Infections caused by anaerobic bacteria are common, and may be serious and life-threatening. Anaerobes predominant in the bacterial flora of normal human skin and mucous membranes, and are a common cause of bacterial infections of endogenous origin. Infections due to anaerobes can evolve all body systems and sites. The predominate ones include: abdominal, pelvic, respiratory, and skin and soft tissues infections. Because of their fastidious nature, they are difficult to isolate and are often overlooked. Failure to direct therapy against these organisms often leads to clinical failures. Their isolation requires appropriate methods of collection, transportation and cultivation of specimens. Treatment of anaerobic bacterial infection is complicated by the slow growth of these organisms, which makes diagnosis in the laboratory only possible after several days, by their often polymicrobial nature and by the growing resistance of anaerobic bacteria to antimicrobial agents.

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Saturday, January 18, 2020

Complications of Otitis Media and Sinusitis Caused by Streptococcus anginosus Group Organisms in Children.

McNeil et al. from Texas Children'sHospital studied 95 children seen between 2011 to 2018 with complications of otitis media and sinusitis caused by Streptococcus anginosus Group (SAG) organisms.  SAG are nonmotile facultative anaerobes that are part of the normal oral cavity, throat, stool, and vagina flora. Cases included were those with Pott's puffy tumor, orbital abscesses, mastoiditis, epidural abscesses, subdural empyema, brain parenchymal abscesses or dural enhancement by imaging.

Streptococcus intermedius was most commonly isolated (80%) followed by Streptococcus constellatus (12.6%) and Streptococcus anginosus (7.4%); 50.5% of cases were polymicrobial. Among polymicrobial cases, Staphylococcus aureus was most frequently isolated. All patients underwent surgical intervention and 8.4% had persistent neurologic deficits. Complications of otitis media and sinusitis caused by SAG are associated with substantial morbidity.


The researchers concluded that intraorbital and intracranial infections in general and SAG in particular are becoming increasingly common at their medical center.





Streptococcus anginosus (Gram stain)
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