Streptococcus milleri pneumonia

　　1. Etiology

　　Streptococcus milleri is a type of Streptococcus, which is further divided into beta-hemolytic pharyngeal Streptococcus (S. angionosus), alpha or beta-hemolytic astragalus Streptococcus, and intermediate Streptococcus (S. intermedius). According to the report by Shancheng, 11.7% (14/120) of Streptococcus milleri with more than 105 CFU/ml were detected in throat swab specimens from healthy adults (20-80 years old). Therefore, if the bacteria are detected in sputum, it does not necessarily mean they are pathogenic.

　　2. Pathogenesis

　　The disease may occur after being infected by inhaling through the respiratory tract. The exact pathogenesis is not yet fully clear.

　　1. Lung abscess (lung abscess) is a suppurative lesion of lung tissue caused by various etiologies, which is initially a suppurative inflammation and then progresses to necrosis and the formation of an abscess. It mostly occurs in adults, with more males than females. According to the cause of onset, there are three types: tracheal infection type, hemogenic infection type, and infection type caused by blockage of multiple abscesses and lung cancer, etc. Lung abscess can also be classified according to the relevant pathogens, such as staphylococcal, anaerobic, or aspergillus lung abscess. Since the widespread use of antibiotics, the incidence of lung abscess has greatly decreased.

　　2, Empyema refers to the invasion of pathogenic bacteria into the pleural cavity, causing infection and pus accumulation. It can occur at any age from neonates to the elderly. Empyema is often caused by pyogenic bacteria. Most empyemas are secondary to pulmonary infections.

　　Among the 18 cases reported in China, there were 3 cases of acute tonsillitis, 3 cases of pneumonia, 11 cases of pleurisy with empyema (including 7 cases of empyema), 1 case of emphysema infection deterioration, ranging in age from 26 to 81 years, with a higher incidence in the elderly (over 55 years old), among which 15 cases were community infections, 2 cases were infections in nursing homes, and 1 case was hospital-acquired infection. Another researcher also confirmed that 80% of empyema caused by Streptococcus milleri is community-acquired. In terms of bacterial species, there were 1 case of Streptococcus pharyngeus, 6 cases of Streptococcus constellatus, and 11 cases of Streptococcus intermedius.

　　Most patients have underlying diseases, including 5 cases of cerebrovascular accidents, 2 cases of liver dysfunction, 2 cases of malignant tumors, 2 cases of diabetes, 1 case of emphysema, and the conditions are all relatively severe. Among the patients, there are 10 heavy smokers and 8 alcoholics. It should be particularly pointed out that inhalation as a route of infection is serious.

　　1, Pneumococcal vaccine can be administered to susceptible populations. Pneumococcal vaccine was used in the 1920s but was abandoned with the rise of antibiotics. With the increase in drug-resistant bacteria, vaccination has been re-emphasized in the past decade. Pure capsular polysaccharide vaccines with multiple serotypes are commonly used. Currently available vaccines contain 23 antigens of pneumococcal type-specific polysaccharides, covering 85% to 90% of the pneumococcal strains that cause infection. Although the precise level of protection is not well understood because antibody titer measurements are usually not possible, it is generally believed that after 2 to 3 weeks of injection of pneumococcal vaccine, antibodies appear in the serum, and the antibody titer continues to increase for 4 to 8 weeks, which can reduce the incidence of pneumococcal pneumonia and the effective rate is over 50%. The duration of protection is at least 1 year. For high-risk populations, revaccination is needed after 5 to 10 years.

　　2, The suitable population for vaccination includes children and adults over 2 years old who are susceptible to Streptococcus pneumoniae, including the elderly over 65, patients with chronic cardiovascular and pulmonary diseases, those with impaired or absent spleen function, patients with Hodgkin's disease, multiple myeloma, diabetes, liver cirrhosis, renal failure, HIV infection, organ transplantation, and other diseases related to immunosuppression. Recurrent upper respiratory tract infections, including otitis media and sinusitis, are generally not considered as indications for vaccination. Approximately half of the vaccinated individuals develop redness and (or) pain at the injection site, 1% develop fever, myalgia, or local obvious reactions, and 5% develop allergic or other obvious reactions. Those who are vaccinated repeatedly within 5 years are more likely to have strong local reactions.

　　When the lungs or bronchi of the human body are infected with bacteria, the amount of sputum increases significantly. Sputum bacterial culture, isolation of pathogenic bacteria, is helpful for the diagnosis and treatment of lower respiratory tract infectious diseases.

　　Normal values of sputum bacterial culture: The lower respiratory tract of normal people is sterile and should not detect pathogenic bacteria, fungi, or tuberculosis bacilli.

　　1. Bacterial culture, this bacterium is mostly pure culture.

　　2. Chest X-ray examination, which may be normal in the early stage, and may appear as patchy shadows after about 24 hours.

