Murray H W, Gross K C, Masur H, Roberts R B
Am J Med. 1978 May;64(5):759-64. doi: 10.1016/0002-9343(78)90514-4.
Viridans streptococci continue to be the most common etiologic agents in bacterial endocarditis. The spectrum of diseases other than endocarditis caused by these organisms, however, has received sparse attention. Moreover, little clinical information is available concerning the individual viridans streptococcal species. During the 16 months of this study, one species of viridans streptococci, Streptococcus milleri, caused a surprising number of clinically significant suppurative infections. Clinical syndromes included the following: abscesses, 10 cases; peritonitis, four cases; endocarditis, three cases; cholangitis, empyema and cellulitis, one case each. A gastrointestinal source was apparent in eight of these 20 cases. Review of 58 cases of viridans streptococcal endocarditis demonstrated that although Strep. milleri was an infrequent cause of endocarditis, this species was associated with an unusual frequency of suppurative complications. Our experience suggests that Strep. milleri may be more commonly associated with serious suppurative infections than other viridans streptococci and that species identification may be a clinically useful procedure.
草绿色链球菌仍然是细菌性心内膜炎最常见的病原体。然而，这些微生物引起的心内膜炎以外的疾病谱很少受到关注。此外，关于各个草绿色链球菌种类的临床信息也很少。在本研究的16个月期间，一种草绿色链球菌——米勒链球菌，引发了数量惊人的具有临床意义的化脓性感染。临床综合征包括：脓肿10例；腹膜炎4例；心内膜炎3例；胆管炎、脓胸和蜂窝织炎各1例。这20例中有8例明显有胃肠道感染源。回顾58例草绿色链球菌心内膜炎病例发现，虽然米勒链球菌是心内膜炎的少见病因，但该菌种与化脓性并发症的异常高发有关。我们的经验表明，米勒链球菌可能比其他草绿色链球菌更常与严重化脓性感染相关，菌种鉴定可能是一种具有临床实用价值的方法。
