Acupuncture treatment is generally regarded as a relatively safe procedure. However, most procedures have some complications and acupuncture treatment is no exception. Reported complications of acupuncture treatment were mostly mild or temporary symptoms, but certain severe adverse effects were also observed. We report here for the first time a case of liver abscess following acupuncture and moxibustion treatment.
Acupuncture ; Liver Abscess ; Liver Abscess, Pyogenic ; Moxibustion ; Streptococcus intermedius

Anginosus group streptococci (AGS) were classified based on the nucleotide sequences of the 16S rRNA gene (16S rDNA) and comprised Streptococcus anginosus, Streptococcus intermedius, and Streptococcus constellatus. It is known that AGS is a causative factor of oral and systematic diseases. The purpose of this study was to discriminate the 56 clinical strains of AGS isolated from Korean oral cavities using phylogenetic analysis of 16S rDNA and species-specific PCR at the species-level. The 16S rDNA of clinical strains of AGS was sequenced using the dideoxy chain termination method and analyzed using MEGA version 5 software. PCR was performed to identify the clinical strains using species-specific primers described in previous studies and S. intermedius-specific PCR primers developed in our laboratory. The resulting phylogenetic data showed that the 16S rDNA sequences can delineate the S. anginosus, S. intermedius, and S. constellatus strains even though the 16S rDNA sequence similarity between S. intermedius and S. constellatus is above 98%. The PCR data showed that each species-specific PCR primer pair could discriminate between clinical strains at the species-level through phylogenetic analysis of 16S rDNA nucleotide sequences. These results suggest that phylogenetic analysis of 16S rDNA and PCR are useful tools for discriminating between AGS strains at the species-level.
Base Sequence ; DNA, Ribosomal ; Genes, rRNA ; Mouth ; Polymerase Chain Reaction ; Streptococcus anginosus ; Streptococcus constellatus ; Streptococcus intermedius

Pylephlebitis (septic thrombophlebitis of the portal venous system) is a rare but serious complication of intra-abdominal infections that drain into the portal venous system. Its diagnosis is based on imaging; computed tomography may reveal a thrombus in the portal vein. Bacteremia may also be evident. As the symptoms are nonspecific, early clinical diagnosis is difficult, and delayed treatment can compromise outcomes. We report a case with extensive pylephlebitis and a liver abscess associated with Streptococcus intermedius sepsis; the case was treated successfully with antibiotics and anticoagulants. Such cases have not been widely reported.
Anti-Bacterial Agents ; Anticoagulants ; Bacteremia ; Diagnosis ; Intraabdominal Infections ; Liver Abscess ; Liver ; Portal Vein ; Sepsis ; Streptococcus intermedius ; Streptococcus ; Thrombophlebitis ; Thrombosis

Transient bacteremia associated with various endoscopic procedures is a well-documented phenomenon. Clinically important bacteremias are very rarely seen, however, this malady has significant morbidity in susceptible patients with valvular heart disease, liver cirrhosis, malignancy and immune deficiency. This bacteremia is a complication that is generally observed secondary to upper endoscopy and other associated invasive procedures in at risk patients, and the more serious manifestations include spontaneous bacterial peritonitis, septic arthritis, meningitis, brain abscess and infective endocarditis. Infective endocarditis is an extremely rare complication of gastrointestinal endoscopy, and it has been convincingly documented in only seven cases. We report a case of native valve endocarditis due to Streptococcus intermedius in a patient with valvular heart disease as a consequence of routine upper endoscopy.
Endocarditis, Subacute Bacterial/*etiology ; Endoscopy, Gastrointestinal/*adverse effects ; Female ; Humans ; Middle Aged ; Streptococcal Infections/*etiology ; Streptococcus intermedius/*isolation & purification

Infective endocarditis usually involves cardiac valves and perivalvular tissue. Sometimes it can penetrate through the free wall of myocardium and form burrowing abscess, usually in patients with congenital heart diseases, such as ventricular septal defect. We experienced a case of mural endocarditis of right atrium in a patient without underlying cardiac diseases. A 55-year old man was admitted due to chest tightness, fever and dyspnea. Streptococcus intermedius grew in 3 pairs of blood culture tests and transesopha- phageal echocardiography revealed a 2 cm-sized vege-tation in the right atrial auricle. Lung ventilation and perfusion scans were checked due to aggravation of dyspnea, which showed pulmonary embolism with high probability. The vegetation penetrated through the free wall of the right atrial auricle and formed a mural abscess, which was removed by surgery and its wall defect repaired with bovine patch.
Abscess* ; Dyspnea ; Echocardiography ; Endocarditis* ; Fever ; Heart Atria* ; Heart Diseases ; Heart Septal Defects, Ventricular ; Heart Valves ; Humans ; Lung ; Middle Aged ; Myocardium ; Perfusion ; Pulmonary Embolism* ; Streptococcus intermedius ; Thorax ; Ventilation

