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Qamar Y, Shazly A, Qamar A, Islam H, Yonis H, Sabry H. An unusual presentation of subacute Haemophilus parainfluenzae endocarditis in a low-risk woman treated by minimally invasive mitral valve repair: a case report. Egypt Heart J 2024; 76:54. [PMID: 38709318 DOI: 10.1186/s43044-024-00482-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 04/15/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND HACEK endocarditis is usually insidious and can often be difficult to diagnose due to the slow-growing nature of the organisms. This report presents our experience in treating a patient with Haemophilus parainfluenzae endocarditis. CASE PRESENTATION We describe the case of a previously fit and well 23 year-old woman who presented to her local emergency department with a four-week history of persistent febrile illness. She had associated nausea, vomiting, and lethargy. This was preceded by an episode of mucopurulent rhinorrhoea. She was treated empirically with oral amoxicillin for a putative diagnosis of rhinosinusitis. Initially, her symptoms abated, however, she was readmitted with high fevers and a new pansystolic murmur. Transthoracic echocardiography revealed a large, mobile, echogenic mass, tethered to the posterior mitral valve leaflet (PMVL) and mild mitral regurgitation (MR). On examination, she had multiple non-tender, erythematous macules on the plantar surface of her feet, consistent with Janeway lesions. Two separate blood cultures grew H. parainfluenzae. Infectious diseases recommended a four-week course of intravenous ceftriaxone. Transesophageal echocardiography demonstrated a perforation within the P3 segment of the PMVL. Subsequently, the patient underwent mitral valve repair surgery with an uneventful recovery. CONCLUSIONS Our case highlights the importance of promptly diagnosing HACEK endocarditis. A prolonged course of antibiotic therapy can be lifesaving, and surgery is often necessary to address complications such as perforation within the mitral valve leaflets. In our patient, we were able to perform a sliding P2 leaflet plasty for good quality repair of the mitral valve, through a minimally invasive right anterior thoracotomy.
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Affiliation(s)
- Younus Qamar
- Department of Cardiothoracic Surgery, The Essex Cardiothoracic Centre, Basildon and Thurrock University Hospital, Mid and South Essex NHS Foundation Trust, Nethermayne, Basildon, SS16 5NL, UK.
| | - Ahmed Shazly
- Department of Cardiothoracic Surgery, The Essex Cardiothoracic Centre, Basildon and Thurrock University Hospital, Mid and South Essex NHS Foundation Trust, Nethermayne, Basildon, SS16 5NL, UK
| | - Amna Qamar
- Department of Cardiothoracic Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Heraa Islam
- Department of General Surgery, Queen's Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - Hannah Yonis
- Department of Cardiothoracic Surgery, The Essex Cardiothoracic Centre, Basildon and Thurrock University Hospital, Mid and South Essex NHS Foundation Trust, Nethermayne, Basildon, SS16 5NL, UK
| | - Haytham Sabry
- Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital Foundation Trust, Liverpool, UK
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2
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Zhang H, Sivalingam V, Qian P, Sivagnanam S. Aggregatibacter actinomycetemcomitans pacemaker lead infection-A case report and literature review. Clin Case Rep 2024; 12:e8843. [PMID: 38681041 PMCID: PMC11052685 DOI: 10.1002/ccr3.8843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/20/2024] [Indexed: 05/01/2024] Open
Abstract
Aggregatibacter spp. is a rare cause for cardiac device infections. Due to limited data, the management of Aggregatibacter spp. device infections is not clearly defined but should always involve device removal and prolonged intravenous antibiotics.
