HACEK endocarditis

HACEK endocarditis

The HACEK organisms are a group of human flora, living in the oral-pharyngeal region.[2]

The bacteria were originally grouped because they were thought to be a significant cause of [1]


  • Organisms 1
  • Presentation 2
  • Treatment 3
  • References 4


HACEK originally referred to

  1. ^ a b c d e Nørskov-Lauritsen, N (Apr 2014). "Classification, identification, and clinical significance of haemophilus and aggregatibacter species with host specificity for humans". Clinical Microbiology Reviews 27 (2): 214–40.  
  2. ^ Feder HM, Jr; Roberts, JC; Salazar, J; Leopold, HB; Toro-Salazar, O (Jun 2003). "HACEK endocarditis in infants and children: two cases and a literature review.". The Pediatric Infectious Disease Journal 22 (6): 557–62.  
  3. ^ Raza, SS; Sultan, OW; Sohail, MR (Aug 2010). "Gram-negative bacterial endocarditis in adults: state-of-the-heart.". Expert review of anti-infective therapy 8 (8): 879–85.  
  4. ^ Chambers, ST; Murdoch, D; Morris, A; Holland, D; Pappas, P; Almela, M; Fernández-Hidalgo, N; Almirante, B; Bouza, E; Forno, D; del Rio, A; Hannan, MM; Harkness, J; Kanafani, ZA; Lalani, T; Lang, S; Raymond, N; Read, K; Vinogradova, T; Woods, CW; Wray, D; Corey, GR; Chu, VH; International Collaboration on Endocarditis Prospective Cohort Study, Investigators (2013). "HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort.". PLoS ONE 8 (5): e63181.  
  5. ^ a b c d Sen Yew, H; Chambers, ST; Roberts, SA; Holland, DJ; Julian, KA; Raymond, NJ; Beardsley, J; Read, KM; Murdoch, DR (Jun 2014). "Association between HACEK bacteraemia and endocarditis". Journal of medical microbiology 63 (Pt 6): 892–5.  
  6. ^ a b c Wassef, N; Rizkalla, E; Shaukat, N; Sluka, M (May 15, 2013). "HACEK-induced endocarditis". BMJ case reports 2013: bcr2012007359.  
  7. ^ [1], eMedicine, HACEK organism infection. June 2005.


The treatment of choice for HACEK organisms in endocarditis is ceftriaxone, a third generation cephalosporin and a β-Lactam antibiotic (as are the penicillins). Ampicillin (a penicillin) and low-dose gentamicin (an aminoglycoside) is another therapeutic option.[7]


In addition to valvular infections in the heart, they can also produce other infections such as bacteremia, abscess, peritonitis, otitis media, conjunctivitis, pneumonia, arthritis, osteomyelitis, and periodontal infections.

All of these organisms are part of the normal oropharyngeal flora, which grow slowly (up to 14 days), prefer a carbon dioxide–enriched atmosphere, and share an enhanced capacity to produce endocardial infections, especially in young children. Collectively they account for 5–10% of cases of infective endocarditis involving native valves and are the most common gram-negative cause of endocarditis among people who do not use IV drugs. They have been a frequent cause of culture-negative endocarditis. Culture negative refers to an inability to produce a colony on regular agar plates; this is because these bacteria are fastidious (requiring a specific nutrient).


A list of HACEK organisms:

[6][5][4] but recent papers are using the new classification.[3]