Vertebral Osteomyelitis, Discitis, and Epidural Abscess: A Rare Complication of <i>Cardiobacterium</i> Endocarditis

Yadava, Sanjay; Eranki, Ambika

doi:10.1177/2324709618807504

Cited by 4 publications

(8 citation statements)

References 14 publications

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“…This is the first reported case of C. hominis prosthetic knee infection, the second reported case of C. hominis septic arthritis of the knee joint and the fourth reported case of C. hominis joint infection when axial joints are included in the review [13][14][15]. In all four patients including ours, the definitive microbiological diagnosis was made by the isolation of C. hominis from multiple blood cultures.…”

Section: Discussionmentioning

confidence: 77%

“…References from the search were reviewed and the reference list of each article was also reviewed for similar cases. We found only three case reports of Cardiobacterium hominis septic arthritis [13][14][15]. The patients are summarized in Table 1.…”

Section: Review Of the Literaturementioning

confidence: 99%

“…The third patient was a 75-year-old man with a 2-week history of dull aching lower back pain. He had a past history of bioprosthetic aortic valve 4 years previously [15]. Physical exam showed fever and tenderness to percussion of lower vertebral area.…”

Section: Review Of the Literaturementioning

confidence: 99%

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Prosthetic Joint Infection Due to Cardiobacterium hominis: Report of First Known Case and Review of C. hominis Septic Arthritis Literature

Otchere¹,

Seif²,

Myers³

2022

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Introduction. The Cardiobacterium species is a pleomorphic Gram-negative bacterium discovered in 1964 and is part of the HACEK (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, and Kingella) group of organisms known to cause endocarditis. It has low virulence and can also cause dacryocystitis, septicemia and abdominal abscess. We report a patient with C. hominis prosthetic joint infection in the absence of definitive endocarditis. Case Report. A 57-year-old man presented to his orthopedic surgeon 17 months after left total knee arthroplasty with a 4–5-day history of left knee pain following yard work. He had an aortic valve replacement in 2003, mitral valve repair in 2006 and bovine aortic valve replacement in 2019 (12 months previously). Aspirate of knee joint fluid was grossly cloudy. Two of two preoperative blood cultures revealed Cardiobacterium species after 4 days’ incubation. He was initially treated with intravenous vancomycin plus piperacillin/tazobactam followed by 6 weeks of parenteral ceftriaxone followed by five months of oral cefdinir. Patient is infection-free 6 months after completion of antimicrobial therapy. Discussion. Cardiobacterium hominis is a slow-growing, fastidious, capnophilic, Gram-negative bacillus commonly found in normal oral and upper respiratory flora. Google Scholar™ and PubMed®searches were conducted and this is the first reported case of prosthetic joint infection due to Cardiobacterium hominis. We found three previously reported cases of C. hominis pyogenic arthritis: one patient with native knee pyogenic arthritis, one patient with cervical spondylodiscitis and one patient with lumbar spondylodiscitis and epidural abscess. Two of these three patients had TEE-documented infective endocarditis and one had a bioprosthetic aortic valve without evident vegetation on TEE. Our patient had a bioprosthetic aortic valve without TEE evidence of endocarditis. C. hominis should be added to the list of organisms that can cause bacteremically spread prosthetic joint infection.

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Section: Discussionmentioning

confidence: 77%

Section: Review Of the Literaturementioning

confidence: 99%

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Prosthetic Joint Infection Due to Cardiobacterium hominis: Report of First Known Case and Review of C. hominis Septic Arthritis Literature

Otchere¹,

Seif²,

Myers³

2022

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“…It should be noted that a single report of C. valvarum aortic endograft infection confirmed by 16S ribosomal RNA sequence analysis has been previously described in a 53-year-old man with total aortic arch replacement and severe aortic regurgitation in Japan [ 14 ]. Likewise, a Cardiobacterium spp ( C. hominis ) causing vertebral osteomyelitis, discitis, and epidural abscess has also been described [ 21 ]. To our knowledge, the present case describes the first known case of C. valvarum both affecting an aortic endograft and resulting in osteomyelitis.…”

Section: Discussionmentioning

confidence: 99%

An unusual case of Cardiobacterium valvarum causing aortic endograft infection and osteomyelitis

Hauser

Nizamuddin

Yarusi

et al. 2021

Ann Clin Microbiol Antimicrob

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Background HACEK (Haemophilus spp., Aggregatibacter spp., Cardiobacterium spp., Eikenella corrodens, and Kingella spp.) group organisms are responsible for 0.8% to 6% of all infective endocarditis cases, with Cardiobacterium spp. being the third most commonly implicated HACEK microorganism. Within this genus is Cardiobacterium valvarum (C. valvarum), a novel organism described in 2004. To date, only 15 cases of C. valvarum infection have been reported in the English-language literature, and have primarily been cases of infective endocarditis in patients with valvular disease. C. valvarum has not been reported to cause infections spreading to the surrounding bone. Case presentation We present a case of a 57-year-old man with a history of aortic dissection followed by aortic endograft replacement who presented with back pain. He was found to have radiographic evidence of an infected aortic endograft, along with vertebral osteomyelitis, discitis, and epidural phlegmon. Blood cultures identified C. valvarum as the causative organism. The patient was treated with ceftriaxone and surgical intervention was deferred due to the patient’s complex anatomy. His course was complicated by septic cerebral emboli resulting in cerebrovascular accident. Conclusions This case report highlights C. valvarum, a rare and emerging HACEK group microorganism that warrants consideration in high-risk patients with evidence of subacute infection and disseminated disease. While C. valvarum classically presents as infective endocarditis, extra-cardiac manifestations have also been described. As demonstrated in this case, endograft involvement and osteomyelitis may occur in rare circumstances.

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“…We searched the PubMed database to identify case reports of C. hominis IE and found 44 cases reported between January 2000 and June 2022 [1] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] . Herein, previously reported cases of C. hominis IE were reviewed and summarized.…”

Section: Introductionmentioning

confidence: 99%

Cardiobacterium hominis infective endocarditis: A literature review

Ono

Kitagawa

Kobayashi

2023

American Heart Journal Plus: Cardiology Research and Practice

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Vertebral Osteomyelitis, Discitis, and Epidural Abscess: A Rare Complication of Cardiobacterium Endocarditis

Cited by 4 publications

References 14 publications

Prosthetic Joint Infection Due to Cardiobacterium hominis: Report of First Known Case and Review of C. hominis Septic Arthritis Literature

Prosthetic Joint Infection Due to Cardiobacterium hominis: Report of First Known Case and Review of C. hominis Septic Arthritis Literature

An unusual case of Cardiobacterium valvarum causing aortic endograft infection and osteomyelitis

Cardiobacterium hominis infective endocarditis: A literature review

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