A Case Report of Cardiobacterium hominis Endocarditis in a Pregnant Woman

Abstract

Infective endocarditis (IE) is an infrequent endovascular disease, which can result in significant mortality and morbidity. Staphylococcus aureus and viridans streptococci remain the most common etiological agent. Cardiobacterium hominis, a member of the HACEK (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) group of fastidious gram-negative bacillus, is a part of normal upper respiratory flora and a rare cause implicated in IE. Cases of Cardiobacterium hominis endocarditis are being increasingly reported in last few years due to advancement in automated blood culture system such as BacT/ALERT Virtuo ® and identification system such as MALDI-TOF MS (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry). We herein report a first case of Cardiobacterium hominis endocarditis in a pregnant woman at 20 weeks of gestation. Following spontaneous abortion and evacuation of the fetus, appropriate surgical intervention under heparinized condition and pathogen-directed medical intervention was initiated in this patient. This case report highlights the importance of appropriate antimicrobial therapy, which augments earlier resolution of the disease.

Cardiobacterium hominis endocarditis associated with cerebral, renal, and splenic infarctions: A case report and review of the literature

“…C. hominis is also known to cause large friable vegetations complicated by systemic embolism [11] . Therefore, we reviewed cases of systemic embolism caused by C. hominis IE ( Table 2 ) [5] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] . 21 cases of C. hominis IE associated with embolism, including the present case, have been reported since 1980.…”

Cardiobacterium hominis Endocarditis in a Healthy Adult - Rare but Not to Be Missed

“…A history of cardiac abnormalities, prosthetic heart valve, previous rheumatic heart disease and dilated cardiomyopathy have been described as predisposing factor for C. hominis endocarditis (3)(4). A preceding history of dental procedure as well as oral infection will increase the risk of developing infective endocarditis with these organisms (3)(4)(5). A traumatised mucosa surface in the oral cavity following a dental procedure especially in those involving manipulation of gingival tissue promotes the entry of such bacteria resulting in bacteraemia.…”

“…Nevertheless, almost all reported cases of C. hominis bacteraemia were complicated with infective endocarditis (1-2). C. hominis endocarditis follows a subacute course where infected patients will develop insidious onset of symptoms, ranging from weeks to months (4)(5). Several constitutional symptoms being reported in the literatures include lethargy, chills, myalgias, arthralgias, loss of appetite and loss of weight.…”

“…HACEK organisms classically grow slowly and need extended incubation periods. With the current improved culture media and automated culture systems such as BacT/ALERT Virtuo, incubation period of about three to seven days may be sufficient to obtain growth of these organisms (3,5). BacT/ALERT virtuo is an advanced, automated blood culture system that has improved automation and enhanced detection algorithm that help to shorten the time to detection.…”

“…The availability of recent advanced automated blood culture systems such as BacT/ALERT® VIRTUO® (BioMérieux) has enhanced the recovery of C. hominis. Besides that, better diagnostic tools such as matrix-assisted laser desorption/ ionization time-of-flight mass spectrometry (MALDI-TOF MS) and PCR amplification of 16S ribosomal DNA has increased the success rate in identifying C. hominis (3)(4)(5). As growing C. hominis can be time-consuming, the susceptibility testing is also difficult to perform.…”