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HACEK group infections

Updated : August 24, 2023





Background

HACEK stands for Haemophilus subtypes, Aggregatibacter subtypes, Cardiobacterial hominis subtypes, Eikenella corrodens subtypes, & Kingella subtypes. A collection of meticulous staphylococci coccobacillus organisms is referred to by the abbreviation HACEK. The HACEK group makes up about 5 percent to 10 percent of patients without intravenous medication who develop community-acquired native-valve infective endocarditis.

In conventional blood culture media, HACEK bacteria grow weakly, & recovery may necessitate extended incubation. It has long been known that HACEK organisms, which are generally oropharyngeal microbes, are a cause of IE (infective endocarditis). The female vaginal tract and digestive tract have both yielded Eikenella & Cardiobacterium organisms.

These Micro-organisms are also suspected of causing bacteremia without periodontitis empyema, endocarditis brain abscesses, endophthalmitis, soft-tissue abscesses, parotitis, & osteomyelitis in addition to IE. In addition, there have been a few isolated incidences of endometritis and UTI. Common conditions that lead to invasive infestations include trauma, pre-existing structural cardiovascular disease, cancer, as well as other immunosuppressed states.

Epidemiology

Frequency

A tiny but discernible portion (about 3%) of endocarditis cases are brought on by HACEK pathogens. It is clear that the increased usage of endovascular implants is contributing to the apparent rise in the incidence of non-HACEK-negative bacteria endocarditis. The identification of these illnesses has increased, although this could be a result of doctors and laboratory staff becoming more aware of the infections, combined with new testing procedures.

Race

Endocarditis brought on by the HACEK pathogens has not been associated with any racial disparities.

Morbidity/Mortality

Except for the endocarditis produced by H. parainfluenza, which might also appear more acutely, IE brought on by the HACEK pathogens is normally mild. Huge valve vegetations are typical at the presentation time. Embolization is frequent and causes serious morbidity. Mortality levels can vary per organism and can range from 10 percent to 40npercent. Modern case studies indicate that the risk of mortality is more likely to be between 10% and 15%.

Sex

Previous data imply a male dominance for HACEK infective endocarditis. However, there isn’t enough information to conclude that there is a preference either for sex in the present era.

Anatomy

Pathophysiology

The HACEK organisms can cause invasive illness and the development of abscesses when introduced into healthy cells. Furthermore, a lot of occurrences result in macro emboli complicated vegetations on infected heart valves. Such vegetations are brought on by the inherent characteristics of the organisms, the length of time between diagnosis and treatment, or a mixture of these two elements.

Various forms of dental pathology are linked to 60% of cases of HACEK IE. Pleomorphic negative coccobacillus called Haemophilus genera need X (hemin) and V (nicotinamide dinucleotide) components to be isolated. RBC naturally includes these ingredients. 0.5% to 1% of all instances of IE are caused by the Haemophilus genus.

Despite frequently being associated with bacteremia, Haemophilus influenza rarely results in IE. A second pathogen, generally alpha-hemolytic Staphylococcus aureus and Streptococcus, is present in 10% of patients.

 

Etiology

Genetics

Prognostic Factors

The prognosis varies greatly based on a number of variables, including the patient’s age, the timing of the diagnosis, and the incidence of comorbidities. The prognosis is favorable for patients with simple IE brought on by HACEK pathogens, who typically react well to treatment.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

Media Gallary

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3656887/

HACEK group infections

Updated : August 24, 2023




HACEK stands for Haemophilus subtypes, Aggregatibacter subtypes, Cardiobacterial hominis subtypes, Eikenella corrodens subtypes, & Kingella subtypes. A collection of meticulous staphylococci coccobacillus organisms is referred to by the abbreviation HACEK. The HACEK group makes up about 5 percent to 10 percent of patients without intravenous medication who develop community-acquired native-valve infective endocarditis.

In conventional blood culture media, HACEK bacteria grow weakly, & recovery may necessitate extended incubation. It has long been known that HACEK organisms, which are generally oropharyngeal microbes, are a cause of IE (infective endocarditis). The female vaginal tract and digestive tract have both yielded Eikenella & Cardiobacterium organisms.

These Micro-organisms are also suspected of causing bacteremia without periodontitis empyema, endocarditis brain abscesses, endophthalmitis, soft-tissue abscesses, parotitis, & osteomyelitis in addition to IE. In addition, there have been a few isolated incidences of endometritis and UTI. Common conditions that lead to invasive infestations include trauma, pre-existing structural cardiovascular disease, cancer, as well as other immunosuppressed states.

Frequency

A tiny but discernible portion (about 3%) of endocarditis cases are brought on by HACEK pathogens. It is clear that the increased usage of endovascular implants is contributing to the apparent rise in the incidence of non-HACEK-negative bacteria endocarditis. The identification of these illnesses has increased, although this could be a result of doctors and laboratory staff becoming more aware of the infections, combined with new testing procedures.

Race

Endocarditis brought on by the HACEK pathogens has not been associated with any racial disparities.

Morbidity/Mortality

Except for the endocarditis produced by H. parainfluenza, which might also appear more acutely, IE brought on by the HACEK pathogens is normally mild. Huge valve vegetations are typical at the presentation time. Embolization is frequent and causes serious morbidity. Mortality levels can vary per organism and can range from 10 percent to 40npercent. Modern case studies indicate that the risk of mortality is more likely to be between 10% and 15%.

Sex

Previous data imply a male dominance for HACEK infective endocarditis. However, there isn’t enough information to conclude that there is a preference either for sex in the present era.

The HACEK organisms can cause invasive illness and the development of abscesses when introduced into healthy cells. Furthermore, a lot of occurrences result in macro emboli complicated vegetations on infected heart valves. Such vegetations are brought on by the inherent characteristics of the organisms, the length of time between diagnosis and treatment, or a mixture of these two elements.

Various forms of dental pathology are linked to 60% of cases of HACEK IE. Pleomorphic negative coccobacillus called Haemophilus genera need X (hemin) and V (nicotinamide dinucleotide) components to be isolated. RBC naturally includes these ingredients. 0.5% to 1% of all instances of IE are caused by the Haemophilus genus.

Despite frequently being associated with bacteremia, Haemophilus influenza rarely results in IE. A second pathogen, generally alpha-hemolytic Staphylococcus aureus and Streptococcus, is present in 10% of patients.

 

The prognosis varies greatly based on a number of variables, including the patient’s age, the timing of the diagnosis, and the incidence of comorbidities. The prognosis is favorable for patients with simple IE brought on by HACEK pathogens, who typically react well to treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3656887/