HACEK Infective Endocarditis

HACEK is an acronym for 5 Gram-negative bacterial genera:

(H) Haemophilus

(A) Aggregatibacter

(C) Cardiobacter

(E) Eikenella

(K) Kingella

Features:

(1) The bacteria are part of the normal oropharyngeal and urogenital flora.

(2) The endocarditis can be insidious with the diagnosis often delayed.

(3) Vegetations with or without emboli may be present.

(4) Some patients present with heart failure.

(5) Blood cultures may require an enriched media and extended incubation in CO2.

Risk factors for endocarditis:

(1) dental infection or surgery

(2) valvular disease or prosthetic valve