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Affiliation(s)
- Hayden Zhang
- Department of Infectious DiseasesBlacktown HospitalBlacktownNew South WalesAustralia
- Blacktown Mount Druitt Clinical SchoolWestern Sydney UniversityBlacktownNew South WalesAustralia
| | - Varsha Sivalingam
- Institute of Clinical Pathology & Medical Research (ICPMR)Westmead HospitalWestmeadNew South WalesAustralia
| | - Pierre Qian
- Department of CardiologyBlacktown HospitalBlacktownNew South WalesAustralia
- Department of CardiologyWestmead HospitalWestmeadNew South WalesAustralia
- Westmead Applied Research CentreUniversity of SydneyWestmeadNew South WalesAustralia
| | - Shobini Sivagnanam
- Department of Infectious DiseasesBlacktown HospitalBlacktownNew South WalesAustralia
- Microbiology DepartmentAustralian Clinical LabsBella VistaNew South WalesAustralia
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3
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Bowden J, Hunt M, Harhay J, Patel T, Thomas-Gosain N. Haemophilus parainfluenzae infective endocarditis complicated by multiorgan septic emboli. BMJ Case Rep 2024; 17:e256308. [PMID: 38627050 PMCID: PMC11029312 DOI: 10.1136/bcr-2023-256308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Infective endocarditis (IE) caused by Haemophilus parainfluenzae is a rare but serious condition if not diagnosed and treated promptly. In this article, we describe a patient with H. parainfluenzae IE who initially presented with non-specific symptoms but subsequently developed multiple sequelae of IE. The diagnosis of IE was made based on clinical, echocardiographic, radiological and microbiological findings. He was treated successfully with a mitral valve replacement along with 4 weeks of intravenous antibiotic therapy. Our case highlights the importance of obtaining a thorough history and a complete physical examination to ensure an early diagnosis of IE.
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Affiliation(s)
| | - Molly Hunt
- VA Memphis Medical Center, Memphis, Tennessee, USA
| | - Jason Harhay
- Division of Infectious Diseases, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Tejal Patel
- VA Memphis Medical Center, Memphis, Tennessee, USA
| | - Neena Thomas-Gosain
- Medicine, Infectious Disease, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, USA
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4
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Vietor FI, Nelson TB. An insidious Aggregatibacter actinomycetemcomitans infection of an ascending aortic endovascular graft. IDCases 2023; 33:e01832. [PMID: 37645535 PMCID: PMC10461122 DOI: 10.1016/j.idcr.2023.e01832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 08/31/2023] Open
Abstract
While HACEK group organisms cause only 1-3% of infective endocarditis (IE) cases, their insidious and varied clinical presentations make for difficult and often delayed diagnoses. We present a 65-year-old male with persistent exertional dyspnea, hemoptysis, and weight loss who was diagnosed with a HACEK aortic graft infection and IE.
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Affiliation(s)
- Faith I. Vietor
- University of Missouri-Columbia School of Medicine, 1 Hospital Drive, Columbia, MO 65212, USA
| | - Taylor B. Nelson
- Division of Infectious Diseases, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, USA
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5
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Ono R, Kitagawa I, Kobayashi Y. Cardiobacterium hominis infective endocarditis: A literature review. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2023; 26:100248. [PMID: 38510192 PMCID: PMC10946042 DOI: 10.1016/j.ahjo.2022.100248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 03/22/2024]
Abstract
Background Cardiobacterium hominis is a member of the HACEK group, which causes infective endocarditis (IE) but is rarely associated with other infections. It is difficult to biologically identify C. hominis because of its slow growth in culture. However, the clinical features of C. hominis IE remain unclear. Method We searched the PubMed database for all articles of C. hominis IE published between January 2000 and July 2022. Results The major clinical features of 44 previously reported cases of C. hominis IE were as follows: the median age was 59 years, of which 36 were men; the initial presenting symptoms were chest discomfort (30 %), followed by fever (27 %), night sweats (20 %), fatigability (18 %), weight loss (16 %), and dyspnea (16 %). Almost half of the patients were febrile upon admission. The major predisposing factors were postsurgical valve treatment (57 %), dental treatment or caries (20 %), and congenital valve abnormality (5 %). The median time to identify C. hominis in the blood culture was 4 days, but the longest time was 42 days. The most commonly infected valve was the aortic valve, and the most common complication was systemic embolism. Surgical treatment was performed in 23 (52 %) patients. The most frequent initial treatment regimen was cephem antibiotics, with a median treatment duration of 6 weeks. The overall mortality and recovery rates of C. hominis IE were 9 % and 91 %, respectively. Conclusion If C. hominis infection is confirmed, physicians should check for the presence of vegetations of the heart valves and understand these characteristics.
