Korean J Clin Microbiol.  2003 Sep;6(2):172-176.

A Case of Haemophilus aphrophilus Endocarditis

• Cha CH
• Shin HB
• Jang S
• Kim MK
• Kim YS
• Song JK
• Kim MN

Abstract

Haemophilus aphrophilus is a facultatively anaerobic gram-negative bacillus and require 5 to 10 % CO2 to grow optimally. H. aphrophilus is differentiated from other members of Haemophilus species by no requirement of X or V factor. This organism is found as the normal flora in upper respiratory tract but a member of the HACEK group that cause native valve endocarditis. Since the first endocarditis of H. aphrophilus was reported at 1985 in Korea, we reported the second case. A 35-year-old male patient was admitted to Asan Medical Center because of fever for 15 days and altered mentality developed 2 days ago. His echocardiography revealed a mitral valve regurgitation with a hypermobile vegetation and multiple septic emboli were also found in the brain MRI. Three sets of blood cultures were taken on the day of admission, all of which grew pleomorphic, gram-negative bacilli at incubation day 1. Catalase and oxidase test was negative and Vitek NHI card (bioMerieux Vitek, Inc., Hazelwood Mo., USA) identified the organisms to H. aphrophilus 50%/H. paraphrophilus 49% (Bionumber 257310). It was finally identified to H. aphrophilus with requirement tests of X or V factors; it required neither X nor V factor. This H. aphrophilus strain was negative inlactamase and was susceptible to ampicillin, gentamicin, cefuroxime, imipenem, ciprofloxacin, aztreonam, azithromycin, rifampin, and trimethoprim/sulfamethoxazole. This patient was successfully treated with ampicillin and gentamicin after mitral valve replacement under diagnosis of H. aphrophilus endocarditis

Keyword

Haemophilus aphrophilus; Endocarditis; septic Embolism

MeSH Terms

Adult
Aggregatibacter aphrophilus*
Ampicillin
Azithromycin
Aztreonam
Bacillus
Brain
Catalase
Cefuroxime
Chungcheongnam-do
Ciprofloxacin
Diagnosis
Echocardiography
Endocarditis*
Fever
Gentamicins
Haemophilus*
Humans
Imipenem
Korea
Magnetic Resonance Imaging
Male
Mitral Valve
Mitral Valve Insufficiency
Oxidoreductases
Respiratory System
Rifampin
Ampicillin
Azithromycin
Aztreonam
Catalase
Cefuroxime
Ciprofloxacin
Gentamicins
Imipenem
Oxidoreductases
Rifampin