WorldWideScience
1

Shewanella putrefaciens infective endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Shewanella putrefaciens rarely causes infection in humans. In the last few decades a growing number of cases have been described. The following report outlines the case of a 40-year- old immunocompetent white man with S. putrefaciens infective endocarditis. This is the first known case of infective [...] endocarditis due to an apparently monomicrobial S. putrefaciens infection, and the second known case of S. putrefaciens-related infective endocarditis worldwide.

Jonathan, Constant; Ivan, Chernev; Eric, Gomez.

2014-12-01

2

[Eikenella corrodens infective endocarditis].  

Science.gov (United States)

The HACEK microorganisms (Haemophilus spp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae) account for 3% of the cases of endocarditis. They have the following similar clinical and microbiological properties: are Gram-negative bacilli, more easily isolated in aerobic media; their cultures require prolonged incubation time for growing (mean, 3.3 days); and may be considered part of normal flora of upper respiratory tract and oropharynx. The following characteristics have been identified in endocarditis caused by the HACEK microorganisms: insidious clinical findings; difficult diagnosis due to the fastidious nature of the microorganisms; and negative cultures. The Eikenella corrodens endocarditis was first described in 1972. That microorganism continues to be a rare etiological agent. We report the case of a female patient with native valve, who had Eikenella corrodens infective endocarditis. PMID:16041457

Cardoso, Juliano Novaes; Ochiai, Marcelo Eidi; Oliveira, Múcio T; Morgado, Paulo; Munhoz, Robinson; Andretto, Fernanda E; Mansur, Alfredo José; Barretto, Antonio Carlos Pereira

2005-07-01

3

Infective endocarditis: surgical therapy  

OpenAIRE

OBJECTIVE: To assess the major causes of surgical morbidity and mortality in patients with infective endocarditis operated upon in a regional cardiology center. METHODS: Thirty-four patients underwent surgical treatment for infective endocarditis. Their ages ranged from 20 to 68 years (mean of 40.6) and 79% were males. Their NYHA functional classes were as follows: IV - 19 (55.8%) patients; III - 12 (35.2%) patients; II - 3 (8.8%) patients. Blood cultures were positive in only 32% of the case...

Fragomeni Luís Sérgio de Moura; Vieira Fabiano Fernandes; Bajerski Júlio Cesar de Mello; Falleiro Roque Paulo; Hoppen Gustavo; Sartori Iselso

2003-01-01

4

Nosocomial infective endocarditis in Hemodialysis  

International Nuclear Information System (INIS)

There is an increased risk of infective endocarditis catheterization usedfor Hemodialysis. We report a case of a young man who had endocarditissecondary to the use of a permanent jugular catheter for hemodialysis. Bloodcultures were repeatedly negative, but vegetations were seen on the tricuspidvalve on echocardiography. A high index of suspicion is recommended for thisserious complication. (author)

5

Immunologic evaluation in infective endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available OBJECTIVE: To analyze the immune response in peripheral blood of patients with infective endocarditis. METHODS: We studied 10 patients with infective endocarditis, age range from 20 to 50 years-old, males and females, and 20 healthy subjects in the same age range. The diagnosis of the disease was based on the clinical picture, echocardiogram, and hemoculture based upon samples drawn and tested before the treatment started. The were no history of atopy or malnutrition, no autoimmune disease, and they were not using any immunosuppressant or antibiotic medication. RESULTS: The patients with endocarditis had significantly higher T and B lymphocyte, CD4+ and CD8+ cell counts, IgM and IgG serum levels, and C4 component of the complement than the control group; no significant difference concerning serum IgA and neutrophil oxidative metabolism; a significant decrease in C3, chemotaxis, and monocyte phagocytosis;cryoglobulins were detected in 66.6% of patients and they were formed by IgG, IgM, IgA, C3, and C4. CONCLUSION: The patients with infective endocarditis were immunocompetent in most sectors of immune response and, at a certain moment, an autoimmune component may be present.

Forte Wilma C. Neves

2001-01-01

6

Immunologic evaluation in infective endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: To analyze the immune response in peripheral blood of patients with infective endocarditis. METHODS: We studied 10 patients with infective endocarditis, age range from 20 to 50 years-old, males and females, and 20 healthy subjects in the same age range. The diagnosis of the disease was ba [...] sed on the clinical picture, echocardiogram, and hemoculture based upon samples drawn and tested before the treatment started. The were no history of atopy or malnutrition, no autoimmune disease, and they were not using any immunosuppressant or antibiotic medication. RESULTS: The patients with endocarditis had significantly higher T and B lymphocyte, CD4+ and CD8+ cell counts, IgM and IgG serum levels, and C4 component of the complement than the control group; no significant difference concerning serum IgA and neutrophil oxidative metabolism; a significant decrease in C3, chemotaxis, and monocyte phagocytosis;cryoglobulins were detected in 66.6% of patients and they were formed by IgG, IgM, IgA, C3, and C4. CONCLUSION: The patients with infective endocarditis were immunocompetent in most sectors of immune response and, at a certain moment, an autoimmune component may be present.

Wilma C. Neves, Forte; Aline C., Mario; Adilson da, Costa; Luciana S., Henriques; Carla L., Gonzales; Roberto A., Franken.

2001-01-01

7

Endocarditis infecciosa: Una enfermedad cambiante / Infective endocarditis: A changing disease  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish A pesar de los avances en el diagnóstico y en el tratamiento antibiótico y quirúrgico, la endocarditis infecciosa sigue siendo una enfermedad con una mortalidad elevada. Los estudios llevados a cabo en nuestro país y en otros países demostraron que el perfil clínico del paciente ha cambiado. Existe [...] mayor prevalencia de pacientes añosos con enfermedad degenerativa valvular, las endocarditis protésicas y nosocomiales son más frecuentes y aumentó la presencia del Staphylococcus aureus. Estos cambios podrían justificar la ausencia de disminución en la mortalidad de esta enfermedad y plantean la necesidad de encarar enfoques más agresivos de tratamiento mediante la confección de estudios prospectivos bien diseñados y controlados. Abstract in english In spite of the advance in diagnosis and antibiotic and surgical treatment, mortality of infective endocarditis remains high. Recent studies in various countries and in Argentina have shown that the clinical profile of infective endocarditis has changed. Currently the patients are older with higher [...] frequency of degenerative valve disease and prosthetic valve and nosocomial endocarditis. The incidence of Staphylococcus aureus as etiological agent has increased. These changes may justify the absence of decrease in mortality and suggests that more aggressive measures are needed based on prospective, well designed and controlled trials.

José Horacio, Casabé.

2008-04-01

8

[Infective endocarditis caused by unusual microorganisms].  

Science.gov (United States)

All series of infective endocarditis had a variable proportion of cases without an etiologic agent because all cultures were negative. New microbiologic techniques have permitted the discovery of the role of many microorganisms in infective endocarditis. C. burnetii is an increasing causative agent of subacute infective endocarditis. In the diagnosis, to the detection of antiphase-I antibodies, immunohistochemical, molecular techniques and cellular cultures have been added. Total cure is difficult to obtain. The combination of doxicicline plus ciprofloxacin for at least 3 years has been proposed as the treatment of choice. Surgery must be reserved for patients with cardiac insufficiency. Less than 2% of cases of acute brucellosis are complicate with infective endocarditis. Infective endocarditis produces serious and rapid valvular destruction with high mortality rates if valve surgery is not performed. For medical treatment at least 3 active agents are required. Bartonella has recently been described as an etiologic agent of infective endocarditis. It mainly affects to homeless people living in poor hygienic conditions. The aortic valve is most commonly involved and, frequently, valve insufficiency requires valve replacement. Blood culture isolation needs long incubation periods. Parenteral nutrition, immunosuppression, wide spectrum antibiotic regimens, intravenous drug addiction and cardiovascular surgery are risk factors previously described in the development of fungal endocarditis. C. albicans and Aspergillus spp. are most frequent etiologic agents. Infective endocarditis should be suspected in any patient with systemic fungal disease. Blood cultures are often negative except for Candida spp. Peripheral emboli and large vegetations are frequent. Mortality is high, antifungal therapy combined with surgery is the treatment of choice. Legionella, Mycoplasma, Chlamydia, Mycobacteria, viruses are potential agents of infective endocarditis, and difficult to diagnose because of special culture requirements. Epidemiological clues, serologic and molecular techniques and blood cultures could identify them. PMID:9658953

Menasalvas, A; Bouza, E

1998-01-01

9

Pseudoaneurysm formation in infective endocarditis.  

Science.gov (United States)

Left ventricular pseudoaneurysms that develop in the setting of infective endocarditis are believed to result from remodeling of extravalvular abscesses. The high pressure generated by the left ventricle is thought to dissect into the abscess causing it to form a characteristic sac-like protuberance readily recognized echocardiographically. Left ventricular pseudoaneurysms most often arise from abscesses in the mitral-aortic intervalvular fibrosa and protrude external to the aorta. Less often, as described herein, they arise from abscesses external the posterior mitral annulus and project into the posterior interventricular groove. Perforation may result in camo-cameral or aorto-cameral fistula formation, as well as fistulous communication with the pericardial space. PMID:23906264

Silbiger, Jeffrey J; Krasner, Andrew; Chikwe, Joanna; Marino, Thomas; Mathewkutty, Shiny; Marcali, Marian; Edebohls, Brian; Kamran, Mazullah

2013-11-01

10

Clinical manifestations of lead-dependent infective endocarditis: analysis of 414 cases.  

Science.gov (United States)

It is important to identify clinical manifestations of lead-dependent infective endocarditis (LDIE), as it begins insidiously with the slow development of nonspecific symptoms. Clinical data from 414 patients with the diagnosis of LDIE according to Modified Duke Lead Criteria (MDLC) were analyzed. Patients with LDIE had been identified in a population of 1,426 subjects submitted to transvenous lead extraction (TLE) in the Reference Clinical Cardiology Center in Lublin between 2006 and 2013. The symptoms of LDIE and pocket infection were detected in 62.1 % of patients. The mean duration of LDIE symptoms prior to referral for TLE was 6.7 months. Fever and shivers were found in 55.3 % of patients, and pulmonary infections in 24.9 %. Vegetations were detected in 67.6 % of patients, and positive cultures of blood, lead, and pocket in 34.5, 46.4, and 30.0 %, respectively. The most common pathogens in all type cultures were coagulase-negative staphylococci (CNS), with Staphylococcus epidermidis domination; the second most common organism was Staphylococcus aureus. 76.3 % of patients were treated with empirical antibiotic therapy before hospitalization due to TLE. In the laboratory tests, the mean white blood cell count was 9,671?±?5,212/?l, mean erythrocyte sedimentation rate 43 mm, C-reactive protein (CRP) 46.3 mg/dl?±?61, and procalcitonin 1.57?±?4.4 ng/ml. The multivariate analysis showed that the probability of LDIE increased with increasing CRP. The diagnosis of LDIE based on MDLC may be challenging because of a relatively low sensitivity of major criteria, which is associated with early antibiotic therapy and low usefulness of minor criteria. The important clinical symptoms of LDIE include fever with shivering and recurrent pulmonary infections. The most specific pathogens were Staphylococcus epidermidis and Staphylococcus aureus. Laboratory tests most frequently revealed normal white blood cell count, relatively rarely elevated procalcitonin level, and significantly increased erythrocyte sedimentation rate (ESR) and CRP. This constellation of signs should prompt a more thorough search for LDIE. PMID:24791953

Polewczyk, A; Janion, M; Podlaski, R; Kutarski, A

2014-09-01

11

Failure of early diagnosis of infective endocarditis in Japan--a retrospective descriptive analysis.  

