Eikenella corrodens in hand infections

Clinical and therapeutic information on 21 patients with hand infection due to Eikenella corrodens is reported. Patients given empiric therapy ineffective against E. corrodens had a high incidence of complications, while proper empiric therapy was associated with good recovery. All hand wounds should be cultured aerobically and anaerobically and empiric antibiotic therapy should include a penicillinase-resistant penicillin or cephalosporin in combination with penicillin G.

Toothpick perforation of the duodenum

An 82-year-old man developed gastrointestinal hemorrhage and polymicrobial sepsis from toothpick perforation of the duodenal bulb. We removed the toothpick endoscopically.

Acute hematogenous osteomyelitis of the rib

Two cases of acute hematogenous osteomyelitis of the rib are presented. In one case the etiologic agent was Staphylococcus aureus coagulase-positive and in the other it was Bacteroides corrodens. Although an uncommon disease, hematogenous osteomyelitis should be considered in the differential diagnosis of destructive lesions of the rib. Anaerobic and aerobic cultures should be obtained for bacteriologic analysis.

Endocarditis due to Eikenella corrodens in a patient with acute lymphocytic leukemia

A patient with acute lymphocytic leukemia in relapse and bacterial endocarditis due to Eikenella corrodens is described. After appropriate treatment was instituted, blood cultures became negative, but the patient died of intracerebral hemorrhage secondary to thrombocytopenia. The role of Eikenella corrodens as a pathogenic bacterium in immunocompromised hosts is described.

Polymicrobial endocarditis involving Eikenella corrodens

Two amphetamine abusers had polymicrobial endocarditis involving Eikenella corrodens as one of the infecting organisms. A 26-year-old woman with left-sided endocarditis due to S. aureus and Eikenella corrodens was treated successfully; however, severe mitral regurgitation resulted from the infection. In the second patient, a 29-year-old man with right-sided endocarditis, three organisms were isolated: a hemolytic Streptococcus, a non-hemolytic Streptococcus, and Eikenella corrodens. This is the first report of polymicrobial endocarditis involving Eikenella corrodens, and emphasizes the importance of this organism parenteral amphetamine abusers. Pitfalls in the diagnosis of polymicrobial endocarditis are discussed, with particular reference to the difficulties in the recognition and management of Eikenella valve infections.

Eikenella corrodens empyema in children

Eikenella corrodens is a slow-growing, Gram-negative, facultative, anaerobic organism that is normally found among oropharyngeal flora. Its isolation as a pathogen is increasingly being reported. Although well documented in the literature on adults, few cases of E corrodens infection have been reported in children. We describe two children with E corrodens pneumonia and empyema. In one, infection was mixed, but in the other the organism was isolated in pure culture. Both patients recovered after therapy with a combination of an antibiotic active in vitro against the organism, and surgical drainage. The diagnosis, bacteriology, and evidence for potential pathogenicity of the organism are reviewed; E corrodens should be considered as a potential pathogen, especially in predisposed patients.

An unusual organism causing orbital cellulitis

Bacterial orbital cellulitis is a feared complication of paranasal sinus infection. Staphylococcus and Streptococcus species are the commoner pathogens involved in these cases. However, anaerobic bacteria and unusual Gram-negative organisms should be suspected as well. We treated a case of bacterial orbital cellulitis due to foci of infected paranasal sinuses caused by Eikenella corrodens, a Gram-negative rod. The patient was managed with intensive antibiotic coverage and surgical intervention.

Abscesses of the frontal lobe of the brain secondary to covert dental sepsis

The bacterial species found in pus aspirated from brain abscesses in two patients were typical of those found in dental sepsis. Subsequently apical-root abscesses were demonstrated in the upper jaws of both patients. This evidence strongly suggests that these cerebral abscesses were secondary to dental sepsis which could have spread from the teeth to the frontal lobes by several possible antaomical pathways.

Sinus infection due to Eikenella corrodens

Eikenella corrodens is a gram-negative rod that has been identified as a cause of endocarditis, osteomyelitis, pneumonia, cellulitis, and other infections. Because it is difficult to grow unless it is incubated in 10% carbon dioxide and because it may be overgrown by other organisms, it can be overlooked as a sinus pathogen. This is a report of the isolation of E corrodens from the sinuses of three patients with sinusitis. Three important features of infection with E corrodens, which are illustrated by these cases, are as follows: (1) the indolence of E corrodens infections; (2) the unusual susceptibility pattern of E corrodens; and (3) the fact that E corrodens is often isolated in mixed culture. The purulent contents of sinus cavities should be cultured in aerobic, anaerobic, and 10% carbon dioxide atmospheres.

Eikenella osteomyelitis of the mandible associated with anemia of chronic disease

An unusual case of mixed bacterial osteomyelitis has been reported. The prodominant organism, E corrodens, normally is an inhabitant of the aerodigestive tract; its pathogenicity should not be overlooked in the diagnosis and treatment of oral infections. In addition, descriptions of anemia of chronic disease and of the spontaneous healing of a large defect of the bone have been presented.