Veillonella Myositis in an Immunocompromised Patient

Beumont, Maria; Duncan, Julie; Mitchell, Susan D.; Esterhai, John L.; Edelstein, Paul H.

doi:10.1093/clinids/21.3.678

Cited by 14 publications

(7 citation statements)

References 7 publications

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“…The genus Veillonella currently consists of eight species (10,16). Veillonella species are rare causes of serious infections such as meningitis, osteomyelitis, prosthetic joint infection, pleuropulmonary infection, endocarditis, and bacteremia (1,2,3,4,12,15,20). In most clinical reports of Veillonella infection, the isolates have not been identified to species level.…”

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confidence: 99%

Veillonella parvula Discitis and Secondary Bacteremia: a Rare Infection Complicating Endoscopy and Colonoscopy?

2007

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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. CASE REPORTA 55-year-old school headmaster presented to the Emergency Department of St. Vincent's Hospital, Sydney, Australia, with a 48-h history beginning with the sudden onset of severe lower back pain. There was no history of injury or trauma. The pain was associated with night sweats, and he described an episode of shaking consistent with rigors. There was no significant past medical history and no recent dental procedure was reported. He had undergone a routine endoscopy and colonoscopy for a slight change in bowel habits 2 months prior to presentation. There were no abnormal findings, but a small bowel biopsy and a rectal biopsy were obtained to exclude celiac disease and histologic colitis.On examination, the patient was initially afebrile, although his temperature rose to 38°C that night. No heart murmurs were present, and there were no peripheral stigmata of infective endocarditis. Dentition was normal, and no gingivitis was noted. Severe back pain was precipitated by minimal movement of the legs and trunk.On examination, moderate tenderness was noted over the lumbar spine and left lumbar paravertebral region. The neurological examination was limited by pain but was considered to be normal. The neutrophil count was 4.6 ϫ 10 9 /liter, but the erythrocyte sedimentation rate was 68 mm/h and the C-reactive protein (CRP) level was 211 mg/liter. An X-ray examination of the lumbar spine revealed degenerative changes at L3, L4, and L5. During the next 12 h the pain worsened, requiring narcotic analgesia, and urinary retention developed, necessitating bladder catheterization and an indwelling catheter. Two sets of blood cultures were collected, and antimicrobial therapy was withheld pending a magnetic resonance imaging scan, which was performed 18 h after admission. The magnetic resonance imaging scan revealed multilevel disc destruction with posterior disc extrusions most severe at the L2/3 level, resulting in compression of the thecal sac and central canal stenosis at this level. No bony destruction was noted.Blood cultures remained negative 48 h after admission. A computed tomography-guided biopsy of the L2/3 disc was undertaken, with three fine-needle aspirate biopsies obtained using a 22-gauge needle. Following the biopsy, the patient was started on flucloxacillin and given a single 1-g dose of ceftriaxone. With...

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Veillonella parvula Discitis and Secondary Bacteremia: a Rare Infection Complicating Endoscopy and Colonoscopy?

2007

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“…Little has been written about the occurrence of Veillonella in infections, and it is difficult to evaluate the prevalence and clinical importance of Veillonella species, which are rare causes for serious infections such as meningitis, osteomyelitis, prosthetic joint infection, pleuropulmonary infection, endocarditis, and bacteremia. 10,11,12,13,14,15,16,17,18,19,20 We performed a MEDLINE search using the keywords "Veillonella infection", "anaerobic osteomyelitis", "anaerobic epidural abscess", and "anaerobic spine infection" to search for reports/studies on spine infection caused by Veillonella species, and found only seven cases (Table 1). 11,12,13,14,15,16,17 Including the present case, the median age of the patients infected was 57.8 years (range: 27e76 years).…”

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confidence: 99%

Epidural abscess caused by Veillonella parvula: Case report and review of the literature

Chen¹,

Ko²,

Yang³

et al. 2016

Journal of Microbiology, Immunology and Infection

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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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“…ont été décrites sur des terrains particuliers : immunodépression [1], toxicomanie intraveineuse [2], prématurité [3,4]. Les atteintes osseuses à Veillonella sont encore plus rares dans la littérature : un cas de sacro-iléite [9], deux cas d'ostéomyélite du rachis [10,11] et un cas de spondylodiscite [12].…”

Section: Discussionunclassified

“…L'ostéomalacie hypophosphatémique oncogénique dite aussi ostéomalacie tumorale (OT) est une entité clinicobiologique rare associant les symptômes d'une ostéomalacie, une hypophosphatémie, un taux normal ou bas non adapté de 1-25 (OH) 2 vitamine D et une tumeur mésenchymateuse habituellement bénigne [1,2]. La résection de la tumeur s'accompagne d'une régression de l'ostéomalacie et d'une normalisation des perturbations biologiques.…”

Section: Discussionunclassified