Granulicatella adiacens

Granulicatella adiacens is a fastidious Gram-positive cocci (pairs, chains) and is part of the nutritionally variant streptococci (NVS). Like other constituents of the NVS, it can cause bacteremia and infective endocarditis (IE), with significant morbidity and mortality. NVS has less often been implicated in a variety of other infections, including those of the orbit, nasolacrimal duct and breast implants. It is a commensal of the human mouth, genital, and intestinal tracts, although it is rarely implicated in infections, in part due to it being a fastidious organism and rarely being identified in the laboratory environment. However, its identification has become more frequent with use of commercial mediums and automated identification systems. Because it has been difficult to identify, it has been considered one of the causes of culture negative IE. Identifying G. adiacens can allow more appropriate selection of antibiotics, especially when susceptibility testing is not available.