Acute pansinusitis with bacteremia due to a beta-hemolytic group C streptococcus: Streptococcus milleri.

A 41-year-old truck driver had acute onset of weakness, severe headache and pain over the left side of the face, forehead, and orbital area. He was found to have acute pansinusitis. Blood cultures and culture of the sinus drainage yielded beta-hemolytic group C streptococcus: Streptococcus milleri. He recovered completely after treatment with cefazolin, surgical drainage and debridement, and outpatient cephalexin therapy. Beta-hemolytic streptococci are uncommon causes, and bacteremia is rare in acute sinusitis. Speciation of the streptococcus is important in determining the epidemiology and clinical spectrum of streptococcal infections.