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

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

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.

References

  1. 1.
    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 267:913–916PubMedCrossRefGoogle Scholar
  2. 2.
    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 30:261–272PubMedCrossRefGoogle Scholar
  3. 3.
    Pritchard TM, Foust RT, Cantely JR, Leman RB (1991) Prosthetic valve endocarditis due to Cardiobacterium hominis occurring after upper gastrointestinal endoscopy. Am J Med 90:516–518PubMedGoogle Scholar
  4. 4.
    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 42:79–81PubMedCrossRefGoogle Scholar
  5. 5.
    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 76:373–377PubMedCrossRefGoogle Scholar
  6. 6.
    Botha P, Venter M (1996) Cardiobacterium hominis as a cause of bacterial endocarditis. S Afr Med J 86:91PubMedGoogle Scholar
  7. 7.
    Bruun B, Buch J, Kirkegaard E, Bjaeldager P (1983) Endocarditis caused by Cardiobacterium hominis. Two case reports. Acta Pathol Microbiol Immunol Scand B 91:325–328PubMedGoogle Scholar
  8. 8.
    Chong Y, Kim TS, Lee SY, Shim WH, Choo BK (1985) Cardiobacterium hominis endocarditis — a case report. Yonsei Med J 26:78–81PubMedGoogle Scholar
  9. 9.
    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 18:291–293PubMedCrossRefGoogle Scholar
  10. 10.
    Colebunders R, Mertens A, Mahler C, Parizel G (1982) Cardiobacterium hominis endocarditis. Acta Clin Belg 37:158–161PubMedGoogle Scholar
  11. 11.
    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 83:579–581PubMedCrossRefGoogle Scholar
  12. 12.
    DeGuise M, Lalonde G, Girouard Y (1990) Cardiobacterium hominis endocarditis. Can J Cardiol 6:461–462PubMedGoogle Scholar
  13. 13.
    el Khizzi N, Kasab SA, Osoba AO (1997) HACEK group endocarditis at the Riyadh Armed Forces Hospital. J Infect 34:69–74PubMedCrossRefGoogle Scholar
  14. 14.
    Ellner JJ, Rosenthal MS, Lerner PI, McHenry MC (1979) Infective endocarditis caused by slow-growing, fastidious, gram-negative bacteria. Medicine (Baltimore) 58:145–158Google Scholar
  15. 15.
    Francioli PB, Roussianos D, Glauser MP (1983) Cardiobacterium hominis endocarditis manifesting as bacterial meningitis. Arch Intern Med 143:1483–1484PubMedCrossRefGoogle Scholar
  16. 16.
    Geraci JE, Greipp PR, Wilkowske CJ, Wilson WR, Washington JA (1978) Cardiobacterium hominis endocarditis. Four cases with clinical and laboratory observations. Mayo Clin Proc 53:49–53PubMedGoogle Scholar
  17. 17.
    Jobanputra RS, Moysey J (1977) Endocarditis due to Cardiobacterium hominis. J Clin Pathol 30:1033–1036PubMedCrossRefGoogle Scholar
  18. 18.
    Johnson MG, Wasilauskas BL (1979) Cardiobacterium hominis endocarditis. Am J Med Technol 45:28–30PubMedGoogle Scholar
  19. 19.
    Jolie A, Gnann JW (1986) Cardiobacterium hominis causing late prosthetic valve endocarditis. South Med J 79:1461–1462PubMedCrossRefGoogle Scholar
  20. 20.
    Kiwan, Y, Shuhaiber H, Chungh T (1989) Cardiobacterium hominis endocarditis. Report of one case and review of the literature. J Cardiovasc Surg (Torino) 30:281–283Google Scholar
  21. 21.
    Laguna J, Derby BM, Chase R (1975) Cardiobacterium hominis endocarditis with cerebral mycotic aneurysm. Arch Neurol 32:438–439PubMedGoogle Scholar
  22. 22.
    Lane T, MacGregor RR, Wright D, Hollander J (1983) Cardiobacterium hominis: an elusive cause of endocarditis. J Infect 6:75–80PubMedCrossRefGoogle Scholar
  23. 23.
    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 28:1057–1061PubMedCrossRefGoogle Scholar
  24. 24.
    Le Quellec A, Bessis D, Perez C, Ciurana AJ (1994) Endocarditis due to beta-lactamase-producing Cardiobacterium hominis. Clin Infect Dis 19:994–995Google Scholar
  25. 25.
    Lin BH, Vieco PT (1995) Intracranial mycotic aneurysm in a patient with endocarditis caused by Cardiobacterium hominis. Can Assoc Radiol J 46:40–42PubMedGoogle Scholar
  26. 26.
    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 38:2015–2017PubMedGoogle Scholar
  27. 27.
    Maeland, A, Teieh AN, Arnesen H, Garborg I (1983) Cardiobacterium hominis endocarditis. Eur J Clin Microbiol 2:216–217PubMedCrossRefGoogle Scholar
  28. 28.
    Manso E, Strusi P, Massacci C, Ferrini L (1987) Endocarditis due to Cardiobacterium hominis. Boll Ist Sieroter Milan 66:489–490PubMedGoogle Scholar
  29. 29.
    Marques MT, Barreira R, Almeida M, Gil V (1995) Cardiobacterium hominis prosthetic valve endocarditis diagnosed in Portugal. Ann Biol Clin (Paris) 53:299–300Google Scholar
  30. 30.
    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 85:104–107PubMedCrossRefGoogle Scholar
  31. 31.
    Midgley J, LaPage SP, Jenkins BA, Barrow GI, Roberts ME, Buck AG (1970) Cardiobacterium hominis endocarditis. J Med Microbiol 3:91–98PubMedCrossRefGoogle Scholar
  32. 32.
    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 162:477–479PubMedCrossRefGoogle Scholar
  33. 33.
    Pankey GA, Horton JM (1978) Cardiobacterium hominis endocarditis: a case report. J Miss State Med Assoc 19:107–109PubMedGoogle Scholar
  34. 34.
    Perdue GD, Dorney ER, Ferrier F (1968) Embolomycotic aneurysm associated with bacterial endocarditis due to Cardiobacterium hominis. Am Surg 34:901–904PubMedGoogle Scholar
  35. 35.
    Piot P, Dasnoy J, Eyckmans L (1978) Bacterial endocarditis due to Cardiobacterium hominis. Acta Clin Belg 33:308–312PubMedGoogle Scholar
  36. 36.
    Prior RB, Spagna VA, Perkins RL (1979) Endocarditis due to strain of Cardiobacterium hominis resistant to erythromycin and vancomycin. Chest 75:85–86PubMedCrossRefGoogle Scholar
  37. 37.
    Robison WJ, Vitelli AS (1985) Infectious endocarditis caused by Cardiobacterium hominis. South Med J 78:1020–1021PubMedCrossRefGoogle Scholar
  38. 38.
    Savage DD, Kagan RL, Young NA, Horvath AE (1977) Cardiobacterium hominis endocarditis: description of two patients and characterization of the organism. J Clin Microbiol 5:75–80PubMedGoogle Scholar
  39. 39.
    Silver SE (1999) Ruptured mycotic aneurysm of the superior mesenteric artery that was due to Cardiobacterium endocarditis. Clin Infect Dis 29:1573–1574PubMedCrossRefGoogle Scholar
  40. 40.
    Snyder AI, Ellner PD (1969) Cardiobacterium hominis endocarditis. N Y State J Med 69:704–705PubMedGoogle Scholar
  41. 41.
    Spernoga, JF, Laskowski L, Marr JJ, Burmeister RW (1979) Cardiobacterium hominis endocarditis. South Med J 72:85–87PubMedGoogle Scholar
  42. 42.
    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 86:1439–1440PubMedCrossRefGoogle Scholar
  43. 43.
    Vogt K, Klefisch F, Hahn H, Schmutzler H (1994) Antibacterial efficacy of ciprofloxacin in a case of endocarditis due to Cardiobacterium hominis. Zentralbl Bakteriol 281:80–84PubMedGoogle Scholar
  44. 44.
    Weiner M, Werthamer S (1975) Cardiobacterium hominis endocarditis. Characterization of the unusual organisms and review of the literature. Am J Clin Pathol 63:131–134PubMedGoogle Scholar
  45. 45.
    Wong MJ, Chan RM (1982) Atypical presentation of Cardiobacterium hominis endocarditis. Can Med Assoc J 127:511–512PubMedGoogle Scholar
  46. 46.
    Wormser GP, Bottone EJ (1983) Cardiobacterium hominis: review of microbiologic and clinical features. Rev Infect Dis 5:680–691PubMedGoogle Scholar
