JACC. Case reports · 2026
Endocarditis Masquerading as Malignancy: Native Valve HACEK Infection.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Shusterman Vlad S, Salamatbad Gidon, Cyr Andrew, Wallach Yisrael, Carlin Alexander, Yen Christine, Kim Eileen, Galmer Andrew
Аннотация
BACKGROUND: HACEK (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella) endocarditis is a rare cause of subacute infective endocarditis typically occurring in patients with pre-existing valvular pathology or structural heart disease.
CASE SUMMARY: A 65-year-old male presented with months of night sweats, fevers, anemia, and weight loss concerning for malignancy. Transthoracic echocardiography was negative for vegetations. Blood cultures grew Aggregatibacter actinomycetemcomitans, and transesophageal echocardiography confirmed vegetations on the mitral and aortic valves. The patient was treated successfully with a 6-week course of intravenous ceftriaxone.
DISCUSSION: This case highlights the diagnostic challenge of indolent HACEK endocarditis in the absence of traditional risk factors, presenting as malignancy, underscoring the importance of transesophageal echocardiography, even when transthoracic imaging is unrevealing.
TAKE-HOME MESSAGE: In patients with persistent constitutional symptoms with negative malignancy workup, HACEK endocarditis should remain in the differential, and transesophageal echocardiography is essential for diagnosis.
CASE SUMMARY: A 65-year-old male presented with months of night sweats, fevers, anemia, and weight loss concerning for malignancy. Transthoracic echocardiography was negative for vegetations. Blood cultures grew Aggregatibacter actinomycetemcomitans, and transesophageal echocardiography confirmed vegetations on the mitral and aortic valves. The patient was treated successfully with a 6-week course of intravenous ceftriaxone.
DISCUSSION: This case highlights the diagnostic challenge of indolent HACEK endocarditis in the absence of traditional risk factors, presenting as malignancy, underscoring the importance of transesophageal echocardiography, even when transthoracic imaging is unrevealing.
TAKE-HOME MESSAGE: In patients with persistent constitutional symptoms with negative malignancy workup, HACEK endocarditis should remain in the differential, and transesophageal echocardiography is essential for diagnosis.