 |
|
Streptococcus milleri
An Organism for Head and Neck Infections and Abscess
Joseph K. Han, MD;
Joseph E. Kerschner, MD
Arch Otolaryngol Head Neck Surg. 2001;127:650-654.
Background Streptococcus milleri, a commensal organism,
has the potential to cause significant morbidity. There is a paucity of published
data regarding this organism in the head and neck.
Objectives To identify and assess the presentation, treatment, and outcomes of
pediatric patients affected by this pathogen.
Study Design Review of the Department of Pathology database at Children's Hospital
of Wisconsin, Milwaukee, between 1997 and 1999 identified 26 patients with
cultures positive for S milleri group (SMG) bacteria.
Retrospective chart analysis examined the demographic data, site of origin
of infection, additional organisms cultured, symptoms, treatments, and complications.
Results Sixteen patients had SMG infections involving the head and neck region.
Sites of origin included the paranasal sinuses, dental, facial soft tissues,
deep neck spaces, peritonsillar region, and a tracheostomy site. The paranasal
sinuses were the most common site in 37% (6/16). Streptococcus
milleri was the only isolate in 69% (11) of the infections. Significant
local extension occurred in 56% (9/16) of the patients and included the orbit,
skull base, cranium, and deep neck spaces. All patients had surgical drainage
and 15 also received intravenous antibiotic treatment. One complication of
osteomyelitis of the frontal bone occurred with resolution after surgical
debridement and intravenous antibiotic treatment.
Conclusions Streptococcus milleri can be an aggressive
pathogen in the head and neck with a propensity for abscess formation and
local extension of the infection in a pediatric population. Surgical drainage
with antibiotics is generally successful in management of the condition. However,
emerging penicillin resistance and the ability for local extension require
suspicion of incomplete treatment if clinical symptoms persist.
From the Department of Otolaryngology and Communications Sciences,
Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee.
Corresponding author: Joseph E Kerschner, MD, Department of Otolaryngology
and Communications Sciences, Medical College of Wisconsin, Children's Hospital
of Wisconsin, 9000 W Wisconsin Ave, Milwaukee, WI 53226 (e-mail: kersch{at}mcw.edu).
RELATED ARTICLE
Archives of Otolaryngology–Head & Neck Surgery Reader's Choice: Continuing Medical Education
Arch Otolaryngol Head Neck Surg. 2001;127(6):725-726.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Anaerobic bacteria in 118 patients with deep-space head and neck infections from the University Hospital of Maxillofacial Surgery, Sofia, Bulgaria.
Boyanova et al.
J Med Microbiol 2006;55:1285-1289.
ABSTRACT
| FULL TEXT
A Case of Streptococcus intermedius Empyema
Wargo et al.
The Annals of Pharmacotherapy 2006;40:1208-1210.
ABSTRACT
| FULL TEXT
Intracerebral Abscess in Children: Historical Trends at Children's Hospital Boston
Goodkin et al.
Pediatrics 2004;113:1765-1770.
ABSTRACT
| FULL TEXT
|
