HACEK organism
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A HACEK organism is one of a set of slow-growing Gram negative bacteria that form a normal part of the human flora.
They are a frequent cause of endocarditis in children.[1]
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[edit] Organisms
The name is formed from their initials:[2]
- Haemophilus (Haemophilus parainfluenzae, Haemophilus aphrophilus, and Haemophilus paraphrophilus)[3]
- Actinobacillus actinomycetemcomitans (Aggregatibacter actinomycetemcomitans)
- Cardiobacterium hominis
- Eikenella corrodens
- Kingella (Kingella kingae)
[edit] Presentation
All of these organisms are part of the normal oropharyngeal flora, which grow slowly, prefer a carbon dioxide–enriched atmosphere, and share an enhanced capacity to produce endocardial infections, especially in young children. Collectivelly they account for 5-10% of cases of infective endocarditis involving native valves and are the most common gram-negative cause of endocarditis among people who do not use IV drugs. They have been a frequent cause of culture-negative endocarditis. Culture negative refers to an inability to produce a colony on regular agar plates; this is because these bacteria are fastidious (require a specific nutrient).
In addition to valvular infections in the heart, they can also produce other infections such as bacteremia, abscess, peritonitis, otitis media, conjunctivitis, pneumonia, arthritis and osteomyelitis, and periodontal infections.
[edit] Treatment
The treatment of choice for HACEK organisms in endocarditis is ceftriaxone, a cephalosporin antibiotic. Ampicillin and low-dose gentamicin is another therapeutic option. Ampicillin should be avoided if the patient is amoxicillin resistant or penicillin-allergic.[4].
[edit] References
- ^ Feder HM, Roberts JC, Salazar JC, Leopold HB, Toro-Salazar O (June 2003). "HACEK endocarditis in infants and children: two cases and a literature review". Pediatr. Infect. Dis. J. 22 (6): 557–62. doi:. PMID 12799515. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0891-3668&volume=22&issue=6&spage=557.
- ^ Morpeth S, Murdoch D, Cabell CH, et al. (December 2007). "Non-HACEK gram-negative bacillus endocarditis". Ann. Intern. Med. 147 (12): 829–35. PMID 18087053.
- ^ "HACEK Group Infections: Overview - eMedicine Infectious Diseases". http://emedicine.medscape.com/article/218158-overview. Retrieved on 2009-03-17.
- ^ [1], eMedicine, HACEK organism infection. June 2005.
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