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For further information, see CMDT Part 33-01: Streptococcal Infections

Key Features

  • Non-group A hemolytic streptococci (eg, groups B, C, and G) produce a spectrum of disease similar to that of group A streptococci

  • Viridans streptococci are part of the normal oral flora but may produce focal pyogenic infection

Clinical Findings

  • Group B streptococci

    • An important cause of sepsis, bacteremia, and meningitis in the neonate

    • Antepartum screening to identify carrier mothers is recommended

    • May cause septic abortion, endometritis, or peripartum infections in women and, less commonly, cellulitis, bacteremia, and endocarditis in adults

  • Viridans streptococci

    • Nonhemolytic or α-hemolytic (ie, producing a green zone of hemolysis on blood agar)

    • Leading cause of native valve endocarditis

  • Group D streptococci

    • Include Streptococcus gallolyticus (bovis) and the enterococci

    • S gallolyticus (bovis) is a cause of endocarditis in association with colorectal cancer or cirrhosis


  • Culture of affected site or blood


  • Non-group A hemolytic streptococci (eg, groups B, C, and G)

    • The treatment of infections caused by these non-group A streptococci is similar to treatment of group A streptococci

  • Group B streptococci

    • Penicillin or vancomycin in doses recommended for treatment of group A streptococci skin and soft tissue infections (Table 33–1)

    • 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

  • See Endocarditis, Infective

Table 33–1.Treatment of common skin and soft tissue infections (SSTIs).

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