If you see me, look deeper.
Streptococcus constellatus is a member of the Streptococcus anginosus group, with a known propensity for invasive pyogenic infections, and as this association is well known, one should always look for occult pyogenic or suppurative collections in a patient with S. constellatus bacteremia.
A 62-year-old diabetic man with history of traumatic brain injury and dementia was admitted to the hospital with a fever (104°F), tachypnea, and leukocytosis and normal liver function test results were found to have S. constellatus bacteremia.
As the nature of this organism is known, although he had no localizing foci of infection and was asymptomatic with normal liver function test results, further workup was done which revealed occult abscesses in his gall bladder.
From the Rosalind Franklin University, Chicago, IL.
Reprints: Parul Aneja, MD, Division of Infectious Diseases, Rosalind Franklin University, 3333 Green Bay Rd, North Chicago, IL 60064. E-mail: firstname.lastname@example.org.
The authors report no conflicts of interest.