The viridans streptococci are a large group of commensal streptococcal Gram-positive bacteria species that are α-hemolytic, producing a green coloration on blood agar plates (hence the name "viridans", from Latin "vĭrĭdis", green), although some species in this group are actually γ-hemolytic, meaning they produce no change on blood agar. The pseudo-taxonomic term "Streptococcus viridans" is often used to refer to this group of species, but writers who do not like to use the pseudotaxonomic term (which treats a group of species as if they were one species) prefer the terms viridans streptococci, viridans group streptococci (VGS), or viridans streptococcal species. These species possess no Lancefield antigens. In general, pathogenicity is low. Identification Viridans streptococci can be differentiated from Streptococcus pneumoniae using an optochin test, as viridans streptococci are optochin-resistant; they also lack either the polysaccharide-based capsule typical of S. pneumoniae or the Lancefield antigens of the pyogenic members of the genus. Pathology The organisms are most abundant in the mouth, and one member of the group, S. mutans, is the cause of dental caries in most cases and populations. S. sanguinis is also another potential cause. Others may be involved in other mouth or gingival infections as pericoronitis. If they are introduced into the bloodstream, they have the potential of causing endocarditis, in particular in individuals with damaged heart valves. They are the most common causes of subacute bacterial endocarditis. Viridans streptococci are identified in cases of neonatal infections. Viridans streptococci have the unique ability to synthesize dextrans from glucose, which allows them to adhere to fibrin-platelet aggregates at damaged heart valves. This mechanism underlies their ability to cause subacute valvular heart disease following their introduction into the bloodstream (e.g., following dental extraction). Identification Phenotypic and biochemical identification Identification of VGS to the species level can be difficult, and phenotypic identification is not always accurate. The name "viridans" is somewhat of a misnomer, as many species do not produce any hemolysis on blood agar. From a classification perspective, it is not useful to try to differentiate alpha-hemolysis from a lack of hemolysis on blood agar plates (sometimes referred to as "gamma-hemolysis"); this feature can vary widely with the growth medium used to cultivate the organism, as well as the incubation temperature. Lack of alpha hemolysis does not seem to correlate with the clinical outcome or severity of disease; no enzymatic or toxigenic effect has ever been documented as a by-product