Abstract Background HACEK endocarditis is usually insidious and can often be difficult to diagnose due to the slow-growing nature of the organisms.This report presents our experience in treating a patient with Haemophilus parainfluenzae endocarditis.Case presentation We describe the case of a previously fit and well 23 year-old woman who presented to her local emergency department with a four-week history of persistent febrile illness.
She had associated nausea, vomiting, and lethargy.This was preceded by an episode of mucopurulent rhinorrhoea.She was treated empirically with oral amoxicillin for a putative diagnosis of rhinosinusitis.
Initially, her symptoms abated, however, she was readmitted with high fevers Event and a new pansystolic murmur.Transthoracic echocardiography revealed a large, mobile, echogenic mass, tethered to the posterior mitral valve leaflet (PMVL) and mild mitral regurgitation (MR).On examination, she had multiple non-tender, erythematous macules on the plantar surface of her feet, consistent with Janeway lesions.
Two separate blood cultures grew H.parainfluenzae.Infectious diseases recommended a four-week course of intravenous ceftriaxone.
Transesophageal echocardiography demonstrated a perforation within the P3 segment of the PMVL.Subsequently, the patient underwent mitral valve repair surgery with an uneventful recovery.Conclusions Our case highlights the importance of promptly diagnosing HACEK endocarditis.
A prolonged course of antibiotic therapy can be lifesaving, and surgery is often necessary to address Bosch PIM851F17E 80cm 5 Zone Induction Hob complications such as perforation within the mitral valve leaflets.In our patient, we were able to perform a sliding P2 leaflet plasty for good quality repair of the mitral valve, through a minimally invasive right anterior thoracotomy.