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

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.

Case report: vertebral osteomyelitis secondary to a dental abscess

“…Veillonella species are generally found in polymicrobial processes, and our case seems to adhere to this as no singular species could be identified. They have been implicated in dental infections, pulmonary infections, endocarditis, prosthetic joint infections, cardiac prosthetic valve infections and osteomyelitis [4,7,9,10,13]. None of these predisposing risk factors could be identified in our patient.…”

“…None of these predisposing risk factors could be identified in our patient. These bacteria are typically resistant to vancomycin, tetracycline, aminoglycosides, and ciprofloxacin, but infections are traditionally known to respond well to therapy with penicillin [7,13]. In vitro, Veillonella is usually susceptible to cephalosporins, clindamycin, metronidazole, and chloramphenicol.…”

“…Due to the scarce number of reports on Veillonella as a pathogen associated with invasive infection, there are no clear treatment recommendations in the literature. A few reports point to penicillin, cephalosporins, chloramphenicol, clindamycin, and metronidazole as providing positive responses [7,[13][14][15][16][17][18].…”

“…The most common gram-positive species are Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus species, and Enterococcus species while the most common gramnegative species are E. coli, Pseudomonas aeruginosa, and Proteus mirabilis. 4,5,6,7 However, vertebral osteomyelitis is rarely caused by strictly anaerobic organisms, accounting for only 3-5% of all spondylodiscitis cases [4][5][6].…”

“…Veillonella is an anaerobic gram-negative bacterial species known to be found in the oral cavity, gastrointestinal tract, and female genital tract [4,[7][8][9]. Thirteen species of the genus have been identified, with only six having been isolated in human oral cavities [10].…”