Prosthetic Valve Endocarditis Caused by HACEK: Systematic Review of literature = Prosthetic Valve Endocarditis Caused by HACEK: Systematic Review of literature

다국어 초록 (Multilingual Abstract)

Background: The HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are rare causes of prosthetic valve endocarditis (PVE).Wang et al. reported the rate of PVE caused by HACEK was 1.4% among all PVE. Little clinical information about HACEK PVE is available in the English-language literature during the last 50 years. The objective of this study is to describe the clinical characteristics and outcomes of patients with HACEK PVE in the English language literature. Methods: We carried out a systematic review of the English-language literature from 1965 to 2014, describing cases of HACEK PVE. Patients were included in this study if they had definite or possible PVE according to the modified Duke’s criteria. Results: We analyze the clinical, microbiologic characteristics, and outcome of 77 patients. Definite PVE was present in 54 of 77 patients (70.1%). Patients were predominantly man (67.5%) with a median age of 48.0 years (5-82). Common predisposing factor was dental invasive procedure (22.1%), and poor dental condition (18.2%). Clinical manifestations of endocarditis of more than 1 months duration were recorded in 35.5% (24/68). Fever presented in 93.6% (59/63) of patients. Aortic and mitral valve was involved at 48.1%, 32.5%, respectively. The most common organism was A. actinomycetemcomitans (36.4%), followed by C. hominis (27.3%). In hospital mortality was 10.0% (7/70 patients) and the most frequent complication was heart failure (42.9%, 18/42), followed by systemic embolization (18.2%, 14/77), and stroke (16.9%, 13/77). Conclusions: HACEK PVE is a very rare disease. HACEK PVE was associated with young age man and it’s vascular complications were relatively frequent and serious. The outcome of HACKE PVE was excellent whether treated medically or with surgery.