Mandibular infection caused by Streptococcus dysgalactiae subsp equisimilis: an unusual case of oral infection / Infecção mandibular causada por Streptococcus dysgalactiae subsp equisimilis: um caso incomum de infecção bucal

Luis Antonio Esmerino, André Takahashi, Mauricio Carvalho, Maria Janina Pinheiro Diniz, Shelon Cristina Souza Pinto


Context: Streptococcus dysgalactiae subsp. equisimillis (SDSE) is an emerging human pathogen which is being increasingly isolated from patients with a myriad of infections. Case report: Male patient, 45 years old, reporting pain in tooth 47 on the mandibular second molar platform on the right side; swelling was visible at the site. Periapical radiography showed a periodontal defect and bone loss around the second molar, as well as a small osteosynthesis plate. A bacteriological profile and an antibiogram were requested. The microscopic examination revealed Gram-positive cocci with paired arrangements, as well as numerous polymorphonuclear leukocytes. In the blood agar culture there were numerous colonies with β-hemolysis of catalase-negative Gram-positive cocci. Serological typing was positive for Lancefield Group G Streptococcus (GGS), and was identified as SDSE. No resistance to the antibiotics tested on the antibiogram was observed. Conclusion: The patient’s management included tooth extraction and the removal of an osteosynthesis plate, together with antibiotic therapy consisting of amoxicillin. The patient made a full recovery.


Oral infection, Streptococcus, Oral microbiology, Fastidious bactéria, Management of dental infection

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