TABLE 1.
Comparison of Cardiobacterium hominis endocarditis with endocarditis caused by other bacteria*
| HACEK† | Typical pathogens | IVDU series | |||
|---|---|---|---|---|---|
| Current review | Paturel et al (41) | Sandre and Shafran (40) | Pelletier and Petersdorf (39) | Sandre and Shafran (40) | |
| Pathogen(s) in series | C hominis | Actinobacillus actinomycetemcomitans | Staphylococcus aureus (30%), streptococci (43%), enterococci (5%), HACEK† (5%), other (17%) | S aureus (29.6%), streptococci (28%), enterococci (9.6%), HACEK† (0.8%), other (32%) | S aureus (40%), streptococci (7%), Pseudomonas aeruginosa (13%), polymicrobial (27%), other (13%) |
| General data | |||||
| Number of cases of endocarditis in series | 67 | 102 | 80 | 125‡ | 15 |
| Patient age (mean years) | 48.5 | 46.8 | 49 | 43 | 35 |
| Symptom duration | 145 days | 91 days | 29 days | 42 days | 11 days |
| Predisposing cardiac condition | 76% (44 of 58) | 76.5% (78 of 102) (26% [27 of 102] with a prosthetic valve) | 55% (no prosthetic valve endocarditis in this series) | 72% (12% with prosthetic heart valve) | 7% |
| Symptoms/signs | |||||
| Constitutional symptoms | 83% (24 of 29)§ | 66.7% (30 of 45) with weight loss | Chills 51%, arthralgias/myalgias 25%, back pain 14% | Chills 41%, sweats 24%, anorexia 24%, myalgias 12%, arthralgias 12% | Chills 67%, arthralgias/ myalgias 20%, back pain 13% |
| Fever | 81% (46 of 57) as either a symptom or a sign | 97.4% (76 of 78) as either a symptom or a sign | 90% as symptom, 63% as sign | 84% as symptom, 77% as sign | 87% as symptom, 54% as sign |
| Splinter hemorrhages | 37.5% (6 of 16) | ND | 35% | ND | 20% |
| Splenomegaly | 50% (23 of 46) | 35.6% (27 of 76) | 19% | 28% | 20% |
| Clubbing | 18.4% (7 of 38) | ND | 15% | 12% | 20% |
| Petechiae | 32.5% (13 of 40) | ND | 16% | ND | 0% |
| Murmur | 96% (25 of 26) | 73% (57 of 78) with a new or altered murmur | 95% | 89% | 93% |
| Congestive heart failure | 38.5% (20 of 52) | 27% (21 of 57) | 41% | 66% | 20% |
| Embolic events | 44% (12 of 27)¶ | 29.5% (23 of 55) | 43% | 50% | 67% |
| Laboratory abnormalities | |||||
| Anemia | 78.6% (33 of 42) | 88% (59 of 67) | 69% | Common | 67% |
| Leukocytosis | 25.6% (10 of 39) | 45.2% (28 of 62) | ND | ND | ND |
| Elevated ESR (>20) | 93.9% (31 of 33) | 98.4% (62 of 63) | 88.9% (48 of 54) | Common | 88.9% (8 of 9) |
Numbers in parentheses indicate the numbers of patients that could be evaluated; where no parentheses appear, percentages reflect those of the total number of cases in a series.
*
Data taken from references 1 to 32 and 39 to 41;
†
A group of microorganisms that includes Haemophilus species, A actinomycetemcomitans, C hominis, Eikenella corrodens and Kingella kingae;
‡
Data are from 122 cases for constitutional symptoms and fever as a symptom;
§
Insufficient data to provide percentages for individual symptoms;
¶
Data taken from reference 1. ESR Erythrocyte sedimentation rate; IVDU Intravenous drug user; ND No data