The genus Aggregatibacter was created in 2006 to accommodate some species that were distantly related to the Haemophilus genus. However, the fastidious feature often challenges traditional microbiological procedures, which may result in diagnostic delay and disease deterioration.Īggregatibacter segnis, formerly known as Haemophilus segnis, was first isolated from human dental plaque in 1976. The HACEK group contributes to most Gram-negative bacterial endocarditis, accounting for 1.2-3% of all IE cases. , which are commensals in the oropharyngeal, respiratory, gastrointestinal, and urogenital tract. The acronym HACEK denotes a group of Gram-negative fastidious organisms, including Haemophilus and Aggregatibacter spp., Cardiobacterium spp., Eikenella corrodens, and Kingella spp. Infective endocarditis (IE) is anx` uncommon disease with diverse presentations and a poor prognosis. The hypothesis-independent molecular techniques can outperform conventional tools to prevent diagnostic delay. segnis infective endocarditis that combined MALDI-TOF and metagenomic next-generation sequencing in the diagnosis. He remained clinically well, with laboratory results restored. The patient was treated with ceftriaxone for four weeks and discharged. While the surgical specimen culture was negative, the mNGS was positive for A. Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry and metagenomic next-generation sequencing (mNGS) identified A. With the suspicion of infective endocarditis and heart failure, we immediately performed microbiological tests and arranged the cardiac replacement surgery. Severe regurgitation of the aortic valve and left heart dysfunction were also detected. Transthoracic echocardiography demonstrated multiple vegetations in the mitral and aortic valves. Pitting edema was evident in the lower extremities. Physical examination revealed systolic murmurs in the aortic and mitral valve areas. On presentation, he was febrile and tachycardic but otherwise with stable vital signs.
Case presentationĪ 31-year-old male was admitted to our hospital for a 3-month history of intermittent high fever, chills, and chest distress.
segnis) is a fastidious Gram-negative coccobacillus that resides in the human oropharyngeal flora. As a member of the HACEK group, Aggregatibacter segnis ( A.
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