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DOI: 10.1055/s-0038-1640873
Streptococcus milleri – relevance for ENT pathology
Introduction:
The micobiological spectrum of a sinusitis which is caused by a dental focus. Do we need to extend our antibiotic therapy?
Methods:
Casereport about managing a fulminant compication of a sinusitis with a dental cause.
Results:
Sinusitis which are caused by a dental focus are still an indication for sinus surgery, even if the dental infection has been treated. Therefore one needs to consider a broad spectrum of bacteria involved which has to be covered perioperatively. Besides the well known aerobic microbes of the oral flora and the anaerobic bacteria of the peridontal sulci we are confronted with bacteriae of the streptococcus viridans group which were formerly considered apathogenic. Recent reports in the literature show that subspecies of the streptococcus mirabilis group such as streptococcus anginosus, strep. constellatus or strep. intermedius are highly pathogenic and may cause abscess in the female genito urinary tract and also in the head and neck.
Conclusion:
To treat patients with such complications a broad spectrum of antibiotics have to be used empirically because culture and sensitivity testing does not provide for timely information while the progressive clinical course requires immediate action.
In case of orbital complication in patients with dentogenous sinusitis, streptococci subspecies have to be considered in the choice of antibiotic coverage. In addition treatment of orbital abscesses require a broad spectrum of surgical techniques.
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No conflict of interest has been declared by the author(s).
Publikationsverlauf
Publikationsdatum:
18. April 2018 (online)
© 2018. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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