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Hemophilus parainfluenzae endocarditis.

R A Cole, R N Winickoff

    Southern Medical Journal
    |May 1, 1979
    PubMed
    Summary
    This summary is machine-generated.

    Hemophilus parainfluenzae endocarditis can affect healthy individuals and is challenging to diagnose, often presenting without typical heart murmurs. Early diagnosis and appropriate antibiotic treatment, such as ampicillin, are crucial for improving patient outcomes.

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    Area of Science:

    • Infectious Diseases
    • Cardiology
    • Microbiology

    Background:

    • Hemophilus parainfluenzae, a common upper respiratory tract commensal, can cause severe infections like endocarditis.
    • Endocarditis caused by H. parainfluenzae is rare but can occur in previously healthy individuals.

    Observation:

    • A case of H. parainfluenzae endocarditis in a young, healthy male is presented, alongside a review of 21 literature cases.
    • Patients often present with prolonged febrile illness (average 7 weeks) and may lack a heart murmur, complicating diagnosis.
    • H. parainfluenzae can be difficult to culture from blood, potentially due to nutritional requirements.

    Findings:

    • H. parainfluenzae endocarditis is diagnostically challenging, with a significant proportion of patients initially lacking a heart murmur.

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  • Cerebral embolus is a major complication, and the mortality rate with modern therapy remains at 12%.

    • Implications:

    • Highlights the importance of considering H. parainfluenzae in the differential diagnosis of endocarditis, especially in patients with recent respiratory infections.
    • Suggests ampicillin, often with an aminoglycoside, as the preferred antibiotic regimen, though ampicillin monotherapy may suffice.
    • Underscores the need for improved diagnostic strategies and awareness of this pathogen in infective endocarditis.