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Streptococcus milleri liver abscess presenting as fulminant pneumonia
1Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
The Australian and New Zealand Journal of Surgery
|March 1, 1993
Summary
A young man developed a Streptococcus milleri liver abscess due to an undetected colonic foreign body. This rare case highlights the need to investigate gastrointestinal pathology when this bacterium is found.
Area of Science:
- Microbiology
- Gastroenterology
- Infectious Diseases
Background:
- Streptococcus milleri is a commensal bacterium of the gastrointestinal tract.
- Liver abscesses can arise from various causes, including bacterial infections.
- Community-acquired pneumonia typically results from respiratory pathogens.
Observation:
- A young male presented with severe community-acquired pneumonia.
- Diagnostic workup revealed a liver abscess.
- The abscess culture identified Streptococcus milleri.
Findings:
- The liver abscess was found to be secondary to an occult (hidden) foreign body in the colon.
- Streptococcus milleri, usually found in the gut, was the causative agent of the abscess.
- The presentation mimicked severe pneumonia, masking the underlying gastrointestinal issue.
Implications:
- Isolation of Streptococcus milleri from abscesses, blood, or sputum warrants investigation for gastrointestinal pathology.
- This includes searching for foreign bodies, silent perforations, or other abnormalities within the GI tract.
- This case underscores the importance of considering non-respiratory sources for severe infections presenting with respiratory symptoms.