{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:06:07Z","timestamp":1785391567955,"version":"3.55.0"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T00:00:00Z","timestamp":1639958400000},"content-version":"vor","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p><jats:italic>Streptococcus constellatus<\/jats:italic> is a member of <jats:italic>Streptococcus anginosus<\/jats:italic> group (SAG) that tends to cause pyogenic infections in various sites. However, <jats:italic>Streptococcus constellatus<\/jats:italic> is easily ignored by routine clinical laboratory tests for its prolonged anaerobic culture environment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 71-year-old man was admitted to our hospital due to productive cough, fever, chest pain and shortness of breath for 3\u00a0weeks. Chest computed tomography showed patchy opacities and right-sided pleural effusion, so a chest tube was inserted and purulent and hemorrhagic fluid was aspirated. The routine\u00a0etiological examinations of the pleural effusion were all negative, and next-generation sequencing (NGS) detected <jats:italic>Streptococcus constellatus<\/jats:italic>. Intravenous piperacillin-tazobactam 4.5 g every 8 h was used accordingly. The patient recovered and subsequent chest computed tomography confirmed the improvement.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We reported a case of empyema secondary to <jats:italic>Streptococcus constellatus<\/jats:italic> infection, which was identified by NGS, instead of bacterial culture. This case highlights the utility of NGS in detecting pathogens negative in traditional bacterial tests.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06955-2","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T10:03:12Z","timestamp":1639994592000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Empyema caused by Streptococcus constellatus: a case report and literature review"],"prefix":"10.1186","volume":"21","author":[{"given":"Jingyan","family":"Xia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lexin","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuhui","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5764-6628","authenticated-orcid":false,"given":"Feng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,20]]},"reference":[{"issue":"4","key":"6955_CR1","doi-asserted-by":"publisher","first-page":"1150","DOI":"10.1128\/JCM.02082-09","volume":"48","author":"AB Olson","year":"2010","unstructured":"Olson AB, Sibley CD, Schmidt L, Wilcox MA, Surette MG, Corbett CR. Development of real-time PCR assays for detection of the Streptococcus milleri group from cystic fibrosis clinical specimens by targeting the cpn60 and 16S rRNA genes. J Clin Microbiol. 2010;48(4):1150\u201360.","journal-title":"J Clin Microbiol"},{"issue":"2","key":"6955_CR2","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1056\/NEJMcpc1411439","volume":"373","author":"SD Gharib","year":"2015","unstructured":"Gharib SD, Berger DL, Choy G, Huck AE. Case records of the Massachusetts general hospital. Case 21-2015. A 37-year-old American man living in Vietnam, with fever and bacteremia. N Engl J Med. 2015;373(2):174\u201383.","journal-title":"N Engl J Med"},{"issue":"10","key":"6955_CR3","doi-asserted-by":"publisher","first-page":"1511","DOI":"10.1086\/320163","volume":"32","author":"JE Claridge 3rd","year":"2001","unstructured":"Claridge JE 3rd, Attorri S, Musher DM, Hebert J, Dunbar S. Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus (\u201cStreptococcus milleri group\u201d) are of different clinical importance and are not equally associated with abscess. Clin Infect Dis. 2001;32(10):1511\u20135.","journal-title":"Clin Infect Dis"},{"issue":"7","key":"6955_CR4","doi-asserted-by":"publisher","first-page":"962","DOI":"10.3950\/jibiinkoka.119.962","volume":"119","author":"M Inoue","year":"2016","unstructured":"Inoue M, Okamoto K, Nagao H, Toyoda K. A case of esophageal submucosal abscess originating from a peritonsillar abscess. Nihon Jibiinkoka Gakkai kaiho. 2016;119(7):962\u20136.","journal-title":"Nihon Jibiinkoka Gakkai kaiho"},{"key":"6955_CR5","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1186\/s12890-015-0128-6","volume":"15","author":"S Noguchi","year":"2015","unstructured":"Noguchi S, Yatera K, Kawanami T, Yamasaki K, Naito K, Akata K, Shimabukuro I, Ishimoto H, Yoshii C, Mukae H. The clinical features of respiratory infections caused by the Streptococcus anginosus group. BMC Pulm Med. 2015;15:133.","journal-title":"BMC Pulm Med"},{"issue":"10","key":"6955_CR6","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1136\/thx.50.10.1093","volume":"50","author":"CA Wong","year":"1995","unstructured":"Wong CA, Donald F, Macfarlane JT. Streptococcus milleri pulmonary disease: a review and clinical description of 25 patients. Thorax. 