Streptococcus constellatus as an aetiological factor of extensive neck phlegmon complicated by sepsis – case study
More details
Hide details
Department of Maxillofacial Surgery, Heliodor Święcicki Clinical Hospital, University of Medical Sciences, Poznan, Poland
Central Microbiological Laboratory, Heliodor Święcicki University Hospital, Poznań, Poland
Department of Genetics and Pharmaceutical Microbiology, University of Medical Sciences, Poznań, Poland
Department of Anaesthesiology, Intensive Care and Pain Management, Heliodor Święcicki Clinical Hospital, University of Medical Sciences, Poznan, Poland
Introduction. Streptococcus constellatus are opportunistic microorganisms. When immunocompromised patients with concomitant systemic diseases are infected with S.constellatus, the bacteria may cause sepsis. Case study. A patient was admitted to hospital due to septic shock and multi-organ dysfunction in the course of neck phlegmon. The microbiological system identified S. constellatus in the patient who worked as a dog groomer. These facts confirmed that this aetiological factor may have caused such a serious infection because S. constellatus is a bacterial species found in dogs. It is most likely that the bacteria colonised the patient. Zoonotic transmission of microorganisms is particularly important for the development of infections in dogs and humans. Knowledge about how to treat deep cervical infections is necessary in the daily practice of a maxillofacial surgeon. The right antibiotic can applied only when the strain causing the infection has been identified.
Joanna Bilska-Stokłosa   
Poznan University of Medical Sciences. Department of Maxillofacial Surgery, Heliodor Święcicki Clinical Hospital, Przybyszewskiego 49, 60-355 Poznań, Poland
1. Ruoff KL. Streptococcus anginosus (“Streptococcus milleri”): the unrecognized pathogen. Clin Microbiol Rev. 1988; 1: 102–108.
2. Wein Ping Ng K, Mukhopadhyay A. Streptococcus constellatus bacteremia causing septic shock following tooth extraction: a case report. Cases J. 2009; 2: 6493.
3. Whiley RA, Beighton D, Winstanley TG, Fraser HY, Hardie JM. Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus (the Streptococcus milleri group): association with different body sites and clinical infections. J Clin Microbiol. 1992; 30: 243–244.
4. Bantar C, Fernandez Caniga L, Relloso S, Lanza A, Bianchini H, Smayevsky J. Species belonging to the “Streptococcus milleri” group: anti-microbial susceptibility and comparative prevalence in significant clinical specimens. J Clin Microbiol. 1996; 34: 2020–2022.
5. Clarridge JE, III, Attorri S, Musher DM, Hebert J, Dunbar S. Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus (“Streptococcus milleri group”) are of different clinical importance and are not equally associated with abscess. Clin Infect Dis. 2001; 32: 1511–1515. doi: 10.1086/320163.
6. Kawczyński M, Amernik K, Kelar I, Jaworowska E, Paradowska-Opałka B. Zakażenia ropne głębokich przestrzeni szyi w Klinice Otolaryngologii PUM w okresie ostatnich 5 lat. Pol. Przegląd Otorynolaryngol 2012; 4 (1): 314–318.
7. Lee YQ, Kanagalingam J. Bacteriology of deep neck abscesses: a retrospective review of 96 consecutive cases. Singapore Med J. 2011; 52: 351–5.
8. Bottin R, Marioni G, Rinaldi R, Boninsegna M, Salvadori L, Staffieri A. Deep neck infection: a present-day complication. A retrospective review of 83 cases (1998–2001). Eur Arch Otorhinolaryngol. 2003; 260: 576–9.
9. Whiley RA, Hall LMC, Hardie JM, Beighton D. A study of small-colony, beta-haemolytic, Lancefield group C streptococci within the anginosus group: description of Streptococcus constellatus subsp. pharyngis subsp. nov., associated with the human throat and pharyngitis. Int J Syst Bacteriol. 1999; Oct; 49 Pt 4: 1443–9.
10. Bancescu G, Carmen D, Bancescu A, Hirjau M. The Susceptibility To Antibiotics Of Some Streptococcus Constellatus Strains Isolated From Odontogenic Infections Farmacia 2016; 64(1): 58–60.
11. Faden H, Mohmand M. Infections Associated With Streptococcus Constellatus in Children The Pediatric Infectious Disease J. 2017; 36(11): 1099–1100.
12. Osborn TM, Assael LA, Bell RB. Deep space neck infection: principles of surgical management. Oral Maxillofac Surg Clin North Am. 2008; 20(3): 353–65.
13. Karkos PD, Leong SC, Beer H, Apostolidou MT, Panarese A. Challenging airways in deep neck space infections. Am J Otolaryngol. 2007; 28: 415–8.
14. Markowski J, Dziubdziela W, Wardas P, Piotrowska A, Sowińska-Krzyżanowska I, Gierek T, et al. Ropowice głowy i szyi – diagnostyka i leczenie – obserwacje własne. Otolaryngol Pol. 2012; 66: 207–13.
15. Cheng Z, Yu J, Xiao L, Lian Z, Wei Y, Wang J. Deep neck infection: clinical analyses of 95 cases. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Sep; 50(9): 769–72.