title: Clinical characteristics of invasive Haemophilus aphrophilus infections.
abstract: Haemophilus aphrophilus, an oral fastidious Gram-negative commensal with low pathogenicity, is a member of the HACEK group (H. aphrophilus, H. paraphrophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella spp.), and a rare cause of human infections. We reviewed the characteristics of 8 cases of H. aphrophilus infections diagnosed in our hospital from 1990-2003, and an additional 20 cases identified from the MEDLINE database, from 1990 to 2003. Their mean age was 47.4 years (range, 7-73 years), and 21 cases (75%) were male. The major manifestation was bone and joint infections (9 cases, 32%), including osteomyelitis, discitis, epidural abscess, spondylodiscitis, septic arthritis and prevertebral infection. Seven cases (25%) presented with infective endocarditis, involving native valves, and one underwent valvular replacement. Of note, 3 cases (10%) had ophthalmic infections (endophthalmitis in 2 cases and canaliculitis in 1), and 2 of them had previous ophthalmic procedures. Other manifestations included bacteremia, meningitis, brain abscess, cervical lymphadenitis, facial cellulitis, empyema, and purulent pericarditis and tamponade. All patients except 1 survived. Recent dental procedure was recalled by 11 cases (39%), and may be a predisposing factor for invasive H. aphrophilus infection. Appropriate antimicrobial therapy, such as a beta-lactam/beta-lactamase inhibitor, ceftriaxone or cefotaxime or a fluoroquinolone, can lead to a favorable clinical outcome.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Shao-Tsung
authors.initials: ST
authors.lastname: Huang
authors.forename: Hsin-Chun
authors.initials: HC
authors.lastname: Lee
authors.forename: Nan-Yao
authors.initials: NY
authors.lastname: Lee
authors.forename: Kung-Hung
authors.initials: KH
authors.lastname: Liu
authors.forename: Wen-Chien
authors.initials: WC
authors.lastname: Ko
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006190:Haemophilus / Q000187:drug effects; D006192:Haemophilus Infections / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies