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Ziga M, Gianoli D, Waldeck F, Dennler C, Schlichtherle R, Forster T, Martens B, Schwizer R. Spondylodiscitis due to anaerobic bacteria Veillonella parvula: Case report and literature review. Surg Neurol Int 2021; 12:496. [PMID: 34754546 PMCID: PMC8571187 DOI: 10.25259/sni_769_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/02/2021] [Indexed: 11/29/2022] Open
Abstract
Background: While pyogenic spondylodiscitis due to Gram-positive aerobic bacteria and its treatment is well known, spondylodiscitis caused by anaerobic Gram-negative pathogen is rare. In particular, the spondylodiscitis caused by Veillonella species is an absolute rarity. Thus no established management recommendations exist. Case Description: A case report of a 79-year-old man with spondylodiscitis caused by Veillonella parvula with intramuscular abscess collection managed conservatively with stand-alone antibiotic therapy without a spinal stabilization procedure. A review of literature of all reported spondylodiscitis caused by Veillonella species was performed. After 3 week-intravenous therapy with the ceftriaxone in combination with the metronidazole followed by 3 weeks per oral therapy with amoxicillin/clavulanate, the complete recovery of the patient with the V. parvula infection was achieved. Conclusion: Treatment of the spondylodiscitis caused by Veillonella species should contain a beta-lactam with beta-lactamase inhibitor or third-generation cephalosporine. Six weeks of treatment seem to be sufficient for the complete recovery of the patient.
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Affiliation(s)
- Michal Ziga
- Department of Neurosurgery, Cantonal Hospital St. Gallen, Switzerland
| | - Daniele Gianoli
- Department of Orthopedics and Traumatology Cantonal Hospital St. Gallen, Switzerland
| | - Frederike Waldeck
- Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, Switzerland
| | - Cyrill Dennler
- Department of Orthopedics and Traumatology Cantonal Hospital St. Gallen, Switzerland
| | - Rainer Schlichtherle
- Department of Orthopedics and Traumatology Cantonal Hospital St. Gallen, Switzerland
| | - Thomas Forster
- Department of Orthopedics and Traumatology Cantonal Hospital St. Gallen, Switzerland
| | - Benjamin Martens
- Department of Orthopedics and Traumatology Cantonal Hospital St. Gallen, Switzerland
| | - Roman Schwizer
- Department of Orthopedics and Traumatology Cantonal Hospital St. Gallen, Switzerland
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Kurihara M, Tamaki I, Tokuda Y. Epidural abscess and spondylitis caused by Veillonella parvula in a man on hemodialysis. Clin Case Rep 2021; 9:e04660. [PMID: 34646558 PMCID: PMC8499856 DOI: 10.1002/ccr3.4660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/07/2022] Open
Abstract
Veillonella species rarely cause serious infections, but the incidence of infection has been increasing among immunocompromised individuals. This case of an epidural abscess and spondylitis caused by Veillonella parvula in a hemodialysis patient illustrates the importance of performing anaerobic blood culture in immunocompromised patients with signs of infection.
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Affiliation(s)
- Masaru Kurihara
- Department of Hospital MedicineUrasoe General HospitalOkinawaJapan
| | - Itaru Tamaki
- Department of Hospital MedicineUrasoe General HospitalOkinawaJapan
| | - Yasuharu Tokuda
- Department of Hospital MedicineUrasoe General HospitalOkinawaJapan
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Djais AA, Theodorea CF, Mashima I, Otomo M, Saitoh M, Nakazawa F. Identification and phylogenetic analysis of oral Veillonella species isolated from the saliva of Japanese children. F1000Res 2019; 8:616. [PMID: 31448103 PMCID: PMC6688723 DOI: 10.12688/f1000research.18506.5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2019] [Indexed: 11/29/2022] Open
Abstract
Background: As the most frequent infectious disease among children worldwide, dental caries have a strong relationship with oral hygiene status, specifically in the development of infection. However, the study regarding the identification and distribution of oral
Veillonella are limited. The oral
Veillonella community may affected by the differences in geographical location, age, diet, lifestyle, socio-economic status and oral hygiene status. Here, we studied the oral hygiene status by examining the composition and proportion of oral
Veillonella species in saliva of Japanese children. Methods: Microbial samples collected from 15 Japanese children divided into three oral hygiene groups were cultured under anaerobic conditions after homogenization and dilution, and inoculated onto brain heart infusion and selective medium
Veillonella agar. Genomic DNA was extracted from each isolate.
Veillonella species were detected by one-step PCR using
rpoB species-specific primers. To analyse the phylogenetic properties of the unknown
Veillonella strains, PCR amplification and sequence analysis of
rpoB were conducted for 10 representative strains. Results: Although
V. rogosae was found as the predominant species among all groups, its prevalence was significantly lower in the children with poor oral hygiene than in those with good oral hygiene.
V. parvula was the prevalent species in the poor oral hygiene group. Approximately 10% of the isolated
Veillonella strains were not classified to any established species; the phylogenetic analysis showed that they were most closely related to
V.infantium Conclusions: This study demonstrates that the composition and proportion of oral
Veillonella species in the saliva of Japanese children is correlated with different oral hygiene status. Changes in detection ratios of
V. parvula and
V. rogosae can be useful indicators of oral hygiene status. Furthermore, new strains closely related to
V. infantium were isolated from the saliva of Japanese children.
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Affiliation(s)
- Ariadna A Djais
- Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Citra Fragrantia Theodorea
- Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Jakarta, 10430, Indonesia.,Department of Oral Microbiology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, 061-0293, Japan
| | - Izumi Mashima
- Department of Microbiology, School of Pharmacy, Aichi Gakuin University, Kusumoto-cho, Nagoya, 470-0915, Japan
| | - Maiko Otomo
- Department of Pediatric Dentistry, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, 061-0293, Japan
| | - Masato Saitoh
- Department of Pediatric Dentistry, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, 061-0293, Japan
| | - Futoshi Nakazawa
- Department of Oral Microbiology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, 061-0293, Japan
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Djais AA, Theodorea CF, Mashima I, Otomo M, Saitoh M, Nakazawa F. Identification and phylogenetic analysis of oral Veillonella species isolated from the saliva of Japanese children. F1000Res 2019; 8:616. [PMID: 31448103 DOI: 10.12688/f1000research.18506.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2019] [Indexed: 11/20/2022] Open
Abstract
Background: As the most frequent infectious disease among children worldwide, dental caries have a strong relationship with oral hygiene status, specifically in the development of infection. However, the study regarding the identification and distribution of oral Veillonella are limited. The oral Veillonella community may affected by the differences in geographical location, age, diet, lifestyle, socio-economic status and oral hygiene status. Here, we studied the oral hygiene status by examining the composition and proportion of oral Veillonella species in saliva of Japanese children. Methods: Microbial samples collected from 15 Japanese children divided into three oral hygiene groups were cultured under anaerobic conditions after homogenization and dilution, and inoculated onto brain heart infusion and selective medium Veillonella agar. Genomic DNA was extracted from each isolate. Veillonella species were detected by one-step PCR using rpoB species-specific primers. To analyse the phylogenetic properties of the unknown Veillonella strains, PCR amplification and sequence analysis of rpoB were conducted for 10 representative strains. Results: Although V. rogosae was found as the predominant species among all groups, its prevalence was significantly lower in the children with poor oral hygiene than in those with good oral hygiene. V. parvula was the prevalent species in the poor oral hygiene group. Approximately 10% of the isolated Veillonella strains were not classified to any established species; the phylogenetic analysis showed that they were most closely related to V. infantium Conclusions: This study demonstrates that the composition and proportion of oral Veillonella species in the saliva of Japanese children is correlated with different oral hygiene status. Changes in detection ratios of V. parvula and V. rogosae can be useful indicators of oral hygiene status. Furthermore, new strains closely related to V. infantium were isolated from the saliva of Japanese children.
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Affiliation(s)
- Ariadna A Djais
- Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Citra Fragrantia Theodorea
- Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Jakarta, 10430, Indonesia.,Department of Oral Microbiology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, 061-0293, Japan
| | - Izumi Mashima
- Department of Microbiology, School of Pharmacy, Aichi Gakuin University, Kusumoto-cho, Nagoya, 470-0915, Japan
| | - Maiko Otomo
- Department of Pediatric Dentistry, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, 061-0293, Japan
| | - Masato Saitoh
- Department of Pediatric Dentistry, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, 061-0293, Japan
| | - Futoshi Nakazawa
- Department of Oral Microbiology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, 061-0293, Japan
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Gouze H, Noussair L, Padovano I, Salomon E, de Laroche M, Duran C, Felter A, Carlier R, Breban M, Dinh A. Veillonella parvula spondylodiscitis. Med Mal Infect 2018; 49:54-58. [PMID: 30385069 DOI: 10.1016/j.medmal.2018.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 10/03/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Veillonella parvula is an anaerobic Gram-negative coccus rarely involved in bone and joint infections. PATIENTS AND METHOD We report the case of a Veillonella parvula vertebral osteomyelitis (VO) in a female patient without any risk factor. RESULTS The 35-year-old patient was immunocompetent and presented with Veillonella parvula VO. She was admitted to hospital for inflammatory lower back pain. The discovertebral sample was positive for Veillonella parvula. Literature data on Veillonella VO is scarce. Reported cases usually occurred in immunocompromised patients. Diagnosis delay can be up to four months. Patients are usually afebrile. Outcome with antimicrobial treatment alone is favorable in half of cases. Other patients must undergo surgery. CONCLUSIONS Veillonella VO may occur in immunocompetent patients and have a clinical spectrum of mechanical lower back pain.
