Prompt and accurate diagnosis of polymicrobial bacteremia, which causes the difficulty in anti-infective treatments, poor treatment outcome and high mortality, is essential for initiating effective antimicrobial therapy. Here we present a case of bacteremia caused by two types of uncommon bacteria, Lactobacillus jenseniand and Veillonella montpellierensis in a 29-year-old pregnant woman at 33 weeks of gestation with anemia due to iron deficiency. She had no comorbidity or other chronic illnesses and was successfully treated with appropriate antibiotic use.

UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.

OBJECTIVE: This study aimed to investigate that these bacteria counts in the oral cavity were modulated by the recurrent aphthous stomatitis (RAS) status according to age and ethnicity with a systematic review and meta-analysis.
METHODS: The relevant case-control studies were searched in the literature database in English, Korean, and Chinese until June 2020 using keywords, and the literature was screened and collated for Review Manager analysis. Sensitivity analysis and quality check of the included literature were conducted.
RESULTS: From the selection process, oral bacteria counts were measured by polymerase chain reaction (PCR) in 8 studies and next-generation sequencing in 4 studies. Healthy control, ulcerative phases of RAS (UC-RAS), non-ulcerative phases of RAS (Non-UC-RAS) groups included 442, 473, and 386 participants in a total of 12 studies. For PCR detection, mean differences (95 % confidence intervals) of Veillonella and Streptococcus counts between the healthy-control and RAS groups were -1.91 (-2.41 ∼ -1.41) and -1.34 (-1.85 ∼ -0.83)(P < 0.0001). The bacteria count results by \"Next-generation\" sequencing (NGS) and PCR methods were similar. Significantly lower Veillonella and Streptococcus counts were observed in the UC-RAS group than in the non-UC-RAS group (P < 0.0001). Veillonella and Streptococcus count differences between RAS and controls aged ≥30 years were greater than those aged <30 years. At the species level, the prevalence of RAS had a negative relation with Veillonella dispar count.
CONCLUSIONS: Counts of Veillonella and Streptococcus are strongly correlated with the recovery and progression of RAS, especially in middle-aged patients. Adjustment of oral microbiota should be considered in the treatment of RAS.

UNASSIGNED: Veillonella parvula is usually regarded as a contaminant bacteria associated with polymicrobial infection. Here we report a rare case of sepsis caused by V. parvula, which was successfully treated by chloramphenicol. In addition, the therapeutic strategy for V. parvula infection was reviewed.
METHODS: A 55-year-old woman underwent surgery for lumbar spinal stenosis and developed high fever (39.5°C) after surgery, accompanied by chills and fatigue. V. parvula was isolated in blood culture and shown to be probably sensitive to both meropenem and chloramphenicol. No improvement was seen after 3 days of treatment with meropenem, and then, iv chloramphenicol (1.5 g once daily) was added to the regimen. The symptoms and fever resolved in 2 days. She was continuously treated with chloramphenicol for another 10 days before discharge.
CONCLUSIONS: The reported antibiotics in the therapy of infections caused by veillonella species include penicillins, metronidazole, cephalosporins, aminoglycosides, imipenem, clindamycin, doxycycline, erythromycin and chloramphenicol. To our knowledge, this is the first case describing successful treatment of V. parvula-caused sepsis with chloramphenicol.

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.

BACKGROUND: 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.
METHODS: 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.

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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Veillonella parvula is a small, nonfermentative anaerobic gram-negative coccus that is part of the normal flora of the mouth, gastrointestinal tract, and vagina in humans. When isolated from clinical specimens, V. parvula is often regarded as a contaminant or commensal, but it has been implicated as a pathogen in infections of the sinuses, lungs, heart, bone, and central nervous system. Meningitis, however, is extremely rare; to our knowledge, only 2 cases have been previously described in the literature. We report a case of V. parvula meningitis and review the literature on Veillonella infections.

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