Science.gov (United States)

Infective endocarditis (IE) is a severe disease with high morbidity and mortality, and these can be exacerbated by delay in diagnosis. We investigated IE diagnosis in Japan with the emphasis on the delay in diagnosis and its cause and implications. We conducted a retrospective study on 82 definite IE patients at Kobe University Hospital from April 1, 2008, through March 31, 2013. We reviewed charts of the patients for data such as causative pathogens, prescription of inappropriate antibiotic use prior to the diagnosis, existence of risk factors of IE, previous doctor's subspecialty, or duration until the diagnosis, with the primary outcome of 180-day mortality. We also qualitatively, as well as quantitatively, analyzed those cases with delay in diagnosis, and hypothesized its causes and implications. Eighty-two patients were reviewed for this analysis. The average age was 61 ± 14.5-year-old. Fifty percent of patients had known underlying risk factors for IEs, such as prosthetic heart valve (10), valvular heart disease (21), congenital heart disease (3), or cardiomyopathy (2). The median days until the diagnosis was 14 days (range 2 days to 1 year). Sixty-five percent of patients received inappropriate antibiotic before the diagnosis (53). Forty percent of causative organisms were Staphylococcus aureus (MSSA 20, MRSA 13), 32% were viridans streptococci and Streptococcus bovis, 28% were others or unknown (CNS 5, Corynebacterium 3, Cardiobacterium 1, Candida 1). Subspecialties such as General Internal Medicine (15), and Orthopedics (13) were associated with delay in diagnosis. Ten patients (12%) died during follow up, and 8 of them had been received prior inappropriate antibiotics. Significant delay in the diagnosis of IE was observed in Japan. Inappropriate antibiotics were prescribed frequently and may be associated with poor prognosis. Further improvement for earlier diagnosis of IE is needed. PMID:25501088

Fukuchi, Takahiko; Iwata, Kentaro; Ohji, Goh

2014-12-01

12

Clinical relevance of vegetations in infective endocarditis.  

Science.gov (United States)

Two-dimensional echocardiograms of 58 patients with infective endocarditis were examined to determine if presence and/or size of vegetations on echocardiogram were predictive of morbidity and mortality. Group 1 (38 patients) with one or more vegetations, had a significantly higher rate of complications (emboli, congestive heart failure, need for surgery and death) than group 2 (20 patients) without vegetations (p less than 0.001). Analysis of morphologic characteristics of the vegetations in group 1 was of no predictive value for complications in individual patients. In contrast, patients whose echocardiograms demonstrated vegetations on aortic valve had a significantly higher incidence of heart failure, embolisation, surgery and death than those with vegetations on mitral valve. Thus, the detection of vegetations on initial echocardiogram clearly identifies a subgroup at risk for complications, more so if vegetations are present on the aortic valve, but the vegetations size does not predict an adverse clinical outcome. PMID:1821000

Soni, D; Dhawan, S; Agarwal, S; Chandra, N; Chandra, P; Dwivedi, S; Puri, V K; Hasan, M

1991-01-01

13

Chemoprophylaxis against infective endocarditis following dental surgery  

OpenAIRE

Patients with certain cardiovascular abnormalities are recognised to beat risk - and some at high risk - of developing infective endocarditis following episodes of bacteraemia. Whenever a clinically important bacteraemia is anticipated in such susceptible patients, chemoprophylaxis (use of systemic antimicrobials) is advocated. However, the effectiveness of such measures remains unclear. Patients undergoing dentisty/oral surgery (especially extractions) experience bacteraemias (mainly viridan...

Kumana, Cr; Yuen, Ky; Samaranayake, Lp

1995-01-01

14

Complete genome and comparative analysis of Streptococcus gallolyticus subsp. gallolyticus, an emerging pathogen of infective endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Streptococcus gallolyticus subsp. gallolyticus is an important causative agent of infectious endocarditis, while the pathogenicity of this species is widely unclear. To gain insight into the pathomechanisms and the underlying genetic elements for lateral gene transfer, we sequenced the entire genome of this pathogen. Results We sequenced the whole genome of S. gallolyticus subsp. gallolyticus strain ATCC BAA-2069, consisting of a 2,356,444 bp circular DNA molecule with a G+C-content of 37.65% and a novel 20,765 bp plasmid designated as pSGG1. Bioinformatic analysis predicted 2,309 ORFs and the presence of 80 tRNAs and 21 rRNAs in the chromosome. Furthermore, 21 ORFs were detected on the plasmid pSGG1, including tetracycline resistance genes telL and tet(O/W/32/O. Screening of 41 S. gallolyticus subsp. gallolyticus isolates revealed one plasmid (pSGG2 homologous to pSGG1. We further predicted 21 surface proteins containing the cell wall-sorting motif LPxTG, which were shown to play a functional role in the adhesion of bacteria to host cells. In addition, we performed a whole genome comparison to the recently sequenced S. gallolyticus subsp. gallolyticus strain UCN34, revealing significant differences. Conclusions The analysis of the whole genome sequence of S. gallolyticus subsp. gallolyticus promotes understanding of genetic factors concerning the pathogenesis and adhesion to ECM of this pathogen. For the first time we detected the presence of the mobilizable pSGG1 plasmid, which may play a functional role in lateral gene transfer and promote a selective advantage due to a tetracycline resistance.

Dreier Jens

2011-08-01

15

Infective endocarditis causing acute aortic regurgitation  

Directory of Open Access Journals (Sweden)

Full Text Available Interesting echocardiographic features in a case o f acute onset aortic regurgitation due to infective endocarditis of bicuspid aortic valve are reported. Early closure of mitral valve (ECMV recog-nised by echocardiography confirmed the clinical diagnosis of acute inset aortic regurgitation. Aortic root echocardiogram showed ec-centric diastolic closure line of bicuspid aortic leaflets and multiple echoes on aortic leaflets due to bacterial vegetations.

Shah Lilam

1979-01-01

16

Infective endocarditis and the pacemaker: cardiac implantable electronic device infection.  

Science.gov (United States)

We are seeing more implantation of cardiac device such as pacemakers and defibrillators and also cardiac implantable electronic device infection. The infection may affect just the pocket site or progress to deeper infection and bacteraemia. Inadequately treated infection may lead to right sided endocarditis, cardiotomy for pacemaker explantation and increased cost and length of stay in the hospital. We report a Staphylococcal infection of a pacemaker system, its successful medical and surgical management. PMID:23770958

Yew, K L

2012-12-01

17

Infective endocarditis: a consumptive disease among the elderly Infective endocarditis: a consumptive disease among the elderly  

Directory of Open Access Journals (Sweden)

Full Text Available The clinical presentation of infective endocarditis varies according to theetiologic agent and the host. In elderly individuals, infective endocarditis canbe difficult to diagnose and poses a challenge for the physician. The course ofsubacute infective endocarditis is indolent, and the onset of cardiac structurallesion is slow and gradual. In elderly patients, anemia and weight loss areoccasionally the only or the most striking symptoms. In such cases, the clinicalreasoning process leads to a hypothesis of wasting syndrome or neoplasticdisease, especially when there is no fever. We report the case of an elderlypatient who had mitral insufficiency due to degenerative valve disease andpresented with bacterial endocarditis due to Streptococcus mitis. The patientwas not treated, because the diagnosis was not established in a timely manner.It is of note that the patient presented with marked weight loss and no fever.The autopsy revealed impairment of the mitral valve and left atrium due toendocarditis, as well as lung involvement due to chronic inhalation of smokefrom biomass burning, such as that produced by wood-burning stoves.The clinical presentation of infective endocarditis varies according to theetiologic agent and the host. In elderly individuals, infective endocarditis canbe difficult to diagnose and poses a challenge for the physician. The course ofsubacute infective endocarditis is indolent, and the onset of cardiac structurallesion is slow and gradual. In elderly patients, anemia and weight loss areoccasionally the only or the most striking symptoms. In such cases, the clinicalreasoning process leads to a hypothesis of wasting syndrome or neoplasticdisease, especially when there is no fever. We report the case of an elderlypatient who had mitral insufficiency due to degenerative valve disease andpresented with bacterial endocarditis due to Streptococcus mitis. The patientwas not treated, because the diagnosis was not established in a timely manner.It is of note that the patient presented with marked weight loss and no fever.The autopsy revealed impairment of the mitral valve and left atrium due toendocarditis, as well as lung involvement due to chronic inhalation of smokefrom biomass burning, such as that produced by wood-burning stoves.

Vilma Takayasu

2011-12-01

18

Endocarditis infecciosa: Una enfermedad cambiante Infective endocarditis: A changing disease  

OpenAIRE

A pesar de los avances en el diagnóstico y en el tratamiento antibiótico y quirúrgico, la endocarditis infecciosa sigue siendo una enfermedad con una mortalidad elevada. Los estudios llevados a cabo en nuestro país y en otros países demostraron que el perfil clínico del paciente ha cambiado. Existe mayor prevalencia de pacientes añosos con enfermedad degenerativa valvular, las endocarditis protésicas y nosocomiales son más frecuentes y aumentó la presencia del Staphylococcus aureus....

José Horacio Casabé

2008-01-01

19

Infective endocarditis in chronic hemodialysis patients: Experience from Morocco  

OpenAIRE

Since the 1960s, regular hemodialysis (HD) was recognized as a risk factor for the development of infective endocarditis (IE), particularly at vascular access sites. The present report describes our experience at the Etat Major General Agadir, Morocco, of taking care of IE in patients on regular dialysis. A retrospective analysis was made of five cases of IE in patients receiving re-gular HD having arteriovenous fistula as vascular access. They were sent from four private centers and admitted...

Montasser Dina; Bahadi Abdelali; Zajjari Yassir; Asserraji Mohamed; Alayoude Ahmed; Moujoud Omar; Aattif Toufik; Kadiri Moncef; Zemraoui Nadir; El Kabbaj Driss; Hassani Mohamed; Benyahia Mohamed; El Allam Mustapha; Oualim Zouhir; Akhmouch Ismail

2011-01-01

20

Cardiac rhabdomyoma presenting as infective endocarditis: a case report.  

Science.gov (United States)

We report a case of cardiac rhabdomyomas in an infant who presented with right ventricular tachycardia, and a clinical picture of infective endocarditis. Typical features of tuberous sclerosis developed subsequently. To the best of our knowledge, cardiac rhabdomyoma has not been reported previously in association with infective endocarditis. PMID:24666881

Azhari, Nawal; Hakim, Manal; Barefah, Ghaith

2015-03-01

21

A severe infective endocarditis successfully treated with linezolid  

Directory of Open Access Journals (Sweden)

Full Text Available Despite significant improvements in surgical and medical therapy, prosthetic valve endocarditis (PVE is a diagnostic and therapeutic challenge and is often associated with a severe prognosis. We report a case of a 59-year-old woman, with  PVE and bacterial endocarditis (Streptococcus bovis successfully treated with linezolid. Linezolid is a bacteriostatic oxazolidinone antibiotic that has been proven to be effective for the treatment of patients with pneumonia, skin and soft tissue infections, and infections due to Gram-positive cocci. Linezolid is not yet recognised as a standard therapy for infective endocarditis, but its use becomes a necessity when infection is due to multidrug-resistant microorganisms.

