Veillonella as a cause of chronic anaerobic pneumonitis

Anaerobes are not well recognized as a cause of chronic respiratory infections. A 44-year-old man was referred for evaluation of a progressive pulmonary disease of 7-month duration characterized by hemoptysis and fever. For these complaints, based on the radiological picture, he had already received antituberculous therapy without any relief. He was also subjected to bronchial artery embolization prior to referral. Evaluation of the patient led to a diagnosis of chronic anaerobic pneumonitis. Anaerobic culture of the computed tomography-guided transthoracic aspirate grew Fusobacterium and Veillonella species. Within 2 weeks of therapy with oral clindamycin, there was a dramatic relief in hemoptysis. This was accompanied by remarkable radiological clearance. This report underscores the importance of Veillonella species as a potential respiratory pathogen. A high index of suspicion is required to diagnose chronic anaerobic pneumonitis, which can mimic pulmonary tuberculosis, especially in tuberculosis endemic regions.