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

Abstract

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)

HACEK endocarditis in infants and children: two cases and a literature review

“…35 There has been one pediatric case report (Table 1) of C. hominis endocarditis, a 17-year-old young man with a prosthetic aortic valve whose prosthetic valve had to be replaced after the C. hominis infection. 20 Fewer than 50 cases of endocarditis caused by C. hominis have been reported in adults. Complications including embolization and congestive heart failure occurred in Ͻ50% of cases.…”

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

“…4,5 No portal of entry was found in our patient, suggesting that the organism had initially spread from an endogenous reservoir and subsequently established a colony on the ePTFE conduit. Prosthetic infective endocarditis caused by C. hominis has been reported on mechanical valves or homografts, 4,5,6,14,15 but our case is the fi rst report of C. hominis endocarditis on an ePTFE conduit.…”

Endokarditis durch Cardiobacterium hominis nach Ross-Operation

“…Überwiegend spielt sich die Infektion an nativen Herzklappen ab, aber in mehr als einem Viertel der berichteten Fälle waren Patienten mit bioprothetischen bzw. mechanischen Herzklappen betroffen [1,5,11,15,17,25,28,29,31]. Über eine C.-hominis-Infektion eines autologen Aortenklappenersatzes nach Ross-Operation wurde in der uns zugänglichen Literatur bisher nicht berichtet.…”

“…Der subakute oder chronische Verlauf der durch C. hominis ausgelösten Endokarditiden wird mit der niedrigen Virulenz dieser Erreger erklärt [5,32]. Das klinische Bild bei Aufnahme in die Klinik hängt davon ab, wie weit die Erkrankung bereits fortgeschritten ist und ob bereits Komplikationen eingetreten sind oder nicht.…”

“…In Anbetracht der bei Stellung der Diagnose oft weit fortgeschrittenen Erkrankung (zunehmende Klappendestruktion, schwere kardiale Insuffizienz) ist in 30-45% der Fälle ein Klappenersatz erforderlich [5,17].…”