Graziano Antonio Minafra

2010-03-01

22

Treatment and prevention of infective endocarditis.  

Science.gov (United States)

The paper presents the most recent recommendations for the treatment and prevention of infective endocarditis (IE). The treatment of IE is complex and requires close collaboration among specialists in infectious diseases, cardiology, cardiac surgery and microbiology. The mainstay of medical treatment is antibiotic therapy. Theoretical considerations regarding vegetations and antibiotics have practical consequences on the route and modalities of administration of antibiotics and on the techniques used to monitor treatment. The choice of antibiotics depends on the microorganism (streptococci, enterococci, staphylococci, HACEK group [Haemophilus sp., Actinobacillus sp., Cardiobacterium sp., Eikenella sp. and Kingella sp.], Coxiella, Brucella, Legionella, Bartonella, fungi) and on whether IE occurs on native or prosthetic valves. Treatment of IE with negative blood cultures is particularly difficult. Cardiac surgery is often needed during the bacteriologically active period (in ~50% of patients). The decision to intervene and the optimal timing of the intervention requires careful consideration of multiple potential risks: the haemodynamic risk, the infectious risk, the risk due to cardiac lesions, the risk due to extracardiac complications and the risk due to the location of infective endocarditis. Even though the efficacy of antibiotic prophylaxis of IE is not completely proven, it is recommended for selected patients who undergo an at-risk procedure. Lists of cardiac conditions and of medical procedures at risk are presented; specific antibiotic prophylactic regimens for dental and upper respiratory tract procedures in out-patients, procedures under general anaesthesia and urological and GI procedures are outlined. PMID:11829727

Delahaye, François; Hoen, Bruno; McFadden, Eugène; Roth, Olivier; de Gevigney, Guy

2002-02-01

23

Infective endocarditis in chronic hemodialysis patients: experience from Morocco.  

Science.gov (United States)

Since the 1960s, regular hemodialysis (HD) was recognized as a risk factor for the development of infective endocarditis (IE), particularly at vascular access sites. The present report describes our experience at the Etat Major General Agadir, Morocco, of taking care of IE in patients on regular dialysis. A retrospective analysis was made of five cases of IE in patients receiving regular HD having arteriovenous fistula as vascular access. They were sent from four private centers and admitted in our formation between January 2004 and March 2009. Infective endocarditis was detected after 34.5 months following initiation of dialysis. The causative organisms included Staphylococcus and Enterococcus in two cases each and negative blood culture in one case. A recent history of infection (<3 months) of the vascular access was found in three cases. Peripheric embolic phenomena were noted in two cases. A pre-existing heart disease was common and contributed to heart failure. Mortality was frequent due to valvular perforations and congestive heart failure, making the medical treatment alone unsatisfactory. Two patients survived and three of our patients received a prosthetic valve replacement, with a median survival after surgery of 10.3 months/person. The clinical diagnosis of infective endocarditis in regularly dialyzed patients remains difficult, with the presence of vascular calcification as a common risk factor. The vascular catheter infections are the cardinal gateway of pathogenic organisms, which are mainly Staphylococcus. The prognosis is bad and the mortality is significant, whereas medical and surgical treatments are often established in these patients who have many factors of comorbidity. PMID:21196639

Montasser, Dina; Bahadi, Abdelali; Zajjari, Yassir; Asserraji, Mohamed; Alayoude, Ahmed; Moujoud, Omar; Aattif, Toufik; Kadiri, Moncef; Zemraoui, Nadir; El Kabbaj, Driss; Hassani, Mohamed; Benyahia, Mohamed; El Allam, Mustapha; Oualim, Zouhir; Akhmouch, Ismail

2011-01-01

24

Infective endocarditis in chronic hemodialysis patients: Experience from Morocco  

Directory of Open Access Journals (Sweden)

Full Text Available Since the 1960s, regular hemodialysis (HD was recognized as a risk factor for the development of infective endocarditis (IE, particularly at vascular access sites. The present report describes our experience at the Etat Major General Agadir, Morocco, of taking care of IE in patients on regular dialysis. A retrospective analysis was made of five cases of IE in patients receiving re-gular HD having arteriovenous fistula as vascular access. They were sent from four private centers and admitted in our formation between January 2004 and March 2009. Infective endocarditis was detected after 34.5 months following initiation of dialysis. The causative organisms included Sta-phylococcus and Enterococcus in two cases each and negative blood culture in one case. A recent history of infection (<3 months of the vascular access was found in three cases. Peripheric embolic phenomena were noted in two cases. A pre-existing heart disease was common and contributed to heart failure. Mortality was frequent due to valvular perforations and congestive heart failure, making the medical treatment alone unsatisfactory. Two patients survived and three of our patients received a prosthetic valve replacement, with a median survival after surgery of 10.3 months/person. The clinical diagnosis of infective endocarditis in regularly dialyzed patients remains difficult, with the presence of vascular calcification as a common risk factor. The vascular catheter infections are the cardinal gateway of pathogenic organisms, which are mainly Staphlococcus. The prognosis is bad and the mortality is significant, whereas medical and surgical treatments are often established in these patients who have many factors of comorbidity.

Montasser Dina

2011-01-01

25

Infective endocarditis due to unusual or fastidious microorganisms.  

Science.gov (United States)

Infective endocarditis due to fastidious microorganisms is commonly encountered in clinical practice. Some organisms such as fungi account for up to 15% of cases of prosthetic valve infective endocarditis, whereas organisms of the HACEK group (Haemophilus parainfluenzae, H. aphrophilus, and H. paraphrophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae) cause 3% of community-acquired cases of infective endocarditis. Special techniques are necessary to identify these microorganisms. A history of contact with mammals or birds may suggest infection caused by Coxiella burnetii (Q fever), Brucella species, or Chlamydia psittaci. A nosocomial cluster of postsurgical infective endocarditis may be caused by Legionella species or Mycobacterium species. If risk factors that are commonly associated with fungal infections (cardiac surgical treatment, prolonged hospitalization, indwelling central venous catheters, and long-term antibiotic use) are present, fungal endocarditis is possible. Patients with endocarditis and a history of periodontal disease or dental work in whom routine blood cultures are negative might have infection due to nutritionally variant streptococci or bacteria of the HACEK group. Communication between the microbiologist and the clinician is of crucial importance for identification of these microorganisms early during the course of the infection before complications such as embolization or valvular failure occur. In this article, we review the microbiologic and clinical features of these organisms and provide recommendations for diagnosis and treatment. PMID:9179137

Berbari, E F; Cockerill, F R; Steckelberg, J M

1997-06-01

26

Takayasu Arteritis Initially Mimicking Infective Endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available

Takayasu’s arteritis (TA is a chronic inflammatory disease that affects large vessels, predominantly the aorta and main branches, leading to vessel wall thickening, fibrosis and stenosis. Cardiac and vascular symptoms are also commonly present at disease onset. In TA with thoracic or abdominal involvement, although murmur can be present as a physical examination finding, the pulse difference may be absent. Here, we mention a case of TA who initially looked like infective endocarditis and had widespread thoracic murmur.

Busra Akin

2011-01-01

27

Infective endocarditis with Lactococcus garvieae in Japan: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Lactococcus garvieae is a well-recognized fish pathogen, and it is considered a rare pathogen with low virulence in human infection. We describe the 11th case of L. garvieae infective endocarditis reported in the literature, and the first reported case in Japan. Case presentation We report a case of a 55-year-old Japanese woman who had native valve endocarditis with L. garvieae. The case was complicated by renal infarction, cerebral infarction, and mycotic aneurysms. After anti-microbial treatment, she was discharged from the hospital and is now well while being monitored in the out-patient clinic. Conclusion We encountered a case of L. garvieae endocarditis that occurred in a native valve of a healthy woman. The 16S ribosomal RNA gene sequencing was useful for the identification of this pathogen. Although infective endocarditis with L. garvieae is uncommon, it is possible to treat high virulence clinically.

Isonuma Hiroshi

2011-08-01

28

Prevention of infective endocarditis in developing countries - justifiable caution?  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english The internationally accepted practice of prescribing prophylactic antibiotics to individuals at risk of infective endocarditis has come under scrutiny. There are no published high-quality randomised controlled trials of the intervention, but new insights have emerged. Bacteraemic episodes are common [...] following simple activities such as brushing teeth. Endocarditis following procedures is extremely rare, and systematic reviews of the evidence for prophylactic antibiotics have failed to demonstrate efficacy.

Andy, Parrish; Breminand, Maharaj.

2012-08-01

29

The role of hemostasis in infective endocarditis.  

Science.gov (United States)

Infective endocarditis (IE) is a thromboinflammatory disease of the endocardium, with pathophysiology mostly the result of the interplay between microorganisms and modifiers of the hemostasis system. In this setting, the evidence gathered so far warrants a more systematic appraisal. In this review article, experimental and clinical data on the role of hemostasis in IE are summarized. Starting from the current pathogenetic model of IE, we discuss the dual role of platelets in this condition, the microbial interaction with the hemostasis system, also describing nonspecific hemostasis changes during sepsis. We finally propose our hypothesis of thrombophilia as a possible trigger of IE, highlighting the challenges that the study of hemostasis in IE presents. The role of hemostasis in IE appears to be an exciting field of research. The activity of the hemostasis system is highly relevant in terms of susceptibility, progression, and treatment of IE. Pharmacologic modulation of hemostasis before and after IE onset is possible and represents still a largely unexplored area of study. PMID:25230604

Durante-Mangoni, Emanuele; Molaro, Rosa; Iossa, Domenico

2014-11-01

30

First Reported Human Case of Native Mitral Infective Endocarditis Caused by Streptococcus canis.  

Science.gov (United States)

A 65 year-old woman was admitted for acute heart failure and severe sepsis revealing definite mitral infective endocarditis with severe regurgitation, complicated by multiple embolisms. Three blood cultures yielded a group G Streptococcus canis strain. Urgent surgery was performed with bioprosthetic valve replacement. Polymerase chain reaction analysis of the valve found S canis DNA. Amoxicillin and gentamicin were given for 2 weeks followed by 4 weeks of amoxicillin alone. She reported contact with a dog without bite. S canis has been reported to cause zoonotic septicemia but to our knowledge, this is the first human case of native valve infective endocarditis. PMID:25442453

Amsallem, Myriam; Iung, Bernard; Bouleti, Claire; Armand-Lefevre, Laurence; Eme, Anne-Line; Touati, Aziza; Kirsch, Matthias; Duval, Xavier; Vahanian, Alec

2014-11-01

31

Infective endocarditis: a review of the best treatment options.  

