1.Aggregatibacter actinomycetemcomitans Endocarditis in a Patient with Chronic Periodontitis: A Case Report
Hui Shan Chua ; Yih Harng Soh ; Shih Keng Loong ; Sazaly Abu Bakar ; Syafinaz Amin Nordin ; Siti Zulaikha Zakariah ; Rosni Ibrahim
Malaysian Journal of Medicine and Health Sciences 2023;19(No.2):337-340
The HACEK organisms consist of the non-influenzae Haemophilus sp., Aggregatibacter sp., Cardiobacterium sp.,
Eikenella corrodens and Kingella sp. are responsible for a sizable percentage of infective endocarditis cases worldwide with the mortality rate of 18%. Amongst them, Aggregatibacter actinomycetemcomitans is the most common
pathogen strongly associated with infective endocarditis. A. actinomycetemcomitans forms part of the oral microbiota and is also the etiological agent of periodontitis. Here, we present a case of a 37-year-old man with underlying
obstructive uropathy, that sought treatment for postural hypotension and symptomatic anaemia with fever. Later,
he had developed decompensated congestive cardiac failure with aortic regurgitation. A cardiac echocardiogram
revealed the presence of vegetation on the aortic valve. Blood culture grew A. actinomycetemcomitans, and he
was treated with furosemide and ceftriaxone. A further dental examination showed the patient is having chronic
periodontitis, which could be the possible source of A. actinomycetemcomitans causing infective endocarditis. The
patient was then transferred to the National Heart Centre for the first time for further management after completion of
4 weeks of intravenous antibiotics. As the pathogen is fastidious, rapid and newer technology like MALDI-TOF mass
spectrometry provides rapid and accurate identification for appropriate patient clinical management.