1
|
Richards T, Stephen J, Lui CL. Severe disseminated Veillonella parvula infection including endocarditis, bilateral psoas abscess, discitis, and osteomyelitis but sparing spinal and hip prostheses: a case report. J Med Case Rep 2022; 16:157. [PMID: 35440093 PMCID: PMC9020012 DOI: 10.1186/s13256-022-03386-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 03/23/2022] [Indexed: 11/11/2022] Open
Abstract
Background Veillonella species are an opportunistically pathogenic commensal anaerobic Gram-negative coccus commonly found in the oral, genitourinary, respiratory, and intestinal tract of humans and some animals. Infection is rare, even in immunocompromised hosts, and has been identified to cause a wide array of different infections, including endocarditis, osteomyelitis, and meningitis. Case presentation An 82-year-old Caucasian male retired ex-gymnast presented to the emergency department with a 2-week history of acute on chronic lower back pain without clear precipitant. He displayed no systemic symptoms, and had not sustained any recent injuries. Initial blood and radiological investigation did not reveal an infective or mechanical cause for his pain; however, a few days into admission, he developed a fever and signs of sepsis. A thorough septic screen was performed, including a spinal magnetic resonance imaging scan, which did not reveal any abnormalities. Blood cultures revealed Veillonella parvula bacteremia, with subsequently repeated magnetic resonance imaging displaying rapid disseminated infection including bilateral psoas abscess, discitis, and osteomyelitis. Infective endocarditis was later identified with echocardiogram. He received intravenous ceftriaxone and later oral amoxicillin and clavulanic and recovered on 6-month follow-up. Conclusions This case illustrates the potential pathogenicity and unexpected rapid course of Veillonella parvula infection even in an immunocompetent host presenting with back pain. This case highlights the critical importance of a thorough septic screen when investigating patients for early signs of sepsis.
Collapse
Affiliation(s)
- Tobias Richards
- Geriatric Medicine, St John of God Midland Public and Private Hospitals, 1 Clayton St, Midland, WA, 6056, Australia.
| | - Juan Stephen
- Geriatric Medicine, St John of God Midland Public and Private Hospitals, 1 Clayton St, Midland, WA, 6056, Australia
| | - Chok Lin Lui
- Geriatric Medicine, St John of God Midland Public and Private Hospitals, 1 Clayton St, Midland, WA, 6056, Australia
| |
Collapse
|
2
|
Anagnostakos K, Grzega C, Sahan I, Geipel U, Becker SL. Occurrence of Rare Pathogens at the Site of Periprosthetic Hip and Knee Joint Infections: A Retrospective, Single-Center Study. Antibiotics (Basel) 2021; 10:antibiotics10070882. [PMID: 34356802 PMCID: PMC8300814 DOI: 10.3390/antibiotics10070882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/08/2021] [Accepted: 07/16/2021] [Indexed: 12/31/2022] Open
Abstract
The frequency and clinical relevance of rare pathogens at the site of periprosthetic infections of the hip and knee joint and their antibiotic resistance profiles have not yet been assessed in-depth. We retrospectively analyzed all periprosthetic hip and knee joint infections that occurred between 2016 and 2020 in a single center in southwest Germany. Among 165 infections, 9.7% were caused by rare microorganisms such as Veilonella sp., Pasteurella sp., Pantoea sp., Citrobacter koseri, Serratia marcescens, Parvimonas micra, Clostridium difficile, Finegoldia magna, Morganella morganii, and yeasts. No resistance to piperacillin/tazobactam, carbapenemes, fluoroquinolones, or gentamicin was observed. Some bacteria displayed resistance to ampicillin, ampicillin/sulbactam, and cefuroxime. We present follow-up data of patients with infections due to rare pathogens and discuss the importance of close, interdisciplinary collaboration between orthopedic surgeons and clinical microbiologists to carefully select the most appropriate anti-infective treatment regimens for the increasing number of patients with such infections.
Collapse
Affiliation(s)
- Konstantinos Anagnostakos
- Zentrum für Orthopädie und Unfallchirurgie, Klinikum Saarbrücken, 66119 Saarbrücken, Germany; (C.G.); (I.S.)
