Abscess Caused by Streptococcus Constellatus Secondary to Tooth Decay on Facial Skin: Case Report

Year 2021, Volume: 23 Issue: 2, 225 - 227, 30.08.2021

Önder Kiliçaslan , Didem Kızmaz İşançlı , Esmanur Fil , Ecem Ertürk Uzundal , Adem Karbuz

https://doi.org/10.18678/dtfd.935676

Abstract

A six-year-old male patient with no known history of disease was presented due to an unfamiliar Streptococcus constellatus growth that developed alongside a tooth abscess and fistulized. The patient was admitted with redness, swelling, and tenderness in the left-most section of his face. We learned that the patient visited a dentist three weeks prior due to complaints of swelling in the jaw and tooth decay. The patient had a leukocyte count of 22,600/μL (neutrophil: 17,190/μL), C-reactive protein level was 105.2 mg/L. The patient was put on an intravenous treatment of clindamycin and cefoperazone-sulbactam. There was spontaneous discharge in the abscess. S. constellatus grew in abscess culture dish. The current therapy was changed to ampicillin-sulbactam. Observations on the seventh day of hospitalization showed that the lesion had subsided almost entirely. S. constellatus is a rare microorganism that produces abscesses and requires immediate medical attention.

Keywords

Abscess, Child, Streptococcus milleri, Streptococcus constellatus, Tooth Decay

Diş Çürümesine İkincil Olarak Yüzde Gelişen Streptococcus Constellatus'un Neden Olduğu Apse: Olgu Sunumu

Abstract

Bilinen bir hastalık öyküsü olmayan altı yaşında bir erkek hasta, diş absesine ikincil gelişen ve fistülize olan cilt apsesinden alınan mikrobiyolojik incelemede alışık olmadığımız bir etken olan Streptococcus constellatus üremesi sebebiyle sunuldu. Hasta yüzün sol yarısında izlenen kızarıklık, şişlik ve hassasiyet ile başvurdu. Hastanın üç hafta önce çenede şişlik ve diş çürüğü şikayetleri ile diş hekimine gittiği öğrenildi. Lökosit sayısı 22.600/μL (nötrofil: 17.190/μL), C-reaktif protein 105,2 mg/L idi. Hastaya intravenöz klindamisin ve sefoperazon-sulbaktam tedavisi başlandı. Apse kendiliğinden drene oldu. Kültürde S. consellatus üredi. Mevcut tedavi ampisilin-sulbaktam ile değiştirildi. Yatışının yedinci gününde lezyonun neredeyse tamamen gerilediği görüldü. S. constellatus nadir görülen ancak yol açtığı apseler nedeniyle dikkat edilmesi gereken bir mikroorganizmadır.

Keywords

Apse, Çocuk, Diş Çürüğü, Streptococcus milleri, Streptococcus constellatus

References

• Jacobs JA, Pietersen HG, Stobberingh EE, Soeters PB. Streptococcus anginosus, Streptococcus constellatus and Streptococcus intermedius. Clinical relevance, hemolytic and serologic characteristics. Am J Clin Pathol. 1995;104(5):547-53.
• Ng KW, Mukhopadhyay A. Streptococcus constellatus bacteremia causing septic shock following tooth extraction: a case report. Cases J. 2009;2:6493.
• Claridge JE 3rd, 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(10):1511-5.
• Dsouza R, Roopavathana B, Chase S, Nayak S. Streptococcus constellatus: a rare causative agent of pyogenic liver abscess. BMJ Case Rep. 2019;12(12):e229738.
• Al Asaadi Z, Srinivasan B, Melchers LJ, Brennan PA. Streptococcus constellatus causing bony destruction secondary to odontogenic infection: three rare cases. Br J Oral Maxillofac Surg. 2019;57(6):594-6.
• Faden H, Mohmand M. Infections associated with Streptococcus constellatus in children. Pediatr Infect Dis J. 2017;36(11):1099-100.
• Chrastek D, Hickman S, Sitaranjan D, Vokshi I, Kakisi O, Kadlec J, et al. Streptococcus constellatus causing empyema and sepsis, necessitating early surgical decortication. Case Rep Infect Dis. 2020;2020:4630809.
• Khan MZ, Tahir D, Kichloo A, Haddad N, Hanan A. Pyogenic liver abscess and sepsis caused by Streptococcus constellatus in the immunocompetent host. Cureus. 2020;12(8):e9802.
• McNeil JC, Dunn JJ, Kaplan SL, Vallejo JG. Complications of otitis media and sinusitis caused by Streptococcus anginosus group organisms in children. Pediatr Infect Dis J. 2020;39(2):108-13.
• Tracy M, Wanahita A, Shuhatovich Y, Goldsmith EA, Clarridge JE 3rd, Musher DM. Antibiotic susceptibilities of genetically characterized Streptococcus milleri group strains. Antimicrob Agents Chemother. 2001;45(5):1511-4.