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International Journal of Surgery Case... 2017Aggregatibacter aphrophilus is a rare cause of infective endocarditis. This pathogen is difficult to identify with common culture methods, which can lead to incorrect...
INTRODUCTION
Aggregatibacter aphrophilus is a rare cause of infective endocarditis. This pathogen is difficult to identify with common culture methods, which can lead to incorrect diagnosis and treatment.
PRESENTATION OF CASE
A 72-year-old woman was admitted to a community hospital with a persistent high fever and deteriorating renal function. Based on negative blood culture and positive serum proteinase 3 anti-neutrophil cytoplasmic antibody (PR3-ANCA), acute renal failure associated with ANCA-rerated vasculitis was initially suspected. However, the patient developed heart failure soon afterward; echocardiography showed mitral insufficiency with mobile vegetation attached to the mitral valve, indicating infective endocarditis. After transfer to our hospital, the patient underwent mitral valve repair. Broad-range polymerase chain reaction (br-PCR) and sequencing identified Aggregatibacter aphrophilus in the excised vegetation. The patient had a good postoperative course, with recovery of renal function.
CONCLUSION
A rare disease, Aggregatibacter aphrophilus infective endocarditis was successfully treated with surgical repair and appropriate antibiotic therapy. To avoid misdiagnosis, br-PCR testing should be performed in patients with blood culture-negative endocarditis.
PubMed: 28152491
DOI: 10.1016/j.ijscr.2017.01.041 -
Medicina 2024Brain abscess is a focal suppurative process produced in most cases by bacterial agents. Aggregatibacter aphrophilus is a gram-negative bacteria belonging to the HACEK...
Brain abscess is a focal suppurative process produced in most cases by bacterial agents. Aggregatibacter aphrophilus is a gram-negative bacteria belonging to the HACEK group, which causes infective endocarditis, liver abscesses, among others. Brain abscesses secondary to this germ are rare and, in most cases, it is associated with contact with pets, poor dental hygiene or dental procedures. Treatment consists of drainage of the abscess (greater than 2.5 cm) combined with antibiotic therapy, ideally beta-lactams. The case of a 64-year-old male patient with no relevant history is here presented. He was admitted to the emergency service due to headache, hemianopsia of a week's duration and later tonic-clonic seizures, in whom imaging studies and culture of a brain lesion subsequently revealed a brain abscess due to A. aphrophilus. This case aims to illustrate about the rarity of this infection, because A. aphrophilus is a normal part of the oropharyngeal flora and respiratory tract, in which it rarely causes invasive bacteremia.
Topics: Brain Abscess; Humans; Male; Aggregatibacter aphrophilus; Middle Aged; Pasteurellaceae Infections; Anti-Bacterial Agents; Drainage
PubMed: 38683524
DOI: No ID Found -
Open Forum Infectious Diseases Apr 2015We report a case of brain and lung abscesses caused by Agreggatibacter aphrophilus in a 43-YEAR-OLD man with past history of splenectomy and drug addiction, in the...
We report a case of brain and lung abscesses caused by Agreggatibacter aphrophilus in a 43-YEAR-OLD man with past history of splenectomy and drug addiction, in the absence of endocarditis. Microbiological samples remain negatives and diagnosis was made by 16S rDNA PCR performance on abscess fluid for this coccobacillus that belongs to the HACEK group. The patient's clinical symptoms resolved within 6 weeks of treatment with cefotaxim.
PubMed: 26380332
DOI: 10.1093/ofid/ofv031 -
BMC Infectious Diseases Aug 2018Post cardiac surgery mediastinitis is the major infectious complication, despite the development of surgical techniques and the application of strict preventive...
BACKGROUND
Post cardiac surgery mediastinitis is the major infectious complication, despite the development of surgical techniques and the application of strict preventive measures. The Haemophilus influenzae mediastinitis is very rare. The mediastinitis caused by the association between Haemophilus influenzae and Aggregatibacter aphrophilus has never been described to our knowledge.
CASE PRESENTATION
We report the case of an exceptional combination of Haemophilus influenzae and Aggregatibacter aphrophilus in a patient operated for single bypass which is complicated by mediastinitis the 10th day after the surgical act.
CONCLUSION
The conclusion to be drawn from this work is to think in unusual seeds in case of mediastinitis post cardiac surgery for the elaboration of recommendations for antibiotic prophylaxis.
Topics: Aged; Aggregatibacter aphrophilus; Anti-Bacterial Agents; Haemophilus influenzae; Heart Diseases; Humans; Male; Mediastinitis; Microbial Sensitivity Tests; Thoracic Surgery
PubMed: 30115033
DOI: 10.1186/s12879-018-3269-4 -
Journal of Medical Case Reports Sep 2011Aggregatibacter aphrophilus (formerly Haemophilus aphrophilus and H. paraphrophilus) is classically associated with infective endocarditis. Other infections reported in...
