Aggressive Presentation of Streptococcus constellatus

Vulisha, Abhinav; Sam, Riya Mary; Nur, Hassan; Bhardwaj, Neharika; Sirineni, Srija

doi:10.7759/cureus.14534

Cited by 10 publications

(13 citation statements)

References 9 publications

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“…Other retrospective studies describing the bacteriology and clinical features of empyema thoracis and lung abscess showed that among the 76 isolated strains of viridans streptococci, the most common were S. constellatus (21 strains), S. intermedius (17), and Streptococcus sanguis (10) ( Jerng et al, 1997 ). Moreover, there is an increase in the number of case reports that indicate S. constellatus as a pulmonary pathogen ( Morinaga et al, 2013 ; Elhussein and Hutchison, 2014 ; Price et al, 2015 ; Zhang et al, 2020 ; Vulisha et al, 2021 ). Taken together, the role of SAG in the pathogenesis of lung diseases is indisputable, with the leading role of S. constellatus and S. intermedius .…”

Section: Streptococcus Anginosus Group – Opportunistic Patho...mentioning

confidence: 99%

The Clinical View on Streptococcus anginosus Group – Opportunistic Pathogens Coming Out of Hiding

2022

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Three distinct streptococcal species: Streptococcus anginosus, Streptococcus intermedius, and Streptococcus constellatus, belonging to the Streptococcus anginosus group (SAG), also known as Streptococcus milleri group, have been attracting clinicians and microbiologists, not only as oral commensals but also as opportunistic pathogens. For years they have been simply classified as so called viridans streptococci, and distinct species were not associated with particular clinical manifestations. Therefore, description of SAG members are clearly underrepresented in the literature, compared to other medically relevant streptococci. However, the increasing number of reports of life-threatening infections caused by SAG indicates their emerging pathogenicity. The improved clinical data generated with the application of modern molecular diagnostic techniques allow for precise identification of individual species belonging to SAG. This review summarizes clinical reports on SAG infections and systematizes data on the occurrence of individual species at the site of infection. We also discuss the issue of proper microbiological diagnostics, which is crucial for further clinical treatment.

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Section: Streptococcus Anginosus Group – Opportunistic Patho...mentioning

confidence: 99%

The Clinical View on Streptococcus anginosus Group – Opportunistic Pathogens Coming Out of Hiding

2022

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“…Streptococcus constellatus is a subgroup of viridans streptococci widely distributed in the oral cavity, nasopharynx, gastrointestinal tract, and vagina ( 20 ). These bacteria have the capability of causing pyogenic infections and abscess formations mainly in the respiratory tract, brain, liver, bone, and soft tissues on a rare occurrence ( 21 ). So, how did this patient's abscess of the psoas major muscle arise?…”

Section: Discussionmentioning

confidence: 99%

Facial Palsy as Initial Symptom in Glycine Receptor Antibody Positive Progressive Encephalomyelitis With Rigidity and Myoclonus: A Case Report

Wang

Zhang

et al. 2022

Front. Neurol.

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Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a rare and disabling syndrome characterized by painful spasms, myoclonic jerks, hyperekplexia, brainstem signs, and dysautonomia, which is considered to be a severe form of stiff person spectrum disorder (SPSD) and is mostly associated with glycine receptor antibodies. The PERM has an acute or subacute course, with complex and varied initial symptoms mainly manifest as stiffness and pain. The authors present the case of a male patient admitted for intractable stiffness and paroxysmal myoclonus of the lower extremities preceded by a 5-day history of facial weakness. After admission, his symptoms deteriorated rapidly. He developed progressive generalized hypertonia and painful spasms, which quickly spread to the upper extremities, and he suffered frequent paroxysmal myoclonus. Serum and cerebrospinal fluid (CSF) were tested by a cell-based assay, and both were positive for glycine receptor antibodies (GlyR-Abs). The patient developed complications, such as crushed teeth, lumbar vertebral compression fractures, and psoas major muscle abscess, during rapid disease progression, although he responded well after being treated with intravenous methylprednisolone and immunoglobulin. This report of PERM, initiated as facial palsy followed by acute progression, helps to expand the clinical spectrum of this rare autoimmune disorder and raise awareness of the prevention of complications.

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“…14 patients in the literature with empyema with S. constellatus cultured from pleural fluid was enrolled. [12][13][14][15][16][17][18][19][20][21][22][23] The clinical information was shown in the table (Supplementary Table 3). 92.9% of patients were male.…”

Section: Literature Reviewmentioning

confidence: 99%

The Clinical Features and Management of Empyema Caused by Streptococcus constellatus

Lin¹,

Bao²,

Lu³

et al. 2022

IDR

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Background Streptococcus constellatus , a commensal, plays an important role in purulent infections. It has been reported as aggressive pathogen causing pleural empyema. But the role of S. constellatus in empyema has not been taken seriously. There are no studies about clinical characteristics of empyema caused by S. constellatus domestically and abroad. This study aimed to explore the clinical features and management of empyema caused by S. constellatus . Methods A retrospective review of 9 patients diagnosed with empyema caused by S. constellatus in a hospital between January 2010 and August 2021 was performed. Results S. constellatus empyema were mostly seen in old males (66.7%) with comorbid diseases. The high-risk factors include diabetes mellitus, oral infection, and oral surgery. All were unilateral encapsulated empyema (right-side, 55.6%), diagnosed with pneumonia (bilateral pneumonia, 88.9%; ipsilateral lung abscess, 44.4%). 33.3% of patients had S. constellatus and anaerobes co-isolated. S. constellatus were sensitive to penicillin G, linezolid, levofloxacin, vancomycin, ceftriaxone, and chloramphenicol, resistant to erythromycin, tetracycline, and clindamycin. 33.3% of the patients needed ventilator support. The primary treatment to S. constellatus empyema was timely pus drainage, intravenous antibiotics, and enough nutrition support, intrapleural fibrinolytics and surgery (VAST recommended first) in necessity. Conclusion S. constellatus may cause pneumonia and lung abscess first and then spread to cause empyema mainly in old males with comorbid diseases. S. constellatus often co-isolated with anaerobes in empyema. Antibiotics should cover simultaneously both S. constellatus and anaerobes.

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Aggressive Presentation of Streptococcus constellatus

Cited by 10 publications

References 9 publications

The Clinical View on Streptococcus anginosus Group – Opportunistic Pathogens Coming Out of Hiding

The Clinical View on Streptococcus anginosus Group – Opportunistic Pathogens Coming Out of Hiding

Facial Palsy as Initial Symptom in Glycine Receptor Antibody Positive Progressive Encephalomyelitis With Rigidity and Myoclonus: A Case Report

The Clinical Features and Management of Empyema Caused by Streptococcus constellatus

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