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Archivos Peruanos de Cardiologia Y... 2023Infective endocarditis is a serious disease associated with high mortality despite recent advances in diagnosis and treatment. is a fastidious Gram-negative member of... (Review)
Review
Infective endocarditis is a serious disease associated with high mortality despite recent advances in diagnosis and treatment. is a fastidious Gram-negative member of the HACEK organisms ( spp., , , , and ). is associated with dental infections but has also been implicated in cases of infective endocarditis. We highlight the importance of a high index of suspicion in symptomatic patients with an initial negative blood culture, particularly in high-risk groups such as patients with congenital valve disease and prosthetic valve. The knowledge of this rare entity may lead to early diagnosis and appropriate management. We review the main characteristics of endocarditis reported in the medical literature.
PubMed: 38046225
DOI: 10.47487/apcyccv.v4i3.306 -
Journal of Clinical Medicine Nov 2021A virulent genotype (JP2) of the periodonto-pathogen, (), is widespread in North and West Africa, while its presence in East Africa has not been thoroughly...
BACKGROUND
A virulent genotype (JP2) of the periodonto-pathogen, (), is widespread in North and West Africa, while its presence in East Africa has not been thoroughly investigated. This JP2 genotype is associated with periodontitis in adolescents and has a high leukotoxicity. The aim of the study was to examine the prevalence of and its JP2 genotype, the prevalence of the oral, commensal in a Maasai adolescent population, and the effect of herbal plants for inhibition of leukotoxicity.
METHODS
A total of 284 adolescents from Maasai Mara, Kenya, underwent an oral examination and microbial sampling. The presence of and was analyzed by quantitative PCR and cultivation (the 58 samples collected at the last day of field study). The collected strains were characterized and leukotoxin promoter typed. Additionally, herbal plants commonly used for oral hygiene were assessed for the inhibition of leukotoxicity.
RESULTS AND CONCLUSIONS
The prevalence of in stimulated whole saliva was high (71.8%), with the JP2 genotype detected in one individual, and in 99% of the sampled individuals. The commonly used herbal plant, , inactivated leukotoxicity. The virulence might be reduced through use of and the high levels of .
PubMed: 34830683
DOI: 10.3390/jcm10225402 -
BMJ Case Reports Jul 2020A 76-year-old woman with a rare case of spinal epidural abscess (SEA) that had no risk factors for such type of infection, presented symptoms of back pain, progressive...
A 76-year-old woman with a rare case of spinal epidural abscess (SEA) that had no risk factors for such type of infection, presented symptoms of back pain, progressive neurological deficit of the lower limb and loss of sphincter control. A gadolinium-enhanced MRI confirmed the diagnosis of an SEA. The patient underwent laminectomy with surgical drainage, where cultures showed the presence of , a bacterium of the HACEK group ( species, species, , , and species), rarely involved in SEA. Following surgery, the patient was treated with intravenous ceftriaxone for 6 weeks, and this gave excellent results.
Topics: Aged; Aggregatibacter aphrophilus; Anti-Bacterial Agents; Ceftriaxone; Epidural Abscess; Female; Humans; Laminectomy; Pasteurellaceae Infections; Postoperative Complications; Spine
PubMed: 32675123
DOI: 10.1136/bcr-2020-235320 -
Medicina Clinica Oct 2021
Topics: Aggregatibacter aphrophilus; Anti-Bacterial Agents; Brain Abscess; Humans
PubMed: 33277020
DOI: 10.1016/j.medcli.2020.07.049 -
Echocardiography (Mount Kisco, N.Y.) Oct 2022Gram-negative organisms of the AACEK group, formerly known as HACEK, rarely cause endocarditis.
INTRODUCTION
Gram-negative organisms of the AACEK group, formerly known as HACEK, rarely cause endocarditis.
CASE SERIES
We present three cases of bacterial endocarditis, involving native and prosthetic valves, caused by AACEK organisms. In two patients, Cardiobacterium hominis was the responsible organism, and in a third, Aggregatibacter aphrophilus was implicated. A dental source of infection was identified in two patients, and in all three patients, the presentation of endocarditis was subacute.