INTRODUCTION
Aggregatibacter aphrophilus (formerly Haemophilus aphrophilus and H. paraphrophilus) is classically associated with infective endocarditis. Other infections reported in the literature include brain abscess, bone and joint infections and endophthalmitis. There are only two cases of empyema ever reported due to this organism. We report the isolation of A. aphrophilus from pleural fluid on three separate hospital admissions in a patient with recurrent empyema.
CASE PRESENTATION
A 65-year-old female patient of Caucasian origin presented with a three-week history of fever, shortness of breath and dry cough. She was found to have a pleural empyema so a chest drain was inserted and a sample of pus was sent to the microbiology laboratory. After overnight incubation, a chocolate blood agar plate incubated in 5% carbon dioxide showed a profuse growth of small, round, glistening colonies which were identified as Gram-negative coccobacilli. They were oxidase- and catalase-negative. Biochemical testing using RapID NH confirmed the identity of the organism as A. aphrophilus. It was susceptible to amoxicillin, levofloxacin and doxycycline. Our patient was treated with intravenous amoxicillin with clavulanic acid and clarithromycin followed by oral doxycycline, but was re-admitted twice over the next three months with recurrent empyema and the same organism was isolated. Each episode was managed with chest drainage and a six-week course of antibiotic--doxycycline for the second episode and amoxicillin for the third episode, after which she has remained well.
CONCLUSION
This is the first case report of recurrent empyema due to A. aphrophilus. Our patient had no underlying condition to explain the recurrence. Although our isolate was doxycycline susceptible, our patient had recurrent infection after treatment with this antibiotic, suggesting that this antibiotic is ineffective in treatment of deep-seated A. aphrophilus infection. This organism can be difficult to identify in the laboratory because, unlike closely related Haemophilus spp., it is oxidase-negative, catalase-negative and X and V independent.
PubMed: 21910872
DOI: 10.1186/1752-1947-5-448 -
Nature Communications Sep 2023Soluble HMW1C-like N-glycosyltransferases (NGTs) catalyze the glycosylation of Asn residues in proteins, a process fundamental for bacterial autoaggregation, adhesion...
Soluble HMW1C-like N-glycosyltransferases (NGTs) catalyze the glycosylation of Asn residues in proteins, a process fundamental for bacterial autoaggregation, adhesion and pathogenicity. However, our understanding of their molecular mechanisms is hindered by the lack of structures of enzymatic complexes. Here, we report structures of binary and ternary NGT complexes of Aggregatibacter aphrophilus NGT (AaNGT), revealing an essential dyad of basic/acidic residues located in the N-terminal all α-domain (AAD) that intimately recognizes the Thr residue within the conserved motif Asn-X-Ser/Thr. Poor substrates and inhibitors such as UDP-galactose and UDP-glucose mimetics adopt non-productive conformations, decreasing or impeding catalysis. QM/MM simulations rationalize these results, showing that AaNGT follows a S2 reaction mechanism in which the acceptor asparagine uses its imidic form for catalysis and the UDP-glucose phosphate group acts as a general base. These findings provide key insights into the mechanism of NGTs and will facilitate the design of structure-based inhibitors to treat diseases caused by non-typeable H. influenzae or other Gram-negative bacteria.
Topics: Glycosylation; Bacterial Proteins; Asparagine; Haemophilus influenzae; Glucose; Uridine Diphosphate
PubMed: 37723184
DOI: 10.1038/s41467-023-41238-1 -
Microbiology Spectrum Dec 2022Growing evidence suggests that oral infections can modify the course of systemic diseases. To date, epidemiological data on microbial oral infections are scarce. Here,...
Growing evidence suggests that oral infections can modify the course of systemic diseases. To date, epidemiological data on microbial oral infections are scarce. Here, we performed a comprehensive analysis of the trend and microbial diversity in oral infection specimens referred for clinical microbiology analysis from 2010 to 2020. The microbes were isolated by culture and were identified via matrix-assisted laser desorption ionization-time of flight mass spectrometry technology (MALDI-TOF MS) throughout the study period. A total of 1,014 referred samples from dental clinics in Stockholm County with dentoalveolar abscesses and jaw osteomyelitis being the main reason were identified. Overall, the microbial composition was dominated by (51%), followed by (19%), (12%), and (5%). At the genus level, Streptococcus spp. (36%), spp. (18%), and Staphylococcus spp. (11%) were among the most frequently reported. Interestingly, a strong increase in trend was noted for Streptococcus anginosus, Streptococcus mitis, Streptococcus sanguinis, Eikenella corrodens, spp., Aggregatibacter aphrophilus, Staphylococcus epidermidis, and Granulicatella adiacens during the study time ( = 0.66 to 0.89, < 0.05), and a minor increase was noted for Enterococcus faecalis and Klebsiella spp., whereas steady levels were noted for most of the others. The present study shows the diversity of bacteria that have been involved in dental infections during the last decade in the capital of Sweden, as well as the emerging oral microbiota trend, with clear clinical implications on the oral-systemic link. Oral diseases and associated microbes are a risk factor for systemic diseases and can change the courses of these diseases. To date, epidemiological data on microbial oral infections are scarce, and longitudinal reports are lacking. We present for the first time the microbial composition of severe oral bacterial infections determined via the MALDI-TOF mass spectrometry technique in a comprehensive study between 2010 and 2020 (11 years) in Stockholm County. The trend and microbial diversity of oral infections were analyzed on referred clinical microbiological samples and were processed by standardized protocols. Trend increase was noted for Streptococcus anginosus, Streptococcus mitis, Streptococcus sanguinis, Eikenella corrodens, spp., Aggregatibacter aphrophilus, Staphylococcus epidermidis, Granulicatella adiacens, Enterococcus faecalis, and Klebsiella spp. Our results provide new insights into the diversity and trend of oral microbiota that were involved in serious oral infections over the past decade in the capital of Sweden and may influence the oral-systemic link.
