title: Symbiotic bacteria induced necrotizing pancreatitis.
abstract: BACKGROUND
  Intestinal flora and anaerobes are frequently implicated in causing infectious necrotizing pancreatitis however Bifidobacterium and Veillonella have rarely been isolated as the causative agents. Bifidobacterium and Veillonella are commensal anaerobes which reside in gastrointestinal tract and help deconjugate bile acids. Bifidobacterium is also frequently used in probiotics.
  
  
  METHODS
  We present a 68-year-old man who initially presented with gallstone pancreatitis but eventually developed Bifidobacterium and Veillonella species induced necrotizing pancreatitis and pseudocyst formation.
  
  
  CONCLUSIONS
  Under rare circumstances commensal gut flora can turn pathogenic which can lead to life-threatening morbidity and may even result in mortality.
authors.affiliation: Department of Internal Medicine, Michigan State University/KCMS, Kalamazoo, MI, USA. rverma@kcms.msu.edu
authors.forename: Rajanshu
authors.initials: R
authors.lastname: Verma
authors.forename: Radhika
authors.initials: R
authors.lastname: Dhamija
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Ross
authors.forename: Donald H
authors.initials: DH
authors.lastname: Batts
authors.forename: Mark E
authors.initials: ME
authors.lastname: Loehrke
mesh_terms: D000368:Aged; D018407:Bacterial Physiological Phenomena; D039941:Bifidobacteriales Infections / Q000150:complications / Q000175:diagnosis; D001644:Bifidobacterium / Q000502:physiology; D042882:Gallstones / Q000150:complications / Q000382:microbiology; D041981:Gastrointestinal Tract / Q000382:microbiology*; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008297:Male; D010192:Pancreatic Pseudocyst / Q000209:etiology / Q000382:microbiology; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology*; D013559:Symbiosis / Q000502:physiology; D014678:Veillonella / Q000502:physiology