Streptococcus constellatus

• Complicated Head and Neck Infections Caused by Streptococcus constellatus at the End of the COVID-19 Pandemic: A Case Series
• Letter to Editor Regarding: "Acute Spinal Epidural Abscess of the Cervical Spine Caused by Streptococcus Constellatus Leads to Paraplegia in an Adult: A Case Report" [Letter]
• Robot-Guided Stereotactic Puncture and Drainage in the Treatment of Thalamic Abscess
• Changes in the epidemiology of pediatric sinogenic and otogenic intracranial infections during the COVID-19 pandemic: a single-institution study
• Subdural empyema in immunocompetent pediatric patients with recent SARS-CoV-2 positivity: case report
• Aggressive Pyogenic Spondylitis Caused by S. constellatus: A Case Report
• Pott's puffy tumour: a rare and life-threatening disease
• Concomitant parasagittal meningioma and adjacent intracranial abscess of occult etiology

Streptococcus constellatus, a coccus from the normal genital, oral, and gut microbiota, has a tendency to form abscesses, but not to cause infective endocarditis (IE). Also, S. constellatus is an extremely rare causative agent of brain abscess.

15-year-old and 12-year-old female children with subdural empyema after SARS-CoV2. The patients presented limitation of the eye in the outward gaze, impaired speech, drowsiness, fever, and vomiting and they also tested positive for COVID-19. MRI indicated subdural empyema and surgical interventions were needed to relieve intracranial pressure and drain pus after receiving broad-spectrum antibiotics treatments. The microbiological analysis of abscess material revealed Streptococcus constellatus which is extremely rare in an immunocompetent child and the patients received appropriate IV antibiotic therapy. Eventually, patients became neurologically intact. Pediatric patients with CoV infections should be closely monitored for neurological symptoms. Further research and more data on the correlation between CoV infections would provide better recognition and treatment options in an efficient manner in children ¹⁾.

García Carretero report the case of a woman with a colorectal tumor who presented with IE and cerebellar abscesses due to an S. constellatus bacteremia ²⁾.

A 38-year-old man underwent a molar Tooth extraction and has had a fever since then. He vomited and has a progressive generalized headache that is preventing him from sleeping.

In the blood culture a Streptococcus constellatus has grown

Extra-axial collection in the left cerebellopontine angle adjacent to the affected portion of the cerebellar hemisphere, consistent with an epidural abscess, with approximate diameters compatible with an abscess of 1.6 cm maximum diameter, 2.6 cm anteroposterior, 2.3 cm transverse, and 0.7 cm craniocaudal. There is another similar collection in the right pontocerebellar angle adjacent to the right middle cerebellar peduncle and hemipontine measuring 1.7 cm craniocaudal, 1.7 cm anteroposterior, and 0.7 cm transverse.

Supine position with right lateralized head. Incision and right retrosigmoid craniotomy near asterion. Dural opening with purulent material exiting between the tentorium and the lateral tentorial surface of the cerebellum. Cerebellum was initially under tension until the pus was drained, which relaxed it. Semi-hermetic closure with Tachosil. Cranium replaced with 2 Synthes mini plates. Muscular and subcutaneous planes closed with absorbable suture and skin with staples.“