DISCUSSION
This case series highlights the indolent nature of infection with the AACEK organisms. It also demonstrates the crucial role of multimodality imaging, especially transesophageal echocardiography, in the diagnosis of AACEk endocarditis of both native and prosthetic valves, and in delineating the extent of abscess in those with prosthetic valve infection.
Topics: Humans; Endocarditis, Bacterial; Echocardiography, Transesophageal; Endocarditis
PubMed: 36198094
DOI: 10.1111/echo.15440 -
Journal of Medical Microbiology Dec 2022are Gram-negative, facultatively anaerobic rods or coccobacilli that are infrequently encountered as pathogens causing infection. The range of invasive infection that...
are Gram-negative, facultatively anaerobic rods or coccobacilli that are infrequently encountered as pathogens causing infection. The range of invasive infection that cause is poorly described. The pathogenicity of species such as is debated. To identify invasive infection due to species in a large healthcare organization and to characterize clinical syndromes, co-morbidities and risk factors. All microbiological samples positive for species were identified by conventional culture or 16S rRNA PCR between October 2017 and March 2021. Electronic records for all patients with positive samples were reviewed and the infection syndrome classified for patients with invasive disease. Twenty-seven patients with invasive infection were identified, with a statistically significant difference in species-specific patterns of invasive infection (=0.02) and a statistically significant association with residence in the 30 % most deprived households in the UK by postcode (<0.01). The three most common co-morbidities were periodontitis or recent dental work (29.6%), cardiovascular disease (25.9%) and diabetes (18.5 %). We describe a novel association of with skin and soft tissue infection. The propensity of the species to cause invasive infection at different body sites and be associated with deprivation is reported. bacteraemia was associated with infective endocarditis, and was implicated in severe appendicitis and noted to cause brain abscess. Areas warranting future research include exploring the risk-factors required for invasive infection and those that may determine the species-specific differences in patterns of invasive disease.
Topics: Humans; Aggregatibacter; Retrospective Studies; RNA, Ribosomal, 16S; Endocarditis, Bacterial
PubMed: 36748613
DOI: 10.1099/jmm.0.001612 -
Journal of Microbiology, Immunology,... Dec 2021This study aimed to investigate the clinical characteristics and outcomes of bacteremia caused by Haemophilus and Aggregatibacter species in patients who were treated at...
BACKGROUND/PURPOSE
This study aimed to investigate the clinical characteristics and outcomes of bacteremia caused by Haemophilus and Aggregatibacter species in patients who were treated at a medical center between 2006 and 2018.
METHODS
Haemophilus and Aggregatibacter isolates were identified up to the species level using Bruker Biotyper MALDI-TOF analysis and ancillary 16S rRNA gene sequencing analysis (in case of ambiguity). Clinical characteristics and outcomes of patients with bacteremia caused by these organisms were evaluated.
RESULTS
Sixty-five Haemophilus and Aggregatibacter species isolates causing bacteremia were identified from nonduplicated patients, including 51 (78.5%) Haemophilus influenzae, 6 (9.2%) Haemophilus parainfluenzae, 1 (1.5%) Haemophilus haemolyticus, 3 (4.6%) A. aphrophilus, and 4 (6.2%) A. segnis. Hospital mortality was observed in 18 (28.1%) of 64 patients with bacteremia caused by Haemophilus (n = 57) and Aggregatibacter species (n = 7). The majority of patients with bacteremia had community-acquired disease with low severity. The average Sequential Organ Failure Assessment (SOFA) score was low (4.4 ± 4.7). But, a higher SOFA score (adjusted odds ratio 2.5, 95% confidence interval 1.22-5.12; P = 0.01) was an independent factor predicting poor 7-day clinical outcomes in patients with community-acquired H. influenzae bacteremia (n = 39).
CONCLUSIONS
The overall hospital mortality of 28.1% was observed among patients with bacteremia due to Haemophilus and Aggregatibacter species. A higher SOFA score was and independent predictor of poor 7-day clinical outcomes in patients with community-acquired H. influenzae bacteremia.
