title: Haemophilus parainfluenzae infective endocarditis.
abstract: Gram-negative endocarditis was uncommon in the past, accounting for 1% to 3% of cases. With the advent of antibiotics, immunosuppressive agents and narcotic abuse, the number has increased to 5% to 10% in the native valves and as high as 17% in the prosthetic valves, with Haemophilus species as the commonest aetiological agent, accounting for about 1% of the cases. We report a case of Haemophilus parainfluenzae endocarditis in a 39-year-old man who presented with heart failure and persistent fever. Echocardiography showed bi-leaflet mitral valve prolapse and severe mitral regurgitation. A small vegetation was seen at the flail anterior valve leaflet. He responded well to 4 weeks of intravenous ampicillin at 9 g/day and 2 weeks of gentamicin at 4 mg/kg/day, and subsequently underwent valve replacement.
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital, Singapore.
authors.forename: P
authors.initials: P
authors.lastname: Lee
authors.forename: K H
authors.initials: KH
authors.lastname: Mak
authors.forename: M L
authors.initials: ML
authors.lastname: Ling
authors.forename: S K
authors.initials: SK
authors.lastname: Cheng
authors.forename: T H
authors.initials: TH
authors.lastname: Koh
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D005500:Follow-Up Studies; D006192:Haemophilus Infections / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D006193:Haemophilus influenzae / Q000187:drug effects / Q000302:isolation & purification*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008943:Mitral Valve; D008945:Mitral Valve Prolapse / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents