Prosthetic valve endocarditis due to cardiobacterium hominis occurring after upper gastrointestinal endoscopy

doi:10.1016/0002-9343(91)90614-4

The American Journal of Medicine

Volume 90, Issue 1, January 1991, Pages 516-518

https://doi.org/10.1016/0002-9343(91)90614-4 Get rights and content

Abstract

Bacterial endocarditis secondary to endoscopic procedures has been convincingly documented in only four cases. We describe a case. of prosthetic valve endocarditis due to Cardiobacterium hominis that developed after upper gastrointestinal endoscopy. Because of this, we recommend subacute bacterial endocarditis prophylaxis in patients who have a prior history of endocarditis or valve replacement.

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Cited by (57)

Cardiobacterium hominis endocarditis associated with cerebral, renal, and splenic infarctions: A case report and review of the literature
2023, IDCases
Citation Excerpt :
Moreover, the patient was known to have diabetes mellitus. Although the risk of bacterial endocarditis secondary to gastrointestinal endoscopic procedure is very low, some cases reported endoscopy might be a predisposing factor for C. hominis infection [5–8]. C. hominis is present in the normal flora colonizing the nose and throat; therefore, upper endoscopy is a possible cause of infection.
Cardiobacterium hominis (C. hominis) is a fastidious, pleomorphic, gram-negative bacillus that causes infective endocarditis. Identification of C. hominis is difficult because it grows very slowly in culture media. C. hominis is also known to cause large friable vegetations in the heart valves, complicated by systemic embolism. Here, we report a case of C. hominis infective endocarditis associated with cerebral, renal, and splenic infarctions. A 58-year-old Japanese man with a medical history of diabetes mellitus presented with acute right-sided back pain. Enhanced abdominal computed tomography scan showed a right renal infarction and splenic embolism, and cerebral magnetic resonance imaging revealed multiple infarctions. Transesophageal echocardiography revealed the presence of a vegetation and severe aortic regurgitation. C. hominis was detected in the blood culture; thus, a diagnosis of C. hominis infective endocarditis was made. The patient received antibiotic therapy and surgical aortic valve replacement, and he was doing well without major complications. We also reviewed the cases of systemic emboli caused by C. hominis infective endocarditis.
Apyretic pulmonary oedema revealing Cardiobacterium hominis endocarditis: Case report and review of literature
2022, IDCases
Cardiobacterium hominis is a member of the HACEK group of bacteria, responsible for infective endocarditis, mainly in patients with damaged or prosthetic valves. The low virulence of this organism can explain the insidious presentation and subacute or chronic progression of C. hominis infective endocarditis. Here, a 41-year-old man with a past history of surgery for a Waldhausen type aortic coarctation was hospitalised with dyspnea and chest pains revealing an acute pulmonary oedema, without fever. Transesophageal echocardiography indicated a 20 mm vegetation on biscuspid aortic valve. Six sets of blood culture were positive with Cardiobacterium hominis. In case of lack of fever, the diagnosis of infectious endocarditis is difficult because other symptoms are non-specific and biological markers of inflammatory syndrome are quiet or non-existent. This is the first case of C. hominis infectious endocarditis with a clinical presentation of acute pulmonary oedema in the literature. We report here an apyretic pulmonary oedema revealing C. hominis endocarditis and a review of the literature on apyretic infective endocarditis due to C. hominis.
Obstructive heart failure with Cardiobacterium hominis infective endocarditis
2020, IDCases
Citation Excerpt :
These risk factors include underlying cardiovascular disease, apparent poor dental hygiene, previous and manipulation of the gingival tissue [5]. Although causing transient bacteremia, guidelines recommend against the use of prophylactic antibacterials during endoscopic procedures, although cases of C. hominis endocarditis after endoscopic procedure have been described [5–7]. Bacterial translocation of microbial flora is postulated to occur secondary to mucosal trauma, related to instrumentation [8].
Infective endocarditis caused by Cardiobacterium hominis endocarditis: A case report and review of the literature
2019, Journal of Infection and Chemotherapy
Citation Excerpt :
We reviewed 60 manuscripts and a total of 73 cases were enrolled in this study, including our case as shown in Table 2. Non-English-language cases were not included [7,9–66]. Some cases lacked sufficient clinical courses and data for the analysis.
While it has been increasing cases of C. hominis endocarditis in the past decades due to advances of diagnostic methods, the epidemiology and clinical manifestations of IE caused by C. hominis is still unknown.
A 62-year old man was admitted to our institute with fever, anorexia and general fatigue for the preceding one month. He had a past medical history of both aortic and mitral valves replacement due to cardiac diseases. He was diagnosed as IE caused by C. hominis according to the modified duke criteria. The patient received 2 weeks of combination therapy of intravenous ceftriaxone (CTRX) 2g and gentamycin 180mg daily followed by 4 weeks CTRX 2g daily alone. Oral moxifloxacin 400mg once daily was given for an additional 4 weeks. After the antibiotic therapy was discontinued, disease recurrence was not observed. We reviewed previously reported C. hominis IE cases in 60 publications including ours. Of 73 patients enrolled, 53 were male, the mean age was 52 years. The most common risk factor of IE was past history of cardiac diseases in 44/73 (60%). As for antibiotics initially prescribed, third-generation cephalosporins was most frequently used in 28/69 (41%). While the cure rate was 67/73 (93%), 31/73 patients (43%) received a surgical intervention. Embolic lesions to the central nervous system and vertebrae were seen in 16/72 (22%) and 5/72 (7%).
IE caused by C. hominis has a favorable prognosis, showing the cure rate of 93%. Physicians should recognize the possible occurrence of emboli among IE patients.
Prophylaxis of Infective Endocarditis
2014, Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases
Other Gram-Negative and Gram-Variable Bacilli
2014, Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases

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Case reportProsthetic valve endocarditis due to cardiobacterium hominis occurring after upper gastrointestinal endoscopy

Abstract

Gastrointest Endosc

Am J Med

Prevention of bacterial endocarditis: a statement for health professionals by the Committee on Rheumatic Fever and Infective Endocarditis of the Council on Cardiovascular Disease in the Young (special report)

Circulation

Gastrointestinal instrumentation, bacteremia, and endocarditis

Gut

Recommendations for antibiotic prophylaxis before endoscopy

Am J Gastroenterol

Case report
Prosthetic valve endocarditis due to cardiobacterium hominis occurring after upper gastrointestinal endoscopy