Science.gov (United States)

Despite significant advances in antimicrobial therapy and an enhanced ability to diagnose and treat complications, infective endocarditis is still associated with substantial morbidity and mortality today, and its incidence has not decreased over the past decades. This apparent paradox may be explained by a progressive change in risk factors, leading to an evolution in its epidemiological and clinical features. In fact, new risk factors for endocarditis have emerged, such as intravenous drug abuse, diffusion of heart surgery procedures and prosthetic valve implantation, atherosclerotic valve disease in elderly patients, and nosocomial disease. Recently identified microorganisms (including Bartonella spp., Abiotrophia defectiva, and the HACEK group of bacteria [including Haemophilus spp., Actinobacillus spp., Cardiobacterium hominis, Eikenella corrodens and Kingella kingae]) are sometimes the cause of culture-negative endocarditis, and emerging resistant bacteria (such as methicillin- or vancomycin-resistant Staphylococci and vancomycin-resistant Enterococci) are becoming a new challenge for conventional antibiotic therapy. New therapeutic approaches need to be developed for the treatment of infective endocarditis caused by drug-resistant Gram-positive cocci, and some antimicrobial compounds recently introduced in clinical practice (such as streptogramins and oxazolidinones) may be an effective alternative, but further clinical studies are needed in order to confirm their effectiveness and safety. This review should help redefine the best therapeutic and preventive strategies against infective endocarditis. PMID:15330728

Calza, Leonardo; Manfredi, Roberto; Chiodo, Francesco

2004-09-01

32

Periannular complications in infective endocarditis involving prosthetic aortic valves.  

Science.gov (United States)

The periannular extension of infection in prosthetic valve endocarditis (PVE) is a serious complication of infective endocarditis associated with high mortality. Periannular lesions in PVE occasionally rupture into adjacent cardiac chambers, leading to aortocavitary fistulae and intracardiac shunting. It is unknown whether the prognosis of patients with aortocavitary fistulae is worse than that of those with nonruptured abscesses. The aims of this study were to determine the distinctive clinical characteristics of patients with PVE and either aortocavitary fistulization or nonruptured abscesses. In a retrospective multicenter study of >872 PVE episodes, 150 patients (17%) with periannular complications in PVE in the aortic position were identified (29 with aortocavitary fistulization and 121 with nonruptured abscesses). Early-onset PVE was present in 73 patients (49%). Rates of heart failure (p = 0.09), ventricular septal defect (p <0.01), and third-degree atrioventricular block (p = 0.07) were higher in patients with fistulization. Surgical treatment was undertaken in 128 patients (83%). In-hospital mortality in the overall population was 39%. Multivariate analysis identified heart failure (odds ratio [OR] 3.3, 95% confidence interval [CI] 1.6 to 6.8), renal failure (OR 2.5, 95% CI 1.2 to 5.2), and co-morbidity (OR 2.4, 95% CI 1.1 to 5.1) as independent risk factors for death. Fistulous tract formation was not associated with increased in-hospital mortality (OR 1.6, 95% CI 0.7 to 3.7). The actuarial 5-year survival rate in surgical survivors was 100% in patients with fistulae and 78% in patients with nonruptured abscesses (log-rank p = 0.14). In conclusion, aortocavitary fistulous tract formation in PVE complicated with periannular complications is associated with higher rates of heart failure, ventricular septal defect, and atrioventricular block than nonruptured abscesses. Despite the frequent complications, fistulous tract formation in the current era of infective endocarditis is not an independent risk factor for mortality. PMID:17056343

Anguera, Ignasi; Miro, Jose M; San Roman, Jose Alberto; de Alarcon, Aristides; Anguita, Manuel; Almirante, Benito; Evangelista, Artur; Cabell, Christopher H; Vilacosta, Isidre; Ripoll, Tomas; Muñoz, Patricia; Navas, Enrique; Gonzalez-Juanatey, Carlos; Sarria, Cristina; Garcia-Bolao, Ignacio; Fariñas, M Carmen; Rufi, Gabriel; Miralles, Francisco; Pare, Carles; Fowler, Vance G; Mestres, Carlos A; de Lazzari, Elisa; Guma, Joan R; del Río, Ana; Corey, G Ralph

2006-11-01

33

HACEK Infective Endocarditis: Characteristics and Outcomes from a Large, Multi-National Cohort  

OpenAIRE

The HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are rare causes of infective endocarditis (IE). The objective of this study is to describe the clinical characteristics and outcomes of patients with HACEK endocarditis (HE) in a large multi-national cohort. Patients hospitalized with definite or possible infective endocarditis by the International Collaboration on Endocarditis Prospective Cohort Study in 64 h...

Chambers, Stephen T.; Murdoch, David; Morris, Arthur; Holland, David; Pappas, Paul; Almela, Manel; Ferna?ndez-hidalgo, Nuria; Almirante, Benito; Bouza, Emilio; Forno, Davide; Del Rio, Ana; Hannan, Margaret M.; Harkness, John; Kanafani, Zeina A.; Lalani, Tahaniyat

2013-01-01

34

Cardiobacterium valvarum infective endocarditis and phenotypic/molecular characterization of 11 Cardiobacterium species strains.  

Science.gov (United States)

Cardiobacterium valvarum is a newly recognized human pathogen related to infective endocarditis. Cardiobacterium species are, however, only rarely the aetiology of infective endocarditis. An infective endocarditis case is presented and, additionally, phenotypic and phylogenetic comparison of a further 10 collection strains, representing the two species within the genus, was performed. C. valvarum was isolated from the blood and DNA was present in valvular tissue (partial 16S rRNA gene analysis) from a 64-year-old man with infective endocarditis of the mitral valve, rupture of chordae and prolapse of pulmonary valves in addition to a fluttering excrescence. A mechanical mitral valve and neochordae were inserted successfully. Phenotypically, the two species within the genus Cardiobacterium resemble each other greatly. When using the Vitek 2 Neisseria-Haemophilus identification card, the reaction for phenylphosphonate was positive for all Cardiobacterium hominis strains, but negative for all C. valvarum strains, thereby separating the two species. The two species made up two separate clusters by phylogenetic examination using 16S rRNA gene sequence analysis. PMID:21163827

Chen, Ming; Kemp, Michael; Bruun, Niels E; Bangsborg, Jette M; Højlyng, Niels; Hesselbjerg, Annemarie; Dargis, Rimtas; Christensen, Jens Jørgen

2011-04-01

35

Cardiobacterium valvarum infective endocarditis and phenotypic/molecular characterization of 11 Cardiobacterium species strains  

DEFF Research Database (Denmark)

Cardiobacterium valvarum is a newly recognized human pathogen related to infective endocarditis. Cardiobacterium species are, however, only rarely the aetiology of infective endocarditis. An infective endocarditis case is presented and, additionally, phenotypic and phylogenetic comparison of a further 10 collection strains, representing the two species within the genus, was performed. C. valvarum was isolated from the blood and DNA was present in valvular tissue (partial 16S rRNA gene analysis) from a 64-year-old man with infective endocarditis of the mitral valve, rupture of chordae and prolapse of pulmonary valves in addition to a fluttering excrescence. A mechanical mitral valve and neochordae were inserted successfully. Phenotypically, the two species within the genus Cardiobacterium resemble each other greatly. When using the Vitek 2 Neisseria–Haemophilus identification card, the reaction for phenylphosphonate was positive for all Cardiobacterium hominis strains, but negative for all C. valvarum strains,thereby separating the two species. The two species made up two separate clusters by phylogenetic examination using 16S rRNA gene sequence analysis.

Chen, Ming; Kemp, Michael

2011-01-01

36

First case of infective endocarditis caused by Helicobacter cinaedi.  

Science.gov (United States)

BackgroundUp to 20% of all infective endocarditis are blood culture-negative and therefore a diagnostic challenge. Here we present the case of an infective endocarditis due to Helicobacter cinaedi finally diagnosed using different molecular methods. This highly fastidious gram-negative spiral rod is increasingly recognized as a human pathogen, above all in immunocompromised patients. So far H. cinaedi has been associated with bacteremia, cellulitis, arthritis and meningitis.Case presentationA 71-year-old man presented with fever and progressive dyspnea for weeks. He was immunocompromised by long-term steroid therapy. As one major and two minor Duke¿s criteria (vegetation, fever and aortic valve stenosis as predisposition) were present, an infective endocarditis was suspected and an empiric therapy with amoxicillin/clavulanic acid and gentamicin was established. The persistent severe aortic regurgitation resulted in a valve replacement. Histological evaluation of the aortic valve showed a polypous-ulcerative endocarditis. Gram stain and culture remained negative. Broad-range bacterial PCR targeting the 16S rRNA gene on the biopsy of the aortic valve identified H. cinaedi as the causative agent. The antibiotic therapy was simplified accordingly to ceftriaxone and gentamicin with a recommended duration of 6 weeks. Ten days after valve replacement the patient was discharged. To complete our molecular finding, we sequenced nearly the complete 16S rRNA gene (accession number KF914917) resulting in 99.9% identity with H. cinaedi reference sequences. Based on this result, 2 species-specific PCR tests amplifying part of the ctd gene were established and applied to the valve specimen. The 2 PCRs confirmed H. cinaedi. In addition, we analyzed stool, urine and saliva from the patient using H. cinaedi PCR. The fecal and urine specimen showed a positive signal, saliva was PCR-negative.ConclusionWe identified H. cinaedi as causative agent of a culture-negative endocarditis in an immunocompromised patient using broad-range and specific PCR. In addition to 2 cases from Japan presented on international meetings in 2010 and 2013, our case report shows that H. cinaedi should be recognized as additional causative organism of infective endocarditis. The use of molecular diagnostic techniques proved to be a powerful complement for the detection of blood culture-negative infective endocarditis. PMID:25403102

Bartels, Hanni; Goldenberger, Daniel; Reuthebuch, Oliver; Vosbeck, Juerg; Weisser, Maja; Frei, Reno; Bättig, Veronika

2014-11-18

37

Variables predictoras de embolias en endocarditis infecciosa / Embolism predictors of infective endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish El evento embólico (EE) aumenta la morbi-mortalidad de la endocarditis infecciosa (EI). La prevalencia de EE oscila entre 22% y 50%, pudiendo ocasionar hasta el 25% de las muertes de los pacientes que lo presentan. El EE puede ocurrir previamente al diagnóstico, durante el tratamiento o bien posteri [...] ormente al mismo. Nuestro objetivo fue analizar las características demográficas, clínicas, microbiológicas, ecocardiográficas y terapeúticas, de pacientes con EI (con y sin embolias) para tratar de establecer variables predictoras del EE. Se realizó en el Hospital Italiano de La Plata, desde marzo de 1996 hasta diciembre de 2004, un estudio descriptivo observacional de una cohorte de pacientes con diagnóstico de EI. Se analizaron en forma retrospectiva 53 pacientes con EI (35 sin EE y 18 con EE). La presencia de vegetación (en el ecocardiograma transtorácico (ETT) y/o en el transesofágico (ETE) al momento del diagnóstico, el tamaño ³ 10 mm y el compromiso de la válvula mitral nativa, fueron las variables en las que existió una asociación estadísticamente significativa con el EE para ser consideradas como predictoras. El tamaño ³ 10 mm fue la única variable asociada a EE en el análisis de regresión logística. Durante el tratamiento antibiótico electivo hubo una reducción de EE, no observándose a partir de la segunda semana. Abstract in english The embolic event (EE) increases the morbidity and mortality of infective endocarditis (IE). Prevalence of EE ranges between 22% and 50%, death rates being up to 25% of patients. EE may occur prior to diagnosis, during treatment or afterwards. The objective of this study was to evaluate the demograp [...] hic, clinical, microbiological, echocardiographic and therapeutic characteristics in patients suffering from IE (with or without emboli) in order to determine predictors for EE. A descriptive study based on observations of patient population diagnosed with IE was conducted at the Hospital Italiano of La Plata during the period March 1996 - December 2004. Fifty-three patients with IE were analyzed (35 without EE and 18 with EE) in retrospect. We found that the presence of vegetations in the transthoracic (TTE) and/or transesophagic (TEE) echocardiographies at the time of diagnosis, the size ³ 10 mm and the compromise of the native mitral valve were the variables that showed significant statistical association with EE to be considered as predictors. The size ³ 10 mm was the only variable associated with EE in the logistic regression analysis. During the elective antibiotic treatment, there was a reduction in EE, without their being present from the second week onwards.

