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Harrison's Principles of Internal Medicine, 18e
| Part 8. Infectious Diseases > Section 6. Diseases Caused by Gram-Negative Bacteria > |
Chapter 146. Infections Due to the HACEK Group and Miscellaneous Gram-Negative Bacteria
Sections: The HACEK Group, Other Gram-Negative Bacteria, Miscellaneous Organisms, Further Readings.
Topics Discussed: hacek.
Excerpt:"HACEK organisms are a group of fastidious, slow-growing, gram-negative bacteria the growth of which requires an atmosphere of carbon dioxide. Species belonging to this group include several Haemophilus species, Aggregatibacter (formerly Actinobacillus) actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae. HACEK bacteria normally reside in the oral cavity and have been associated with local infections in the mouth. They are also known to cause severe systemic infections—most often bacterial endocarditis, which can develop on either native or prosthetic valves (Chap. 124).In large series, up to 3% of cases of infective endocarditis are attributable to HACEK organisms, most often A. actinomycetemcomitans, Haemophilus species, and C. hominis. Invasive infection typically occurs in patients with a history of cardiac valvular disease, often in the setting of a recent dental procedure, nasopharyngeal infection, or tongue piercing or scraping. The aortic and mitral valves are most commonly affected. The clinical course of HACEK endocarditis tends to be subacute; however, embolization is..."
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