Eikenella corrodens infections

E. corrodens is an anaerobic facultative Gram-negative rod whose natural habitat is the oral cavity and the upper respiratory tract. This work describes four new cases of verified infections associated with this bacterium. A literature review of cases from 1975 to 1984 has been made. In this report, we discuss the pathogenicity of E. corrodens and predisposing factors for infections including underlying diseases. Successful antibiotic therapy can be achieved with benzylpenicillin or ampicillin which are the drugs of choice. E. corrodens is a slow growing bacterium of low virulence, rarely isolated in current practice because of its unusual association with conditions such as human bites, infections of the oral cavity or immuno-suppressive therapy.     

Eikenella corrodens infective endocarditis

The HACEK microorganisms (Haemophilus spp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae) account for 3% of the cases of endocarditis. They have the following similar clinical and microbiological properties: are Gram-negative bacilli, more easily isolated in aerobic media; their cultures require prolonged incubation time for growing (mean, 3.3 days); and may be considered part of normal flora of upper respiratory tract and oropharynx. The following characteristics have been identified in endocarditis caused by the HACEK microorganisms: insidious clinical findings; difficult diagnosis due to the fastidious nature of the microorganisms; and negative cultures. The Eikenella corrodens endocarditis was first described in 1972. That microorganism continues to be a rare etiological agent. We report the case of a female patient with native valve, who had Eikenella corrodens infective endocarditis.     

Thyroid abscess caused by Eikenella corrodens

To our knowledge, this is only the fourth case recorded of thyroid abscess due to Eikenella corrodens and the first in which the causative organism has been isolated in pure culture from the site of infection. E. corrodens may be the cause of apparently sterile thyroid abscesses encountered in head and neck surgery and should be considered in their differential aetiology.     

Isolation of bacteroides corrodens and Eikenella corrodens from human clinical specimens

Summary In the course of a systematic search for Bacteroides corrodens and Eikenella corrodens in clinical specimens submitted for microbiological analysis, 61% of the specimens from anal abscesses, 6% of the vaginal specimens and none of the pharyngeal specimens yielded B. corrodens, whereas E. corrodens was recovered from only 9% of the pharyngeal specimens. Some characteristics were found to be useful in differentiating between the two species: B. corrodens strains were strictly anaerobic, cytochrome-oxidase-negative, urease-positive and gelatinase-positive; they were sensitive to lincomycin but resistant to vancomycin. E. corrodens strains on the other hand were facultatively anaerobic, oxidase-positive, urease-negative and gelatinase-negative; they were resistant to lincomycin but sensitive to vancomycin. The pathogenicity of the two species was difficult to assess as in most cases they were recovered from mixed cultures.

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Die Isolierung der Bacteroides corrodens und Eikenella corrodens aus pathologischem Untersuchungsmaterial bei Menschen. Vergleichende Studie des positiven Nachweises und der Nachweismethode

Zusammenfassung Im Laufe einer systematischen Suche nach Bacteroides corrodens und Eikenella corrodens in klinischem Untersuchungsmaterial, das zur Untersuchung kam, enthielten 61% der Proben von Analabszessen, 6% von Vaginalabstrichen und keiner von Rachenabstrichen B. Corrodens. Hingegen wurden 9% von E. corrodens bei Rachenabstrichen nachgewiesen. Einige Charakteristika wurden als besonders brauchbar für die Differenzierung beider Species gefunden. B. corrodens-Stämme waren streng anacrob, cytochromoxidase-negativ, urease-positiv, und gelatinase-positiv; sie waren lincomycin-empfindlich, aber vancomycin-resistent. Andererseits waren E. corrodens-Stämme fakultativ anaerob, oxydase-positiv, urease-negativ, lincomycinresistent aber vancomycin-empfindlich. Es war schwierig, die Pathogenizität der beiden Species zu beurteilen, da sie in den meisten Fällen aus Mischkulturen isoliert wurden.

     

Pleuropulmonary infections caused by Eikenella corrodens.

A case of pleuropulmonary infection caused by Eikenella corrodens is reported, followed by a review of clinical cases reported in the English-language literature since 1970. On the basis of this review, the predisposing factors, clinical features, and principles of diagnosis and treatment of this infection are outlined. Although infection may occur at any age, it seems to occur most often in patients less than or equal to 14 or greater than or equal to 44 years of age. Adult patients commonly have some underlying medical illness, pleuropulmonary malignancy being the most common. Patients present with a variable combination of fever, cough, and pleuritic chest pain. Four radiographic patterns may be seen: pleural effusion, pneumonia, cavitation, or a combination of these. Ampicillin and penicillin G are effective therapeutic agents; although the susceptibility of E. corrodens to penicillin G has been accepted as the rule, it may not always prevail. The need for increased awareness of this organism as a cause of pleuropulmonary disease is stressed because it is resistant to clindamycin, an agent that is increasingly used to treat anaerobic pleuropulmonary infections.     

Eikenella corrodens as a cause of brain abscess

A case of brain abscess due to Eikenella corrodens in a 67-year-old woman is reported. To our knowledge, this is the first case in which the causative organism has been isolated from the occipital lobe. E. corrodens may be the cause of apparently sterile brain abscesses encountered in neurosurgery and should be considered in the differential etiology of brain abscess.     

Tale of a Toothpick: Eikenella corrodens Osteomyelitis

Summary Tale of a Toothpick is a case of Eikenella corrodens osteomyelitis in a young woman, that resulted from puncture of her foot with a toothpicl. The epidemiology, microbiology, common clinical presentations and therapy of E. corrodens are reviewed. A brief summary of the extent of toothpick injuries and their infectious complications are also presented. Received: Mai 15, 2000 · Revision accepted: July 18, 2000     

Isolation of Eikenella corrodens from pulmonary infections.

Eikenella corrodens is a capnophilic gram-negative rod that is part of the normal human oral flora. We report the isolation of E. corrodens by transtracheal aspiration or percutaneous aspiration from 7 patients with pneumonia and/or lung abscess. Four of the 7 patients had an associated carcinoma of the lung. The susceptibilities of strains were tested to penicillin, dicloxacillin, clindamycin, and 10 cephalosporins. All strains were very susceptible to penicillin and cefoxitin and resistant to dicloxacillin and clindamycin. Susceptibilities of strains to the cephalosporins were variable. E. corrodens has been increasingly identified as a pathogen and should be recognized as an etiologic agent of pneumonia, especially in cases not responding to therapy with a penicillinase-resistant penicillin, clindamycin, or cephalosporin.     

Eikenella corrodens isolated from a polymicrobial hepatic abscess

A 71-yr-old woman developed a hepatic abscess from which Eikenella corrodens was isolated as part of a polymicrobial flora. This facultatively anaerobic organism is now recognized as a true pathogen. Selective culture media may be required to isolate Eikenella corrodens, and it may be resistant to antibiotics commonly used for anaerobic infections. Special attempts to isolate this organism may be indicated when hepatic abscesses are likely to have resulted from spread of oral or abdominal infections.