Alberto R., Cremona; Santiago J., Ramírez Borga; Juan F., Losinno; Luis R., Cartasegna; Eduardo M., Escudero; José L., Fernández; Gustavo E., Cremona; Miriam E., Blanco.

2007-02-01

38

Endocardite infecciosa em adolescentes. Análise dos fatores de risco de mortalidade intra-hospitalar Infective endocarditis in adolescents. analysis of risk factors for in-hospital mortality  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Estudar os aspectos epidemiológicos, clínicos, terapêuticos e evolutivos da endocardite infecciosa (EI em grupo de pacientes com idade entre 12 e 20 (média de 15,5 anos. MÉTODOS: Foram estudados, retrospectivamente, 33 pacientes consecutivos (14 do sexo masculino e 19 do feminino, admitidos com diagnóstico de EI. RESULTADOS: A mortalidade da EI foi de 42%. A cardiopatia reumática predominou como condição predisponente (63% dos casos, seguida das cardiopatias congênitas (24% e próteses cardíacas (12%. A maioria dos pacientes (78% encontrava-se na admissão em CF III e IV e apresentava mortalidade significativamente maior do que os que se encontravam na CF I e II (p=0,01. Complicações embólicas foram detectadas em 51% e determinaram maior mortalidade (p=0,05. O agente etiológico mais isolado foi o Staphylococcus aureus (em 42% das hemoculturas positivas, seguido do Staphylococcus viridans (em 21%. A análise multivariada mostrou que a contagem global de leucócitos acima de 10.000/mm ³, e a CF referidos na admissão (p=0,01 e p=0,04, e a ocorrência de embolias (p=0,03 eram preditores independentes de mortalidade intra-hospitalar. CONCLUSÃO: A cardiopatia reumática permanece, semelhante à população adulta, como principal fator predisponente da EI nos adolescentes, tendo como principal agente etiológico o S.aureus, semelhante à população pediátrica. A mortalidade é elevada e representam preditores de mortalidade intra-hospitalar a CF na admissão, a ocorrência da fenômenos embólicos e a leucocitose.PURPOSE: To study the epidemiological, clinical, therapeutic and evolutive aspects of endocarditis in a group of patients aging 12 to 20 years-old ( mean 15.5. METHODS: Thirty-three consecutive patients (14 males, 19 females admitted with infective endocarditis were retrospectively studied. RESULTS: Infective endocarditismortality was 42%. Rheumatic heart disease was the predominant underlying condition in 63% of patients. Congenital heart disease (24% and cardiac prosthesis (12% were the other affections involved. The majority of patients (78% were in functional class III and IV, with more deaths than the 22% who were in functional class I and II (p=0.01. Staphylococcus aureus was the most frequently isolated agent (42% of the positive blood cultures, followed by Staphylococcus viridans, 21%. Multivariate analysis identified total leukocyte count above 10,000/mm³ and functional class, both at admission (p=0.01 and p=0.004, respectively, and the occurrence of embolic complications (p=0.03 as independent predictors of in-hospital mortality. CONCLUSION: Rheumatic heart disease remains, as in adults, the main predisposing factor for infective endocarditis in adolescents, and S.aureus is, like in children, the leading agent. Mortality is high and functional class at hospital admission, embolic complications and leukocytosis are independent predictors of in-hospital mortality.

Nádia Barreto Tenório Aoun

1997-12-01

39

Isolated Whipple's endocarditis: an underestimated diagnosis that requires molecular analysis of surgical material.  

Science.gov (United States)

Tropheryma whipplei is known as the bacterium that causes Whipple's disease, a rare systemic illness typically affecting gastrointestinal tract, joints, and central nervous system. In addition, T whipplei infection may present as an isolated endocarditis. Although previously regarded as a rare condition, T whipplei has been recognized as a major cause of culture-negative endocarditis when integrating specific molecular analysis of surgical material into the diagnostic algorithm. Here, we report the case of a 67-year-old man undergoing mitral valve replacement due to T whipplei endocarditis, and discuss diagnostic and therapeutic implications. PMID:24996742

Herrmann, Markus D; Neumayr, Annette; Essig, Andreas; Spiess, Jochen; Merk, Johannes; Möller, Peter; Liebold, Andreas; Barth, Thomas F E

2014-07-01

40

Clinical classification and prognosis of isolated right-sided infective endocarditis.  

Science.gov (United States)

From an epidemiologic point of view, right-sided infective endocarditis (RSIE) affects different types of patients: intravenous drug users (IDUs), cardiac device carriers (pacemakers and implantable automatic defibrillators), and the "3 noes" endocarditis group: no left-sided, no IDUs, no cardiac devices. Our objective is to describe and compare the clinical profile and outcome of these groups of patients.Every episode of infective endocarditis (IE) consecutively diagnosed in 3 tertiary centers from 1996 to 2012 was included in an ongoing multipurpose database. We assessed 85 epidemiologic, clinical, echocardiographic, and outcome variables in patients with isolated RSIE. A bivariated comparative analysis between the 3 groups was conducted.Among 866 IE episodes, 121 were classified as isolated RSIE (14%): 36 IDUs (30%), 65 cardiac device carriers (54%), and 20 "3 noes" group (16%). IDUs were mainly young men (36?±?7 years) without previous heart disease, few comorbidities, and frequent previous endocarditis episodes (28%). Human immunodeficiency virus infection was frequent (69%). Cardiac device carriers were older (66?±?15 years) and had less comorbidities (34%). Removal of the infected device was performed in 91% of the patients without any death. The "3 noes" endocarditis group was composed mainly by middle-age men (56?±?18 years), health care related infections (50%), and had many comorbidities (75%). Whereas Staphylococcus aureus were the most frequent cause in IDUs (72% vs 34% in device carriers and 34% in the "3 noes" group, P?=?0.001), coagulase negative Staphylococci predominated in the device carriers (58% vs 11% in drug users and 35% in the "3 noes", P?

Ortiz, Carlos; López, Javier; García, Héctor; Sevilla, Teresa; Revilla, Ana; Vilacosta, Isidre; Sarriá, Cristina; Olmos, Carmen; Ferrera, Carlos; García, Pablo Elpidio; Sáez, Carmen; Gómez, Itziar; San Román, José Alberto

2014-12-01

41

Management of neurological complications of infective endocarditis in ICU patients  

OpenAIRE

Patients with infective endocarditis (IE) are generally referred to the intensive care unit (ICU) for one or more organ dysfunctions caused by complications of IE. Neurologic events are frequent causes of ICU admission in patients with IE. They can arise through various mechanisms consisting of stroke or transient ischemic attack, cerebral hemorrhage, mycotic aneurysm, meningitis, cerebral abscess, or encephalopathy. Most complications occur early during the course of IE and are a hallmark of...

Sonneville, Romain; Mourvillier, Bruno; Bouadma, Lila; Wolff, Michel

2011-01-01

42

Isolated tricuspid valve infective endocarditis in young drug abusers  

OpenAIRE

Isolated tricuspid valve infective endocarditis (TVIE) is a rare clinical condition. Thus, there is no common consensus for the treatment options for TVIE. Vege-tectomy and valvulectomy, valve repair, and valve replacement, which are controversial in regard to hemodynamic consequences in right-sided low-pressure system and long-term prognosis. We present 2 young intravenous drug users with TVIE and our surgical strategy.

Cenap Ozkara; Omer Faruk Dogan; Cevdet Furat

2012-01-01

43

Embolic Events And Neurological Complications In Infective Endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Infective endocarditis (IE is an infection of the endocardial surface of the heart. The intracardiac effects of this infection include severe valvular insuffi ciency, which may lead to congestive heart failure and many complications. Valvular infections have entered the era of IE caused by increased usage of intravascular devices and medical procedures. Typically, the diagnosis is made relatively late, compared to the onset of valvular infection. Complications of infective endocarditis result from embolization, slowly progressive valvular destruction and various immunological mechanisms. Complications are very frequent in IE, complicating 20–60% of cases of IE. Th e risk of embolism is the highest during the first 2 weeks of antibiotic therapy and is clearly related to the size and mobility of the vegetation. Risk is increased with large vegetations (>10 mm and particularly high with very mobile and even larger vegetations (>15 mm. Neurological complications develop in 20–40% of all patients with IE and are mainly the consequence of embolization. Rapid diagnosis and initiation of appropriate therapy especially antibiotics are of major importance to prevent a first or recurrent neurological complication.

Vesna Suknjaja

2011-06-01

44

Infective Endocarditis: Identification of Catalase-Negative, Gram-Positive Cocci from Blood Cultures by Partial 16S rRNA Gene Analysis and by Vitek 2 Examination  

DEFF Research Database (Denmark)

Streptococci, enterococci and Streptococcus-like bacteria are frequent etiologic agents of infective endocarditis and correct species identification can be a laboratory challenge. Viridans streptococci (VS) not seldomly cause contamination of blood cultures. Vitek 2 and partial sequencing of the 16S rRNA gene were applied in order to compare the results of both methods. STRAINS ORIGINATED FROM TWO GROUPS OF PATIENTS: 149 strains from patients with infective endocarditis and 181 strains assessed as blood culture contaminants. Of the 330 strains, based on partial 16S rRNA gene sequencing results, 251 (76%) were VS strains, 10 (3%) were pyogenic streptococcal strains, 54 (16%) were E. faecalis strains and 15 (5%) strains belonged to a group of miscellaneous catalase-negative, Gram-positive cocci. Among VS strains, respectively, 220 (87,6%) and 31 (12,3%) obtained agreeing and non-agreeing identifications with the two methods with respect to allocation to the same VS group. Non-agreeing species identification mostly occurred among strains in the contaminant group, while for endocarditis strains notably fewer disagreeing results were observed.Only 67 of 150 strains in the mitis group strains obtained identical species identifications by the two methods. Most VS strains belonging to the groups of salivarius, anginosus, and mutans obtained agreeing species identifications with the two methods, while this only was the case for 13 of the 21 bovis strains. Pyogenic strains (n=10), Enterococcus faecalis strains (n=54) and a miscellaneous group of catalase-negative, Gram-positive cocci (n=15) seemed well identified by both methods, except that disagreements in identifications in the miscellaneous group of strains occurred for 6 of 15 strains.

