Complete Match of Streptococcus salivarius from Oral Saliva and Stool in a Patient with Hepatic Encephalopathy

Intern Med. 2025 Feb 15;64(4):551-556. doi: 10.2169/internalmedicine.3989-24. Epub 2024 Jul 4.

Abstract

We herein report a 67-year-old Japanese woman with liver cirrhosis caused by primary biliary cholangitis. The patient was admitted to the hospital with loss of consciousness. Hepatic encephalopathy (HE) was diagnosed after diagnostic imaging and symptom assessments. Molecular biology tests were performed on oral saliva and stool samples. The test results indicated sequence similarity between urease-positive S. salivarius in both oral saliva and stool, as revealed by the signals in the overlapping peaks. This bacterium can potentially increase ammonia production in the gut, leading to HE in patients with liver cirrhosis.

Keywords: Streptococcus salivarius; hepatic encephalopathy; liver cirrhosis; urease-activity.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Feces* / microbiology
  • Female
  • Hepatic Encephalopathy* / diagnosis
  • Hepatic Encephalopathy* / etiology
  • Hepatic Encephalopathy* / microbiology
  • Humans
  • Liver Cirrhosis / complications
  • Saliva* / microbiology
  • Streptococcal Infections* / complications
  • Streptococcal Infections* / diagnosis
  • Streptococcal Infections* / microbiology
  • Streptococcus salivarius* / genetics
  • Streptococcus salivarius* / isolation & purification