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Affiliation(s)
- Ryohei Ono
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Izumi Kitagawa
- Department of General Internal Medicine, Shonan Fujisawa Tokushukai Hospital, 1-5-1 Tsujido Kandai, Fujisawa, Kanagawa 251-0041, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
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6
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Kitagawa I, Ono R, Tobe S, Nagatsuka M. Cardiobacterium hominis endocarditis associated with cerebral, renal, and splenic infarctions: A case report and review of the literature. IDCases 2023; 31:e01655. [DOI: 10.1016/j.idcr.2022.e01655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/27/2022] [Accepted: 11/30/2022] [Indexed: 12/03/2022] Open
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7
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Zhang Z, Yu W, Li G, He Y, Shi Z, Wu J, Ma X, Zhu Y, Zhao L, Liu S, Wei Y, Xue J, Guo S, Gao Z. Characteristics of oral microbiome of healthcare workers in different clinical scenarios: a cross-sectional analysis. BMC Oral Health 2022; 22:481. [PMID: 36357898 PMCID: PMC9648452 DOI: 10.1186/s12903-022-02501-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/12/2022] [Indexed: 11/11/2022] Open
Abstract
The environment of healthcare institutes (HCIs) potentially affects the internal microecology of medical workers, which is reflected not only in the well-studied gut microbiome but also in the more susceptible oral microbiome. We conducted a prospective cross-sectional cohort study in four hospital departments in Central China. Oropharyngeal swabs from 65 healthcare workers were collected and analyzed using 16S rRNA gene amplicon sequencing. The oral microbiome of healthcare workers exhibited prominent deviations in diversity, microbial structure, and predicted function. The coronary care unit (CCU) samples exhibited robust features and stability, with significantly higher abundances of genera such as Haemophilus, Fusobacterium, and Streptococcus, and a lower abundance of Prevotella. Functional prediction analysis showed that vitamin, nucleotide, and amino acid metabolisms were significantly different among the four departments. The CCU group was at a potential risk of developing periodontal disease owing to the increased abundance of F. nucleatum. Additionally, oral microbial diversification of healthcare workers was related to seniority. We described the oral microbiome profile of healthcare workers in different clinical scenarios and demonstrated that community diversity, structure, and potential functions differed markedly among departments. Intense modulation of the oral microbiome of healthcare workers occurs because of their original departments, especially in the CCU.
