Abstract
Cardiobacterium hominis, a member of the HACEK group (Haemophilus parainfluenzae, Haemophilus aphrophilus, and Haemophilus paraphrophilus, Actinobacillus actinomycetemcomitans, C. hominis, Eikenella corrodens, and Kingella species), is a rare cause of endocarditis. There are 61 reported cases of C. hominis infective endocarditis in the English-language literature, 15 of which involved prosthetic valve endocarditis. There is one reported case of C. hominis after upper endoscopy and none reported after colonoscopy. Presented here are two cases of C. hominis prosthetic valve endocarditis following colonoscopy and a review of the microbiological and clinical features of C. hominis endocarditis. Patients with C. hominis infection have a long duration of symptoms preceding diagnosis (138±128 days). The most common symptoms were fever (74%), fatigue/malaise (53%), weight loss/anorexia (40%), night sweats (24%), and arthralgia/myalgia (21%). The most common risk factors were pre-existing cardiac disease (61%), the presence of a prosthetic valve (28%), and history of rheumatic fever (20%). Of the 61 cases reviewed here, the aortic valve was infected in 24 (39%) and the mitral valve in 19 (31%) patients. The average duration of blood culture incubation before growth was detected was 6.3 days (range, 2–21 days). Complications were congestive heart failure (40%), central nervous system (CNS) emboli (21%), arrhythmia (16%), and mycotic aneurysm (9%). C. hominis is almost always susceptible to β-lactam antibiotics. Ceftriaxone is recommended by the recently published American Heart Association guidelines. The prognosis of C. hominis native valve and prosthetic valve endocarditis is favorable. The cure rate among 60 patients reviewed was 93% (56/60). For prosthetic valve endocarditis, the cure rate was 16/17 (94%). Valve replacement was required in 27 (45%) cases.
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References
Tucker DN, Slotnick IJ, King EO, Tynes B, Nicholson J, Crevasse L (1962) Endocarditis caused by a Pasteurella-like organism; report of four cases. N Engl J Med 267:913–916
Slotnick IJ, Dougherty M (1964) Further characterization of an unclassified group of bacteria causing endocarditis in man: Cardiobacterium hominis gen. et sp. n. Antonie Van Leeuwenhoek 30:261–272
Pritchard TM, Foust RT, Cantely JR, Leman RB (1991) Prosthetic valve endocarditis due to Cardiobacterium hominis occurring after upper gastrointestinal endoscopy. Am J Med 90:516–518
Apisarnthanarak A, Johnson RM, Braverman AC, Dunne WM, Little JR (2002) Cardiobacterium hominis bioprosthetic mitral valve endocarditis presenting as septic arthritis. Diagn Microbiol Infect Dis 42:79–81
Arnold DM, Smaill F, Warkentin TE, Christjanson L, Walker I (2004) Cardiobacterium hominis endocarditis associated with very severe thrombocytopenia and platelet autoantibodies. Am J Hematol 76:373–377
Botha P, Venter M (1996) Cardiobacterium hominis as a cause of bacterial endocarditis. S Afr Med J 86:91
Bruun B, Buch J, Kirkegaard E, Bjaeldager P (1983) Endocarditis caused by Cardiobacterium hominis. Two case reports. Acta Pathol Microbiol Immunol Scand B 91:325–328
Chong Y, Kim TS, Lee SY, Shim WH, Choo BK (1985) Cardiobacterium hominis endocarditis — a case report. Yonsei Med J 26:78–81
Christen RD (1990) Cardiobacterium hominis endocarditis in a patient with a hypersensitivity reaction to penicillin. Successful treatment with partial resection of the posterior mitral valve leaflet and antibiotic therapy with cefazolin. Infection 18:291–293
Colebunders R, Mertens A, Mahler C, Parizel G (1982) Cardiobacterium hominis endocarditis. Acta Clin Belg 37:158–161
Currie PF, Codispoti M, Mankad PS, Godman MJ (2000) Late aortic homograft valve endocarditis caused by Cardiobacterium hominis: a case report and review of the literature. Heart 83:579–581
DeGuise M, Lalonde G, Girouard Y (1990) Cardiobacterium hominis endocarditis. Can J Cardiol 6:461–462
el Khizzi N, Kasab SA, Osoba AO (1997) HACEK group endocarditis at the Riyadh Armed Forces Hospital. J Infect 34:69–74
Ellner JJ, Rosenthal MS, Lerner PI, McHenry MC (1979) Infective endocarditis caused by slow-growing, fastidious, gram-negative bacteria. Medicine (Baltimore) 58:145–158
Francioli PB, Roussianos D, Glauser MP (1983) Cardiobacterium hominis endocarditis manifesting as bacterial meningitis. Arch Intern Med 143:1483–1484
