Streptococcus constellatus appendicitis in children: A case series

Background: Streptococcus constellatus (SC) is a pathogen well-known for its involvement in pyogenic infections, with a notable preference for manifesting within the oral cavity, head and neck, and abdomen. This bacterium, belonging to the Streptococcus milleri group, has garnered attention for its propensity to incite inflammatory processes, especially in the abdominal region. Objectives: This study aims to present and characterise nine cases of paediatric patients with SC appendicitis. Methods: We conducted a report on nine cases of SC appendicitis, all of whom presented to the emergency room with typical symptoms of appendicitis. Results: Patients diagnosed with SC appendicitis exhibited a severe clinical course, necessitating appendectomy at presentation and requiring prolonged parenteral antimicrobial therapy. Furthermore, a higher readmission rate was observed among these patients, even several months after their initial discharge. Conclusions: Surgeons should be vigilant regarding SC appendicitis and its severe clinical course. Prolonged treatment with antimicrobial agents may be necessary for these patients to achieve better outcomes.