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Affiliation(s)
- Zhixia Zhang
- Nursing Department, Linfen Central Hospital, 041000 Shanxi, Shanxi China
| | - Wenyi Yu
- grid.411634.50000 0004 0632 4559Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Guangyao Li
- Science and Education Department, Linfen Central Hospital, Hainan, Shanxi China
| | - Yukun He
- grid.411634.50000 0004 0632 4559Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Zhiming Shi
- Cardiology Department, Linfen Central Hospital, Hainan, Shanxi China
| | - Jing Wu
- Nursing Department, Linfen Central Hospital, 041000 Shanxi, Shanxi China
| | - Xinqian Ma
- grid.411634.50000 0004 0632 4559Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Yu Zhu
- Science and Education Department, Linfen Central Hospital, Hainan, Shanxi China
| | - Lili Zhao
- grid.411634.50000 0004 0632 4559Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Siqin Liu
- grid.440653.00000 0000 9588 091XThe Stomatology College of Binzhou Medical University, Yantai, Shandong China
| | - Yue Wei
- grid.263452.40000 0004 1798 4018Nursing College of Shanxi Medical University, Shanxi, China
| | - Jianbo Xue
- grid.411634.50000 0004 0632 4559Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Shuming Guo
- Nursing Department, Linfen Central Hospital, 041000 Shanxi, Shanxi China
| | - Zhancheng Gao
- grid.411634.50000 0004 0632 4559Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China ,grid.411634.50000 0004 0632 4559Department of Pulmonary and Critical Care Medicine, Peking University People’s Hospital, 100044 Beijing, China
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8
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Olagunju A, Martinez J, Kenny D, Gideon P, Mookadam F, Unzek S. Virulent endocarditis due to Haemophilus parainfluenzae: A systematic review of the literature. World J Cardiol 2022; 14:546-556. [PMID: 36339888 PMCID: PMC9627352 DOI: 10.4330/wjc.v14.i10.546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/27/2022] [Accepted: 09/16/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Haemophilus parainfluenzae (HPI) belongs to the HACEK (Haemophilus spp., Aggregatibacter spp., Cardiobacterium spp., Eikenella spp., and Kingella spp.) group of organisms. The HACEK group of organisms are a part of the oropharyngeal flora and can cause invasive opportunistic infection such infective endocarditis (IE) in hosts with compromised immunological barriers.
AIM To perform a 20-year systematic review of the literature characterizing the clinical presentation, epidemiology and prognosis of HPI IE.
METHODS We performed a systematic review of Medline, Pubmed, Scopus and Embase from 2000 to 2022 to identify all cases of HPI IE.
RESULTS Thirty-nine adult cases were identified. HPI IE was found to affect males slightly more than females and is common in patients with predisposing risk factors such as underlying valvular abnormalities. It mostly affected the mitral valve and had an indolent course; significantly sized vegetations (> 1 cm) developed in most cases. Central nervous system septic embolization was common. It had a favorable prognosis compared to staphylococcal and streptococcal IE.
CONCLUSION Clinicians should be attentive to the indolent course of HPI IE and the presence of predisposing risk factors in order to allow for timely management.
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Affiliation(s)
- Abdulbaril Olagunju
- Department of Internal Medicine, Creighton University School of Medicine, Phoenix, AZ 85013, United States
| | - Jake Martinez
- Department of Cardiology, Heart Center, University of Arizona College of Medicine-Phoenix, Banner University Medical Center, Phoenix, AZ 85006, United States
| | - Dorothy Kenny
- Department of Internal Medicine, Creighton University School of Medicine, Phoenix, AZ 85013, United States
| | - Philip Gideon
- Department of Cardiology, Heart Center, University of Arizona College of Medicine-Phoenix, Banner University Medical Center, Phoenix, AZ 85006, United States
| | - Farouk Mookadam
- Department of Cardiology, Heart Center, University of Arizona College of Medicine-Phoenix, Banner University Medical Center, Phoenix, AZ 85006, United States
- Department of Cardio-oncology, Banner MD Anderson Cancer Center, Phoenix, AZ 85006, United States
| | - Samuel Unzek
- Department of Cardiology, Heart Center, University of Arizona College of Medicine-Phoenix, Banner University Medical Center, Phoenix, AZ 85006, United States
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9
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Milliere L, Loïez C, Patoz P, Charlet A, Duployez C, Wallet F. Apyretic pulmonary oedema revealing Cardiobacterium hominis endocarditis: case report and review of literature. IDCases 2022; 29:e01506. [PMID: 35669524 PMCID: PMC9166381 DOI: 10.1016/j.idcr.2022.e01506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/21/2022] [Accepted: 05/16/2022] [Indexed: 11/16/2022] Open
Abstract
Cardiobacterium hominis is a member of the HACEK group of bacteria, responsible for infective endocarditis, mainly in patients with damaged or prosthetic valves. The low virulence of this organism can explain the insidious presentation and subacute or chronic progression of C. hominis infective endocarditis. Here, a 41-year-old man with a past history of surgery for a Waldhausen type aortic coarctation was hospitalised with dyspnea and chest pains revealing an acute pulmonary oedema, without fever. Transesophageal echocardiography indicated a 20 mm vegetation on biscuspid aortic valve. Six sets of blood culture were positive with Cardiobacterium hominis. In case of lack of fever, the diagnosis of infectious endocarditis is difficult because other symptoms are non-specific and biological markers of inflammatory syndrome are quiet or non-existent. This is the first case of C. hominis infectious endocarditis with a clinical presentation of acute pulmonary oedema in the literature. We report here an apyretic pulmonary oedema revealing C. hominis endocarditis and a review of the literature on apyretic infective endocarditis due to C. hominis.
