Gas-containing spinal epidural abscesses are uncommon. Moreover, acute spinal epidural abscesses rarely complicate bacterial meningitis in adults. Here, we report a rare case of a gas-containing cervical epidural abscess accompanying bacterial meningitis. In spite of aggressive fluid and continuous antibiotic therapy after the isolation of Streptococcus anginosus and Streptococcus constellatus in the cerebrospinal fluid cultures, the patient showed remaining motor dysfunction and bladder involvement. Our experience suggests that the effort to prevent neurologic deterioration by emergent surgical decompression and drainage of pus is mandatory to avoid additional spinal cord dysfunction in patients with spinal epidural abscesses accompanying bacterial meningitis.
Abscess ; Adult* ; Cerebrospinal Fluid ; Decompression, Surgical ; Drainage ; Epidural Abscess* ; Humans ; Meningitis ; Meningitis, Bacterial* ; Spinal Cord ; Streptococcus anginosus ; Streptococcus constellatus ; Suppuration ; Urinary Bladder

Gas gangrene, a subset of necrotizing myositis, is a bacterial infection that produces gas in tissues in gangrene. It is usually caused by Clostridium species, most commonly Clostridium perfringens. Streptococcus anginosus is a rare cause of gas gangrene, with very few cases reported. We report a rare case of traumatic gas gangrene caused by S. anginosus in a 57-year-old female with diabetes after being stabbed with scissors.
Bacterial Infections ; Clostridium ; Clostridium perfringens ; Diabetes Mellitus ; Female ; Gangrene ; Gas Gangrene* ; Humans ; Middle Aged ; Myositis ; Streptococcus anginosus* ; Streptococcus*

Dialister pneumosintes is a nonfermentative, gram-negative anaerobic rod which is considered as a commensal organism of the oral cavity. A 77-year-old man with a history of aortic stenosis was visited to ER for dyspnea and fever. D. pneumosintes and Streptococcus anginosus were isolated from blood culture, and also D. pneumosintes was identified by 16S rRNA-based gene sequencing. This case report is the first case of isolation of D. pneumosintes from blood in Korea, and highlights the usefulness of DNA sequencing to identify pathogens in organism which is difficult to identify by biochemical identification method.
Aged ; Aortic Valve Stenosis ; Bacteremia* ; Dyspnea ; Endocarditis ; Fever ; Humans ; Korea ; Mouth ; Sequence Analysis, DNA ; Streptococcus anginosus*

Purulent pericarditis is a rare condition with a high mortality rate. We report a case of purulent pericarditis subsequently caused by Candida parapsilosis, Peptostreptococcus asaccharolyticus, Streptococcus anginosus, Staphylococcus aureus, Prevotella oralis, and Mycobacterium tuberculosis in a previously healthy 17-year-old boy with mediastinal tuberculous lymphadenitis. The probable route of infection was a bronchomediastinal lymph node-pericardial fistula. The patient improved with antibiotic, antifungal, and antituberculous medication in addition to pericardiectomy.
Adolescent ; Bronchial Fistula ; Candida ; Coinfection ; Fistula* ; Humans ; Male ; Mortality ; Mycobacterium tuberculosis ; Peptostreptococcus ; Pericardiectomy ; Pericarditis* ; Pericarditis, Tuberculous ; Prevotella ; Staphylococcus aureus ; Streptococcus anginosus ; Tuberculosis, Lymph Node*

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

Streptococcus anginosus is a member of Streptococcus milleri group, and is found in the oral mucosa, respiratory tract, and gastrointestinal tract as normal flora. It can develop into a disease in patients with deteriorating clinical condition or with clinical risk factors. A previously healthy 15-year-old boy was admitted due to fever, abdominal discomfort and vomiting which lasted for 7 days. He had a history of dental procedure 1 day before the development of fever. He was diagnosed with acute acalculous cholecystitis based on the clinical, laboratory, and imaging finding, and S. anginosus was isolated from the blood culture. The patient was successfully treated with antibiotic therapy.
Acalculous Cholecystitis ; Adolescent ; Bacteremia ; Cholecystitis ; Fever ; Gastrointestinal Tract ; Humans ; Mouth Mucosa ; Respiratory System ; Risk Factors ; Streptococcus ; Streptococcus anginosus ; Streptococcus milleri Group ; Vomiting