Geraci JE, Greipp PR, Wilkowske CJ, Wilson WR, Washington JA (1978) Cardiobacterium hominis endocarditis. Four cases with clinical and laboratory observations. Mayo Clin Proc 53:49–53
Jobanputra RS, Moysey J (1977) Endocarditis due to Cardiobacterium hominis. J Clin Pathol 30:1033–1036
Johnson MG, Wasilauskas BL (1979) Cardiobacterium hominis endocarditis. Am J Med Technol 45:28–30
Jolie A, Gnann JW (1986) Cardiobacterium hominis causing late prosthetic valve endocarditis. South Med J 79:1461–1462
Kiwan, Y, Shuhaiber H, Chungh T (1989) Cardiobacterium hominis endocarditis. Report of one case and review of the literature. J Cardiovasc Surg (Torino) 30:281–283
Laguna J, Derby BM, Chase R (1975) Cardiobacterium hominis endocarditis with cerebral mycotic aneurysm. Arch Neurol 32:438–439
Lane T, MacGregor RR, Wright D, Hollander J (1983) Cardiobacterium hominis: an elusive cause of endocarditis. J Infect 6:75–80
Le Moing V, Lacassin F, Delahousse M, Duval X, Longuet P, Leport C, Vilde JL (1999) Use of corticosteroids in glomerulonephritis related to infective endocarditis: three cases and review. Clin Infect Dis 28:1057–1061
Le Quellec A, Bessis D, Perez C, Ciurana AJ (1994) Endocarditis due to beta-lactamase-producing Cardiobacterium hominis. Clin Infect Dis 19:994–995
Lin BH, Vieco PT (1995) Intracranial mycotic aneurysm in a patient with endocarditis caused by Cardiobacterium hominis. Can Assoc Radiol J 46:40–42
Lu PL, Hsueh PR, Hung CC, Teng LJ, Jang TN, Luh, KT (2000) Infective endocarditis complicated with progressive heart failure due to beta-lactamase-producing Cardiobacterium hominis. J Clin Microbiol 38:2015–2017
Maeland, A, Teieh AN, Arnesen H, Garborg I (1983) Cardiobacterium hominis endocarditis. Eur J Clin Microbiol 2:216–217
Manso E, Strusi P, Massacci C, Ferrini L (1987) Endocarditis due to Cardiobacterium hominis. Boll Ist Sieroter Milan 66:489–490
Marques MT, Barreira R, Almeida M, Gil V (1995) Cardiobacterium hominis prosthetic valve endocarditis diagnosed in Portugal. Ann Biol Clin (Paris) 53:299–300
Meyer DJ, Gerding DN (1988) Favorable prognosis of patients with prosthetic valve endocarditis caused by gram-negative bacilli of the HACEK group. Am J Med 85:104–107
Midgley J, LaPage SP, Jenkins BA, Barrow GI, Roberts ME, Buck AG (1970) Cardiobacterium hominis endocarditis. J Med Microbiol 3:91–98
Nikkari S, Gotoff R, Bourbeau PP, Brown RE, Kamal NR, Relman DA (2002) Identification of Cardiobacterium hominis by broad-range bacterial polymerase chain reaction analysis in a case of culture-negative endocarditis. Arch Intern Med 162:477–479
Pankey GA, Horton JM (1978) Cardiobacterium hominis endocarditis: a case report. J Miss State Med Assoc 19:107–109
Perdue GD, Dorney ER, Ferrier F (1968) Embolomycotic aneurysm associated with bacterial endocarditis due to Cardiobacterium hominis. Am Surg 34:901–904
Piot P, Dasnoy J, Eyckmans L (1978) Bacterial endocarditis due to Cardiobacterium hominis. Acta Clin Belg 33:308–312
Prior RB, Spagna VA, Perkins RL (1979) Endocarditis due to strain of Cardiobacterium hominis resistant to erythromycin and vancomycin. Chest 75:85–86
Robison WJ, Vitelli AS (1985) Infectious endocarditis caused by Cardiobacterium hominis. South Med J 78:1020–1021
Savage DD, Kagan RL, Young NA, Horvath AE (1977) Cardiobacterium hominis endocarditis: description of two patients and characterization of the organism. J Clin Microbiol 5:75–80
Silver SE (1999) Ruptured mycotic aneurysm of the superior mesenteric artery that was due to Cardiobacterium endocarditis. Clin Infect Dis 29:1573–1574
Snyder AI, Ellner PD (1969) Cardiobacterium hominis endocarditis. N Y State J Med 69:704–705
Spernoga, JF, Laskowski L, Marr JJ, Burmeister RW (1979) Cardiobacterium hominis endocarditis. South Med J 72:85–87
Taveras JM, Campo R, Segal N, Urena PE, Lacayo L (1993) Apparent culture-negative endocarditis of the prosthetic valve caused by Cardiobacterium hominis. South Med J 86:1439–1440
Vogt K, Klefisch F, Hahn H, Schmutzler H (1994) Antibacterial efficacy of ciprofloxacin in a case of endocarditis due to Cardiobacterium hominis. Zentralbl Bakteriol 281:80–84
Weiner M, Werthamer S (1975) Cardiobacterium hominis endocarditis. Characterization of the unusual organisms and review of the literature. Am J Clin Pathol 63:131–134
Wong MJ, Chan RM (1982) Atypical presentation of Cardiobacterium hominis endocarditis. Can Med Assoc J 127:511–512