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Affiliation(s)
- Laurine Milliere
- Laboratoire Bactériologie Hygiène, CHU Lille, Univ Lille, 59037 Lille, France
- Corresponding author.
| | - Caroline Loïez
- Laboratoire Bactériologie Hygiène, CHU Lille, Univ Lille, 59037 Lille, France
| | - Pierre Patoz
- Laboratoire de biologie médicale, CH Dron, 59200 Tourcoing, France
| | - Audrey Charlet
- Laboratoire Bactériologie Hygiène, CHU Lille, Univ Lille, 59037 Lille, France
| | - Claire Duployez
- Laboratoire Bactériologie Hygiène, CHU Lille, Univ Lille, 59037 Lille, France
| | - Frédéric Wallet
- Laboratoire Bactériologie Hygiène, CHU Lille, Univ Lille, 59037 Lille, France
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10
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Caldara M, Belgiovine C, Secchi E, Rusconi R. Environmental, Microbiological, and Immunological Features of Bacterial Biofilms Associated with Implanted Medical Devices. Clin Microbiol Rev 2022; 35:e0022120. [PMID: 35044203 PMCID: PMC8768833 DOI: 10.1128/cmr.00221-20] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The spread of biofilms on medical implants represents one of the principal triggers of persistent and chronic infections in clinical settings, and it has been the subject of many studies in the past few years, with most of them focused on prosthetic joint infections. We review here recent works on biofilm formation and microbial colonization on a large variety of indwelling devices, ranging from heart valves and pacemakers to urological and breast implants and from biliary stents and endoscopic tubes to contact lenses and neurosurgical implants. We focus on bacterial abundance and distribution across different devices and body sites and on the role of environmental features, such as the presence of fluid flow and properties of the implant surface, as well as on the interplay between bacterial colonization and the response of the human immune system.
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Affiliation(s)
- Marina Caldara
- Interdepartmental Center on Safety, Technologies, and Agri-food Innovation (SITEIA.PARMA), University of Parma, Parma, Italy
| | - Cristina Belgiovine
- IRCCS Humanitas Research Hospital, Rozzano–Milan, Italy
- Scuola di Specializzazione in Microbiologia e Virologia, Università degli Studi di Pavia, Pavia, Italy
| | - Eleonora Secchi
- Institute of Environmental Engineering, ETH Zürich, Zürich, Switzerland
| | - Roberto Rusconi
- IRCCS Humanitas Research Hospital, Rozzano–Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele–Milan, Italy
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11
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Bae JY, Murugiah K, McLeod GX, Anwer M, Howes CJ. Haemophilus Parainfluenzae mural endocarditis with large atrial septal defect and peripheral embolization. J Cardiol Cases 2022; 25:149-152. [DOI: 10.1016/j.jccase.2021.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/01/2021] [Accepted: 08/16/2021] [Indexed: 11/25/2022] Open
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12
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Abstract
PURPOSE OF REVIEW Gram-negative bacilli (GNB) cause between 1% and 10% of infective endocarditis (IE). Most episodes are caused by microorganisms of the Haemophilus spp., Aggregatibacter spp. Cardiobacterium spp., Eikenella spp., and Kingella spp (HACEK) group. The frequency of IE caused by non-HACEK (GNB-IE) has increased in recent years. Uncertainties persist regarding its best medical treatment and the appropriateness and timing of surgical treatment. In addition, there are new drugs with activity against multiresistant microorganisms, of which there is little experience in this disease. We review this topic by answering the most frequently asked questions that arise among our colleagues. RECENT FINDINGS HACEK microorganisms cause 1.5-2% of IE with only a 2% mortality. In contrast, non-HACEK GNB-IE accounts for 2.5-3% of all IE cases and is associated with nosocomial acquisition, advanced age, solid organ transplantation and 20-30% mortality. Drug addiction is important in areas with epidemic opioid abuse. SUMMARY The frequency of IE caused by GNB has been modified in recent years. HACEK episodes are no longer treated with ampicillin and aminoglycosides. In non-HACEK GNB-IE, combination therapy with a beta-lactam and a quinolone or aminoglycoside is recommended. The surgical indication and its value are evident in many patients. Management should rely on a collaborative group with experience in this disease.
