Streptococcus anginosus group: Difference between revisions
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Streptococcus anginosus group
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==Background== |
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===Microbiology=== |
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* 20-30% clindamycin resistance |
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*Catalase [[Catalase::negative]], variably hemolytic [[Stain::Gram-positive]] [[Shape::coccus|cocci]] within the [[viridans group streptococci]] |
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**''S. anginosus'' has two subspecies: ''S. anginosus'' subsp. ''anginosus'' and ''S. anginosus'' subsp. ''whileyi'' |
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**''S. constellatus'' has three subspecies: ''S. constellatus'' subsp. ''constellatus'', ''S. constellatus'' subsp. ''pharyngis'', and ''S. constellatus'' subsp. ''viborgensis'' |
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*Normal flora of oral cavity, throat, stool, and vagina |
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*Identified using three rapid tests: |
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**Voges-Proskaur (VP) test for acetoin production |
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**Arginine hydrolysis |
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**Failure to ferment sorbitol |
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==Clinical Manifestations== |
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*Tendency to form [[Abscess|abscesses]], unlike other [[streptococci]], which can be polymicrobial with [[anaerobes]] and [[Enterobacterales]] |
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*Infections can range in severity, and include [[pharyngitis]], [[dental abscess]], [[skin and soft tissue infection]], [[pneumonia]], [[empyema]], [[lung abscess]], [[brain abscess]], [[liver abscess]], and [[kidney abscess]] |
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==Investigations== |
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*Presence of bacteremia without focus should prompt investigations to identify an occult abscess |
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*The [[HANDOC score]] can assess need for [[echocardiography]] |
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==Management== |
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*Typically treated with [[Is treated by::ceftriaxone]] or other third-generation [[Cephalosporins|cephalosporin]] pending susceptibilities |
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*If found in an abscess, should be considered polymicrobial and treated with concomitant [[metronidazole]] |
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*Clindamycin resistance is high, approximately 20-30% |
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{{DISPLAYTITLE:''Streptococcus anginosus'' group}} |
{{DISPLAYTITLE:''Streptococcus anginosus'' group}} |
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Latest revision as of 18:25, 13 October 2020
Background
Microbiology
- Catalase negative, variably hemolytic Gram-positive cocci within the viridans group streptococci
- Contains Streptococcus anginosus, Streptococcus constellatus, and Streptococcus intermedius
- S. anginosus has two subspecies: S. anginosus subsp. anginosus and S. anginosus subsp. whileyi
- S. constellatus has three subspecies: S. constellatus subsp. constellatus, S. constellatus subsp. pharyngis, and S. constellatus subsp. viborgensis
- Have a buttered popcorn smell on plate
- Normal flora of oral cavity, throat, stool, and vagina
- Identified using three rapid tests:
- Voges-Proskaur (VP) test for acetoin production
- Arginine hydrolysis
- Failure to ferment sorbitol
Clinical Manifestations
- Tendency to form abscesses, unlike other streptococci, which can be polymicrobial with anaerobes and Enterobacterales
- Infections can range in severity, and include pharyngitis, dental abscess, skin and soft tissue infection, pneumonia, empyema, lung abscess, brain abscess, liver abscess, and kidney abscess
Investigations
- Presence of bacteremia without focus should prompt investigations to identify an occult abscess
- The HANDOC score can assess need for echocardiography
Management
- Typically treated with ceftriaxone or other third-generation cephalosporin pending susceptibilities
- If found in an abscess, should be considered polymicrobial and treated with concomitant metronidazole
- Clindamycin resistance is high, approximately 20-30%