- Correspondence:
| | - Christoph Grzega
- Zentrum für Orthopädie und Unfallchirurgie, Klinikum Saarbrücken, 66119 Saarbrücken, Germany; (C.G.); (I.S.)
| | - Ismail Sahan
- Zentrum für Orthopädie und Unfallchirurgie, Klinikum Saarbrücken, 66119 Saarbrücken, Germany; (C.G.); (I.S.)
| | - Udo Geipel
- Bioscientia MVZ Saarbrücken GmbH, 66119 Saarbrücken, Germany;
| | - Sören L. Becker
- Institut für Medizinische Mikrobiologie und Hygiene, Universitätsklinikum des Saarlandes, 66421 Homburg/Saar, Germany;
| |
Collapse
|
3
|
Abstract
Septic arthritis usually presents as subacute monoarticular inflammation. Majority of the cases in healthy adults are caused by methicillin-resistant Staphylococcus aureus, streptococci and certain gram-negative organisms, mostly in the setting of extremes of ages, trauma or immunosuppression. This is a case of a healthy adult with a sudden onset of inflammation of the knee joint, being diagnosed with septic arthritis of the left knee with Veillonella sp. growing from the joint aspirate on two successive cultures. The patient was treated with 6 weeks of oral metronidazole and 4 weeks of intravenous ceftriaxone in addition to arthroscopic drainage and irrigation. Rare causes of septic arthritis should be considered even in healthy adults with native joints. Closer follow-up might be needed to ensure successful treatment.
Collapse
Affiliation(s)
- Syed Shah
- Department of Internal Medicine, Michigan State University, Lansing, Michigan, USA
| | - Daniel Havlichek
- Department of Internal Medicine, Michigan State University, Lansing, Michigan, USA
| |
Collapse
|
4
|
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.
Collapse
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.
| |
Collapse
|
5
|
Rodríguez Duque JC, Galindo Rubín P, González Humara B, Quesada Sanz AA, Busta Vallina MB, Fernández-Sampedro M. Fusobacterium nucleatum prosthetic hip infection: Case report and review of the literature of unusual anaerobic prosthetic joint infection. Anaerobe 2018; 54:75-82. [PMID: 30118892 DOI: 10.1016/j.anaerobe.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 07/26/2018] [Accepted: 08/12/2018] [Indexed: 12/26/2022]
Abstract
The anaerobic Gram-negative rod Fusobacterium nucleatum is an oral commensal and periodontal pathogen that has been associated with a wide variety of infections, yet it is extremely rare to be associated with prosthetic joint infection. After an exhaustive literature review, only two cases of prosthetic joint infection by F. nucleatum have been previously reported. To our knowledge, the case we report on here is the first combined with periprosthetic abscess and related with hemochromatosis. We therefore sought to provide a comprehensive literature review of case reports or series of less commonly encountered anaerobic microorganisms isolated from prosthetic joint infections.
Collapse
Affiliation(s)
- J C Rodríguez Duque
- Infectious Diseases Unit, Department of Medicine, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - P Galindo Rubín
- Department of Orthopaedic Surgery, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - B González Humara
- Department of Radiology, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - A A Quesada Sanz
- Service of Microbiology, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - M B Busta Vallina
- Department of Orthopaedic Surgery, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - M Fernández-Sampedro
- Infectious Diseases Unit, Department of Medicine, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| |
Collapse
|
6
|
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
| |
Collapse
|
7
|
Libertin CR, Peterson JH, Brodersen MP, Huff T. A Case of Penicillin-Resistant Veillonella Prosthetic Joint Infection of the Knee. Case Rep Orthop 2016; 2016:7171947. [PMID: 28050296 PMCID: PMC5165143 DOI: 10.1155/2016/7171947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/18/2016] [Accepted: 10/30/2016] [Indexed: 01/24/2023] Open
Abstract
Veillonella sp. and V. dispar are emerging pathogens. This is the third case of a monomicrobial Veillonella sp. prosthetic joint infection (PJI) among knees and hips; this is the second prosthetic knee infection described. The infection was treated with a 2-stage procedural approach combined with 6 weeks of ceftriaxone with excellent clinical response. There was no relapse in 2 years of follow-up care. This case exemplifies the importance of incubating anaerobic cultures for at least 7 days to grow some anaerobic pathogens.