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13
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Gagliardi R, Sensi C, Flaminio G, De Canale E, Vettor R, De Carlo E. Haemophilus parainfluenzae endocarditis in a low-risk woman: a case report. Clin Case Rep 2021; 9:e05066. [PMID: 34868585 PMCID: PMC8599499 DOI: 10.1002/ccr3.5066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/14/2021] [Accepted: 10/17/2021] [Indexed: 11/09/2022] Open
Abstract
Haemophilus parainfluenzae endocarditis is a rare but dangerous disease. With this work, we intend to show the importance of early diagnosis and appropriate treatment in order to avoid complications. We also highlight the importance of local epidemiology to choose antibiotic prophylaxis for high-risk procedures in selected predisposed patients.
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Affiliation(s)
| | | | - Giulio Flaminio
- Department of Molecular MedicineUniversity of PaduaPadovaItaly
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14
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Bläckberg A, Morenius C, Olaison L, Berge A, Rasmussen M. Infective endocarditis caused by HACEK group bacteria-a registry-based comparative study. Eur J Clin Microbiol Infect Dis 2021; 40:1919-1924. [PMID: 33852103 PMCID: PMC8346386 DOI: 10.1007/s10096-021-04240-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/29/2021] [Indexed: 12/28/2022]
Abstract
Infective endocarditis (IE) caused by bacteria within Haemophilus (excluding Haemophilus influenzae), Aggregatibacter, Cardiobacterium, Eikenella and Kingella (HACEK) is rare. This study aimed to describe clinical features of IE caused by HACEK genera in comparison with IE due to other pathogens. Cases of IE due to HACEK were identified through the Swedish Registry of Infective Endocarditis (SRIE). Clinical characteristics of IE cases caused by HACEK were compared with cases of IE due to other pathogens reported to the same registry. Ninety-six patients with IE caused by HACEK were identified, and this corresponds to 1.8% of all IE cases. Eighty-three cases were definite endocarditis, and the mortality rate was 2%. The median age was 63 years, which was lower compared to patients with IE caused by other pathogens (66, 70 and 73 years respectively, p ≤ 0.01). Patients with IE caused by Haemophilus were younger compared to patients with IE due to Aggregatibacter (47 vs 67 years, p ≤ 0.001). Patients with IE due to HACEK exhibited longer duration from onset of symptoms to hospitalization and had more prosthetic valve endocarditis compared to patients with IE due to Staphylococcus aureus (10 vs 2 days, p ≤ 0.001, and 35 vs 14%, p ≤ 0.001). This is, to date, the largest study on IE due to HACEK. Aggregatibacter was the most common cause of IE within the group. The condition has a subacute onset and often strikes in patients with prosthetic valves, and the mortality rate is relatively low.
