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If You See Me, Look Deeper: A Case of Occult Pyogenic Foci With Streptococcus Constellatus

Aneja, Parul MD; Patel, Pawan MD; Khayr, Walid MD

Infectious Diseases in Clinical Practice: July 2010 - Volume 18 - Issue 4 - p 273-274
doi: 10.1097/IPC.0b013e3181d04a31
Case Reports

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:

The authors report no conflicts of interest.

© 2010 Lippincott Williams & Wilkins, Inc.