Abstract
S. milleri is a commensal organism of the oropharynx and intestinal tract. It is the streptococcal pathogen most often found in pyogenic lesions in internal organs and clearly has a tendency to produce abscesses. It also can produce purulent diseases in the oral cavity, CNS, lung and pleural space, abdomen, and subcutaneous tissue; it is a potential cause of endocarditis. Therefore, when S. milleri is isolated from blood, a thorough evaluation must be undertaken to rule out an occult visceral organ or endocarditis abscess and to establish a source of infection. When S. milleri has been isolated from an aspirate or blood, it is imperative that appropriate antibiotic therapy be started promptly and surfical intervention performed if warranted. S. milleri is an important but unappreciated pathogen.
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