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Affiliation(s)
- Anna Bläckberg
- Division of Infection Medicine, Department of Clinical Sciences, Lund, Lund University, BMC B14, SE-221 84, Lund, Sweden. .,Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden.
| | - Christian Morenius
- Division of Infection Medicine, Department of Clinical Sciences, Lund, Lund University, BMC B14, SE-221 84, Lund, Sweden
| | - Lars Olaison
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.,Swedish Society of Infectious Diseases, Uppsala, Sweden
| | - Andreas Berge
- Unit of Infectious Diseases, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Rasmussen
- Division of Infection Medicine, Department of Clinical Sciences, Lund, Lund University, BMC B14, SE-221 84, Lund, Sweden.,Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden
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15
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Yakut K, Ecevit Z, Tokel NK, Varan B, Ozkan M. Infective Endocarditis in Childhood: a Single-Center Experience of 18 Years. Braz J Cardiovasc Surg 2021; 36:172-182. [PMID: 33113327 PMCID: PMC8163273 DOI: 10.21470/1678-9741-2020-0035] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Introduction We aimed to present the risk factors, clinical and laboratory findings, treatment management, and risk factors for morbidity and mortality of infective endocarditis (IE) as well as to relate experiences at our center. Method We retrospectively analyzed data of 47 episodes in 45 patients diagnosed with definite/possible IE according to the modified Duke criteria between May 2000 and March 2018. Results The mean age of all patients at the time of diagnosis was 7.6±4.7 years (range: 2.4 months to 16 years). The most common symptoms and findings were fever (89.3%), leukocytosis (80.8%), splenomegaly (70.2%), and a new heart murmur or changing of pre-existing murmur (68%). Streptococcus viridans (19.1%), Staphylococcus aureus (14.8%), and coagulase-negative Staphylococci (10.6%) were the most commonly isolated agents. IE-related complications developed in 27.6% of the patients and the mortality rate was 14.8%. Conclusion We found that congenital heart disease remains a significant risk factor for IE. The highest risk groups included operated patients who had conduits in the pulmonary position and unoperated patients with a large ventricular septal defect. Surgical intervention was required in most of the patients. Mortality rate was high, especially in patients infected with S. aureus, although the time between the onset of the first symptom and diagnosis was short. Patients with fever and a high risk of IE should be carefully examined for IE, and evaluation in favor of IE until proven otherwise will be more accurate. In high-risk patients with prolonged fever, IE should be considered in the differential diagnosis.
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Affiliation(s)
- Kahraman Yakut
- Department of Pediatric Cardiology, Baskent University School of Medicine, Ankara, Turkey
| | - Zafer Ecevit
- Department of Pediatric Infectious Diseases, Baskent University School of Medicine, Ankara, Turkey
| | - Niyazi Kursad Tokel
- Department of Pediatric Cardiology, Baskent University School of Medicine, Ankara, Turkey
| | - Birgul Varan
- Department of Pediatric Cardiology, Baskent University School of Medicine, Ankara, Turkey
| | - Murat Ozkan
- Department of Cardiovascular Surgery, Baskent University School of Medicine, Ankara, Turkey
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Talha KM, DeSimone DC, Sohail MR, Baddour LM. Pathogen influence on epidemiology, diagnostic evaluation and management of infective endocarditis. Heart 2020; 106:1878-1882. [PMID: 32847941 DOI: 10.1136/heartjnl-2020-317034] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/18/2020] [Accepted: 07/22/2020] [Indexed: 12/23/2022] Open
Abstract
Infective endocarditis (IE) is uncommon and has, in the past, been most often caused by viridans group streptococci (VGS). Due to the indolent nature of these organisms, the phrase 'subacute bacterial endocarditis', so-called 'SBE', was routinely used as it characterised the clinical course of most patients that extended for weeks to months. However, in more recent years, there has been a significant shift in the microbiology of IE with the emergence of staphylococci as the most frequent pathogens, and for IE due to Staphylococcus aureus, the clinical course is acute and can be associated with sepsis. Moreover, increases in IE due to enterococci have occurred and have been characterised by treatment-related complications and worse outcomes. These changes in pathogen distribution have been attributed to a diversification in the target population at risk of IE. While prosthetic valve endocarditis and history of IE remain at highest risk of IE, the rise in prevalence of injection drug use, intracardiac device implantations and other healthcare exposures have heavily contributed to the existing pool of at-risk patients. This review focuses on common IE pathogens and their impact on the clinical profile of IE.
