Endocarditis Caused by a Pasteurella-like Organism

Tucker, Daniel N.; Slotnick, Irving J.; King, Elizabeth O.; Tynes, Bayard; Nicholson, James J.; Crevasse, Lamar

doi:10.1056/nejm196211012671804

Cited by 55 publications

(17 citation statements)

References 6 publications

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“…hominis is rarely the cause of human infection and was first isolated from four patients with infective endocarditis in 1962 (22). Since then, fewer than 70 cases of C. hominis endocarditis have been reported in the literature.…”

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confidence: 99%

Direct Detection of Cardiobacterium hominis in Serum from a Patient with Infective Endocarditis by Broad-Range Bacterial PCR

Gatselis¹,

Malli

Papadamou³

et al. 2006

J Clin Microbiol

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Bacterial DNA was detected directly in the serum of a patient with endocarditis by broad-range 16S rRNA PCR followed by sequencing and analysis of the results by the BLAST search. Using these methods, Cardiobacterium hominis was identified in 2 days from the date of serum collection. The microorganism was also isolated and identified using conventional methods (bacterial culture and biochemical tests) 17 days from the date of sample collection. This is the first report showing the direct detection of C. hominis in a patient's serum using molecular-based methods, emphasizing their potential usefulness as additional and rapid diagnostic tools for the detection and identification of fastidious bacteria. CASE REPORTA 62-year-old man with a past history of arterial hypertension was admitted to our department because of a 3-week history of poor dietary intake, fatigue, weakness, diffuse abdominal discomfort, chills, and night sweats. His symptoms began after a short period of diarrhea and fever. He also reported a history of toothache and gum bleeding 4 weeks prior to admission. One week prior to his admission he was seen by his primary physician, who diagnosed viral infection. He had no previous history of cardiac murmur, heart disease, intravenous drug use, recent dental work, skin injury, or previous hospitalizations.On admission, physical examination revealed a temperature of 39°C, a heart rate of 105 beats per minute, 25 respirations per minute, and blood pressure of 160/70 mm Hg. He appeared pale and moderately ill but was not in acute distress. He had no subconjunctival, palatal, or subungual splinter hemorrhages, and his ocular fundi were normal. Dental caries was noted. There was no palpable peripheral adenopathy, but a spleen tip and a palpable liver were felt. Auscultation of the heart revealed a grade 2 of 6 at the apex of heart, without S3 sound or signs of heart failure. The remainder of the physical examination was unremarkable.A complete blood count revealed a white-blood-cell count of 14,400 cells/mm 3 , with 87% neutrophils, 5.5% lymphocytes, and 7.5% monocytes. Hemoglobin was 11.5 g/dl, and the platelet count was 262,000/mm 3 . Renal function testing revealed normal creatinine and blood urea levels. At that time, the erythrocyte sedimentation rate (ESR) was 62 mm in the first hour, C-reactive protein was 14.33 mg/dl, and fibrinogen was 597 mg/dl. Arterial blood gas analysis showed respiratory alkalosis with pH 7.503, 69 mm Hg PaO 2 , 26.2 mm Hg PaCO 2 , and 20.8 mmol/liter HCO 3 . A urine specimen was positive for hemoglobin (ϩϩϩ) and protein (ϩ); the sediment contained 4 to 6 red blood cells, 1 to 2 white cells per high-power field, and granular casts. Mild proteinuria (636 mg/24 h) was also present. His electrocardiogram showed sinus tachycardia. At entry, a two-dimensional trans-thoracic echocardiography showed normal valves without any obvious sign of valve vegetations and a left ventricular ejection fraction of 65 to 70%. Additional investigation included an abdominal ultrasonography, which con...

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confidence: 99%

Direct Detection of Cardiobacterium hominis in Serum from a Patient with Infective Endocarditis by Broad-Range Bacterial PCR

Gatselis¹,

Malli

Papadamou³

et al. 2006

J Clin Microbiol

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“…1,2 In 1962, C. hominis was fi rst isolated from patients with endocarditis. 9 At that time, it was classifi ed as a Pasteurella-like organism and designated group 2D. In 1964, Slotnick et al proposed the name Cardiobacterium hominis.…”

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confidence: 99%

Infective endocarditis in a child caused by Cardiobacterium hominis after right ventricular outflow tract reconstruction using an expanded tetrafluoroethylene conduit

Maekawa

Sakamoto

Umezu

et al. 2011

Gen Thorac Cardiovasc Surg

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Cardiobacterium hominis, a member of the HACEK group of organisms, is a rare cause of endocarditis. We report a case of infective endocarditis caused by C. hominis in a male child who had undergone right ventricular outflow tract (RVOT) reconstruction using an expanded polytetrafluoroethylene conduit for tetralogy of Fallot with pulmonary atresia. Two days before admission, the patient suffered from exertional shortness of breath. Right ventricular hypertension was confirmed and RVOT stenosis was suspected based on the echocardiography findings. A CT scan revealed vegetation above the cusp of the conduit. An emergency operation was performed to avoid a pulmonary embolism due to large friable vegetation. C. hominis was cultured from the blood and the vegetation, prompting a diagnosis of prosthetic valve endocarditis. The patient was discharged after a 6-week course of intravenous ceftriaxone therapy.

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“…The organism is rarely the cause of human infection but was named when it was first isolated from four patients with infective endocarditis in 1962 4. Since then, fewer than 50 cases of C hominis endocarditis have been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Late aortic homograft valve endocarditis caused by Cardiobacterium hominis: a case report and review of the literature

Currie

Codispoti

Mankad

et al. 2000

Heart

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An unusual case of Cardiobacterium hominis endocarditis involving an aortic homograft valve is presented. Although the patient was young (a 17 year old man) and showed few of the characteristic features of the disease, the report does illustrate a number of the problems associated with this illness and highlights the need for the careful assessment of apparent culture negative endocarditis. The organism itself is susceptible to most antibiotics but further treatment, including surgery, may be necessary. Patients must therefore be examined repeatedly and assessed for haemodynamic deterioration, valve destruction or embolic phenomena. Homograft valve replacement may oVer some benefits in the setting of aortic valve endocarditis and is therefore an attractive option in this situation. (Heart 2000;83:579-581)

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Endocarditis Caused by a Pasteurella-like Organism

Cited by 55 publications

References 6 publications

Direct Detection of Cardiobacterium hominis in Serum from a Patient with Infective Endocarditis by Broad-Range Bacterial PCR

Direct Detection of Cardiobacterium hominis in Serum from a Patient with Infective Endocarditis by Broad-Range Bacterial PCR

Infective endocarditis in a child caused by Cardiobacterium hominis after right ventricular outflow tract reconstruction using an expanded tetrafluoroethylene conduit

Late aortic homograft valve endocarditis caused by Cardiobacterium hominis: a case report and review of the literature

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