European Journal of Clinical Microbiology and Infectious Diseases

, Volume 25, Issue 9, pp 587–595

Cardiobacterium hominis endocarditis: two cases and a review of the literature

  • A. N. Malani
  • D. M. Aronoff
  • S. F. Bradley
  • C. A. Kauffman
Article

DOI: 10.1007/s10096-006-0189-9

Cite this article as:
Malani, A.N., Aronoff, D.M., Bradley, S.F. et al. Eur J Clin Microbiol Infect Dis (2006) 25: 587. doi:10.1007/s10096-006-0189-9

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.

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • A. N. Malani
    • 1
    • 3
  • D. M. Aronoff
    • 1
  • S. F. Bradley
    • 1
    • 2
    • 3
  • C. A. Kauffman
    • 1
    • 3
  1. 1.Division of Infectious DiseasesUniversity of Michigan Medical School, Veterans Affairs Ann Arbor Healthcare SystemAnn ArborUSA
  2. 2.Division of Geriatric MedicineUniversity of Michigan Medical School, Veterans Affairs Ann Arbor Healthcare SystemAnn ArborUSA
  3. 3.Department of Internal MedicineUniversity of Michigan Medical School, Veterans Affairs Ann Arbor Healthcare SystemAnn ArborUSA