title: Streptococcus anginosus infections: crossing tissue planes.
abstract: Streptococcus anginosus has long been recognized to cause invasive pyogenic infections. This holds true for thoracic infections where S. anginosus has a propensity for abscess and empyema formation. Early diagnosis is important given the significant morbidity and mortality associated with thoracic S. anginosus infections. Yet, distinguishing thoracic S. anginosus clinically is difficult. We present three cases of thoracic S. anginosus that demonstrated radiographic extension across tissue planes, including the interlobar fissure, diaphragm, and chest wall. Few infectious etiologies are known to cross tissue planes. Accordingly, we propose S. anginosus be considered among the differential diagnosis of potential infectious etiologies causing radiographic extension across tissue planes.
authors.affiliation: Department of Medicine, Division of Pulmonary, Allergy, Critical Care Medicine, Division of Sleep Medicine, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA. Electronic address: bernie.sunwoo@uphs.upenn.edu.
authors.forename: Bernie Y
authors.initials: BY
authors.lastname: Sunwoo
authors.affiliation: Department of Radiology, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA.
authors.forename: Wallace T
authors.initials: WT
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D006801:Humans; D007262:Infusions, Intravenous; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000382:microbiology*; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D012141:Respiratory Tract Infections / Q000000981:diagnostic imaging / Q000382:microbiology*; D013183:Sputum / Q000382:microbiology; D013290:Streptococcal Infections / Q000000981:diagnostic imaging / Q000382:microbiology*; D034366:Streptococcus anginosus / Q000302:isolation & purification*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents