We present a case of endocarditis with embolic stroke and digital infarction due to the recently renamed Aggregatibacter aphrophilus. The isolation and identification of this organism can be problematic but was achieved in this case using both older phenotypic and newer genotypic methods. A benign tongue lesion is suggested as the likely portal of entry for this oropharyngeal organism. The patient made a good recovery with six weeks of intravenous ceftriaxone but will need cardiac valvular surgery at some point in the future.
KhairatO.Endocarditis due to a new species of Haemophilus.J Pathol Bacteriol1940; 50: 497–505.
2.
ZinnemanK, RogersKB, FrazerJ, BoyceJMH.New V-dependent Haemophilus species preferring increased CO2 tension for growth and named Haemophilus paraphrophilus, Nov. Sp.J Pathol Bacteriol1968; 96: 413–19.
3.
Nørskov-LauritsenN, KilianM.Reclassification of Actinobacillus actinomycetemcomitans, Heamophilus aphrophilus, Haemophilus paraphrophilus and Haemophilus segnis as Aggregatibacter actinomycetemcomitans gen. nov., comb. Nov., Aggregatibacter aphrophilus comb. Nov. and Aggregatibacter segnis comb. Nov., and emended description of Aggregatibacter aphrophilus to include V factor-dependent and V factor-independent isolates.Int J Syst Evol Microbiol2006; 56: 2135–46.
4.
BiegerRC, BrewerNS, WashingtonJA.Haemophilus aphrophilus: a microbiologic and clinical review and report of 42 cases.Medicine1978; 57: 345–55.
DoernGV, DavaroR, GeorgeM, CampognoneP.Lack of requirement for prolonged incubation of Septi-Chek blood culture bottles in patients with bacteremia due to fastidious bacteria.Diagn Microbiol Infect Dis1996; 24: 141–3.
8.
BaronEJ, ScottJD, TompkinsLS.Prolonged incubation and extensive subculturing do not increase recovery of clinically significant microorganisms from standard automated blood cultures.CID2005; 41: 1677–80.
9.
GouldFK, DenningDW, ElliotTSJ.Guidelines for the diagnosis and antibiotic treatment of endocarditis in adults: report of the Working Party of the British Society for Antimicrobial Chemotherapy.J Antimicrob Chemother2012; 67: 269–89.