Abdul-Redha, Rawaa Jalil; Kemp, Michael

2010-01-01

45

Technetium-99m-ubiquicidin scintigraphy in the detection of infective endocarditis.  

Science.gov (United States)

We present a case of infective endocarditis (IE) diagnosed by the increased (99m)Tc-UBI specific uptake in the tricuspid valve region. In conclusion, our case data may indicate a first pass-like distribution with strong avidity of the tracer to infective endocarditis, facilitating image interpretation. PMID:24563884

Taghizadeh Asl, Mina; Mandegar, Mohammad-Hossein; Assadi, Majid

2014-01-01

46

Endocardite infecciosa causada por Eikenella corrodens Eikenella corrodens infective endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Os microorganismos do grupo HACEK (Haemophilus spp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens e Kingella kingae são responsáveis por 3% dos casos de endocardites. Eles apresentam propriedades clínicas e microbiológicas semelhantes entre si: são bacilos gram-negativos, isolados mais facilmente em meios aeróbicos, suas culturas necessitam de tempo prolongado de incubação para crescimento (média 3,3 dias e podem ser considerados como parte da flora normal do trato respiratório superior e da orofaringe1,2. Algumas características foram identificadas nas endocardites por esses agentes, como o quadro clínico insidioso¹, diagnóstico difícil pela natureza fastidiosa e culturas negativas3,4. A endocardite por Eikenella corrodens foi descrita pela primeira vez em 1972(5 e continua sendo um agente etiológico raro. Relatamos o caso de uma paciente com valva nativa que apresentou endocardite infecciosa causada por Eikenella corrodens.The HACEK microorganisms (Haemophilus spp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae account for 3% of the cases of endocarditis. They have the following similar clinical and microbiological properties: are Gram-negative bacilli, more easily isolated in aerobic media; their cultures require prolonged incubation time for growing (mean, 3.3 days; and may be considered part of normal flora of upper respiratory tract and oropharynx1,2. The following characteristics have been identified in endocarditis caused by the HACEK microorganisms: insidious clinical findings¹; difficult diagnosis due to the fastidious nature of the microorganisms; and negative cultures3,4. The Eikenella corrodens endocarditis was first described in 1972(5. That microorganism continues to be a rare etiological agent. We report the case of a female patient with native valve, who had Eikenella corrodens infective endocarditis.

Juliano Novaes Cardoso

2005-07-01

47

Endocardite infecciosa causada por Eikenella corrodens / Eikenella corrodens infective endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Os microorganismos do grupo HACEK (Haemophilus spp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens e Kingella kingae) são responsáveis por 3% dos casos de endocardites. Eles apresentam propriedades clínicas e microbiológicas semelhantes entre si: são bacilos gram- [...] negativos, isolados mais facilmente em meios aeróbicos, suas culturas necessitam de tempo prolongado de incubação para crescimento (média 3,3 dias) e podem ser considerados como parte da flora normal do trato respiratório superior e da orofaringe1,2. Algumas características foram identificadas nas endocardites por esses agentes, como o quadro clínico insidioso¹, diagnóstico difícil pela natureza fastidiosa e culturas negativas3,4. A endocardite por Eikenella corrodens foi descrita pela primeira vez em 1972(5) e continua sendo um agente etiológico raro. Relatamos o caso de uma paciente com valva nativa que apresentou endocardite infecciosa causada por Eikenella corrodens. Abstract in english The HACEK microorganisms (Haemophilus spp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae) account for 3% of the cases of endocarditis. They have the following similar clinical and microbiological properties: are Gram-negative bacilli, more ea [...] sily isolated in aerobic media; their cultures require prolonged incubation time for growing (mean, 3.3 days); and may be considered part of normal flora of upper respiratory tract and oropharynx1,2. The following characteristics have been identified in endocarditis caused by the HACEK microorganisms: insidious clinical findings¹; difficult diagnosis due to the fastidious nature of the microorganisms; and negative cultures3,4. The Eikenella corrodens endocarditis was first described in 1972(5). That microorganism continues to be a rare etiological agent. We report the case of a female patient with native valve, who had Eikenella corrodens infective endocarditis.

Juliano Novaes, Cardoso; Marcelo Eidi, Ochiai; Múcio T., Oliveira Jr.; Paulo, Morgado; Robinson, Munhoz; Fernanda E., Andretto; Alfredo José, Mansur; Antonio Carlos Pereira, Barretto.

2005-07-01

48

Streptococcus intermedius causing infective endocarditis and abscesses: a report of three cases and review of the literature  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Streptococcus intermedius is a member of the Streptococcus anginosus group. Clinical disease with S. intermedius is characterized by abscess formation and rarely endocarditis. Identification of Streptococcus intermedius is difficult, leading to the development of molecular methods to more accurately identify and characterize this organism. Case presentation Over a period of 6 months we encountered three cases of invasive Streptococcus intermedius infection presenting as hepatic abscesses, brain abscess, and endocarditis. We confirmed our microbiologic diagnosis through 16S sequencing and found a common virulence gene in each case. Conclusion Our report illustrates three different clinical manifestations due to Streptococcus intermedius infection that can be encountered in healthy individuals in a community hospital setting. To our knowledge, this is the first case of Streptococcus intermedius endocarditis confirmed by 16S sequencing analysis. The use of molecular methods may allow a better understanding of the epidemiology and pathogenesis of this organism.

Khalife Walid

2008-11-01

49

Kocuria kristinae endocarditis related to diabetic foot infection.  

Science.gov (United States)

We report an unusual case of endocarditis occurring in a 74-year-old man with a history of systemic hypertension, diabetes mellitus and minor amputation for left forefoot ulcer. The patient was hospitalized for vacuum-assisted closure therapy to aid in wound healing. After the first treatment session, the patient reported abdominal pain with haematemesis and fever (40 °C). Owing to persistent fever, three blood cultures were performed, all positive for Kocuria kristinae. The identification was based on biochemical tests and automated systems. The speciation of the micro-organism was achieved with MALDI-TOF and then confirmed by 16S rRNA gene sequencing. Transthoracic echocardiographic examination showed the presence of a large vegetation (38×20 mm) on the posterior mitral leaflet and moderate mitral regurgitation. Since there are no current guidelines for the treatment of K. kristinae endocarditis, empiric antibiotic therapy with intravenous sulbactam/ampicillin (1.5 g twice daily) and gentamicin (6 mg kg(-1) per day) was started. After 7 days of hospitalization, the patient's condition suddenly worsened because of the occurrence of haemorrhagic stroke. Despite inotropic support and rifampicin infusion, the haemodynamic status progressively deteriorated. After an initial improvement, he worsened again, becoming stuporous, hypotensive and dyspnoeic. In the following days, the patient developed compartment syndrome resulting in right foot ischaemia. Unfortunately, 25 days after hospitalization, the patient died of multiple organ failure from overwhelming sepsis. To the best of our knowledge, this is the first case of K. kristinae endocarditis on a native valve that is not related to a central venous catheter but associated with diabetic foot infection. PMID:23518651

Citro, Rodolfo; Prota, Costantina; Greco, Luigi; Mirra, Marco; Masullo, Alfonso; Silverio, Angelo; Bossone, Eduardo; Piscione, Federico

2013-06-01

50

Successful Treatment of Infective Endocarditis in Four Kidney Transplant Recipients  

Directory of Open Access Journals (Sweden)

Full Text Available Infective endocarditis (IE is a serious complication in kidney transplantation, leading to graft loss and a high mortality rate. We report 4 successfully managed cases of IE in kidney transplant recipients. Blood culture revealed Enterococcus in 2 patients, group D Streptococcus in 1, and no bacteria in 1. All of the patients were diagnosed based on at least 2 major Duke criteria for diagnosis of IE. Although a mild increase in the serum creatinine level was observed in 3 out of 4 patients, no graft rejection occurred during the follow-up. Early diagnostic and therapeutic intervention, particularly intensive antibiotic therapy and surgical management can preserve the patient and the kidney allograft. Studies on previous recurrent infections and simultaneous diseases such as cytomegalovirus in these patients are warranted.

Fatemeh Pour-Reza-Gholi

2009-04-01

51

Infective endocarditis due to Enterobacter cloacae resistant to third- and fourth-generation cephalosporins.  

Science.gov (United States)

We report the case of using a long-term combination of meropenem and amikacin to treat infective endocarditis caused by Enterobacter cloacae resistant to third- and fourth-generation cephalosporins. Multi-drug resistant Gram-negative bacilli, such as the E. cloacae in our study, may become possible pathogens of infective endocarditis. Our experience with this case indicates that long-term use of a combination of ?-lactam and aminoglycosides might represent a suitable management option for future infective endocarditis cases due to non-Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella spp. (HACEK group) Gram-negative bacilli such as ours. PMID:23017689

Yoshino, Yusuke; Okugawa, Shu; Kimura, Satoshi; Makita, Eiko; Seo, Kazunori; Koga, Ichiro; Matsunaga, Naohisa; Kitazawa, Takatoshi; Ota, Yasuo

2012-09-24

52

Endocarditis  

Science.gov (United States)

... higher risk for IE. For example, poor dental hygiene and unhealthy teeth and gums increase your risk for the infection. Other risk factors include using intravenous (IV) drugs, having a catheter ( ...

53

Prognostic criteria for the development of infective endocarditis in children with heart pathology  

Directory of Open Access Journals (Sweden)

Full Text Available To determine the most informative prognostic signs of infectious endocarditis development in children with heart pathology on the background of bacterial infections clinical course of 15 cases of infective endocarditis in children aged from 1 month to 17 years was performed. The comparison group consisted of 40 children aged 5 - 17 years with mitral valve prolapse. Of 19 analyzed clinical-anamnestic predictive diagnostic features for the development of infective endocarditis in children, presence of febrile fever during infusion therapy, the operated congenital heart disease, treatment in an intensive therapy unit with mechanical ventilation, intravenous infusions through a catheter lasting more than three days, a positive blood culture during the disease course, diagnostic catheterization of large vessels were of high informative value. In a positive prognosis of infective endocarditis development with a probability of 95% and more, children underwent complex of therapeutic measures with the following observation of pediatric cardio-rheumatologist.

Porokhnya N.G.

2014-09-01

54

Postcaesarean open-heart surgery for Streptococcus sanguinis infective endocarditis.  

