Bacterial endocarditis due to Hemophilus aphrophilus with cerebral embolism

Mesko, Z; Bauza, Julio; Vinas, Carlo

doi:10.1016/s0022-3476(76)80628-2

Cited by 10 publications

(1 citation statement)

References 4 publications

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“…In the subgroup of paediatric IE, A. aphrophilus is the 3 rd most relevant HACEK pathogen after K. kingae and H. parainfluenzae with 6 cases reported [3,11,16,20,21,24]. Median age was 11,5 years (range 7 to 13 years) and a previous history of congenital heart disease was identified in 5 patients.…”

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Recurrent Infective Endocarditis due to Aggregatibacter aphrophilus and Staphylococcus lugdunensis

Hidalgo-García

Olbrich

et al. 2015

Klin Padiatr

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Uncommon microorganisms are increasingly being recognized as causative agents of paediatric infectious endocarditis (IE). We report a 4-year old girl with congenital heart disease, who suffered from 2 IE episodes secondary to Aggregatibacter aphrophilus (formerly Haemophilus aphrophilus) and Staphylococcus lugdunensis, both rarely reported pathogens in this age group. The patient was initially successfully treated with prolonged intravenous antibiotic courses, however removal of the Contegra valved conduit during the second episode was required due to recurrence of fever and development of pulmonary embolism despite completion of antibiotic therapy. A. aphrohilus is a member of the fastidious gram negative microorganisms of the HACEK group (Haemophilus spp., Aggregatibacter spp, Cardiobaterium hominis, Eikenella corrodens and Kingella kingae), that colonize the oropharynx and are a recognised cause of IE. Prognosis of children with IE due to HACEK group members varies, half of them suffering from complications and mortality rates of 10-12.5%. Although S. lugdunensis belongs to coagulase negative staphylococci (CONS), it behaves more like S. aureus species rather than CONS. This microorganism is a well-described cause of endocarditis in adult patients, associated with high requirements of surgical procedures and mortality (42-78%). In conclusion, paediatric IE can be caused by uncommon microorganisms associated with severe complications and potential fatality. The isolation of S. lugdunensis or A. aphrophilus in febrile patients should be considered clinically relevant and cardiac involvement must be ruled out. Those patients with proved IE will require prolonged intravenous antibiotic courses and in complicated cases surgical intervention.

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confidence: 99%