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Peptostreptococcus Infection

Peptostreptococcus infection is rarely reported in general practice, but this genus of anaerobic bacteria can cause infections of virtually any tissue. Osteomyelitis, endocarditis, genitourinary and upper respiratory tract infections, as well as central nervous system infections, have all been described in the literature. This pathogen, being sensitive to aerobic conditions, is often underrecognized due to improper sampling and storage. Meticulous microbiological workup is crucial in order to identify Peptostreptococcus as the cause of infection.

Presentation

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].

Entire Body System

  • Animal Bite

    Bites and Scratches 885 EctoparasiteRelated Diseases 891 Human Immunodeficiency Virus and AIDS 903 Epidemiology and Prevention 905 AIDS Pathogenesis Molecular Biology and Virology of HIV 915 AIDS Immunology 927 Clinical Manifestations of HIV Infection [books.google.de]

    This can occur due to trauma or surgery, such as animal bites or root canals. [healthline.com]

    bites, infected cysts, abscesses of the breast, rectum, and anus. [en.wikipedia.org]

Gastrointestinal

  • Abdominal Mass

    Biopsies of the abdominal wall mass exhibited fibrosis, inflammation, and microabscesses, with no evidence of tumour. [ijidonline.com]

Cardiovascular

  • 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]

Skin

  • Foot Ulcer

    [citation needed] Peptostreptococcus spp. can cause infections such as gluteal decubitus ulcers, diabetes-related foot infections, and rectal abscesses. [en.wikipedia.org]

Face, Head & Neck

  • Neck Mass

    This demonstrated a mass at the root of the neck on the left side, partially destroying the left lobe of the thyroid gland. [ijidonline.com]

Workup

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].

X-Ray

  • Ground Glass Appearance

    Multiple small nodules and a patchy ground glass appearance were present bilaterally in the lungs and there was consolidation in the right middle lobe. [ijidonline.com]

  • Pulmonary Infiltrate

    Computed tomography scanning revealed a neck mass invading the thyroid gland, pulmonary infiltrates, liver lesions, and deposits on the anterior abdominal wall, consistent with disseminated malignancy. [ijidonline.com]

Biopsy

  • Liver Biopsy

    Subsequently a liver biopsy showed a necro-inflammatory process with extensive destruction of normal liver tissue. No malignant cells were noted. [ijidonline.com]

Treatment

[…] infections have decreased in the last 30 years and will continue to do so due to better treatment. [en.wikipedia.org]

Prognosis

Article Sidebar Published: Mar 18, 2014 Clinical Cases Keywords Ocular infections, Severe prognosis in ocular infections, Endophthalmitis, Peptostreptococcus tetradius. [pagepressjournals.org]

Prognosis Complete recovery should be achieved with the appropriate surgery and antibiotic treatment. Untreated or uncontrolled infections can cause severe tissue and bone destruction, which would require plastic surgery to repair. [encyclopedia.com]

Hence, pharmacotherapy for effective elimination of this potentially pathogenic microorganism can have a beneficial effect on the prognosis of root canal retreatments. [ijpsr.com]

[…] patients described in these studies were either newborns or were over 6 weeks of age and suffered from chronic debilitating disorders such as malignant neoplasms, immunodeficiencies, chronic renal insufficiency, or decubitus ulcers and carried a poor prognosis [ccforum.biomedcentral.com]

Etiology

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

The microbiology of pyogenic brain abscess has Staphylococcus and Streptococcus as the leading etiologic pathogens in immunocompetent individuals. Peptostreptococcus is also recognized as a common cause of brain abscess in this patient population. [mdpi.com]

Mediastinit efter hjärtkirurgi – mikrobiologisk etiologi och patogenes. Svenska Läkarsällskapets riksstämma 2000, p.211. Hansson C, Hoborn J, Möller A, Swanbeck G. The microbial flora in venous leg ulcers without clinical signs of infection. [referensmetodik.folkhalsomyndigheten.se]

Septic arthritis was experienced one week to one year after reconstructive surgery, and had evolved for several months to years before etiologic diagnosis in 5 cases. [pubmed.ncbi.nlm.nih.gov]

Epidemiology

Epidemiology: Peptostreptococcus species are commensal organisms in humans, living predominantly in the mouth, skin, gastrointestinal, vagina and urinary tracts, and compose a portion of the bacterial gut flora. [quizlet.com]

Tropical Countries 859 Endemic and Travelers Diarrhea in Tropical Countries 875 Eosinophilia in Travelers to Tropical Countries 881 Infections after Animal Bites and Scratches 885 EctoparasiteRelated Diseases 891 Human Immunodeficiency Virus and AIDS 903 Epidemiology [books.google.de]

Society of Internal Medicine, American Medical Association, American Society for Microbiology, American Thoracic Society, American Venereal Disease Association, Infectious Diseases Society of America, International AIDS Society, Society for Healthcare Epidemiology [emedicine.medscape.com]

J Infect 55:1–7 Article CAS PubMed Google Scholar Lamagni T (2014) Epidemiology and burden of prosthetic joint infections. [link.springer.com]

Tissierellia)                   Epidemiology[edit] Since they are commonly found in soils and in microbiota of humans and animals, Clostridia wounds and infections are found worldwide. [en.wikipedia.org]

Pathophysiology

A new species within the genus Peptostreptococcus is Peptostreptococcus hydrogenalis; it contains the indole-positive, saccharolytic strains of the genus. [9] Pathophysiology Peptostreptococcus organisms are part of the normal florae of human mucocutaneous [microjeganesh.blogspot.com]

A new species within the genus Peptostreptococcus is Peptostreptococcus hydrogenalis; it contains the indole-positive, saccharolytic strains of the genus. [10] Pathophysiology Peptostreptococcus organisms are part of the normal florae of human mucocutaneous [emedicine.medscape.com]

Pathophysiology and treatment. New York: Marcel Dekker Inc., 1991. [referensmetodik.folkhalsomyndigheten.se]

Prevention

Getting treatment for minor infections can help prevent the spread of bacteria. [healthline.com]

A patient's recovery from anaerobic infection depends on prompt and proper treatment according to the following principles: (1) neutralizing toxins produced by anaerobes, (2) preventing local bacterial proliferation by changing the environment, and (3 [emedicine.medscape.com]

Endemic and Travelers Diarrhea in Tropical Countries 875 Eosinophilia in Travelers to Tropical Countries 881 Infections after Animal Bites and Scratches 885 EctoparasiteRelated Diseases 891 Human Immunodeficiency Virus and AIDS 903 Epidemiology and Prevention [books.google.de]

The highlighting of oral infectious foci, their eradication, and the follow-up of patients who had been subject to a vascular graft procedures are essential elements in preventing any associated lesions. [jomos.org]

When Peptostreptococci and other anaerobes predominate, aggressive treatment of acute infection can prevent chronic infection. [en.wikipedia.org]

References

  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.
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