Actinobacillus actinomycetem-comitans endocarditis in a child with a prosthetic heart valve

Abstract

The first case of Actinobacillus actinomycetem-comitans endocarditis in a child with a prosthetic cardiac valve is reported. Endocarditis was possibly caused by dental work done without antibiotic prophylaxis four weeks prior to admission.

Gingival colonization with selective HACEK microbes in children with congenital heart disease

“…and A.a. have been associated with infectious endocarditis, especially if prosthetic materials are used in the surgical repair [2,5,8,10,12,13]. In fact, A.a. has been specifically identified as the causative organism of infective endocarditis in children with prosthetic valves and shunts in which carious dentition and the periodontium were specifically implicated [2,10]. Controversy also exists concerning whether E.c.…”

Prosthetic valve endocarditis due to Actinobacillus actinomycetemcomitans

“…Time from the start of symptoms to diagnosis was 66 days (range, 2-280 days), based on data from 30 reported patients [3,19,[21][22][23][24][25][26][27][28][29][30][31][32][34][35][36][37]39,40,[43][44][45]47] and our case. This delay in diagnosis was exacerbated by the slow growth of this organism.…”

“…There were 22 (61%) men; the mean age of patients was 42.5 years (range, 8-76 years). The cases were distributed as follows: 13 from the USA [3,19,20,[21][22][23][24][25][26][27][28]; 10 from Spain [29-36, and our case]; three from Taiwan [37]; two each from Canada [38,39], Belgium [40,41], and France [42,43]; and one each from Brazil [44], Netherlands [45], South Africa [46] and Israel [47].…”

“…The most commonly used antibiotic regimens reported in clinical infections have been either penicillin or ampicillin, sometimes combined with an aminoglycoside [3,22,23,[25][26][27][28][29]32,33,[35][36][37][39][40][41][42][44][45][46][47]. Sixteen of these patients achieved cure and two died.…”

“…The most common valve involved was the aortic valve in 16 patients [3,[22][23][24][26][27][28][31][32][33][34]36,37,44,46] followed by the mitral valve in 13 [19,20,25,29,37,[39][40][41][42][43]45,47 and our case]. In six patients both aortic and mitral valves were affected [3,22,30,35,37]; in one case three valves were involved [21].…”