anginosus. Many authors prefer to continue using the term SM for the three species for two reasons: firstly, because the term is useful to the clinician, since it warns of the presence of a suppurative process [4,5] and secondly, because the three species appear to be equally represented as a cause of thoracic infection [6,7].The SM group is part of the usual flora of the mouth, but its true prevalence is unknown. It is also found among normal faecal flora in 16-67% of healthy adults and has been isolated from normal appendix and from vaginal secretions [3,[8][9][10]. The most important clinical feature of these micro-organisms is their tendency to cause suppurative infections at various sites, ranging from dental abscesses to deep visceral abscesses [1,4,8,[11][12][13][14][15].The purpose of this study was to contribute to a better understanding of the importance of members of the SM group as respiratory pathogens, by studying the epidemiological and clinical features of thoracic infections caused by SM and contrasting the features of empyema caused by SM with those in cases of pneumococcal aetiology. Patients and methodsA review was undertaken of the clinical histories and microbiological reports of episodes of infection by SM isolated from clinically significant samples in our institution, an acute care general hospital serving around 250,000 inhabitants, between January 1988 and December 1995. Only those cases in which some type of thoracic infection was diagnosed were analysed. The cases of pneumococcal empyema that occurred during the same period were also analysed. For the purposes of this study, thoracic infection was defined as all processes of an infectious nature localized to any of the organs, systems or anatomical structures in the thoracic cavity, except intravascular lesions with endothelial infection. Infections were considered to be acquired The clinical histories and microbiology reports were reviewed in 27 cases of thoracic infection caused by SM over a period of 8 yrs. Cases of pneumococcal empyema that occurred during the same period were also analysed.Diagnoses were made of cases of empyema, including six with pneumonia and one with pulmonary abscess, three cases of pneumonia and two of mediastinitis. In 17 cases, SM was the only pathogen isolated. There was a history of instrument or surgical procedures on the digestive or respiratory tract in 59%. Secondary bacteraemia was documented in three cases. The treatment administered, a combination of antibiotics and surgery, was successful in 22 of 27 (81%) of cases. All strai...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Thoracic infection caused by Streptococcus milleri

Porta

Rodríguez-Carballeira²,

Gómez³

et al. 1998

Eur Respir J

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“…Streptococcus intermedius, a member of the Streptococcus anginosus group, is considered to be part of the normal microbial flora of the oral cavity [8], and rarely causes abdominal abscess. Aspiration of commensal oropharyngeal Streptococcus anginosus can lead to pneumonia, lung abscess, and pleural empyema [9][10][11][12][13]. Aspirated Streptococcus intermedius with a fish bone may induce abdominal abscess in this case.…”

Section: Case Reportmentioning

confidence: 83%

Abdominal Abscess due to Perforation of the Terminal Ieum Caused by a Fish Bone Treated by the Conservative Treatment Using Antibiotics

et al. 2017

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Accidental ingestion of the foreign bodies rarely develops the perforation of gastrointestinal tract, and the perforation of gastrointestinal tract can lead to severe complications such as abscess, enteric fistula, or intestinal obstruction, and peritonitis. As the standard management for foreign body-induced bowel perforation, surgery is commonly selected. We experienced a patient whose abdominal abscess is due to perforation of the terminal ileum by a fish bone. Streptococcus intermedius was isolated from abdominal abscess. An absence of fistula between intestinal tract and abscess and a remarkable improvement of laboratory data and symptoms by using antibiotics made us select the conservative treatment. In conclusion, we succeeded to treat conservatively abdominal abscess due to perforation by a fish bone by using appropriately selected antibiotics.

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“…2 Patients who develop lung abscess commonly have periodontal disease. 1,3 A bacterial inoculum from the gingival crevice reaches the lower airways, and infection is initiated because the bacteria are not cleared by the patient's host defense mechanisms. This results in aspiration pneumonitis and progression to tissue necrosis 7-14 days later, resulting in lung abscess.…”

Section: Discussionmentioning

confidence: 99%