Topics: Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Bacteria; Carnobacteriaceae; Streptococcus; Streptococcus anginosus
PubMed: 36420577
DOI: 10.1128/spectrum.02487-22 -
Acta Medica Academica 2015The aim of this report was to describe the occurrence of a bacterial brain abscess in a healthy individual, without any predisposing condition.
OBJECTIVE
The aim of this report was to describe the occurrence of a bacterial brain abscess in a healthy individual, without any predisposing condition.
CASE REPORT
A thirteen-year old boy was admitted to the Department of Neurosurgery after the onset of vomiting, headache and dizziness. A neurological deficit was detected during the physical examination so urgent magnetic resonance imaging of the brain was performed, revealing an intrahemispheric, right positioned solitary expansive mass with ring enhancement. Purulent material was obtained during osteoplastic craniotomy with total extirpation of the brain abscess. Aggregatibacter aphrophilus and Bacteroides uniformis were isolated. The patient's general condition improved and the neurological deficit subsided as a result of the prompt recognition and treatment of this life threatening condition.
CONCLUSION
To achieve a favourable clinical outcome, prompt recognition and surgical treatment of a brain abscess are of primary importance,followed by administration of appropriate antimicrobial therapy. To our best knowledge, this is the first report of this combination of microorganisms as the cause of a brain abscess.
Topics: Adolescent; Aggregatibacter aphrophilus; Anti-Bacterial Agents; Bacteroides; Bacteroides Infections; Brain Abscess; Cefixime; Ceftriaxone; Coinfection; Craniotomy; Drainage; Humans; Magnetic Resonance Imaging; Male; Metronidazole; Pasteurellaceae Infections
PubMed: 26702912
DOI: 10.5644/ama2006-124.144 -
Cureus Mar 2022, formerly known as , is one member of a group of bacteria referred to as HACEK (, , , , ) organisms. Infections from any of the HACEK organisms typically lead to very...
, formerly known as , is one member of a group of bacteria referred to as HACEK (, , , , ) organisms. Infections from any of the HACEK organisms typically lead to very poor outcomes and can be difficult to manage, especially when complicated by intracranial hemorrhage (ICH). HACEK organisms can also be difficult to grow on blood cultures, and is rarely seen, if at all. Traditionally, most laboratories follow an extended incubation protocol of 14 to 21 days to aid the growth of HACEK bacteria. Herein we report a case of infective endocarditis where resulted on blood culture in three days, in a patient with a right shoulder abscess, complicated by septic embolization leading to ICH. We explore a potential link between the prompt growth of on blood culture and the presence of the right shoulder abscess.
PubMed: 35464520
DOI: 10.7759/cureus.23107 -
BMC Ophthalmology Aug 2016Chronic canaliculitis is often misdiagnosed as conjunctivitis, delaying proper documentation and management. Aggregatibacter aphrophillus has not been implicated in...
BACKGROUND
Chronic canaliculitis is often misdiagnosed as conjunctivitis, delaying proper documentation and management. Aggregatibacter aphrophillus has not been implicated in chronic canaliculitis.
CASE PRESENTATION
We report a case of unilateral chronic epiphora associated with chronic lacrimal canaliculitis resistant to prolonged topical antibiotic treatment in a 65-year-old woman without notable medical history. Canaculotomy, curettage with removal of concretions and tubing with silicone stent for six weeks resolved this chronic infection. Culturing lacrimal secretions and concretions yielded Aggregatibacter aphrophilus in pure culture. Histological analyses showed elongated seed clusters surrounded by neutrophils. Fluorescence in Situ Hybridization confirmed the presence of bacteria in two distinctive concretions.
CONCLUSION
This first documented case of A. aphrophilus chronic lacrimal canaliculitis illustrates that optimal surgical management of chronic lacrimal canaliculitis allows for both accurate microbiological diagnosis and treatment.
Topics: Aged; Aggregatibacter aphrophilus; Canaliculitis; Chronic Disease; Female; Humans; Ophthalmologic Surgical Procedures; Pasteurellaceae Infections; Treatment Outcome
PubMed: 27485631
DOI: 10.1186/s12886-016-0312-3