ABSTRACT
A 52-year-old Japanese man with a history of type 2 diabetes mellitus (DM) presented with mild dizziness. On admission, the physical examination only revealed tachycardia and right sided cervical lymphadenopathy. On the fifth day of admission, his mental status slightly worsened. Urgent Computed Tomography (CT) of the head and neck revealed multiple abscesses spreading from the right temporal bone to the right sternocleidomastoid muscle. Bezold's abscess was diagnosed. Streptococcus pneumoniae was isolated from middle ear fluid and blood cultures. Bezold's abscess has rarely been described in the era of antimicrobial therapy. However this abscess can still occur in patients without any typical severe symptoms. Repeated history taking and thorough physical examination can help detect Bezold's abscess.
ABSTRACT
An 84-year-old man was admitted to our hospital with bloody sputum. He was found to have a right lower lobe wedge-shaped nodular lesion with chest X-ray and computed tomography of the chest. Ceftriaxone and minocycline were started empirically based on a working diagnosis of community-acquired pneumonia. Streptococcus parasanguinis was isolated with sputum cultures obtained on three consecutive days and was identified based on its biochemical properties. S. parasanguinis is a member of the sanguinis group of viridans Streptococci. It is known as a causative pathogen for endocarditis. There are very few reports of S. parasanguinis associated with pulmonary infections. The present report describes the association of S. parasanguinis with a wedge-shaped nodular lesion in the lungs.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Ceftriaxone/therapeutic use , Pneumonia/drug therapy , Streptococcal Infections/drug therapy , Streptococcus/isolation & purification , Aged, 80 and over , Community-Acquired Infections/diagnosis , Community-Acquired Infections/pathology , Humans , Male , Pneumonia/diagnosis , Streptococcal Infections/diagnosis , Streptococcal Infections/pathologyABSTRACT
Streptococcus salivarius subsp. salivarius occasionally causes meningitis associated with iatrogenic or traumatic events. We herein describe a case of meningitis caused by this organism in a patient without any apparent risk factors. In an assay of the patient's cerebrospinal fluid, cross-reaction occurred with Streptococcus pneumoniae antigen-coated latex particles in the Pastorex Meningitis Kit. In the in vitro assays, three of the five clinically isolated S. salivarius strains showed cross-reactions with the kit, indicating that these strains expressed pneumococcal antigen-like antigens. This case shows that meningitis caused by S. salivarius can occur spontaneously and it may sometimes be misdiagnosed as S. pneumoniae infection.
