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HACEK endocarditis in infants and children: two cases and a literature review
Henry M Feder1, Jenna C Roberts, Juan C Salazar
1Division of Infectious Disease, Connecticut Children's Medical Center, Hartford, CT, USA. Feder@nso2.uchc.edu
Abstract:
We report 2 cases of Haemophilus parainfluenzae endocarditis and review 34 cases of HACEK endocarditis from the literature. HACEK organisms are the most common cause of Gram-negative endocarditis in children. They have a propensity to form friable vegetations (especially H. parainfluenzae) that break off and cause symptomatic emboli. HACEK endocarditis (from a review of the 36 published cases) may involve previously normal hearts (33%), may be complicated by embolization (31%) and may require vegetectomy or other surgery (31%). Mortality with HACEK endocarditis was 14%. HACEK organisms may be resistant to penicillins but are susceptible to third generation cephalosporins.
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