1995;50(10):1093\u20136.","journal-title":"Thorax"},{"issue":"2","key":"6955_CR7","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1183\/09031936.98.12020357","volume":"12","author":"G Porta","year":"1998","unstructured":"Porta G, Rodriguez-Carballeira M, Gomez L, Salavert M, Freixas N, Xercavins M, Garau J. Thoracic infection caused by Streptococcus milleri. Eur Respir J. 1998;12(2):357\u201362.","journal-title":"Eur Respir J"},{"issue":"1","key":"6955_CR8","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1155\/2014\/170517","volume":"25","author":"A Walkty","year":"2014","unstructured":"Walkty A, Embil JM, Nichol K, Karlowsky J. An unusual case of Streptococcus anginosus group pyomyositis diagnosed using direct 16S ribosomal DNA sequencing. Can J Infect Dis Med Microbiol. 2014;25(1):32\u20134.","journal-title":"Can J Infect Dis Med Microbiol"},{"issue":"4","key":"6955_CR9","doi-asserted-by":"publisher","first-page":"e01730-19","DOI":"10.1128\/JCM.01730-19","volume":"58","author":"KC Carroll","year":"2020","unstructured":"Carroll KC, Reid JL, Thornberg A, Whitfield NN, Trainor D, Lewis S, Wakefield T, Davis TE, Church KG, Samuel L, et al. Clinical performance of the novel GenMark Dx ePlex blood culture ID Gram-positive panel. J Clin Microbiol. 2020;58(4):e01730-19.","journal-title":"J Clin Microbiol"},{"issue":"11","key":"6955_CR10","doi-asserted-by":"publisher","first-page":"3580","DOI":"10.1128\/JCM.01892-15","volume":"53","author":"R Arinto-Garcia","year":"2015","unstructured":"Arinto-Garcia R, Pinho MD, Carrico JA, Melo-Cristino J, Ramirez M. Comparing matrix-assisted laser desorption ionization-time of flight mass spectrometry and phenotypic and molecular methods for identification of species within the Streptococcus anginosus group. J Clin Microbiol. 2015;53(11):3580\u20138.","journal-title":"J Clin Microbiol"},{"issue":"1","key":"6955_CR11","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s12941-018-0294-5","volume":"17","author":"J Cheng","year":"2018","unstructured":"Cheng J, Hu H, Kang Y, Chen W, Fang W, Wang K, et al. Identification of pathogens in culture-negative infective endocarditis cases by metagenomic analysis. Ann Clin Microbiol Antimicrob. 2018;17(1):43.","journal-title":"Ann Clin Microbiol Antimicrob"},{"issue":"3","key":"6955_CR12","doi-asserted-by":"publisher","first-page":"351","DOI":"10.3390\/jcm8030351","volume":"8","author":"JH Lin","year":"2019","unstructured":"Lin JH, Wu ZY, Gong L, Wong CH, Chao WC, Yen CM, et al. Complex microbiome in brain abscess revealed by whole-genome culture-independent and culture-based sequencing. J Clin Med. 2019;8(3):351.","journal-title":"J Clin Med"},{"issue":"1","key":"6955_CR13","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.jinf.2018.08.002","volume":"78","author":"LY Guo","year":"2019","unstructured":"Guo LY, Feng WY, Guo X, Liu B, Liu G, Dong J. The advantages of next-generation sequencing technology in the detection of different sources of abscess. J Infect. 2019;78(1):75\u201386.","journal-title":"J Infect"},{"issue":"2","key":"6955_CR14","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1093\/jac\/37.2.371","volume":"37","author":"JA Jacobs","year":"1996","unstructured":"Jacobs JA, Stobberingh EE. In-vitro antimicrobial susceptibility of the \u201cStreptococcus milleri\u201d group (Streptococcus anginosus, Streptococcus constellatus and Streptococcus intermedius). J Antimicrob Chemother. 1996;37(2):371\u20135.","journal-title":"J Antimicrob Chemother"},{"issue":"12","key":"6955_CR15","doi-asserted-by":"publisher","first-page":"1792","DOI":"10.1902\/jop.2014.130291","volume":"85","author":"TE Rams","year":"2014","unstructured":"Rams TE, Feik D, Mortensen JE, Degener JE, van Winkelhoff AJ. Antibiotic susceptibility of periodontal Streptococcus constellatus and Streptococcus intermedius clinical isolates. J Periodontol. 2014;85(12):1792\u20138.","journal-title":"J Periodontol."},{"issue":"1","key":"6955_CR16","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1902\/jop.2013.130142","volume":"85","author":"TE Rams","year":"2014","unstructured":"Rams TE, Degener JE, van Winkelhoff AJ. Antibiotic resistance in human chronic periodontitis microbiota. J Periodontol. 2014;85(1):160\u20139.","journal-title":"J Periodontol"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06955-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-021-06955-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06955-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T10:03:54Z","timestamp":1639994634000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-021-06955-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["6955"],"URL":"https:\/\/doi.org\/10.1186\/s12879-021-06955-2","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"5 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 December 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The work has been approved by the Ethnic Committee of Second Affiliated Hospital, Zhejiang University School of Medicine.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patient provided written informed consent for their personal or clinical details along with any identifying images to be published in this study. A copy of the written consent is available for review by the Editor of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1267"}}