Collapse
Affiliation(s)
- Claudia R. Libertin
- Division of Infectious Diseases, Mayo Clinic Health System (MCHS-W), Waycross, GA, USA
- Departments of Pathology and Laboratory Medicine, Mayo Clinic Health System-Waycross, Waycross, GA, USA
- Division of Infectious Diseases, Mayo Clinic, Jacksonville, FL, USA
| | - Joy H. Peterson
- Departments of Pathology and Laboratory Medicine, Mayo Clinic Health System-Waycross, Waycross, GA, USA
| | - Mark P. Brodersen
- Department of Orthopedics, Mayo Clinic Health System-Waycross, Waycross, GA, USA
- Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Tamara Huff
- Department of Orthopedics, Mayo Clinic Health System-Waycross, Waycross, GA, USA
- Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA
| |
Collapse
|
8
|
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.
Collapse
|
9
|
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.
Collapse
Affiliation(s)
- Thomas J Kishen
- Spine Service, St George Hospital and Clinical School, University of New South Wales, Sydney, Australia.
| | | | | | | |
Collapse
|
10
|
Rogers GB, Stressmann FA, Walker AW, Carroll MP, Bruce KD. Lung infections in cystic fibrosis: deriving clinical insight from microbial complexity. Expert Rev Mol Diagn 2010; 10:187-96. [PMID: 20214537 DOI: 10.1586/erm.09.81] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Lower respiratory tract bacterial infections, such as those associated with cystic fibrosis lung disease, represent a major healthcare burden. Treatment strategies are currently informed by culture-based routine diagnostics whose limitations, including an inability to isolate all potentially clinically significant bacterial species present in a sample, are well documented. Some advances have resulted from the introduction of culture-independent molecular assays for the detection of specific pathogens. However, the application of bacterial community profiling techniques to the characterization of these infections has revealed much higher levels of microbial diversity than previously recognized. These findings are leading to a fundamental shift in the way such infections are considered. Increasingly, polymicrobial infections are being viewed as complex communities of interacting organisms, with dynamic processes key to their pathogenicity. Such a model requires an analytical strategy that provides insight into the interactions of all members of the infective community. The rapid advance in sequencing technology, along with protocols that limit analysis to viable bacterial cells, are for the first time providing an opportunity to gain such insight.
Collapse
Affiliation(s)
- Geraint B Rogers
- Molecular Microbiology Research Laboratory, Pharmaceutical Science Division, 150 Stamford Street, Franklin-Wilkins Building, King's College London, London, SE1 9NH, UK.
| | | | | | | | | |
Collapse
|
11
|
Marculescu CE, Berbari EF, Cockerill FR, Osmon DR. Unusual aerobic and anaerobic bacteria associated with prosthetic joint infections. Clin Orthop Relat Res 2006; 451:55-63. [PMID: 16906072 DOI: 10.1097/01.blo.0000229317.43631.81] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The association of certain microorganisms, such as Staphylococcus epidermidis, Staphylococcus aureus, and beta-hemolytic streptococci, with prosthetic joint infection (PJI) has been recognized for many years. To our knowledge, a systematic review of the presentation and management of less commonly encountered species of coagulase-negative staphylococci, nutritional-variant streptococci, aerobic non-spore and spore forming Gram-positive or anaerobic bacteria is not available. We therefore sought to provide a comprehensive literature review of PJI due to these microorganisms that will provide a valuable and quick reference for clinicians caring for these patients. We conducted a Medline search of all case reports and case series of PJI due to unusual aerobic and anaerobic bacteria. The presentation, surgical, and medical management strategies were reviewed. Appropriate medical and surgical management of such infections is complex and evolving as newer diagnostic tests, surgical techniques and antimicrobials become available. Management of patients with these infections requires close collaboration between the orthopaedic surgeon, infectious disease specialist and microbiology laboratory.
Collapse
|
12
|
Isner-Horobeti ME, Lecocq J, Dupeyron A, De Martino SJ, Froehlig P, Vautravers P. Veillonella discitis. A case report. Joint Bone Spine 2006; 73:113-5. [PMID: 16085443 DOI: 10.1016/j.jbspin.2005.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2004] [Accepted: 02/15/2005] [Indexed: 11/26/2022]
|