title: Streptococcus anginosus group disseminated infection: case report and review of literature.
abstract: Streptococcus anginosus group is widely known for its ability to cause invasive pyogenic infections. There are very few reports of disseminated infections sustained by members of this streptococcal group. We report a case of a highly disseminated infection and analyse previous literature reports. Disseminated pyogenic infection has been defined as an infection affecting two or more of the following organs/systems: central nervous system, lung, liver and spleen. We performed a PubMed search using the terms: S. milleri, S. anginosus, brain abscess, pulmonary abscess, hepatic abscess, spleen abscess. We reviewed 12 case reports including the one presented in this paper. Underlying conditions such as dental infections, malignancy, gastrointestinal and respiratory tract disease accounted for 42% of cases. No definite endocarditis was encountered, even though positive blood cultures were found in 67% of patients. Concomitant brain-liver, brain-lung and brain-spleen involvement occurred in 50%, 42% and 8% of cases respectively. Ninety-one percent (91%) of patients were treated with β-lactams, and surgical procedures were performed in 67% of patients. Infections caused by S. anginosus group members are satisfactorily treated with penicillin G and cephalosporins. It is very important to associate surgery to antimicrobial chemotherapy in order to achieve a full or nearly full clinical recovery.
authors.affiliation: Dipartimento di Sanità Pubblica, Università Sapienza, Roma, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Giuliano
authors.forename: Giuliano
authors.initials: G
authors.lastname: Simone
authors.forename: Giorgia
authors.initials: G
authors.lastname: Rubini
authors.forename: Andrea
authors.initials: A
authors.lastname: Conte
authors.forename: Andrea
authors.initials: A
authors.lastname: Conti
authors.forename: Paola
authors.initials: P
authors.lastname: Goldoni
authors.forename: Marco
authors.initials: M
authors.lastname: Falcone
authors.forename: Antonio
authors.initials: A
authors.lastname: Vena
authors.forename: Mario
authors.initials: M
authors.lastname: Venditti
authors.forename: Sergio
authors.initials: S
authors.lastname: Morelli
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D001922:Brain Abscess / Q000382:microbiology / Q000628:therapy; D003131:Combined Modality Therapy; D016724:Empyema, Pleural / Q000382:microbiology / Q000628:therapy; D006529:Hepatomegaly / Q000382:microbiology; D006801:Humans; D008100:Liver Abscess / Q000382:microbiology / Q000628:therapy; D008169:Lung Abscess / Q000382:microbiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D013163:Splenomegaly / Q000382:microbiology; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery / Q000628:therapy*; D034366:Streptococcus anginosus / Q000302:isolation & purification / Q000472:pathogenicity; D034364:Streptococcus milleri Group / Q000302:isolation & purification / Q000472:pathogenicity; D013396:Suction; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents