Tsai Wen-Cheng, Chang Liang-Kai, Lin Tzu-Chiang
Section of Infectious Disease, Armed Forces Tsoying Hospital, Kaohsiung, Taiwan, ROC.
J Microbiol Immunol Infect. 2004 Feb;37(1):63-6.
Streptococcus constellatus infection is a rare cause of myocardial abscess. The complication of cerebritis is also rare. We report a case of S. constellatus bacteremia in a 21-year-old woman who developed fever and watery diarrhea 7 days prior to admission. Computed tomography of the brain showed severe effacement of the cerebral sulci, narrowing of the ventricular system, and severe brain swelling. Echocardiography showed a cystic lesion of about 2 cm(2) over the left atrium. Mannitol and dexamethasone were administered. Hyperventilation was performed. Intravenous penicillin G and ceftazidime were administered but without response. The increased intracranial pressure persisted despite medical treatment. She died 3 days after admission. Culture of cerebrospinal fluid grew S. constellatus and 3 sets of blood cultures grew S. constellatus. This case emphasizes the potential pathogenic role of S. constellatus in myocardial abscess.
星座链球菌感染是心肌脓肿的罕见病因。脑脊髓炎并发症也很罕见。我们报告一例21岁女性的星座链球菌菌血症病例，该患者在入院前7天出现发热和水样腹泻。脑部计算机断层扫描显示脑沟严重消失、脑室系统变窄以及严重的脑肿胀。超声心动图显示左心房上方有一个约2 cm²的囊性病变。给予甘露醇和地塞米松治疗。进行了过度换气。静脉注射青霉素G和头孢他啶，但无反应。尽管进行了治疗，颅内压仍持续升高。她在入院3天后死亡。脑脊液培养出星座链球菌，3组血培养也培养出星座链球菌。该病例强调了星座链球菌在心肌脓肿中的潜在致病作用。
