HACEK organisms are the normal flora of upper respiratory tract and orophaynx. They infect abnormal cardiac valves, causing subacute native valve endocarditis or prosthetic valve endocarditis more than one year after valve surgery. Haemophilus species are responsible for only 0.5-1% of all infectious endocarditis cases. Embolization occurs in 60% and the mortality rate ranges from 16-45% of cases of infective endocarditis caused by H. parainfluenzae. We report two cases of H. parainfluenzae endocarditis, one of them is a 25-year-old male with tricuspid valve vegetations complicated with pulmonary embolism and the other is a 22-year-old female presented with heart failure.
Adult ; Endocarditis* ; Female ; Haemophilus parainfluenzae* ; Haemophilus* ; Heart Failure ; Heart Valves ; Humans ; Male ; Mortality ; Paramyxoviridae Infections ; Pulmonary Embolism ; Respiratory System ; Tricuspid Valve ; Young Adult

HACEK organisms are the normal flora of upper respiratory tract and orophaynx. They infect abnormal cardiac valves, causing subacute native valve endocarditis or prosthetic valve endocarditis more than one year after valve surgery. Haemophilus species are responsible for only 0.5-1% of all infectious endocarditis cases. Embolization occurs in 60% and the mortality rate ranges from 16-45% of cases of infective endocarditis caused by H. parainfluenzae. We report two cases of H. parainfluenzae endocarditis, one of them is a 25-year-old male with tricuspid valve vegetations complicated with pulmonary embolism and the other is a 22-year-old female presented with heart failure.
Adult ; Endocarditis* ; Female ; Haemophilus parainfluenzae* ; Haemophilus* ; Heart Failure ; Heart Valves ; Humans ; Male ; Mortality ; Paramyxoviridae Infections ; Pulmonary Embolism ; Respiratory System ; Tricuspid Valve ; Young Adult

PURPOSE: A full view of the spectrum of all bacterial diseases in healthy children is essential to the establishment of public health priorities. Accurate information on the relative importance of the various pathogens in terms of the age of the affected patients, the site of infection and the case fatality rate are valuable to the clinician in choosing antimicrobial treatments. METHODS: Fifty-nine episodes of bacteremia were analysed. Data were collected at Ilsan Paik Hospital from January 2000 to December 2003. Analysis of each collected episode included isolating pathogen from blood culture, diagnosis, hospital course, isolating pathogens from other tissue sites, and studying results of antimicrobial sensitivity tests. RESULTS: Fifty-nine cases of community-acquired bacteremia were reviewed. The most common pathogen was Staphylococcus aureus (11 cases, 18.6 percent), followed by Salmonella (10 cases, 16.9 percent), E. coli (7 cases, 11.9 percent), Streptococcus pneumoniae (five cases, 8.5 percent), Streptococcus viridans (5 cases 8.5 percent). The most common diagnosis was bacteremia without an indentified focus (61 percent), followed by meningitis (12 percent), bacteremia with enteritis (10.2 percent) and bacteremia with urinary tract infection (8.5 percent). Salmonella was still an important causative agent of bacteremia. The relative importance of Haemophilus influenza and Streptococcus pneumoniae was lower than in other studies. The most common organism responsible for bacteremia without an identified focus was Staphylococcus aureus The case-fatality was 3.4 percent for all cases of bacteremia. CONCLUSION: We reviewed the etiology of community-acquired bacteremia. These data may be useful in the establishment of public health priorities and serve as a reference for selection of antibiotics in the empirical therapy of suspected invasive bacterial infection.
Anti-Bacterial Agents ; Bacteremia* ; Bacterial Infections ; Child* ; Community-Acquired Infections ; Diagnosis ; Enteritis ; Haemophilus ; Humans ; Influenza, Human ; Meningitis ; Mortality ; Public Health ; Salmonella ; Staphylococcus aureus ; Streptococcus pneumoniae ; Urinary Tract Infections ; Viridans Streptococci

