HACEK GROUP

·         Gram –ve + Capnophilic

·         Normal flora of oral cavity therefore, can cause local infections.

·         Most common severe systemic infection is Subacute Infective Endocarditis of both native and prosthetic valves.

·         Most common valves – Aortic and Mitral valves

·         Embolization is common

·         Diagnosis-

§  Culture

§  PCR (e.g. heart valves)

·         Antibiotic susceptibility should always be done. (E-test methodology used)

·         Treatment should be for

§  Native Valves endocarditis - 4 weeks

§  Prosthetic Valve endocarditis - 6 weeks

HACEK GROUP	CHARACTERISTICS	TREATMENT
		INITIAL	ALTERTNATIVE
Haemophilus spp.	·         H. aphrophilus (requires factor X) and H. parainfluenzae (requires factor V) are the most common isolated.	Ceftriaxone (2g/day)	Ampicillin + Sulbactam/ Fluoroquinolones
Aggregatibacter (formerly Actinobacillus) actinomycetemcomitans	·         Associated with periodontal abscess and dental procedures	Ceftriaxone	Ampicillin + sulbactam/ Fluoroquinolones
Cardiobacterium hominis	·         Valvular heart disease + Prosthetic valves ·         Aortic valve (M.C.)	Ceftriaxone	Ampicillin + Sulbactam
Eikenella corrodens		Ampicillin	Ceftriaxone/ Fluoroquinolones
Kingella kingae			Fluoroquinolones