Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 33-01: Streptococcal Infections + Key Features Download Section PDF Listen +++ ++ Non-group A hemolytic streptococci (eg, groups B, C, and G) produce a spectrum of disease similar to that of group A beta-hemolytic streptococci Viridans streptococci are part of the normal oral flora but may produce focal pyogenic infection + Clinical Findings Download Section PDF Listen +++ ++ Group B streptococci An important cause of sepsis, bacteremia, and meningitis in the neonate Antepartum screening vaginal cultures are recommended to identify carrier mothers May cause septic abortion, endometritis, or peripartum infections in women and, less commonly, cellulitis, bacteremia, and endocarditis in adults Group D streptococci Include Streptococcus bovis and the enterococci S bovis is a cause of endocarditis in association with colorectal cancer or cirrhosis Viridans streptococci Nonhemolytic or alpha-hemolytic (ie, producing a green zone of hemolysis on blood agar) Leading cause of native valve endocarditis + Diagnosis Download Section PDF Listen +++ ++ Culture of affected site or blood + Treatment Download Section PDF Listen +++ ++ Non-group A hemolytic streptococci (eg, groups B, C, and G Give penicillin G aqueous, 4 million units every 4 hours intravenously Vancomycin, 1 g intravenously every 12 hours, is recommended for persons allergic to penicillin Group B streptococci Addition of low-dose gentamicin, 1 mg/kg every 8 hours is recommended by some experts because of in vitro synergism Peripartum antimicrobial prophylaxis is recommended Viridans streptococci Give penicillin with or without addition of gentamicin Alternatives are cephalosporin and vancomycin S bovis infection treated like viridans streptococci