gram-positive cocci and microaerophilic streptococci. Upper respiratory tract and dental infections There is a high rate of anaerobic cocci colonization which accounts for the organisms significance in these infections. Anaerboci gram-positive cocci and micraerophilic streptococci are often recovered in these infections. They have been recovered in 15% of patients with chronic mastoiditis. When Peptostreptococci and other anaerobes predominate, aggressive treatment of acute infection can prevent chronic infection. When the risk of anaerobic infection is high, as with intra-abdominal and post-surgical infections, proper antimicrobial prophylaxis may reduce the risk 90% of the time, other organisms were mixed in with the anaerobic gram-positive cocci and microaerophilic streptococci. This includes streptococcus species, and staphylococcus aureus. Peptostreptococcus micros has a moderate association with periodontal disease. Bacteremia and endocarditis Peptostreptococci can cause fatal endocarditis, paravalvular abscess, and pericarditis. The most frequent source of bacteremia due to Peptostreptococcus are infections of the oropharynx, lower respiratory tract, female genital tract, abdomen, skin, and soft tissues. Recent gynecological surgery, immunosuppression, dental procedures, infections of the female genital tract, abdominal and soft tissue along with gastrointestinal surgery are predisposing factors for bacteremia due to peptostreptococcus. Microaerophilic streptococci typically account for 5-10% of cases of endocarditis; however, Peptostreptococci have only rarely been isolated. Anaerobic pleuropulmonary infections Anaerobic gram-positive cocci and microaerophilic streptococci are most frequently found in aspiration pneumonia, empyema, lung abscesses, and mediastinitis. These bacteria account for 10-20% of anaerobic isolated recovered from pulmonary infections. It is difficult to obtain appropriate culture specimens. It requires a direct lung puncture, or the use of trans-tracheal aspiration. Abdominal infections Anaerobic gram-positive cocci are part of the normal gastrointestinal microbiota. They are isolated in approximately 20% of specimens from intra-abdominal infections, such as peritonitis. Found in abscesses of the liver, spleen, and abdomen. Like in upper respiratory tract and dental infections, anaerobic gram-positive cocci are recovered mixed with other bacteria. In this case they are mixed with organisms of intestinal origin such as E coli, bacteroides fragilis group, and clostridium species. Female pelvic infections Anaerobic gram-positive cocci are frequently isolated from anaerobically infected bones and joints., they accounted for 40% of anaerobic isolates of osteomyelitis caused by anaerobic bacteria and 20% of anaerobic isolates of arthritis caused by anaerobic bacteria. P magnus and P prevotii are the predominant bone and joint isolates. Management of these infections requires prolonged courses of antimicrobials and is enhanced by removal of the foreign material. Peptostreptococcus species