Published online Oct 26, 2022. doi: 10.4330/wjc.v14.i10.546
Peer-review started: July 2, 2022
First decision: August 1, 2022
Revised: August 27, 2022
Accepted: September 15, 2022
Article in press: September 15, 2022
Published online: October 26, 2022
Processing time: 109 Days and 4.4 Hours
Existing data indicate that the incidence of infective endocarditis (IE) continues to rise steadily. Although components of the skin flora including Staphylococcus spp., Streptococcus spp., and Enterococcus spp. are the most implicated organisms particularly in virulent IE, the oropharyngeal flora including the HACEK group of are a significant cause of IE.
An interesting presentation of Haemophilus parainfluenza (HPI) IE in a 25-year-old man with no significant past medical history and no predisposing risk factor for IE was the basis for this systematic review. It aimed to determine if there have been temporal changes in the presentation and prognosis of IE caused by HPI over the past two decades.
To characterize the risk factors, signs and symptoms, echocardiographic findings and the prognosis of IE caused HPI.
A search of Medline, Pubmed, Scopus and Embase was conducted to identify the cases of HPI IE published in 2000–2022. A systematic review of these cases was performed to analyze the trends in the presentation and prognosis of HPI IE.
This systematic review of 39 HPI IE cases in the English literature highlights the slight male predominance of the disease, the nonspecific presentation with constitutional symptoms, the predilection for the mitral valve, a high rate of central nervous system embolic events and a lower mortality rate compared to IE caused by microbes of the skin flora.
HPI IE is an indolent disease that requires a high index of suspicion to diagnose and is associated with a favorable prognosis with timely intervention.
We have illustrated a case and conducted a two-decade systematic review of the HPI IE cases published in the English language literature. In doing so, we have highlighted its indolent course, presentation and prognosis. We have also compared our findings with those of a review of HPI IE cases between 1984 and 1995; in doing so, we have enumerated some temporal changes in this disease entity. These include a younger mean age of presentation, identical rate of infection between males and females, improvement in diagnosis, a higher rate of embolic events and an increasing association with intravenous drug use.