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Serious infections caused by Streptococcus milleri
Abstract:
Viridans streptococci continue to be the most common etiologic agents in bacterial endocarditis. The spectrum of diseases other than endocarditis caused by these organisms, however, has received sparse attention. Moreover, little clinical information is available concerning the individual viridans streptococcal species. During the 16 months of this study, one species of viridans streptococci, Streptococcus milleri, caused a surprising number of clinically significant suppurative infections. Clinical syndromes included the following: abscesses, 10 cases; peritonitis, four cases; endocarditis, three cases; cholangitis, empyema and cellulitis, one case each. A gastrointestinal source was apparent in eight of these 20 cases. Review of 58 cases of viridans streptococcal endocarditis demonstrated that although Strep. milleri was an infrequent cause of endocarditis, this species was associated with an unusual frequency of suppurative complications. Our experience suggests that Strep. milleri may be more commonly associated with serious suppurative infections than other viridans streptococci and that species identification may be a clinically useful procedure.
Insights
Streptococcus milleri, a type of viridans streptococci, is linked to serious suppurative infections beyond endocarditis. Identifying this specific bacterial species is clinically valuable for diagnosing and treating these infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
Background:
- Viridans streptococci are common causes of bacterial endocarditis.
- Limited information exists on non-endocarditis diseases caused by these bacteria and specific species.
Observation:
- During a 16-month study, Streptococcus milleri was identified as a significant cause of suppurative infections.
- Observed clinical syndromes included abscesses, peritonitis, endocarditis, cholangitis, empyema, and cellulitis.
- A gastrointestinal source was identified in 8 of the 20 cases.
Findings:
- Streptococcus milleri, though infrequent in endocarditis, showed a high rate of suppurative complications.
- This species appears more frequently associated with severe suppurative infections compared to other viridans streptococci.
- Species-level identification of viridans streptococci may offer clinical utility.
Implications:
- Highlights the importance of identifying Streptococcus milleri in suppurative infections.
- Suggests Streptococcus milleri may be an underrecognized pathogen in serious infections.
- Emphasizes the clinical relevance of specific bacterial species identification in patient care.