BACKGROUND AND OBJECTIVES: Orbital complications of sinusitis are uncommon but can result in significant morbidity if not appropriately managed. We have experienced 8 cases of orbital subperiosteal absces- ses (SPA) as a complication of acute sinusitis. The purposes of our study are to assess the clinical features, diagnosis, isolated bacteria, and therapeutic results. MATERIALS AND METHOD: Eight patients with acute rhinosinusitis and orbital SPA who had been treated between April 1989 and September 2002 were retrospectively studied with medical records and CT. RESULTS: The most common symptoms and signs were proptosis and opthalmoplegia, and five patients (62%) complained of ocular pain or periorbital erythema. Seven patients (87%) complained of diplopia. We carried out medical treatment in 4 cases and surgical intervention in 4 cases. All patients were cured without complications. Streptococcus intermedius was isolated from 1 case and peptostreptococcus species from another but there was no growth of bacteria in 2 cases. CONCLUSION: Conservative treatment with intravenous antibiotics, topical nasal decongestants are the appropriate initial management in orbital SPA. In cases of medially located SPA of orbit, we recommend endoscopic surgical drainage because it does not require an external incision and has less postoperative edema.
Abscess* ; Anti-Bacterial Agents ; Bacteria ; Diagnosis ; Diplopia ; Drainage ; Edema ; Erythema ; Exophthalmos ; Humans ; Medical Records ; Nasal Decongestants ; Orbit* ; Peptostreptococcus ; Retrospective Studies ; Sinusitis* ; Streptococcus intermedius

Pyogenic sacroiliitis is a rare infection that may accompany psoas muscle abscess with vague clinical presentation, which present a diagnostic challenge requiring a high index of suspicion. We report a 48-year-old male, diagnosed pyogenic sacroiliitis with psoas abscess caused by Streptococcus intermedius and Sphingomonas paucimobilis. Magnetic resonance imaging showed multiloculated rim-enhancing lesion in right psoas muscle and joint effusion with osteomyelitis around sacroiliac joint. Intravenous antibiotics were administered after ultrasonographically guided abscess aspiration. Surgical drainage was done and his fever and symptom gradually subsided.
Abscess ; Anti-Bacterial Agents ; Drainage ; Fever ; Humans ; Joints ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteomyelitis ; Psoas Abscess ; Psoas Muscles ; Sacroiliac Joint ; Sacroiliitis ; Sphingomonas ; Streptococcus intermedius

BACKGROUND: Sternoclavicular septic arthritis manifests serious complications such as abscess, osteomyelitis, mediastinitis and empyema; therefore, a prompt diagnosis and appropriate treatment are necessary. MATERIAL AND METHOD: The treatment results of eight patients with sternoclavicular septic arthritis and who had been surgically treated at our institutions between September 2005 and July 2008 were retrospectively reviewed. The surgical treatment they underwent was en bloc resection, including partial resection of the sternum, the clavicular head and the 1st rib. RESULT: The patients ranged in age from 40 to 74 years with an average of 55.1+/-10.3 years. Five were men and three were women. There were 6 patients with spontaneous sternoclavicular septic arthritis and 2 patients had their condition induced by central venous catheters. The pathogens isolated from the patients' blood and wounds were MRSA (3), Streptococcus intermedius (1), Streptococcus agalactiae (1) and Pseudomonas luteola (1). One patient expired from aggravation of preoperative sepsis on POD 31. CONCLUSION: The life-threatening complications from sternoclavicular septic arthritis can progress and lead to death unless appropriate treatment is administered. A prompt diagnosis, appropriate antibiotics therapy and effective surgical treatment such as radical en bloc resection can reduce the morbidity and mortality of this malady.
Abscess ; Anti-Bacterial Agents ; Arthritis, Infectious ; Central Venous Catheters ; Female ; Head ; Humans ; Male ; Mediastinitis ; Methicillin-Resistant Staphylococcus aureus ; Osteomyelitis ; Pseudomonas ; Retrospective Studies ; Ribs ; Sepsis ; Sternoclavicular Joint ; Sternum ; Streptococcus agalactiae ; Streptococcus intermedius ; Treatment Outcome