Science.gov (United States)

A 33-week pregnant (gravida 3), 29-year-old woman was transferred for management of Streptococcus sanguinis infective endocarditis. A vegetation was present on the posterior leaflet of the mitral valve with moderate mitral regurgitation. On admission (day 1), the ultrasound examination revealed splenic abscesses and retarded intrauterine growth albeit with normal vessels. The fetal heart rate was 140 bpm. On day 11, the baby was delivered by Caesarean, and then the mother underwent tubal ligation followed by a mitral valve repair. The splenic abscess was treated with antibiotics. The woman was clinically stable and recovered uneventfully. This successful outcome was achieved by a strategic (optimal and sequential) timeline for selecting the mode of delivery and type of mitral valve correction. PMID:24234426

Kongwattanakul, Kiattisak; Tribuddharat, Sirirat; Prathanee, Sompop; Pachirat, Orathai

2013-01-01

55

Infective endocarditis detection through SPECT/CT images digital processing  

Science.gov (United States)

Infective endocarditis (IE) is a difficult-to-diagnose pathology, since its manifestation in patients is highly variable. In this work, it was proposed a semiautomatic algorithm based on SPECT images digital processing for the detection of IE using a CT images volume as a spatial reference. The heart/lung rate was calculated using the SPECT images information. There were no statistically significant differences between the heart/lung rates values of a group of patients diagnosed with IE (2.62+/-0.47) and a group of healthy or control subjects (2.84+/-0.68). However, it is necessary to increase the study sample of both the individuals diagnosed with IE and the control group subjects, as well as to improve the images quality.

Moreno, Albino; Valdés, Raquel; Jiménez, Luis; Vallejo, Enrique; Hernández, Salvador; Soto, Gabriel

2014-03-01

56

Infective endocarditis complicated by aortic graft infection and osteomyelitis: case report and review of literature  

Directory of Open Access Journals (Sweden)

Full Text Available Elie Zouein,1 Robert Wetz,1 Neville Mobarakai,1 Samer Hassan,1 Iris Tong21Department of Medicine, Staten Island University Hospital, New York, NY USA; 2Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USAAbstract: Primary aortic graft infection early after aortic graft insertion is well described in the literature. Here, we present a unique case of late aortic graft infection 5 years after insertion secondary to mitral valve endocarditis, resulting from cellulitis in a patient with severe venous varicosities. A 63-year-old male presented for severe low back pain, constipation, and low-grade fever. An abdominal computed tomography scan with oral and intravenous contrast showed a normal spine and urinary tract. Blood and urine cultures, done at the same time, grew Staphylococcus aureus. A transesophageal echocardiogram confirmed the diagnosis of endocarditis. Subsequently, a gallium scan showed increased uptake in the vertebral bodies, aortic graft, left patella, and left ankle. After 3 months of antibiotic therapy, the patient's low back pain resolved with normalization of his laboratory values. He remained free of infection at a 2-year follow-up. We reviewed the literature concerning the atypical presentation of infective endocarditis, with a focus on distant metastases at initial presentation, such as osteomyelitis and aortic graft infection, as well as the different treatment modalities. This report describes successful medical treatment with intravenous followed by oral antibiotics for an infected endovascular graft without any surgical intervention.Keywords: endocarditis, osteomyelitis, aortic graft infection, septic emboli, endovascular abdominal aortic aneurysm repair (EVAR

Zouein E

2012-07-01

57

HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort.  

Science.gov (United States)

The HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are rare causes of infective endocarditis (IE). The objective of this study is to describe the clinical characteristics and outcomes of patients with HACEK endocarditis (HE) in a large multi-national cohort. Patients hospitalized with definite or possible infective endocarditis by the International Collaboration on Endocarditis Prospective Cohort Study in 64 hospitals from 28 countries were included and characteristics of HE patients compared with IE due to other pathogens. Of 5591 patients enrolled, 77 (1.4%) had HE. HE was associated with a younger age (47 vs. 61 years; p<0.001), a higher prevalence of immunologic/vascular manifestations (32% vs. 20%; p<0.008) and stroke (25% vs. 17% p = 0.05) but a lower prevalence of congestive heart failure (15% vs. 30%; p = 0.004), death in-hospital (4% vs. 18%; p = 0.001) or after 1 year follow-up (6% vs. 20%; p = 0.01) than IE due to other pathogens (n = 5514). On multivariable analysis, stroke was associated with mitral valve vegetations (OR 3.60; CI 1.34-9.65; p<0.01) and younger age (OR 0.62; CI 0.49-0.90; p<0.01). The overall outcome of HE was excellent with the in-hospital mortality (4%) significantly better than for non-HE (18%; p<0.001). Prosthetic valve endocarditis was more common in HE (35%) than non-HE (24%). The outcome of prosthetic valve and native valve HE was excellent whether treated medically or with surgery. Current treatment is very successful for the management of both native valve prosthetic valve HE but further studies are needed to determine why HE has a predilection for younger people and to cause stroke. The small number of patients and observational design limit inferences on treatment strategies. Self selection of study sites limits epidemiological inferences. PMID:23690995

Chambers, Stephen T; Murdoch, David; Morris, Arthur; Holland, David; Pappas, Paul; Almela, Manel; Fernández-Hidalgo, Nuria; Almirante, Benito; Bouza, Emilio; Forno, Davide; del Rio, Ana; Hannan, Margaret M; Harkness, John; Kanafani, Zeina A; Lalani, Tahaniyat; Lang, Selwyn; Raymond, Nigel; Read, Kerry; Vinogradova, Tatiana; Woods, Christopher W; Wray, Dannah; Corey, G Ralph; Chu, Vivian H

2013-01-01

58

Value of echocardiographic findings in predicting cardiovascular complications in infective endocarditis.  

Science.gov (United States)

Echocardiography allows the detection of vegetations and estimation of valvular dysfunction in patients with infective endocarditis. The value of echocardiographic findings in predicting cardiac and other vascular complications in infective endocarditis is not well understood. Identification of high-risk patients and early surgery may improve their prognosis. The authors reviewed echocardiographic findings and related them to the development of congestive heart failure, systemic embolism, and the need for surgery or the risk of death without surgery in patients with infective endocarditis. There were 125 episodes of endocarditis in 114 patients (84 episodes [67%] in men) with a mean age +/- standard deviation of 37 +/- 7 years. Vegetations were detected by echocardiography on at least 1 valve in 87 episodes (70%); on the mitral valve in 36 episodes (29%); on the aortic valve in 21 episodes (17%); and on the tricuspid valve in 45 episodes (36%). Severe aortic regurgitation was present in 9 episodes (7%) and severe mitral regurgitation in 4 instances (3%). In 12 of 21 episodes (57%) of vegetations on the aortic valve compared with 15 of 104 patients (14%) without vegetations on the aortic valve (p predict the risk of systemic embolism in patients with infective endocarditis. Vegetations on the aortic valve and severe aortic regurgitation detected by echocardiography predict a high risk of developing congestive heart failure, and for the combined outcome of requiring surgery, or dying without surgery in infective endocarditis. Early surgery may improve the outlook for survival of these patients. PMID:11775621

Mathew, J; Anand, A; Addai, T; Freels, S

2001-12-01

59

INFECTIVE ENDOCARDITIS: AETIOLOGY, CLINICAL FEATURES, PRINCIPLES OF TREATMENT AND PREVENTION  

Directory of Open Access Journals (Sweden)

Full Text Available Infective endocarditis (IE is characterized by pathogen colonization and endocardium invasion, causing the formation of vegetations - amorphous aggregates, composed of platelets, fibrin, microorganisms and inflammatory cells. IE microbiological aspects are variable from country to country, reason for which, the purpose of this review was to integrate some original data concerning the etiology and antimicrobial resistance markers in microbial strains isolated from infections occurred in patients with underlying cardiovascular diseases in the general microbiological picture IE (i.e. diagnosis, etiology and treatment. In our hospital, the etiology of positive blood cultures and prosthetic devices associated infections occurred in patients with cardiovascular diseases is dominated by Gram-positive cocci, especially S. aureus and coagulase-negative staphylococci (CNS, followed by Gram-negative fermentative and non-fermentative bacilli. The major concerns regarding the resistance markers of the isolated strains are the methicillin and macrolides lincosamides streptogramines resistance exceeding 50%, both in S. aureus and CNS and the aminoglycosides high level resistance (30% in E. faecium strains.

Coralia Bleotu

2012-03-01

60

Successful combination therapy with vancomycin and arbekacin against infective endocarditis caused by MRSA.  

Science.gov (United States)

Infective endocarditis caused by methicillin-resistant Staphylococcus aureus (MRSA) is a serious disease and sometimes leads to poor prognosis. We should have several therapeutic options. Arbekacin is one of the aminoglycoside antibiotics, which is more active against MRSA and less nephrotoxic than gentamicin. Here we presented a successfully treated case of severe MRSA endocarditis without any adverse effect by monitoring therapeutic level of vancomycin and arbekacin. PMID:22686009

To, Kentaro; Miyake, Noriko; Nagasaki, Yoji; Shimono, Nobuyuki

2011-12-01

61

Induction of a putative laminin-binding protein of Streptococcus gordonii in human infective endocarditis.  

OpenAIRE

There is evidence to suggest that the virulence of Streptococcus strains in infective endocarditis might be due to the expression of binding sites for the extracellular matrix proteins of damaged valves. In this communication, we draw attention to one laminin-binding protein from a strain of Streptococcus gordonii isolated from a patient with human endocarditis. This 145-kDa protein was found on the cell wall of the bacterium. The level of expression of this binding protein might be regulated...

Sommer, P.; Gleyzal, C.; Guerret, S.; Etienne, J.; Grimaud, J. A.

1992-01-01

62

Endocarditis infecciosa actinomicótica de la válvula mitral: Caso de autopsia y revisión de la literatura / Actinomycotic infective endocarditis of the mitral valve: Anatomoclinical case and review of literature  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish La infección actinomicótica del corazón es una enfermedad poco común, especialmente cuando el compromiso endocárdico valvular es primario. Sólo unos pocos casos han sido publicados. Comunicamos un caso de endocarditis primaria por Actinomyces sp de la válvula mitral, diagnosticada en la necropsia de [...] un hombre de 34 años con antecedentes de valvulopatía reumática crónica, que falleció con una endocarditis infecciosa Abstract in english Actinomycotic infections of the heart is an uncommon disease, especially if the infection affects the valvular endocardium as primary focus. Just a few cases have been reported previously. We report a case of primary endocarditis of the mitral valve caused by Actinomyces sp diagnosed at necropsy in [...] a 34 year-old man with history of chronic rheumatic disease presenting as a usual case of infective endocarditis

David, Oddó B; Fernanda, Ayala R.

2007-06-01

63

Infective endocarditis of a rare etiology: Serratia marcescens  

Directory of Open Access Journals (Sweden)

Full Text Available Infective endocarditis (IE is a unique diagnostic and therapeutic challenge. It is a severe disease, fatal before penicillin discovery. Atypical presentations frequently led to delayed diagnosis and poor outcome. There was little information about the natural history of the vegetations during medical treatment or the relation of morphologic changes in vegetation to late complications. Application of a new diagnostic criteria and echocardiography, increased the number of definite diagnosis. Trans-thoracic and trans-esophageal echocardiography had an established role in the management of patients with IE. The evolution of vegetation size, its mobility, and consistency, the extent of the disease, and the severity of valvular regurgutation were related to late complications. With therapeutic options including modern antibiotic treatment and early surgical intervention IE turned out to be a curable disease. Reduction in mortality also depended on prevention. Antibiotic prophylaxis of IE was important, but low mortality was also the result of early treatment, especially in the event of early recognition of symptoms and signs of the disease.

