Gram (+) Cocci
Identification and Clinical Syndromes
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Streptococci: catalase (-)
	cocci in pairs or chains 
Strep. pneumonia:
	lancet-shaped cocci  in pairs
Staphylococci: calalase (+)
	cocci in clusters

Staph. aureus: coagulase (+)
Staph. saprophyticus,
Staph. epidermidis: coagulase (-)
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Staph. aureus:
	folliculitis, furuncle, 
	carbuncle, cellulitis, abscess, 
	empyema, osteomyelitis, 
	septic arthritis, psoas abscess, 
	pneumonia, acute endocarditis, 
	thrombophlebitis, meningitis, 
	food poisoning (acute), 
	scalded skin syndrome, 
	toxic shock syndrome

Staph. epidermidis:
	foreign body infection, SBE,
	prosthetic valve endocarditis,
	bacteremia (immunocompromised),
	sternal abscess s/p thoracotomy

Staph. saprophyticus: 
	UTI, foreign body infection
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Strep. species [Lancefield Group] 
	(hemolysis pattern):
	Clinical syndromes

Strep. pyogenes [A] (beta):
	pharyngitis, sinusitis, 
	acute glomerular nephritis,
	scarlet fever, rheumatic fever,
	impetigo, erysipelas, cellulitis,
	necrotizing fasciitis, pneumonia

Strep. agalactiae [B] (alpha, gamma):
	neonatal sepsis, meningitis,
	chorioamnionitis, 
	septic abortion, UTI
	post-partum endometritis
	diabetic ulcer, SBE

Strep. agalactiae [C] (beta):
	mostly animal pathogen. can 
	cause pharyngitis, meningitis

Enterococcus (Strep. faecalis) [D]
   (alpha,  beta, gamma*):
	SBE, UTI, biliary tract, 
	bacteremia, pelvic, wounds, 
	neonatal sepsis, SBE

Strep. bovis [D] (alpha, gamma*):
	associated with colon neoplasms,
	bacterimia, SBE

Strep. mutans [F] (beta):
	dental abscesses

Strep. species [G] (beta):
	bacteremia, cellulitis, 
	ulcers in cancer patients  
	(d/t venous insuff.)

Strep. viridans (alpha)
	SBE, UTI, pneumonia, wounds

Strep. pneumoniae (alpha)
	pneumonia, sinusitis,
	otitis media, mastoiditis
	epiglottitis

SBE = subacute bacterial endocarditis
UTI = urinary tract infection 
* Usually non-hemolytic = gamma
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by Michael T. Milano, MD PhD
MTMilano@yahoo.com
www.geocities.com/MTMilano/palm/