It is often present in suppurative infections in and around the mouth but rarely in pure culture from this site. It has been isolated more often from inflamed than normal appendices , but the significance of this finding is not clear. It is an uncommon cause of meningitis. The mechanisms of pathogenicity of Strep. Prophylactic use of metronidazole plus gentamicin in patients undergoing colorectal surgery has sometimes been followed by abdominal sepsis caused by Strep.
Surgical drainage is a necessary part of the management of abscesses.
Antibiotic treatment for 28 days or longer may be required for conditions such as liver abscess. The choice of antibiotics will be influenced by the presence, or possible presence, of gram-negative anaerobes in the infection. These organisms may be isolated in pure culture or mixed with anaerobes . On rare occasions, Strep. Brain abscess is a focal suppuration within the brain parenchyma.