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Affiliation(s)
- H Gouze
- Service de médecine interne, CHU Ambroise Paré, UVSQ, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France; Département de rhumatologie, CHU Ambroise Paré, UVSQ, AP-HP, Boulogne-Billancourt, France
| | - L Noussair
- Département de microbiologie, CHU Raymond-Poincaré, UVSQ, AP-HP, 104, boulevard R. Poincaré, 92380 Garches, France
| | - I Padovano
- Département de rhumatologie, CHU Ambroise Paré, UVSQ, AP-HP, Boulogne-Billancourt, France
| | - E Salomon
- Laboratoire de microbiologie, CHU Ambroise Paré, UVSQ, AP-HP, Boulogne-Billancourt, France
| | - M de Laroche
- Service de médecine interne, CHU Ambroise Paré, UVSQ, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - C Duran
- Service de médecine interne, CHU Ambroise Paré, UVSQ, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
| | - A Felter
- Département de radiologie, CHU Ambroise Paré, UVSQ, AP-HP, Boulogne-Billancourt, France
| | - R Carlier
- Département de radiologie, CHU Ambroise Paré, UVSQ, AP-HP, Boulogne-Billancourt, France
| | - M Breban
- Département de rhumatologie, CHU Ambroise Paré, UVSQ, AP-HP, Boulogne-Billancourt, France
| | - A Dinh
- Service de médecine interne, CHU Ambroise Paré, UVSQ, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France.
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Baker S, Allyn R. Lytic lesions: looking lethal but leaving room for a simple cure? A case of Veillonella spinal osteomyelitis. JMM Case Rep 2017; 4:e005108. [PMID: 29026635 PMCID: PMC5610710 DOI: 10.1099/jmmcr.0.005108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 08/02/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction. Diagnosing clinically significant infection caused by Veillonella species can be a challenge. Veillonella species are usually found in polymicrobial processes and are often regarded as a contaminant. Additionally, they are slow to grow in culture and this can lead to a delay in diagnosis or a missed diagnosis. Veillonella species rarely cause serious infections, but have been found to cause bacteraemia and osteomyelitis. Case presentation. A 67-year-old man with a history of treated prostate cancer presented with 2 weeks of progressive lower back pain and weakness. He had no signs or symptoms of active infection. He was found to have multiple lytic lesions in his lumbar spine that were initially suspected to be secondary to metastatic cancer. However, tissue and blood cultures were ultimately consistent with infection by Veillonella species. Conclusion. This case report highlights the fact that uncommon illnesses can often present like common disease processes. Because of the radiological appearance of the patient’s lesions and his lack of infectious symptoms, a diagnosis of metastatic cancer was initially thought to be likely. Relying on the pathology and culture data, and waiting on the initiation of antimicrobials until the diagnosis was accurately established, were important factors in diagnosing and treating this infection. Veillonella species can be true pathogens when found in isolation and associated with bacteraemia. Additionally, they can cause an indolent infection that can lead to osteomyelitis. Failure to accurately diagnose this infection in a timely manner would have led to ongoing debility and diagnostic uncertainty for this patient.
