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CASE REPORT
Year : 2003  |  Volume : 21  |  Issue : 2  |  Page : 135-136
 

Bacterial endocarditis due to eikenella corrodens: A case report


Department of Microbiology, MKCG Medical College, Berhampur - 760 004, Ganjam, Orissa, India

Correspondence Address:
Department of Microbiology, MKCG Medical College, Berhampur - 760 004, Ganjam, Orissa, India

 ~ Abstract 

Of all the causes of bacterial endocarditis, HACEK group consisting of Haemophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella Kingae are rare causative agents. We report a case of bacterial endocarditis by E. corrodens, which is one of the members of the HACEK group.

How to cite this article:
Mahapatra A, Mishra S, Pattnaik D, Patnaik K. Bacterial endocarditis due to eikenella corrodens: A case report. Indian J Med Microbiol 2003;21:135-6


How to cite this URL:
Mahapatra A, Mishra S, Pattnaik D, Patnaik K. Bacterial endocarditis due to eikenella corrodens: A case report. Indian J Med Microbiol [serial online] 2003 [cited 2019 Jun 27];21:135-6. Available from: http://www.ijmm.org/text.asp?2003/21/2/135/7994


Endocarditis is most commonly caused by bacteria and occasionally by a rickettsia and rarely by a fungus.[1] Out of all the bacteria that cause endocarditis; the HACEK group of bacteria, part of the oropharyngeal flora, have been incriminated recently as rare causes. These bacteria are difficult to isolate from blood. We report a case of endocarditis due to E. corrodens, a rare isolate from blood.

 ~ Case Report Top

A 38 year old male was admitted to a private hospital of Berhampur having complaints of irregular fever and weight loss since three months with a past history of mitral stenosis. On examination the patient was febrile (39C) with anaemia, splenomegaly and a cardiac murmur. The hemoglobin was 9.6 gm/dL, TLC 12000/cmm with 78% polymorphs. ESR was 98 mm in first hour and the patient was seropositive for rheumatoid factor. X-ray of the chest (P-A view) revealed cardiomegaly but there was no significant echocardiographic finding.
Three samples of venous blood (each 10mL) were aseptically collected at 30 minutes interval and were inoculated into glucose broth. The samples sent for culture and sensitivity were incubated aerobically at 37C and observed daily for signs of growth. Turibidity was noticed in all the three bottles on sixth day of incubation. Gram films from all bottles showed Gram negative cocobacilli. Subculture on MacConkey's agar showed no growth where as blood agar showed small, nonhaemolytic, matt, pitting colonies with slightly irregular margin and dirty yellow pigment. The bacteria were gram negative, non motile, oxidase positive, catalase negative and nonfermentative in O-F medium. It also reduced nitrate to nitrite, produced indole, did not hydrolyse arginine though lysine was decarboxylated. The colony was suspected to be that of a member of fastidious Gram negative HACEK group due to its isolation from blood of an endocarditis case, slower growth rate, ability to pit the agar suface, inability to grow on MacConkey agar with negative catalase and positive oxidase reactions. The bacteria were provisionally identified as E. corrodens considering their reactions in different tests.
The antimicrobial susceptibility test by Kirby-Bauer method on blood agar showed the isolate to be sensitive to ceftriaxone, cefotaxime, chloramphenicol, amikacin, ciprofloxacin and resistant to clindamycin, vancomycin and penicillin. There had not been any clinical improvement inspite of initial empirical therapy with penicillin and gentamicin. The therapy was changed to ceftriaxone 1 gm and ciprofloxacin 500mg intravenously 12 hrly, for 1 week followed by oral therapy. The patient improved clinically with remission of fever at the end of first week.

 ~ Discussion Top

E. corrodens is mostly associated with dental and periodontal infections, ocularinfections and pleuropulmonary infections.[2] Bacteraemia and endocarditis caused by E. corrodens have been reported by many authors in persons with previous valvular damage and/or dental extractions.[3],[4] In recent years E. corrodens has been reported to cause a wide variety of infections ranging from cutaneous, subcutaneous abscesses, intestinal, genitourinary tract infection to osteomyelitis, cerebral abscess and cellulitis associated with the intravenous drug users.[5],[6] E. corrodens is usually sensitive to most of the commonly used antibiotics.[7] Considering the varied infections that can be caused by  E.corrodens  , if attempt for culture isolation and sensitivity test is made many of these infections can easily be treated. The small, unusual, corroding colonies on surface of blood agar from infective clinical specimens cannot be ignored and E. corrodens should be sought for. The infections by this bacteria may be fatal at times and the proper sensitivity report can help the patient recover easily. 

 ~ References Top

1.McDonald A. In: Price's Text Book of Medicine, 12th Edn. 1978 Ed. Sir RB Scott. (Oxford University Press, London). P. 770.  Back to cited text no. 1    
2.Joshi N, O'Bryant, Appelbaum PC. Pleuropulmonary infections caused by E. corrodens. Rev Infect Dis 1991;13:1207-12.  Back to cited text no. 2    
3.Deckerc MD, Graham BS, Hunter EB, et al. Endocarditis and infections of intravascular devices due to E. corrodens. Am J Med Sci 1986;292:209-123.  Back to cited text no. 3    
4.Patrick WD, Brown WD, Bowmer ML, et al. Infective endocarditis due to E.corrodens: case report and review of literture. Can J Infect Dis 1990;1:139-42.  Back to cited text no. 4    
5.Angus BJ, Green ST, MC Neil JT, et al. E. corrodens septicaemia among drug injectors; a possible association with licking wounds. J Infect 1994;28:102-103.  Back to cited text no. 5    
6.Raab MG, Lutz RA, Stauffers ES. E. corrodens vertebral osteomyelitis. A case report and literature review. Clin Orthop 1993;293:144-147.  Back to cited text no. 6    
7.Sfianou D, Kolokotronis A. Susceptibility of E. corrodens to antimicrobial agents. J Chemother 1990;2:156-158.  Back to cited text no. 7    
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2004 - Indian Journal of Medical Microbiology
Published by Wolters Kluwer - Medknow

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