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J Thorac Cardiovasc Surg 2006;131:744-745
© 2006 The American Association for Thoracic Surgery

Brief Communication

Transthoracic drainage of large Streptococcus milleri liver abscess

Arul Bala, MBBS, Pankaj Saxena, MCh, DNB, Igor E. Konstantinov, MD, PhD *

Department of Cardio-Thoracic Surgery, Sir Charles Gairdner Hospital, Nedlands, Australia

Received for publication September 22, 2004; accepted for publication October 7, 2005.

* Address for reprints: Igor E. Konstantinov, MD, PhD, Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Hospital Avenue, Perth, Western Australia 6009, Australia (Email: igorkonst@hotmail.com).

The first 20% of the full text of this article appears below.


Figure 1
Drs P. Saxena, A. Bala, I.E. Konstantinov (left to right)


Streptococcus milleri rarely causes a life-threatening infection. However, in patients with chronic disease S milleri may produce suppurative infection, including liver abscess. The latter is associated with up to 100% mortality if untreated and 50% to 60% mortality after treatment. 1 Go Although S milleri seems to be the most common cause of pyogenic liver abscess, 2 Go only a few cases are described in the medical literature.

Clinical Summary

A 45-year-old malnourished man with a history of intravenous drug use, iron deficiency anemia, and hepatitis C presented with 2 weeks of increasing dyspnea, fever, and malaise. Blood cultures were positive for S milleri, sensitive to penicillin, erythromycin, vancomycin, tetracycline, and cephalexin. Echocardiogram was unremarkable but, incidentally, identified an intrahepatic mass adjacent to the inferior vena cava. Abdominal computed tomographic scan demonstrated a 13 x 11 x 8 . . . [Full Text of this Article]




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R. M. Rashid, W. Salah, and J. P. Parada
'Streptococcus milleri' aortic valve endocarditis and hepatic abscess
J. Med. Microbiol., February 1, 2007; 56(2): 280 - 282.
[Abstract] [Full Text] [PDF]


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