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

Abstract


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.


Keywords


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

Full Text:

PDF

References


Vandamme P, Pot B, Falsen E, Kersters K, Devriese LA. Taxonomic study of Lancefield streptococcal groups C, G, and L (Streptococcus dysgalactiae) and proposal of S. dysgalactiae subsp. equisimilis subsp. nov. International Journal of Systematic Bacteriology 1996; 46: 774-781.

Shimomura Y, Okumura K, Murayama SY, Yagi J, Ubukata K, Kirikae T, Miyoshi-Akiyama T. Complete genome sequencing and analysis of a Lancefield group G Streptococcus dysgalactiae subsp. equisimilis strain causing streptococcal toxic shock syndrome (STSS). BMC Genomics 2011; 12: 17.

Hughes JM, Wilson ME, Brandt CM, Spellerberg B. Human Infections Due to Streptococcus dysgalactiae Subspecies equisimilis. Clinical Infectious Diseases 2009; 49:766–772.

Broyles LN, Beneden CV, Beall B, Facklam R, Shewmaker PL, Daily PMP, Farley M M. Population-Based Study of Invasive Disease Due to β-Hemolytic Streptococci of Groups Other than A and B. Clinical Infectious Diseases 2009; 48: 706–712.

Takahashi T, Sunaoshi K, Sunakawa K, Fujishima S, Ubukata K. Clinical aspects of invasive infections with Streptococcus dysgalactiae ssp. equisimilis in Japan: differences with respect to Streptococcus pyogenes and Streptococcus agalactiae infections. Clinical and Microbiology Infection 2010; 16: 1097–1103.

Takahashi T, Ubukata K, Watanabe H. Invasive infection caused by Streptococcus dysgalactiae subsp. equisimilis: characteristics of strains and c linical features. Journal of Infection and Chemotherapy 2011; 17: 1-10.

Rantala, S. Streptococcus dysgalactiae subsp. equisimilis bacteremia: an emerging infection. European Journal of Clinical Microbiology Infectious Diseases 2014; 33: 1303–1310.

Oppegaard O, Skrede S, Mylvaganam H, Kittang BR. Temporal trends of β-hemolytic streptococcal osteoarticular infections in western Norway. BMC Infections Diseases 2016; 16:535.

Oppegaard O, Mylvaganam H, Skrede S, Lindemann PC, Kittang BR. Emergence of a Streptococcus dysgalactiae subspecies equisimilis stG62647-lineage associated with severe clinical manifestations. Scientific Report 2017; 7:7589.

Heldt Manica LA, Cohen PR. Streptococcus dysgalactiae-associated penile bacterial disease in an elderly man acquired by fellatio: case report and literature review of penile and perianal Streptococcus dysgalactiae in men acquired by anilingus and fellatio. Dermatology Online Journal 2018; 24.

Matsue M, Ogura K, Sugiyama H, Miyoshi-Akiyama T, Takemori-Sakai Y, Iwata Y, Okamoto S. Pathogenicity Characterization of Prevalent-Type Streptococcus dysgalactiae subsp. equisimilis Strains. Frontiers in Microbiology 2020; 11: 97.

Erden T, Gültepe BS, Küçükdurmaz, F. Periprosthetic joint infection with streptococcus dysgalactiae subspecies equisimilis: Case report. Joint Diseases and Related Surgery. 2020; 31: 399-402.

Lee Y, Koh KM, Hwang KY, Kwon YA, Lee DW, Song SW, Kim KY (2020) A case report of fulminant endophthalmitis caused by Streptococcus dysgalactiae in a patient with traumatic corneal laceration. BMC Ophthalmol 2020; 20: 238.

Kakuta R, Shimizu T, Goto H, Endo S, Kanamori H, Ohta N, Kaku M. Abdominal Aortic Graft Infection Caused by stG485.0, ST29 Streptococcus dysgalactiae subsp. equisimilis. Japonese Journal of Infectious Diseases 2020; 73: 65-67.

Winn, W., Allen, S., Janda, W., Koneman, E., Procop, G., Schreckenberger, P, and Woods, G. Gram-positive cocci part II: streptococci, enterococci, and the “streptococcus-like” bacteria. Konemans’s Color Atlas and Textbook of Diagnostic Microbiology 6th ed Wilkins LW and, editor 2006; p.672-764.

Clinical Laboratory Standards Institute. CLSI. Performance standards for antimicrobial susceptibility testing; 26th informational supplement. CLSI M100S. CLSI, Wayne, PA 2016.

Mota, G.A.; Prince, K.A.; Lafetá, B. N.; França, D.S.; Rocha, M. F. Prevalence of colonization by Streptococcus agalactiae in pregnant women. Brazilian Journal of Development 2020; 6 (7): 45611- 45620.

Bahl R, Sandhu S, Singh k, Sahai N, Gupta M. (2014) Odontogenic infections: Microbiology and management. Contemporary Clinical Dentistry 2014; 5: 307–311.

Fu B, McGowan K, Sun JH, Batstone M. Increasing frequency and severity of odontogenic infection requiring hospital admission and surgical management. British Journal of Oral and Maxillofacial Surgery 2020; 58: 409-15.

Chunduri NS, Madasu K, Goteki VR, Karpe T, Reddy H. Evaluation of bacterial spectrum of orofacial infections and their antibiotic susceptibility. Annals of Maxillofacial Surgery 2012; 2:46–50.

Oppegaard O, Skrede S, Mylvaganam H, Kittang BR. Emerging Threat of Antimicrobial Resistance in β-Hemolytic Streptococci. Frontiers in Microbiology 2020; 11:797.

Scottish Dental Clinical Effectiveness Programme. SDCEP. Drugs for the Management of Dental Problems During COVID-19 Pandemic 2020.

Jevon P, Abdelrahman A, Pigadas N. Management of odontogenic infections and sepsis: an update. British Dental Journal 2020; 229:363–370.




DOI: https://doi.org/10.34117/bjdv.v7i5.29166

Refbacks

  • There are currently no refbacks.