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Affiliation(s)
- Sarah Baker
- School of Medicine, University of Colorado, 13001 E. 17th Place, Aurora, CO 80045, USA
| | - Rebecca Allyn
- Denver Health Medical Center, 777 Bannock Street, Denver, CO 80204, USA
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Li J, Chen P, Li J, Gao X, Chen X, Chen J. A new treatment of sepsis caused byveillonella parvula: A case report and literature review. J Clin Pharm Ther 2017; 42:649-652. [PMID: 28543519 DOI: 10.1111/jcpt.12559] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 04/20/2017] [Indexed: 11/30/2022]
Affiliation(s)
- J. Li
- Department of Pharmacy; The First Affiliated Hospital of Sun Yat-sen University; Guangzhou China
- Institute of Clinical Pharmacology; School of Pharmaceutical Sciences; Sun Yat-sen University; Guangzhou China
| | - P. Chen
- Department of Pharmacy; The First Affiliated Hospital of Sun Yat-sen University; Guangzhou China
| | - J. Li
- Reproductive Medicine Center; The Sixth Affiliated Hospital of Sun Yat-Sen University; Guangzhou China
| | - X. Gao
- Department of Pharmacy; The First Affiliated Hospital of Sun Yat-sen University; Guangzhou China
| | - X. Chen
- Department of Pharmacy; The First Affiliated Hospital of Sun Yat-sen University; Guangzhou China
| | - J. Chen
- Department of Pharmacy; The First Affiliated Hospital of Sun Yat-sen University; Guangzhou China
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Osteomyelitis caused by Veillonella species: Case report and review of the literature. J Infect Chemother 2016; 22:417-20. [PMID: 26857179 DOI: 10.1016/j.jiac.2015.12.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 12/03/2015] [Accepted: 12/18/2015] [Indexed: 11/21/2022]
Abstract
Previously, Veillonella species had been considered as nonpathogenic and rarely caused serious infections. We report a case of 25-year-old man with osteomyelitis caused by Veillonella species. He was admitted to the hospital due to an open fracture to the left radial bone caused by industrial washing machine accident, and emergency surgery was performed. However, wound infections occurred one week after the operation. Although Acinetobacter baumannii and Serratia marcescens were cultured from the pus, obligate anaerobic bacteria were not detected at that point. Debridement was repeated and antibiotics were changed according to the result of bacterial culture and drug sensitivity. Despite this, the infection was poorly controlled. On the 5th debridement, granulomatous bone tissues on pseudarthrosis were found for the first time at the infection site. Although no bacteria was detected with aerobic culture, anaerobic incubation revealed Gram-negative cocci which was later identified as Veillonella species by 16S rRNA gene sequence analysis. His condition improved without any additional debridement after adding effective antibiotics against Veillonella species. It is well known that prolonged infection with aerobes consumes oxygen in the infection site and leads the environment to more favorable conditions for anaerobic bacteria, thus we speculated that prolonged infection with bacteria such as S. marcescens induced the favorable environment for Veillonella species. Physicians should realize the importance of anaerobic culture method in routine practice, especially in complicated cases such as the present case. In this article, we reviewed case reports of Veillonella infection and summarized the clinical features of this organism.
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Al-Otaibi FE, Al-Mohizea MM. Non-vertebral Veillonella species septicemia and osteomyelitis in a patient with diabetes: a case report and review of the literature. J Med Case Rep 2014; 8:365. [PMID: 25388792 PMCID: PMC4304151 DOI: 10.1186/1752-1947-8-365] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 08/27/2014] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Veillonella is a nonfermentative, strictly anaerobic, Gram-negative coccus that forms part of the human gastrointestinal tract, mouth and vaginal flora. Like other anaerobic infection, Veillonella species usually are involved in polymicrobial processes, which make it difficult to determine their pathogenic role. Isolation of a clinically significant Veillonella species is rare and V. parvula is the most common one reported to cause infection in humans. The most frequently reported infection caused by V. parvula is osteomyelitis, almost always in association with bacteremia. CASE PRESENTATION Here, we describe a rare case of nonvertebral osteomyelitis and septicemia caused by Veillonella species in a 49-year-old Saudi man with diabetes. Initial treatment with ciprofloxacin was associated with treatment failure and poor response. Identification of the organism was essential for the selection of appropriate treatment. There have been only seven previous reports of Veillonella vertebral osteomyelitis and one report of V. parvula foot osteomyelitis with sepsis in the literature. This is the second case of Veillonella nonvertebral osteomyelitis associated with septicemia reported to date. CONCLUSIONS Veillonella species should be considered a true pathogen in diabetic patients with osteomyelitis and those with underlying immune suppression, particularly if the organism is isolated from blood. The isolation of those obligate anaerobes from blood may signal the presence of severe underlying disease and the probable need for timely surgical intervention.
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Affiliation(s)
- Fawzia Eida Al-Otaibi
- King Khalid University Hospital, King Saud University, PO: 2925, Riyadh 11461, Saudi Arabia.