PURPOSE: The most common cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is respiratory infection. Most studies of bacterial or viral cause in AECOPD have been conducted in Western countries. We investigated bacterial and viral identification rates in AECOPD in Korea. MATERIALS AND METHODS: We reviewed and analyzed medical records of 736 cases of AECOPD at the Korea University Guro Hospital. We analyzed bacterial and viral identification rates and classified infections according to epidemiological factors, such as Global Initiative for Chronic Obstructive Lung Disease stage, mortality, and seasonal variation. RESULTS: The numbers of AECOPD events involving only bacterial identification, only viral identification, bacterial-viral co-identification, and no identification were 200 (27.2%), 159 (21.6%), 107 (14.5%), and 270 (36.7%), respectively. The most common infectious bacteria identified were Pseudomonas aeruginosa (13.0%), Streptococcus pneumoniae (11.4%), and Haemophilus influenzae (5.3%); the most common viruses identified were influenza virus (12.4%), rhinovirus (9.4%), parainfluenza virus (5.2%), and metapneumovirus (4.9%). The bacterial identification rate tended to be higher at more advanced stages of chronic obstructive pulmonary disease (p=0.020 overall, p=0.011 for P. aeruginosa, p=0.048 for S. pneumoniae). Staphylococcus aureus and Klebsiella pneumoniae were identified more in mortality group (p=0.003 for S. aureus, p=0.009 for K. pneumoniae). All viruses were seasonal (i.e., greater prevalence in a particular season; p < 0.050). Influenza virus and rhinovirus were mainly identified in the winter, parainfluenza virus in the summer, and metapneumovirus in the spring. CONCLUSION: This information on the epidemiology of respiratory infections in AECOPD will improve the management of AECOPD using antibiotics and other treatments in Korea.
Anti-Bacterial Agents ; Bacteria ; Epidemiology ; Haemophilus influenzae ; Klebsiella pneumoniae ; Korea ; Medical Records ; Metapneumovirus ; Mortality ; Orthomyxoviridae ; Paramyxoviridae Infections ; Prevalence ; Pseudomonas aeruginosa ; Pulmonary Disease, Chronic Obstructive ; Respiratory Tract Infections ; Rhinovirus ; Seasons ; Staphylococcus aureus ; Streptococcus pneumoniae

BACKGROUND: Invasive bacterial infection is a considerable cause of morbidity and mortality in children. An overall view of the spectrum of invasive bacterial diseases is essential to the establishment of public health priorities. Information regarding the causative bacteria with respect to the age of affected patients and the site of infection, and case-fatality rate is invaluable in the empirical selection of antimicrobial agents. METHODS: One-hundred-and-fifteen episodes of invasive infections in presumably immunocompetent children at ages from 2 months to 15 years at the Seoul National University Children's Hospital, were reviewed retrospectively. Cases with nosocomial infection or underlying conditions that predispose to infection were excluded. RESULTS: The most common clinical entities were bacteremia without an identified focus (37%), followed by meningitis (28%), bacteremic pneumonia or empyema (18%) and bone and joint infection (15%). Staphylococcus aureus (24%), Streptococcus pneumoniae (24%), Salmonella species (23%), Haemophilus influenzae (14 %) and Streptococcus species (4%) together accounted for 90% of all cases. S. aureus was the most common pathogen in bacteremic pneumonia or empyema and bone and joint infection. S. pneumoniae together with H. influenzae were the most common causes of meningitis. The most common organism responsible for bacteremia without an identifiable focus was Salmonella species. The case-fatality rate was 4.8% for all cases of invasive infection. CONCLUSION: We reviewed the relative frequency of bacteria as etiological agents of invasive infections in children. The data may be useful in the establishment of public health priorities and serve as a reference for selection of antibiotics in the empirical therapy of suspected invasive bacterial infections.
Anti-Bacterial Agents ; Anti-Infective Agents ; Bacteremia ; Bacteria ; Bacterial Infections* ; Child* ; Cross Infection ; Empyema ; Haemophilus influenzae ; Humans ; Influenza, Human ; Joints ; Meningitis ; Mortality ; Osteomyelitis ; Pneumonia ; Public Health ; Retrospective Studies ; Salmonella ; Seoul ; Staphylococcus aureus ; Streptococcus ; Streptococcus pneumoniae