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Infective endocarditis caused by Actinobacillus actinomycetemcomitans: report of four cases
Abstract:
Four patients with infective endocarditis caused by Actinobacillus actinomycetemcomitans are reported. The clinical course was characterized by chronicity. Three of the four patients were treated with combined penicillin and aminoglycoside therapy on an empiric basis; the fourth patient was given ampicillin alone for 3 weeks. Cure was achieved in all four cases, with antibiotic therapy alone in the first three and ampicillin alone plus valve replacement surgery in the fourth patient. Further in vitro bactericidal data are needed, and actual therapy with ampicillin alone is desirable to see whether these patients with endocarditis of natural valves cannot be treated with ampicillin alone for a 3-week period.
Insights
This study reports on four cases of infective endocarditis caused by Actinobacillus actinomycetemcomitans. Antibiotic therapy, including ampicillin alone in one case, successfully treated all patients, suggesting potential for ampicillin monotherapy.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Infective endocarditis (IE) is a serious infection of the heart's inner lining.
- Actinobacillus actinomycetemcomitans is a rare but significant cause of IE.
- Chronic clinical courses are often observed in IE.
Observation:
- Four patients with IE caused by Actinobacillus actinomycetemcomitans were identified.
- The patients presented with a chronic clinical course.
- Treatment regimens varied, including combined penicillin and aminoglycoside therapy, and ampicillin alone.
Findings:
- All four patients achieved a cure.
- Three patients were cured with combined antibiotic therapy.
- One patient required ampicillin plus valve replacement surgery for cure.
Implications:
- Ampicillin monotherapy may be a viable treatment option for Actinobacillus actinomycetemcomitans endocarditis on natural valves.
- Further in vitro and clinical studies are warranted to confirm the efficacy of ampicillin monotherapy.
- This could simplify treatment protocols for specific IE cases.