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Chen YC, Ko PH, Yang CJ, Chen YC, Lay CJ, Tsai CC, Hsieh MH. Epidural abscess caused by Veillonella parvula: Case report and review of the literature. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2014; 49:804-808. [PMID: 25066704 DOI: 10.1016/j.jmii.2014.05.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 11/18/2013] [Accepted: 05/15/2014] [Indexed: 10/25/2022]
Abstract
Veillonella parvula, an anaerobic, Gram-negative coccus is part of the normal flora of the oral, gastrointestinal, respiratory, and genitourinary tracts in humans and animals. We herein present a case of epidural abscess caused by V. parvula in a 68-year-old man with sinus squamous cell carcinoma who presented with a 3-week history of low back pain. Blood and pus cultures were positive for Veillonella spp. After sequencing of the 16S ribosomal DNA, the pathogen was identified as V. parvula. Surgical debridement was performed following which the patient received intravenous administration of amoxicillin/clavulanate. To our knowledge, there are only seven reported cases of spinal infection caused by Veillonella spp. and these are reviewed here.
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Affiliation(s)
- Yen-Chun Chen
- Department of Medicine, Buddhist Dalin Tzu Chi Hospital, Chiayi, Taiwan
| | - Ping-Hung Ko
- Department of Medicine, Buddhist Dalin Tzu Chi Hospital, Chiayi, Taiwan
| | - Chang-Jen Yang
- Department of Orthopedics, Buddhist Dalin Tzu Chi Hospital, Chiayi, Taiwan
| | - Yu-Chuan Chen
- Department of Clinical Pathology, Buddhist Dalin Tzu Chi Hospital, Chiayi, Taiwan
| | - Chorng-Jang Lay
- Department of Medicine, Buddhist Dalin Tzu Chi Hospital, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chen-Chi Tsai
- Department of Medicine, Buddhist Dalin Tzu Chi Hospital, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Min-Hong Hsieh
- Department of Orthopedics, Buddhist Dalin Tzu Chi Hospital, Chiayi, Taiwan.
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Kishen TJ, Lindstrom ST, Etherington G, Diwan AD. Veillonella spondylodiscitis in a healthy 76-year-old lady. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2011; 21 Suppl 4:413-7. [PMID: 21674211 DOI: 10.1007/s00586-011-1871-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 04/11/2011] [Accepted: 05/29/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE To report a case of Veillonella spondylodiscitis in a healthy 76-year-old lady. METHODS A previously healthy 76-year-old lady presented with worsening axial back pain at the thoracolumbar junction, fever and loss of weight. Examination revealed deep tenderness over the thoracolumbar junction with painful and restricted spinal movements. The lower limb motor power, sensation and reflexes were normal. RESULTS Radiographs of the lumbosacral spine showed evidence of spinal instability with lateral translation and loss of disc space at L1-L2. MRI scans revealed fluid intensity within the L1-L2 disc with infective debris elevating the posterior longitudinal ligament and narrowing the spinal canal. Both tissue and blood cultures were positive for the anaerobic organism, Veillonella. A staged anterior-posterior spinal surgery followed by an extended course of antibiotics resulted in the clinical improvement and normalisation of blood parameters. A review of the literature on Veillonella infections is also presented. CONCLUSION The aim of this report is to bring Veillonella spondylodiscitis to the attention of spinal surgeons and infectious disease specialists and discuss the management options.
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Affiliation(s)
- Thomas J Kishen
- Spine Service, St George Hospital and Clinical School, University of New South Wales, Sydney, Australia.
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Marriott D, Stark D, Harkness J. Veillonella parvula discitis and secondary bacteremia: a rare infection complicating endoscopy and colonoscopy? J Clin Microbiol 2006; 45:672-4. [PMID: 17108070 PMCID: PMC1829049 DOI: 10.1128/jcm.01633-06] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report a case of Veillonella parvula lumbar discitis and secondary bacteremia confirmed by molecular characterization of the 16S rRNA genes. Identification of the organism was essential for an appropriate choice of antimicrobial therapy following the failure of empirical flucloxacillin. Veillonella spp. are normal flora of the gastrointestinal tract, raising the possibility that an endoscopy and colonoscopy performed 8 weeks prior to presentation, during which small intestinal and rectal biopsies were obtained, was the portal of entry. This case highlights the importance of obtaining a microbiologic diagnosis, particularly in patients who previously have had procedures involving instrumentation.
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Affiliation(s)
- D Marriott
- Department of Microbiology, St.Vincent's Hospital, Darlinghurst, Sydney, NSW 2010, Australia.
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