Topics: Adult; Aged; Aggregatibacter; Anti-Bacterial Agents; Bacteremia; Female; Haemophilus; Hospital Mortality; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Organ Dysfunction Scores; RNA, Ribosomal, 16S
PubMed: 33390332
DOI: 10.1016/j.jmii.2020.12.002 -
The New Microbiologica May 2023We report a case of a 26-year-old female who developed a brain abscess that was strongly suspected to be caused by Staphylococcus epidermidis, A. aphrophilus, and E....
We report a case of a 26-year-old female who developed a brain abscess that was strongly suspected to be caused by Staphylococcus epidermidis, A. aphrophilus, and E. corrodens species. In general, A. aphrophilus and E. corrodens, members of the HACEK group (Haemophilus spp., Aggregatibacter spp., C. hominis, E. corrodens, and K. kingae), have been associated with the development of endocarditis, meningitis, sinusitis, otitis media, pneumonia, osteomyelitis, peritonitis, and wound infections. Cerebral abscesses are a rare manifestation of these bacteria; only a few cases are described in the literature, generally related to the diffusion of these organisms through the bloodstream after a dental procedure or a heart disease. Our case is unique because the rarity of the infection site appeared apparently in absence of risk factors. The patient underwent surgery to drain the abscess and was subsequently put on intravenous antibiotic treatment with ceftriaxone, vancomycin, and metronidazole. After 6 months, brain imaging revealed that the lesion had disappeared. The patient achieved excellent results with this approach.
Topics: Female; Humans; Adult; Aggregatibacter aphrophilus; Eikenella corrodens; Endocarditis, Bacterial; Anti-Bacterial Agents; Brain Abscess
PubMed: 37247244
DOI: No ID Found -
IDCases 2020previously , is an uncommon organism that historically has been associated with HACEK infective endocarditis and brain abscesses. This organism is most often isolated...
previously , is an uncommon organism that historically has been associated with HACEK infective endocarditis and brain abscesses. This organism is most often isolated as part of normal oral flora, and patients with infection usually have an underlying periodontal infection or immunocompromised state allowing for infection. This case report outlines a unique presentation of left superficial temporal abscess due to infection in an immunocompetent individual.
PubMed: 32346513
DOI: 10.1016/j.idcr.2020.e00753 -
Retinal Cases & Brief Reports Jan 2024To describe a rare case of unilateral, endogenous endophthalmitis caused by Aggregatibacter aphrophilus (HACEK group) confirmed in vitreous and blood cultures, in a...
PURPOSE
To describe a rare case of unilateral, endogenous endophthalmitis caused by Aggregatibacter aphrophilus (HACEK group) confirmed in vitreous and blood cultures, in a patient with dentophobia.
METHODS
Case report.
PATIENTS
A seventy-five-year-old male patient with Type 2 diabetes, previous myocardial infarction, and pacemaker implantation.
RESULTS
Patient was observed with sudden loss of vision at the Department of Ophthalmology, Uppsala University. Initial diagnosis was posterior vitreous detachment and anterior uveitis, but progression of disease led to vitrectomy, which actually demonstrated endophthalmitis and growth of A. aphrophilus of the HACEK group. Aggregatibacter bacteremia and pacemaker endocarditis were also identified and dental examination confirmed growth of Aggregatibacter in the oral cavity. Intravitreal treatment with ceftazidime and vancomycin according to Endophthalmitis Vitrectomy Study protocol was administered with quick resolution of endophthalmitis.
CONCLUSION
Aggregatibacter endophthalmitis is a rare, but devastating cause of vision loss where immediate diagnosis may be delayed. Prompt diagnosis may be facilitated by a thorough medical history and early vitreous biopsy. Systemic investigation by an infectious disease specialist and multidisciplinary assessment are mandatory. Ophthalmologic treatment is effective with intravitreal injections of ceftazidime and vancomycin.
Topics: Male; Humans; Aged; Ceftazidime; Anti-Bacterial Agents; Vancomycin; Aggregatibacter; Diabetes Mellitus, Type 2; Dental Anxiety; Endophthalmitis; Vitrectomy; Eye Infections, Bacterial
PubMed: 36007190
DOI: 10.1097/ICB.0000000000001335