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Cardiobacterium hominis infective endocarditis: A literature review
Ryohei Ono1, Izumi Kitagawa2, Yoshio Kobayashi1
1Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
Insights
Cardiobacterium hominis infective endocarditis (IE) is challenging to diagnose due to slow growth. Key features include chest discomfort, fever, and aortic valve involvement, with a 91% recovery rate.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Cardiobacterium hominis, a HACEK group bacterium, is an uncommon cause of infective endocarditis (IE).
- Diagnosis is often delayed due to slow bacterial growth in culture.
- Clinical manifestations of C. hominis IE are not well-defined.
Purpose of the Study:
- To elucidate the clinical characteristics of infective endocarditis caused by Cardiobacterium hominis.
- To provide insights into diagnosis, treatment, and outcomes of C. hominis IE.
Main Methods:
- A systematic literature search was conducted on PubMed for C. hominis IE cases.
- Articles published between January 2000 and July 2022 were included.
- Data from 44 reported cases were analyzed for clinical features, predisposing factors, and outcomes.
Main Results:
- The median patient age was 59 years, with a male predominance (36/44).
- Common symptoms included chest discomfort, fever, and night sweats. Predisposing factors involved postsurgical valve treatment and dental issues.
- The aortic valve was most frequently affected, with systemic embolism as a common complication. Median diagnosis time was 4 days (range: 4-42 days).
Conclusions:
- Physicians should consider C. hominis in IE cases, especially with risk factors like valve disease or dental procedures.
- Echocardiography is crucial for detecting vegetations on heart valves.
- Prompt diagnosis and appropriate antibiotic therapy (e.g., cephem) and surgical intervention improve patient outcomes, with a high recovery rate (91%).
Background:
Cardiobacterium hominis is a member of the HACEK group, which causes infective endocarditis (IE) but is rarely associated with other infections. It is difficult to biologically identify C. hominis because of its slow growth in culture. However, the clinical features of C. hominis IE remain unclear.
Method:
We searched the PubMed database for all articles of C. hominis IE published between January 2000 and July 2022.
Results:
The major clinical features of 44 previously reported cases of C. hominis IE were as follows: the median age was 59 years, of which 36 were men; the initial presenting symptoms were chest discomfort (30 %), followed by fever (27 %), night sweats (20 %), fatigability (18 %), weight loss (16 %), and dyspnea (16 %). Almost half of the patients were febrile upon admission. The major predisposing factors were postsurgical valve treatment (57 %), dental treatment or caries (20 %), and congenital valve abnormality (5 %). The median time to identify C. hominis in the blood culture was 4 days, but the longest time was 42 days. The most commonly infected valve was the aortic valve, and the most common complication was systemic embolism. Surgical treatment was performed in 23 (52 %) patients. The most frequent initial treatment regimen was cephem antibiotics, with a median treatment duration of 6 weeks. The overall mortality and recovery rates of C. hominis IE were 9 % and 91 %, respectively.
Conclusion:
If C. hominis infection is confirmed, physicians should check for the presence of vegetations of the heart valves and understand these characteristics.
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