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[Infectious endocarditis induced by Actinobacillus actinomycetemcomitans. 8 new cases]
Archives Des Maladies Du Coeur Et Des Vaisseaux
|December 1, 1994
Summary
Actinobacillus actinomycetemcomitans (AAC) causes infectious endocarditis, often linked to dental procedures. Early weight loss and cholestasis can signal AAC endocarditis, which has a better prognosis than other forms with appropriate antibiotic treatment.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Actinobacillus actinomycetemcomitans (AAC), a common oral bacterium, is an emerging cause of infectious endocarditis.
- This retrospective study analyzes 90 cases of AAC infectious endocarditis, highlighting its incidence and clinical presentation.
Observation:
- Dental procedures are a frequent portal of entry for AAC into the bloodstream.
- Key clinical signs include rapid weight loss (43%) and anicteric cholestasis (8%), prompting suspicion of AAC endocarditis.
- Echocardiography findings are often non-specific, complicating early diagnosis.
Findings:
- Blood cultures confirm diagnosis, though AAC grows slowly.
- Complications such as renal (26%), cardiac (24%), and neurological (18%) issues arise in two-thirds of patients.
- Hospital mortality is 9%, with a 6% late mortality, suggesting a potentially better prognosis compared to other endocarditis types.
Implications:
- Prompt diagnosis and treatment with cephalosporins and aminoglycosides are crucial for favorable outcomes.
- Surgical intervention follows standard guidelines for infectious endocarditis.
- Prophylaxis involves amoxicillin for at-risk cardiac patients undergoing dental work and emphasis on oral hygiene.