Recurrent Infective Endocarditis due to Aggregatibacter aphrophilus and Staphylococcus lugdunensis
| Autor: | Peter Olbrich, Angela Hurtado-Mingo, Olaf Neth, L Hidalgo-García, Ignacio Obando, A Moruno-Tirado |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Heart Defects
Congenital medicine.medical_specialty Aggregatibacter Eikenella corrodens Staphylococcus lugdunensis Postoperative Complications Rare Diseases Haemophilus aphrophilus Recurrence Internal medicine medicine Humans Endocarditis Infusions Intravenous Aggregatibacter aphrophilus biology Kingella kingae Endocarditis Bacterial Staphylococcal Infections biology.organism_classification medicine.disease Long-Term Care Anti-Bacterial Agents Surgery Echocardiography Child Preschool Infective endocarditis Pediatrics Perinatology and Child Health Female Pasteurellaceae Infections |
| Zdroj: | Klinische Pädiatrie. 227:89-92 |
| ISSN: | 1439-3824 0300-8630 |
| DOI: | 10.1055/s-0034-1398536 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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