Journal of the Formosan Medical Association
Volume 105, Issue 9 , Pages 760-764, 2006

Disseminated Streptococcus anginosus Infection with Empyema Thoracis in a Patient with Sarcoma

  • Yu-Min Chuang

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
    • ,
  • Po-Ren Hsueh

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
    • Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
    • ,
  • Peilin Lee

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Peilin Lee, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan

Received 20 July 2005; received in revised form 6 September 2005; accepted 4 October 2005.

Article Outline

Streptococcus anginosus is a member of the normal flora of the oral cavity and a pathogen of thoracic infection. However, disseminated infection that was identified from different body fluids at the same time has never been reported. We report a 52-year-old man with advanced pulmonary sarcoma who developed neutropenia, bronchopleural fistula and thoracic empyema after chemotherapy. Viridans group Streptococcus was isolated from both empyema and urine, which was confirmed as S. anginosus according to the biochemical reaction profiles and 16S rRNA gene sequencing results. The patient recovered uneventfully after tube drainage and treatment with imipenem. Disseminated S. anginosus infection should be considered as a possible pathogen in immunocompromised patients with empyema and can be rapidly identified by 16S rRNA gene sequencing.

Key Words:  disseminated , empyema thoracis , sarcoma , Streptococcus anginosus

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References 

  1. Jacobs JA , Schouten HC , Stobberingh EE , et al.   Viridans streptococci isolated from the bloodstream. Relevance of species identification . Diagn Microbiol Infect Dis . 1995;22:267–273
  2. Perkins DE , McRae RP . An arteriosclerotic aneurysm of the abdominal aorta secondarily infected with group C, beta-hemolytic streptococci. Report of a case . Am J Clin Pathol . 1974;62:646–648
  3. Whiley RA , Duke B , Hardie JM , et al.   Heterogeneity among 16S-23S rRNA intergenic spacers of species within the ‘Streptococcus milleri group’ . Microbiology . 1995;141(Pt 6):1461–1467
  4. Bannatyne RM , Randall C . Ecology of 350 isolates of group F Streptococcus . Am J Clin Pathol . 1977;67:184–186
  5. Jerng JS , Hsueh PR , Teng LJ , et al.   Empyema thoracis and lung abscess caused by viridans streptococci . Am J Respir Crit Care Med . 1997;156:1508–1514
  6. Whiley RA , Fraser H , Hardie JM , et al.   Phenotypic differentiation of Streptococcus intermedius, Streptococcus constellatus and Streptococcus anginosus strains within the “Streptococcus milleri group” . J Clin Microbiol . 1990;28:1497–1501
  7. Shinzato T , Saito A . The Streptococcus milleri group as a cause of pulmonary infections . Clin Infect Dis . 1995;21(Suppl 3):S238–S243
  8. Fujiki R , Kawayama T , Rikimaru T , et al.   A three-year review of acute respiratory tract infections caused by Streptococcus milleri group . Kansenshogaku Zasshi . 2002;76:174–179
  9. Jacobs JA , Schot CS , Bunschoten AE , et al.   Rapid species identification of “Streptococcus milleri” strains by line blot hybridization: identification of a distinct 16S rRNA population closely related to . Streptococcus constellatus. J Clin Microbiol . 1996;34:1717–1721
  10. Ruoff KL , Whiley RA , Beighton D . Streptococcus . In:  Murray PR ,  Baron EJ ,  Pfaller MA , et al. editor. Manual of Clinical Microbiology . Washington, DC: American Society for Microbiology; 1999;p. 283–296
  11. Mirzanejad Y , Stratton CW . Streptococcus anginosus Group . In:  Mandell GL ,  Bennett JE ,  Dolin R editor. Principles and Practice of Infectious Diseases . New York: Churchill Livingstone; 2005;p. 2451–2457
  12. Porta G , Rodriguez-Carballeira M , Gomez L , et al.   Thoracic infection caused by Streptococcus milleri . Eur Respir J . 1998;12:357–362
  13. Chen KY , Hsueh PR , Liaw YS , et al.   A 10-year experience with bacteriology of acute thoracic empyema: emphasis on Klebsiella pneumoniae in patients with diabetes melli-tus . Chest . 2000;117:1685–1689
  14. Farber BF , Eliopoulos GM , Ward JI , et al.   Multiply resistant viridans streptococci: susceptibility to beta-lactam antibiotics and comparison of penicillin-binding protein patterns . Antimicrob Agents Chemother . 1983;24:702–705
  15. Libertin CR , Hermans PE , Washington JA . Beta-hemolytic group F streptococcal bacteremia: a study and review of the literature . Rev Infect Dis . 1985;7:498–503

PII: S0929-6646(09)60205-9

doi:10.1016/S0929-6646(09)60205-9

Journal of the Formosan Medical Association
Volume 105, Issue 9 , Pages 760-764, 2006

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