An unusual case of multiple hepatic and pulmonary abscesses caused by Aggregatibacter aphrophilus in a young man: a case report

Abstract

Background Aggregatibacter aphrophilus, formerly known as Haemophilus aphrophilus, belongs to the HACEK organisms, a group of pathogens classically associated with infectious endocarditis. A. aphrophilus is a rarely found pathogen, though abscess formation in various organs has been described, typically due to spread from an infected heart valve. Here we describe the unusual case of multiple hepatic abscesses caused by A. aphrophilus. Case presentation A 33-year-old Caucasian man presented at our hospital with fever and malaise, elevated inflammatory markers, and liver enzymes. Imaging was compatible with multiple liver and pulmonary abscesses, without evidence of endocarditis. Cultures of blood and liver abscess material remained without growth. Polymerase chain reaction finally revealed Aggregatibacter aphrophilus in the liver tissue. The patient recovered fully within 6 weeks of doxycycline treatment. Conclusions There are only a few case descriptions of liver abscesses caused by A. aphrophilus. As a ubiquitous organism in the gastrointestinal tract, A. aphrophilus may reach the liver via the portal venous system, as well as through hematogenous spread from the oropharynx. HACEK organisms are notoriously difficult to grow on culture, which highlights the diagnostic importance of eubacterial PCR.

Case Report: The First Case of Bloodstream Infection Complicated with Psoas Abscess and Pulmonary Infection Caused by Aggregatibacter aphrophilus in China

“…Moreover, there is limited information on multiple anatomic sites infection caused by Aggregatibacter aphrophilus . 11–13 In this case, lung, psoas and bloodstream were infected with Aggregatibacter aphrophilus , contributing to knowledge on multiple anatomic site infections. However, Aggregatibacter aphrophilus was negative in pus from psoas and effusion fluid cultures, which is possibly due to the effective treatment using cefoperazone/sulbactam.…”

Infective endocarditis with primary thrombocytopenia caused by Aggregatibacter aphrophilus: a case report

“…In previous case reports, the identi cation of A. aphrophilus required polymerase chain reaction-based [5,10,11], mass spectrometry [12], and 16S rRNA gene sequencing techniques [4-6, 13, 14]. The bacterium is rarely the causative agent in IE, which frequently involves the mitral and aortic valves; however, dental procedures and heart valve diseases are common risk factors [15].…”