Fournier's gangrene is a rare, rapidly progressive, necrotizing fasciitis of the genital, perianal and perineal regions. It is usually caused by a synergistic infection of aerobic and anaerobic organisms. A 51-year-old male patient with diabetes mellitus and chronic renal insufficiency on peritoneal dialysis was admitted with severe scrotal pain and swelling that lasted 4 days. An emergent non-contrast-enhanced computed tomography revealed extensive gas formation, fatty haziness and edema in the left scrotal and inguinal area. The patient was successfully treated with immediate surgical debridements and antibiotics. Streptococcus anginosus group Streptococcus anginosus was isolated from surgical wound cultures and identified with biochemical identification methods and direct sequencing of DNA. Herein, we report a rare case of Fournier's gangrene caused by S. anginosus. We also review the relevant literature
Anti-Bacterial Agents ; Debridement ; Diabetes Mellitus ; DNA ; Edema ; Fasciitis, Necrotizing ; Fournier Gangrene ; Humans ; Male ; Middle Aged ; Peritoneal Dialysis ; Renal Insufficiency, Chronic ; Streptococcus ; Streptococcus anginosus

Streptococcus anginosus is a normal flora found in multiple body sites and belongs to the Streptococcus milleri group. It has often been associated with pyogenic infection, such as perio-dontitis, endocarditis, pulmonary abscess and abdominal or cerebral abscess. Also uncommonly, it can cause osteomyelitis. A 42-year-old man was admitted due to gastric ulcer perforation. At 12th hospital day, left humeral osteomyelitis and soft tissue abscess developed. Streptococcus anginosus grew in blood culture. He was treated with intravenous penicillin and surgical debridement of the necrotic tissue which lead to a satisfactory result. We report a rare case of Streptococcus anginosus-induced humeral osteomyelitis and soft tissue abscess.
Abscess ; Adult ; Bacteremia ; Brain Abscess ; Debridement ; Endocarditis ; Humans ; Humerus ; Lung Abscess ; Osteomyelitis ; Penicillins ; Stomach Ulcer ; Streptococcus ; Streptococcus anginosus ; Streptococcus milleri Group

Streptococcus anginosus is a normal flora found in multiple body sites and belongs to the Streptococcus milleri group. It has often been associated with pyogenic infection, such as perio-dontitis, endocarditis, pulmonary abscess and abdominal or cerebral abscess. Also uncommonly, it can cause osteomyelitis. A 42-year-old man was admitted due to gastric ulcer perforation. At 12th hospital day, left humeral osteomyelitis and soft tissue abscess developed. Streptococcus anginosus grew in blood culture. He was treated with intravenous penicillin and surgical debridement of the necrotic tissue which lead to a satisfactory result. We report a rare case of Streptococcus anginosus-induced humeral osteomyelitis and soft tissue abscess.
Abscess ; Adult ; Bacteremia ; Brain Abscess ; Debridement ; Endocarditis ; Humans ; Humerus ; Lung Abscess ; Osteomyelitis ; Penicillins ; Stomach Ulcer ; Streptococcus ; Streptococcus anginosus ; Streptococcus milleri Group

The aim of this study was to investigate the susceptibility of mutans streptococci (S. mutans and S. sobrinus) and Streptococcus anginosus, for seven antibiotics, penicillin G, amoxicillin, ciprofloxacin, cefuroxime, erythromycin, bacitracin, and vancomycin. The minimum inhibitory concentration (MIC) of seven antibiotics against 3 species (type strains) of mutans streptococci and S. anginosus, 10 strains (wild type) of S. mutans, 7 strains (wild type) of S. sobrinus, and 11 strains (wild type) of S. anginosus, were measured by broth dilution method. All of the type strains of mutans streptococci and S. anginosus had the same susceptibility for penicillin G, amoxicillin, cefuroxime and bacitracin. Type strain of S. anginosus was sensitive in ciprofloxacin, but those of mutans streptococci were not. All of the clinical isolates of mutans streptococci and S. anginosus had the same susceptibility for the seven antibiotics. Our data reveal that mutans streptococci and S. anginosus have similar antibiotic-resistant character. In addition, these results may offer the basic data to verify the antibiotic-resistant mechanism of mutans streptococci and S. anginosus.
Amoxicillin ; Anti-Bacterial Agents ; Bacitracin ; Cefuroxime ; Ciprofloxacin ; Dental Plaque* ; Erythromycin ; Microbial Sensitivity Tests ; Penicillin G ; Penicillins ; Streptococcus anginosus* ; Streptococcus* ; Vancomycin