Wormser GP, Bottone EJ (1983) Cardiobacterium hominis: review of microbiologic and clinical features. Rev Infect Dis 5:680–691
Wormser GP, Bottone EJ, Tudy J, Hirschman SZ (1978) Case report. Cardiobacterium hominis: review of prior infections and report of endocarditis on a fascia lata prosthetic heart valve. Am J Med Sci 276:117–126
Zbinden R, Hany A, Luthy R, Conen D, Heinzer I (1998) Antibody response in six HACEK endocarditis cases under therapy. APMIS 106:547–552
Mueller NJ, Kaplan V, Zbinden R, Altwegg M. (1999) Diagnosis of Cardiobacterium hominis endocarditis by broad-range PCR from arterio-embolic tissue. Infection 27:278–279
Slotnick IJ, Mertz JA, Dougherty M (1964) Fluorescent antibody detection of human occurrence of an unclassified bacterial group causing endocarditis. J Infect Dis 114:503–505
Von Graevenitz A, Zbinden R, Mutters R (1980) Actinobacillus, Capnocytophaga, Eikenella, Kingella, Pasteurella, and other fastidious or rarely encountered gram-negative rods. In: Murray PR, Baron E, Jorgensen JH, Pfaller MA, Yolken RH (eds) Manual of clinical microbiology. ASM Press,Washington, District of Columbia, pp 609–623
Slotnick IJ (1968) Cardiobacterium hominis in genitourinary specimens. J Bacteriol 95:1175
Rechtman DJ, Nadler JP (1991) Abdominal abscess due to Cardiobacterium hominis and Clostridium bifermentans. Rev Infect Dis 13:418–419
Ronnevik PK, Neess HC (1981) Septicaemia caused by Cardiobacterium hominis. A case report. Acta Pathol Microbiol Scand B 89:243–244
Nurnberger M, Treadwell T, Lin B, Weintraub A. (1998) Pacemaker lead infection and vertebral osteomyelitis presumed due to Cardiobacterium hominis. Clin Infect Dis 27:890–891
Han, XY, Meltzer MC, Woods T, Fainstein V (2004) Endocarditis with ruptured cerebral aneurysm caused by Cardiobacterium valvarum sp. nov. J Clin Microbiol 42:1590–1595
Han XY, Falsen E (2005) Characterization of oral strains of Cardiobacterium valvarum and emended description of the organism. J Clin Microbiol 43:2370–2374
Darras-Joly C, Lortholary O, Mainardi JL, Etienne J, Guillevin L, Acar J (1997) Haemophilus endocarditis: report of 42 cases in adults and review. Haemophilus Endocarditis study group. Clin Infect Dis 24:1087–1094
Kaplan AH, Weber DJ, Oddone EZ, Perfect JR (1989) Infection due to Actinobacillus actinomycetemcomitans: 15 cases and review. Rev Infect Dis 11:46–63
Paturel, L, Casalta, JP, Habib G, Nezri M, Raoult D (2004) Actinobacillus actinomycetemcomitans endocarditis. Clin Microbiol Infect 10:98–118
Patrick WD, Bowmer MI, Sinave CP (1990) Infective endocarditis due to Eikenella corrodens: case report and review of the literature. Can J Infect Dis 1:139–142
Das M, Badley AD, Cockerill FR, Steckelberg JM, Wilson WR (1997) Infective endocarditis caused by HACEK microorganisms. Ann Rev Med 48:25–33
Avlami A, Kordossis T, Vrizidis N, Sipsas NV (2001) Lactobacillus rhamnosus endocarditis complicating colonoscopy. J Infect 42:283–285
Giusti de Marle M, Sgreccia A, Carmenini E, Morelli S (2004) Infective endocarditis from Enterococcus faecalis complicating colonoscopy in Heyde’s syndrome. Postgrad Med J 80:619–620
Hirota WK, Petersen K, Baron TH, Goldstein JL, Jacobson BC, Leighton, JA, Mallery JS, Waring JP, Fanelli RD, Wheeler-Harbough J, Faigel DO (2003) Guidelines for antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc 58:475–482
Watanakunakorn C (1988) Streptococcus bovis endocarditis associated with villous adenoma following colonoscopy. Am Heart J 116:1115–1116
Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME, Ferrieri P, Gerber MA, Tani LY, Gewitz MH, Tong DC, Steckelberg JM, Baltimore RS, Shulman ST, Burns JC, Falace DA, Newburger JW, Pallasch TJ, Takahashi M, Taubert KA (2005) Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association — executive summary: endorsed by the Infectious Diseases Society of America. Circulation 111:3167–3184
Feder HM, Roberts JC, Salazar JC, Leopold HB, Toro-Salazar O (2003) HACEK endocarditis in infants and children: two cases and a literature review. Pediatr Infect Dis J 22:557–562
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Malani, A.N., Aronoff, D.M., Bradley, S.F. et al. Cardiobacterium hominis endocarditis: two cases and a review of the literature. Eur J Clin Microbiol Infect Dis 25, 587–595 (2006). https://doi.org/10.1007/s10096-006-0189-9
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DOI: https://doi.org/10.1007/s10096-006-0189-9