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Section 3. Summaries of Infectious Diseases

Non-Group A or B Streptococcal and Enterococcal Infections

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS

Streptococci of Lancefield groups other than A or B can be associated with invasive disease in infants, children, adolescents, and adults. The principal clinical syndromes of groups C, F, and G streptococci are septicemia, upper and lower respiratory tract infections, skin and soft tissue infections, septic arthritis, meningitis with a parameningeal focus, brain abscess, and endocarditis. Viridans streptococci are associated with endocarditis in patients with congenital or valvular heart disease and bacteremia in neutropenic patients with cancer. Among the viridans streptococci, organisms from the anginosus group often are isolated from patients with brain abscess or abscesses in other sites, including lymph nodes, liver, and lung. Enterococci are associated with bacteremia in neonates and bacteremia, device-associated infections, intra-abdominal abscesses, and urinary tract infections in older children and adults.


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ETIOLOGY

Changes in taxonomy and nomenclature of the Streptococcus genus have evolved with advances in molecular technology. Among gram-positive organisms that are catalase negative and that display chains by Gram stain, the 2 genera associated most often with human disease are Streptococcus and Enterococcus. The Streptococcus genus contains organisms that are (1) beta-hemolytic on blood agar plates (Streptococcus pyogenes [see Group A Streptococcal Infections, p 616], Streptococcus agalactiae [see Group B Streptococcal Infections, p 628], and groups C, F, and G streptococci); (2) non-beta–hemolytic (alpha-hemolytic or non-hemolytic) on blood agar plates (Streptococcus pneumoniae [see Pneumococcal Infections, p 524], Streptococcus bovis group, Streptococcus milleri group and more than 20 species of viridans streptococci commonly isolated from humans, which are divided into 6 groups by phenotypic characteristics; (3) nutritionally variant streptococci (now referred to as Abiotrophia and Granulicatella. . . [Go to Full Text]


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