  47. 47.
    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 276:117–126PubMedCrossRefGoogle Scholar
  48. 48.
    Zbinden R, Hany A, Luthy R, Conen D, Heinzer I (1998) Antibody response in six HACEK endocarditis cases under therapy. APMIS 106:547–552PubMedCrossRefGoogle Scholar
  49. 49.
    Mueller NJ, Kaplan V, Zbinden R, Altwegg M. (1999) Diagnosis of Cardiobacterium hominis endocarditis by broad-range PCR from arterio-embolic tissue. Infection 27:278–279PubMedCrossRefGoogle Scholar
  50. 50.
    Slotnick IJ, Mertz JA, Dougherty M (1964) Fluorescent antibody detection of human occurrence of an unclassified bacterial group causing endocarditis. J Infect Dis 114:503–505PubMedGoogle Scholar
  51. 51.
    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 609–623Google Scholar
  52. 52.
    Slotnick IJ (1968) Cardiobacterium hominis in genitourinary specimens. J Bacteriol 95:1175PubMedGoogle Scholar
  53. 53.
    Rechtman DJ, Nadler JP (1991) Abdominal abscess due to Cardiobacterium hominis and Clostridium bifermentans. Rev Infect Dis 13:418–419PubMedGoogle Scholar
  54. 54.
    Ronnevik PK, Neess HC (1981) Septicaemia caused by Cardiobacterium hominis. A case report. Acta Pathol Microbiol Scand B 89:243–244PubMedGoogle Scholar
  55. 55.
    Nurnberger M, Treadwell T, Lin B, Weintraub A. (1998) Pacemaker lead infection and vertebral osteomyelitis presumed due to Cardiobacterium hominis. Clin Infect Dis 27:890–891PubMedCrossRefGoogle Scholar
  56. 56.
    Han, XY, Meltzer MC, Woods T, Fainstein V (2004) Endocarditis with ruptured cerebral aneurysm caused by Cardiobacterium valvarum sp. nov. J Clin Microbiol 42:1590–1595PubMedCrossRefGoogle Scholar
  57. 57.
    Han XY, Falsen E (2005) Characterization of oral strains of Cardiobacterium valvarum and emended description of the organism. J Clin Microbiol 43:2370–2374PubMedCrossRefGoogle Scholar
  58. 58.
    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 24:1087–1094PubMedCrossRefGoogle Scholar
  59. 59.
    Kaplan AH, Weber DJ, Oddone EZ, Perfect JR (1989) Infection due to Actinobacillus actinomycetemcomitans: 15 cases and review. Rev Infect Dis 11:46–63PubMedGoogle Scholar
  60. 60.
    Paturel, L, Casalta, JP, Habib G, Nezri M, Raoult D (2004) Actinobacillus actinomycetemcomitans endocarditis. Clin Microbiol Infect 10:98–118PubMedCrossRefGoogle Scholar
  61. 61.
    Patrick WD, Bowmer MI, Sinave CP (1990) Infective endocarditis due to Eikenella corrodens: case report and review of the literature. Can J Infect Dis 1:139–142Google Scholar
  62. 62.
    Das M, Badley AD, Cockerill FR, Steckelberg JM, Wilson WR (1997) Infective endocarditis caused by HACEK microorganisms. Ann Rev Med 48:25–33PubMedCrossRefGoogle Scholar
  63. 63.
    Avlami A, Kordossis T, Vrizidis N, Sipsas NV (2001) Lactobacillus rhamnosus endocarditis complicating colonoscopy. J Infect 42:283–285PubMedCrossRefGoogle Scholar
  64. 64.
    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 80:619–620PubMedCrossRefGoogle Scholar
  65. 65.
    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 58:475–482PubMedCrossRefGoogle Scholar
  66. 66.
    Watanakunakorn C (1988) Streptococcus bovis endocarditis associated with villous adenoma following colonoscopy. Am Heart J 116:1115–1116PubMedCrossRefGoogle Scholar
  67. 67.
    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 111:3167–3184CrossRefGoogle Scholar
  68. 68.
    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 22:557–562PubMedCrossRefGoogle Scholar

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

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