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Aggregatibacter aphrophilus pacemaker endocarditis: a case report
BACKGROUND: Aggregatibacter bacteria are a rare cause of endocarditis in adults. They are part of a group of organisms known as HACEK – Haemophilus, Aggregatibacter, Cardiobacter, Eikenella, and Kingella. Among these organisms, several Haemophilus species have been reclassified under the genus Aggre...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295285/ https://www.ncbi.nlm.nih.gov/pubmed/25486984 http://dx.doi.org/10.1186/1756-0500-7-885 |
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author | Patel, Sahil R Patel, Nishi H Borah, Amit Saltzman, Heath |
author_facet | Patel, Sahil R Patel, Nishi H Borah, Amit Saltzman, Heath |
author_sort | Patel, Sahil R |
collection | PubMed |
description | BACKGROUND: Aggregatibacter bacteria are a rare cause of endocarditis in adults. They are part of a group of organisms known as HACEK – Haemophilus, Aggregatibacter, Cardiobacter, Eikenella, and Kingella. Among these organisms, several Haemophilus species have been reclassified under the genus Aggregatibacter. Very few cases of Aggregatibacter endocarditis in patients with pacemaker devices have been reported. CASE PRESENTATION: We present here what we believe to be the first case of Aggregatibacter aphrophilus pacemaker endocarditis. A 62-year-old African American male with a medical history significant for dual-chamber pacemaker placement in 1996 for complete heart block with subsequent lead manipulation in 2007, presented to his primary care doctor with fever, chills, night sweats, fatigue, and ten-pound weight loss over a four-month period. Physical examination revealed a new murmur and jugular venous distension which prompted initiation of antibiotics for suspicion of endocarditis. Both sets of initial blood cultures were positive for A. aphrophilus. Transesophageal echocardiogram revealed vegetations on the tricuspid valve and the right ventricular pacemaker lead (Figure 1). This case highlights the importance of identifying rare causes of endocarditis and recognizing that treatment may not differ from the standard treatment for typical presentations. The patient received intravenous ceftriaxone for his endocarditis for a total of six weeks. Upon device removal, temporary jugular venous pacing wires were placed. After two weeks of antibiotic treatment and no clinical deterioration, a new permanent pacemaker was placed and the patient was discharged home. CONCLUSIONS: This is the first case of A. aphrophilus endocarditis in a patient with a permanent pacemaker. Our patient had no obvious risk factors other than poor dentition and a history of repeated pacemaker lead manipulation. This suggests that valvulopathies secondary to repeated lead manipulation can be clinically significant factors in morbidity and mortality in this patient population. |
format | Online Article Text |
id | pubmed-4295285 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-42952852015-01-16 Aggregatibacter aphrophilus pacemaker endocarditis: a case report Patel, Sahil R Patel, Nishi H Borah, Amit Saltzman, Heath BMC Res Notes Case Report BACKGROUND: Aggregatibacter bacteria are a rare cause of endocarditis in adults. They are part of a group of organisms known as HACEK – Haemophilus, Aggregatibacter, Cardiobacter, Eikenella, and Kingella. Among these organisms, several Haemophilus species have been reclassified under the genus Aggregatibacter. Very few cases of Aggregatibacter endocarditis in patients with pacemaker devices have been reported. CASE PRESENTATION: We present here what we believe to be the first case of Aggregatibacter aphrophilus pacemaker endocarditis. A 62-year-old African American male with a medical history significant for dual-chamber pacemaker placement in 1996 for complete heart block with subsequent lead manipulation in 2007, presented to his primary care doctor with fever, chills, night sweats, fatigue, and ten-pound weight loss over a four-month period. Physical examination revealed a new murmur and jugular venous distension which prompted initiation of antibiotics for suspicion of endocarditis. Both sets of initial blood cultures were positive for A. aphrophilus. Transesophageal echocardiogram revealed vegetations on the tricuspid valve and the right ventricular pacemaker lead (Figure 1). This case highlights the importance of identifying rare causes of endocarditis and recognizing that treatment may not differ from the standard treatment for typical presentations. The patient received intravenous ceftriaxone for his endocarditis for a total of six weeks. Upon device removal, temporary jugular venous pacing wires were placed. After two weeks of antibiotic treatment and no clinical deterioration, a new permanent pacemaker was placed and the patient was discharged home. CONCLUSIONS: This is the first case of A. aphrophilus endocarditis in a patient with a permanent pacemaker. Our patient had no obvious risk factors other than poor dentition and a history of repeated pacemaker lead manipulation. This suggests that valvulopathies secondary to repeated lead manipulation can be clinically significant factors in morbidity and mortality in this patient population. BioMed Central 2014-12-08 /pmc/articles/PMC4295285/ /pubmed/25486984 http://dx.doi.org/10.1186/1756-0500-7-885 Text en © Patel et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Patel, Sahil R Patel, Nishi H Borah, Amit Saltzman, Heath Aggregatibacter aphrophilus pacemaker endocarditis: a case report |
title | Aggregatibacter aphrophilus pacemaker endocarditis: a case report |
title_full | Aggregatibacter aphrophilus pacemaker endocarditis: a case report |
title_fullStr | Aggregatibacter aphrophilus pacemaker endocarditis: a case report |
title_full_unstemmed | Aggregatibacter aphrophilus pacemaker endocarditis: a case report |
title_short | Aggregatibacter aphrophilus pacemaker endocarditis: a case report |
title_sort | aggregatibacter aphrophilus pacemaker endocarditis: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295285/ https://www.ncbi.nlm.nih.gov/pubmed/25486984 http://dx.doi.org/10.1186/1756-0500-7-885 |
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