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HACEK

QuestionAnswer
What are the HACEK organisms? Haemophilus aphrophilus. Actinobacillus actinomycetemcomitans. Cardiobacterium hominis. Eikenella corrodens. Kingella species.
Which organism is the most prevalent in causing endocarditis and what are the biochemical chemical reactions? Haemophilus aphropilus. Catalase, urea, and indole = negative. Ferments lactose.
What are the two species of Kingella and which is important in children? 1) Kingella denitrificans 2) Kingella kingae, most important in children <5, causing bone and joint infections and bacteremia.
What is A. actinomycetemcomitans associated with and what are some ways to identify it? It is associated with Actinomycotic lesions, normally of the jaw, destructive periodontitis, and abscesses within the thoracic cavity. It is a coccobacillary GNR, with Morse Code appearance. Star like colony morphology but does NOT grow on MAC.
Which organism forms rosette-like arrangements on gram stain and what are the biochemical reactions? Cardiobacterium hominis. It is oxidase + and spot indole +. It is also urea, catalase, nitrate, gel, and esculin negtaive. It will NOT grow on MAC.
How is an Eikenella corrodens infection acquired? Causes bacteremia and endocarditis often seen in IV drug users or from extensive dental work. Also human bites or "clenched fist wounds."
How is Eikenella corrodens identified? Gram stain = GNR Media = grows well on BAP or CHOC but NOT MAC. some isolates may "pit" or corrode the agar. Biochemical = Oxidase, lysine, ornithine, and nitrate = postive. Catalase negative. Non-glucose utilizer.
What do all the HACEK organisms have in common? They are GNRs, that grow in increased CO2. They are the major cause of endocarditis while also considered as normal oral flora that are opportunists.