　　I.食疗方 for Mycoplasma pneumoniae

　　1, Stir-fried Crucian Carp with Celery

　　250 grams of crucian carp, 50 grams of fresh celery, starch, ginger slices, garlic slices, soy sauce, sugar, vinegar, monosodium glutamate, fine salt, cooking wine, pickled chili peppers, and vegetable oil. Preparation: Cut the crucian carp into shreds, cut the celery into segments, and mix soy sauce, sugar, vinegar, monosodium glutamate, cooking wine, salt, and starch with broth to make a sauce. Heat a wok on high heat, add oil, and when it reaches 5 degrees, add the fish shreds to stir-fry and drain the excess oil. Add ginger slices and pickled chili peppers. Stir-fry the celery segments until fragrant, then add the sauce, pour in some bright oil, and remove from heat. Benefits: Crucian carp has the effects of clearing heat and detoxifying, promoting diuresis and reducing swelling, and stopping cough and relieving asthma; celery has the effects of calming the liver and clearing heat, removing wind and promoting diuresis, and nourishing the spirit and invigorating the Qi. Eating crucian carp and celery together is suitable for the auxiliary treatment of acute and chronic pneumonia.

　　2, Rabbit Meat and Mushroom Shreds

　　100 grams of cooked rabbit meat, 50 grams of mushrooms, 25 grams of scallion whites, appropriate amounts of chili oil, soy sauce, vinegar, sugar, sesame oil, sesame paste, Sichuan pepper powder, and monosodium glutamate. Preparation: Shred the cooked rabbit meat and scallion whites, and cook the mushrooms. Place the scallion and mushrooms at the bottom, cover with rabbit shreds, and serve in a plate. Dissolve the sesame paste in soy sauce in several steps, mix with sesame oil to make a sauce, and pour it over the rabbit shreds. Benefits: Rabbit meat has the effects of clearing heat and detoxifying, invigorating the Qi and strengthening the spleen, removing dampness and cooling the blood, and promoting defecation; mushrooms have the effects of detoxifying and moistening the dryness, invigorating the Qi and strengthening the spleen, and removing dampness and stopping diarrhea. Eating rabbit meat and mushrooms together is suitable for treating acute pneumonia.

　　3, Quail and Lily Soup

　　One quail, 25 grams of lily, appropriate amounts of ginger, scallion, monosodium glutamate, and fine salt. Preparation: Kill the quail, remove feathers, feet, and internal organs, wash, and blanch in boiling water, then remove and cut into pieces; separate the lily petals, wash, and set aside. Wash the ginger and scallion, smash the ginger, and cut the scallion into segments. Place a pot on a high heat, add some water, put in the quail, bring to a boil, add lily petals, ginger pieces, and scallion segments, then simmer on low heat until the quail is cooked. Add salt and monosodium glutamate, simmer for a few minutes, and serve in a soup bowl. Benefits: Quail meat has the effects of nourishing the five internal organs, benefiting the liver and clearing the lungs, clearing heat and promoting diuresis, reducing accumulation and stopping diarrhea; lily has the effects of moistening the lungs and stopping cough, nourishing yin and clearing heat, calming the mind. Eating both together is suitable for acute and chronic pneumonia.

　　4. Lean meat and cabbage soup

　　Ingredients: lean meat, 100 grams of cabbage heart, a little ginger, garlic, salt, monosodium glutamate, and chicken oil. Preparation: slice the lean meat, wash and slice the cabbage, put it in boiling water, remove it when it is just cooked, rinse it in clean water, drain the water and set it aside; place the pot on a high heat, add chicken oil to five degrees of maturity, add garlic and stir-fry until golden, then add the lean meat and stir-fry together, add fine salt, cook in the soup, then add the cabbage heart and bring to a boil, add monosodium glutamate and it is ready to eat. Effects: lean meat has the effects of invigorating the middle, generating body fluid, and moistening the intestines; cabbage is mild in nature and sweet in taste, with the effects of clearing heat, detoxifying, resolving phlegm, and relieving constipation. The combination of lean meat and cabbage is suitable for acute and chronic pneumonia.

　　Second, what foods are good for the body in Streptococcus mitis pneumonia?

　　1. Foods should be high in nutrition, light, and easy to digest;

　　2. Fresh fruits and vegetables;

　　3. Foods with high oil content, eggs, and other foods rich in vitamin A.

　　Third, what foods should not be eaten for Streptococcus mitis pneumonia?

　　1. Avoid spicy and greasy foods. Do not eat large fish, meat, and overly greasy products. Pneumonia patients should not add spices such as chili, pepper, mustard, Sichuan pepper, etc. to their diet. Quit smoking and drinking.

　　2. It is not advisable to eat sweet and warm fruits such as peaches, apricots, plums, oranges, etc.

　　1. Treatment

　　The antibiotics that are more sensitive to this disease include penicillin, cephalosporins (cephems), carbapenems, and tetracyclines, lincomycin, which can be used alone or in combination.

　　2. Prognosis

　　If treated actively, clinical conditions can be completely cured. It is worth noting that timely and sufficient drainage of empyema is essential; otherwise, the consequences may be poor. Some reports indicate that this bacterium is prone to cause lung abscess and empyema, with a mortality rate of 20% to 30%, which should not be ignored.