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Affiliation(s)
- Khawaja M Talha
- Division of Infectious Diseases, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA
| | - Daniel C DeSimone
- Division of Infectious Diseases, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA.,Department of Medicine, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA.,Department of Cardiovascular Diseases, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA
| | - M Rizwan Sohail
- Division of Infectious Diseases, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA.,Department of Medicine, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA.,Department of Cardiovascular Diseases, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA
| | - Larry M Baddour
- Division of Infectious Diseases, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA.,Department of Medicine, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA.,Department of Cardiovascular Diseases, Mayo Clinic School of Medicine and Science, Rochester, Minnesota, USA
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Solsi A, Findakly D, Mihyawi N, Fath AR. An Unusual Case of Neisseria flavescens/subflava Group Tricuspid Valve Endocarditis in a Patient With Previously Treated Methicillin-Resistant Staphylococcus aureus Endocarditis. Cureus 2020; 12:e9752. [PMID: 32944467 PMCID: PMC7489790 DOI: 10.7759/cureus.9752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Infective endocarditis (IE) is classified as an infection of any cardiac valve or endocardial surface and is often associated with high morbidity and mortality. Certain bacteria such as gram-positive cocci and viridans group streptococci have high predilection for both naïve and damaged cardiac valvular tissues, accounting for the majority of IE cases. In very infrequent instances, gram-negative bacteria (GNB), more specifically non-meningococcal, non-gonococcal GNB, have been shown to cause IE. The following is a case of a young male diagnosed with Neisseria flavescens/subflava tricuspid valve endocarditis after being previously treated for Methicillin-resistant Staphylococcus aureus (MRSA) endocarditis.
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Clinical Detection of Chronic Rhinosinusitis through Next-Generation Sequencing of the Oral Microbiota. Microorganisms 2020; 8:microorganisms8060959. [PMID: 32604855 PMCID: PMC7356624 DOI: 10.3390/microorganisms8060959] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/23/2020] [Accepted: 06/23/2020] [Indexed: 12/22/2022] Open
Abstract
Chronic rhinosinusitis (CRS) is the chronic inflammation of the sinus cavities of the upper respiratory tract, which can be caused by a disrupted microbiome. However, the role of the oral microbiome in CRS is not well understood. Polymicrobial and anaerobic infections of CRS frequently increased the difficulty of cultured and antibiotic therapy. This study aimed to elucidate the patterns and clinical feasibility of the oral microbiome in CRS diagnosis. Matched saliva and nasal swabs were collected from 18 CRS patients and 37 saliva specimens from normal volunteers were collected for 16S rRNA sequencing. The α-diversity of the saliva displayed no significant difference between control and CRS patients, whereas the β-diversity was significantly different (p = 0.004). Taxonomic indices demonstrated that Veillonella dispar, Rothia mucilaginosa, and Porphyromonas endodontalis were enriched, while Campylobacter and Cardiobacterium were reduced in the saliva of CRS patients. These microbial markers could significantly distinguish CRS patients from control (AUC = 0.939). It is noted that the 16S rRNA results of the nasal swab were consistent with the nasopharynx aerobic culture, and additionally detected multiple pathogens in CRS patients. In summary, these results indicated these oral microbiomes may provide a novel signal for CRS detection and that NGS may be an alternative approach for CRS diagnosis.
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