Peptostreptococcus infection is a term encompassing a wide range of infections caused by Peptostreptococci, a large group of more than a dozen bacteria [1] [2] [3]. Peptostreptococci are the main representatives of Gram-positive anaerobic cocci and most notable species are Peptostreptococcus micros and Peptostreptococcus magnus, both being a part of the normal flora of the skin, genitourinary tract, and the oral cavity [1] [3] [4]. Although these bacterial species have been confirmed as causative agents of many types of infections, Peptostreptococcus seems to be missed in many cases, presumably because of its sensitivity to oxygen and poorly handled specimens obtained for microbiological investigations [1] [3] [5] [6] [7]. Nevertheless, endocarditis (involving both native and artificial valves), infections of the oral cavity, osteomyelitis, genitourinary (such as prostatitis) and respiratory tract infections, as well as central nervous system (CNS), cutaneous, and intra-abdominal infections, have all been documented by various authors [1] [2] [4] [5] [7] [8]. Furthermore, they are among the most frequently described pathogens when it comes to polymicrobial infections, especially in the formation of abscesses [4]. The clinical presentation depends on the site. Severe localized pain is typical for joint and other soft tissue infections [1], whereas high fever and chills, either with or without heart murmurs, are seen in cases of endocarditis [6].

• Localized Pain

  Severe localized pain is typical for joint and other soft tissue infections, whereas high fever and chills, either with or without heart murmurs, are seen in cases of endocarditis. [symptoma.com]

• Pleural Effusion

  Effusion (water on the lungs): 4 people, 57.14% Consciousness - Decreased: 4 people, 57.14% Leukocytosis (increased white blood cells): 4 people, 57.14% Ventricular Bigeminy (alternating normal sinus and premature ventricular complexes): 4 people, 57.14% [ehealthme.com]

• Heart Murmur

  Severe localized pain is typical for joint and other soft tissue infections, whereas high fever and chills, either with or without heart murmurs, are seen in cases of endocarditis. [symptoma.com]

• Ventricular Bigeminy

  Bigeminy (alternating normal sinus and premature ventricular complexes): 4 people, 57.14% * Approximation only. [ehealthme.com]

• Irregular Heart Rhythm

  heart rhythm): 6 people, 85.71% Convulsion (muscles contract and relax rapidly and repeatedly, resulting in an uncontrolled shaking of the body): 6 people, 85.71% Cerebral Hypoxia (not enough oxygen getting to the brain): 6 people, 85.71% Low Tissue [ehealthme.com]

• Convulsions

  1 person, 14.29% Eprex: 1 person, 14.29% Top symptoms for these people *: Fusobacterium Infection (bacterial infection): 6 people, 85.71% Cardiac Arrest: 6 people, 85.71% Ventricular Fibrillation (abnormally irregular heart rhythm): 6 people, 85.71% Convulsion [ehealthme.com]

• Excitement

  The first years of the 21st century have witnessed many exciting discoveries in the etiology and pathogenesis of rheumatic disorders. [books.google.de]

• Radiculopathy

  Infections 649 Genital Herpes Syphilis and Genital Ulcer Disease 657 Urethritis Epidydimitis Orchitis Prostatitis 669 Vulvovaginitis Cervicitis and Pelvic Inflammatory Disease 681 Meningitis 689 Encephalitis 703 Infections Associated with Myelopathy Radiculopathy [books.google.de]

The diagnosis of a Peptostreptococcus infection starts with a thorough clinical assessment. A detailed patient history, during which the physician must assess the presence of symptoms, their course, and progression, is highly important. The role of a proper physical examination has an equal value, particularly if endocarditis, osteomyelitis, or CNS infections are suspected. Once sufficient evidence is obtained and a presumptive diagnosis of an infection is made, microbiological testing is the cornerstone for identifying the underlying cause. Because Peptostreptococci are anaerobes, the use of swabs for obtaining a sample for evaluation can often yield a false-negative result. Aspirates, tissue specimens, or blood are much better samples for the preservation of Peptostreptococcus species during the process of microbiological identification [1] [4]. Despite the fact that Peptostreptococci are commensals of the skin and the oral cavity, their presence must not be overlooked when other sites are involved in the infectious process, particularly if a polymicrobial infection is recognized. Additional methods to confirm Peptostreptococcus are described, such as enzyme assays. The introduction of molecular methods such as polymerase chain reaction (PCR) has greatly improved the overall rate of the diagnosis [1] [3] [4].

• Ventricular Bigeminy

  Bigeminy (alternating normal sinus and premature ventricular complexes): 4 people, 57.14% * Approximation only. [ehealthme.com]

• Pleural Effusion

  Effusion (water on the lungs): 4 people, 57.14% Consciousness - Decreased: 4 people, 57.14% Leukocytosis (increased white blood cells): 4 people, 57.14% Ventricular Bigeminy (alternating normal sinus and premature ventricular complexes): 4 people, 57.14% [ehealthme.com]

1. Riesbeck K, Sanzén L. Destructive Knee Joint Infection Caused by Peptostreptococcus micros: Importance of Early Microbiological Diagnosis. J Clin Microbiol. 1999;37(8):2737-2739.
2. Capunitan JA, Conte HA. Peptostreptococcus species: an unusual cause of infective endocarditis. Conn Med. 2010;74(2):93-96.
3. Murdoch DA. Gram-Positive Anaerobic Cocci. Clinical Microbiology Reviews. 1998;11(1):81-120.
4. Riggio MP, Lennon A. Identification of Oral Peptostreptococcus Isolates by PCR-Restriction Fragment Length Polymorphism Analysis of 16S rRNA Genes. J Clin Microbiol. 2003;41(9):4475-4479.
5. Wu PH, Lin YT, Lin CY, et al. Peptostreptococcus anaerobius infective endocarditis complicated by spleen infarction. Am J Med Sci. 2011;342(2):174-176.
6. Van der Vorm ER, Dondorp AM, van Ketel RJ, Dankert J. Apparent Culture-Negative Prosthetic Valve Endocarditis Caused by Peptostreptococcus magnus. J Clin Microbiol. 2000;38(12):4640-4642.
7. Brook I. Recovery of anaerobic bacteria from clinical specimens in 12 years at two military hospitals. J Clin Microbiol. 1988;26:1181-1188
8. Magri V, Restelli A, Marras E, Perletti G. A severely symptomatic case of anaerobic chronic bacterial prostatitis successfully resolved with moxifloxacin therapy. Anaerobe. 2010;16(3):206-209.