?oki? Milomir

2004-01-01

64

Infective endocarditis caused by Staphylococcus aureus in a patient with atopic dermatitis: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction- Atopic dermatitis (AD is a common condition in the United Kingdom with the prevalence varying from 21% in infants aged 0–6 months to 6.4% at the age of 16 years. Patients with AD experience high rates of colonization of their skin surfaces by Staphylococcus aureus (S. aureus. In severe AD there is a potential risk of staphylococcal bacteremia and invasive infection such as acute endocarditis. Case presentation- We report a case of acute endocarditis with mitral valve destruction caused by S. aureus in a 30-year-old man with severe AD. The patient received intensive inpatient treatment with antibiotics and underwent successful mitral valve replacement and skin treatment for AD. Conclusion- Patients with severe AD are at higher risk of staphylococcal bacteremia and endocarditis. Staphylococcal endocarditis has to be considered in the differential diagnosis of febrile illness in patients with uncontrolled atopic dermatitis.

Mohiyiddeen Gadha

2008-05-01

65

Mitral valve aneurysm as a sequela of infective endocarditis: review of pathologic findings in Japanese cases.  

Science.gov (United States)

Mitral valve aneurysm is defined as a localized protrusion of the valve with a different radius from that of the remaining portion of the valve. The medical records and pathological findings of seven patients with mitral valve aneurysm [aged 48-69 years (mean 64), 4 males] and the pathological findings of other 29 Japanese cases were reviewed. All seven patients were diagnosed pathologically as infective endocarditis, but two patients had no documentation of clinical symptoms suggestive of infective endocarditis (latent infective endocarditis). The underlying lesion of the heart was aortic valve disease and/or fibrosal degeneration of the mitral valve. Only 29 of 36 Japanese case reports stated a precise description of the valve pathology. Of these 29 cases, 23 were associated with infective endocarditis, two with rheumatic valvular disease with fusion and/or shrinkage of the chordae tendineae, three with mitral valve prolapse or myxomatous degeneration of the mitral valve, and one with aortitis syndrome. Neovascularization was described in eight cases. Neovascularization with thick wall should be considered as post-inflammatory vascularization. This review indicates that patients with latent infective endocarditis and mitral valve aneurysm should be considered as potential candidates for valve surgery. PMID:9666395

Kawai, S; Oigawa, T; Sunayama, S; Yamaguchi, H; Okada, R; Hosoda, Y; Sawada, H; Aoki, K; Furuta, S; Kato, K; Sunamori, M; Takamoto, T; Shirai, T; Amano, J

1998-01-01

66

Periannular complications in infective endocarditis involving native aortic valves.  

Science.gov (United States)

The extension of infection in native valve infective endocarditis (IE) from valvular structures to the periannular tissue is incompletely understood. It is unknown, for example, whether the prognosis of patients with aortocavitary fistulae is worse than that of those with nonruptured abscesses. The aims of this study were to determine the distinct clinical characteristics of patients with aortocavitary fistulae and nonruptured abscesses in native valve IE and to evaluate the impact of fistulization on the outcomes of patients with native aortic valve IE complicated with periannular lesions. In a retrospective multicenter study of 2,055 native valve IE episodes, 201 patients (9.8%) with periannular complications in aortic valve IE were identified (46 with aortocavitary fistulization and 155 with nonruptured abscesses). Rates of heart failure (p = 0.07), ventricular septal defect (p 60 years (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.3 to 5.2), renal failure (OR 3.0, 95% CI 1.5 to 6.0), and moderate or severe heart failure (OR 2.5, 95% CI 1.2 to 5.2) as independent risk factors for death. There was a trend toward increased in-hospital mortality in patients with aortocavitary fistulae (OR 1.5, 95% CI 0.7 to 3.0). The actuarial 5-year survival rate in surgical survivors was 80% in patients with fistulae and 92% in patients with nonruptured abscesses (log-rank p = 0.6). In conclusion, aortocavitary fistulous tract formation in the setting of native valve IE is associated with higher rates of heart failure, ventricular septal defect, and atrioventricular block than nonruptured abscess. Despite these higher rates of complications, fistulous tract formation in the current era of IE is not an independent risk factor for mortality. PMID:17056342

Anguera, Ignasi; Miro, Jose M; Evangelista, Artur; Cabell, Christopher H; San Roman, Jose Alberto; Vilacosta, Isidre; Almirante, Benito; Ripoll, Tomas; Fariñas, M Carmen; Anguita, Manuel; Navas, Enrique; Gonzalez-Juanatey, Carlos; Garcia-Bolao, Ignacio; Muñoz, Patricia; de Alarcon, Aristides; Sarria, Cristina; Rufi, Gabriel; Miralles, Francisco; Pare, Carles; Fowler, Vance G; Mestres, Carlos A; de Lazzari, Elisa; Guma, Joan R; Moreno, Asunción; Corey, G Ralph

2006-11-01

67

Aortic Valve Replacement for Infective Endocarditis in a Renal Transplant Recipient  

Directory of Open Access Journals (Sweden)

Full Text Available Renal transplant recipients are more prone to developing infections. We report a 37-year old renal transplant recipient who developed infective endocarditis of the aortic valve, heart failure and renal allograft dysfunction. He underwent aortic valve replacement which was followed by improvement in cardiac as well as allograft function.

Masmoudi Sayda

2000-01-01

68

Quadricuspid aortic valve complicated with infective endocarditis: report of a case.  

Science.gov (United States)

Congenital quadricuspid aortic valve is a rare cardiac malformation with an unknown risk of infective endocarditis. We report a case of quadricuspid aortic valve complicated with infective endocarditis. A 53-year-old Japanese woman was hospitalized with leg edema and a fever of unknown origin. Corynebacterium striatum was detected in the blood culture. Echocardiography demonstrated a quadricuspid aortic valve with vegetation and severe functional regurgitation. The condition was diagnosed as a quadricuspid aortic valve with infective endocarditis, for which surgery was performed. The quadricuspid aortic valve had three equal-sized cusps and one smaller cusp (type B according to Hurwitz classification). We dissected the vegetation and infectious focus and implanted a mechanical valve. Following the case report, we review the literature. PMID:24496979

Mizoguchi, Hiroki; Sakaki, Masayuki; Inoue, Kazushige; Kobayashi, Yasuhiko; Iwata, Takashi; Suehiro, Yasuo; Miura, Takuya

2014-12-01

69

[Echocardiographic prediction of risk for embolism in patients with infective endocarditis].  

Science.gov (United States)

The relationship between two-dimensional echocardiographic findings of vegetation and embolic events was investigated in 26 patients with infective endocarditis (17 males and 9 females, mean [+/-SD] age 51 +/- 17 years). The size and the other morphologic characteristics of vegetation (mobility, extent and consistency) were analyzed retrospectively according to the criteria by Sanfilippo, et al., and parameters were assigned scores from 1 to 4 to provide a total score. Patients with a maximum vegetation diameter > 10 min had a significantly higher incidence of embolic events than those with or = 10 had embolic events, whereas those without embolic events had a total score endocarditis. However, the incidence of heart failure was higher, but not significantly, in patients with aortic valve (67%) and combined valve endocarditis (67%) than in those with mitral valve endocarditis (36%). The maximum size and total score reflecting mobility, extent and consistency of vegetation using two-dimensional echocardiography provide useful information to predict the occurrence of embolic events in patients with infective endocarditis. PMID:9211112

Koie, S; Iwase, M; Hasegawa, K; Matsuyama, H; Yamamoto, H; Takeda, K; Kato, C; Kimura, M; Hishida, H; Kamiya, H; Ohno, M

1997-01-01

70

Rapid identification of Cardiobacterium hominis by MALDI-TOF mass spectrometry during infective endocarditis.  

Science.gov (United States)

We report a new case of Cardiobacterium hominis endocarditis identified during an acute coronary syndrome. The positivity of the blood cultures was confirmed rapidly (50 h) as a result of improvements to the automated detection system, whereby it is no longer necessary to incubate the vials for long periods of time when Aggregatibacter-Cardiobacterium-Eikenella-Kingella infections is suspected. The phenotype-based VITEK 2 NH identification system is not able to distinguish between the two species of Cardiobacterium, as it does not contain C. valvarum in its library. The method for 16S rRNA gene sequence analysis is able to separate the two species but is not available in all laboratories. We used MALDI-TOF mass spectrometry, as an alternative, to rapidly distinguish between C. hominis and C. valvarum, because both species are contained in the system library. PMID:21788710

Wallet, Frédéric; Loïez, Caroline; Decoene, Christophe; Courcol, René

2011-01-01

71

Cardiobacterium hominis prosthetic valve endocarditis: an infrequent infection.  

Science.gov (United States)

A case of prosthetic aortic valve endocarditis due to Cardiobacterium hominis in a 67-year-old woman is described. The diagnosis was confirmed by a positive blood culture and echocardiographic detection of aortic valve vegetations. The patient underwent replacement of the valve with a homograft, and received antibiotics postoperatively. She remained well after 12 months. PMID:22718724

Pousios, Dimitrios; Gao, Fangfei; Tsang, Geoff M

2012-06-01

72

Infective Endocarditis Associated with Transcatheter Aortic Valve Replacement: Potential Importance of Local Trauma for a Deadly Nidus  

Science.gov (United States)

Recently, transcatheter aortic valve replacement (TAVR) has emerged as an alternative for the treatment of severe symptomatic aortic stenosis patients. Although experience with TAVR is increasing exponentially, few cases of post-TAVR endocarditis are reported. We present a case of 76-year-old man with infective endocarditis after TAVR who was definitely diagnosed by echocardiography. PMID:25309690

Lee, Hak Seung; Jung, Ji-Hyun; Kim, Hyue Mee; Kim, Chee Hae; Park, Jun-Bean; Kim, Hyung-Kwan; Kim, Yong-Jin; Kim, Hyo-Soo; Sohn, Dae-Won

2014-01-01

73

Infective Endocarditis Associated with Transcatheter Aortic Valve Replacement: Potential Importance of Local Trauma for a Deadly Nidus  

OpenAIRE

Recently, transcatheter aortic valve replacement (TAVR) has emerged as an alternative for the treatment of severe symptomatic aortic stenosis patients. Although experience with TAVR is increasing exponentially, few cases of post-TAVR endocarditis are reported. We present a case of 76-year-old man with infective endocarditis after TAVR who was definitely diagnosed by echocardiography.

Lee, Hak Seung; Lee, Seung-pyo; Jung, Ji-hyun; Kim, Hyue Mee; Kim, Chee Hae; Park, Jun-bean; Kim, Hyung-kwan; Kim, Yong-jin; Kim, Hyo-soo; Sohn, Dae-won

2014-01-01

74

High rates of complications following Kingella kingae infective endocarditis in children: a case series and review of the literature.  

Science.gov (United States)

Kingella kingae is part of the Haemophilus spp., Aggregatibacter spp., Cardiobacterium hominis, Eikenella corrodens and Kingella spp. organisms that are known to cause bacterial endocarditis. Evidence suggests it is also a common pharyngeal colonizer in children <2 years of age. We reviewed the literature to determine common complications of K. kingae infective endocarditis in children. PMID:24921624

Foster, Monique A; Walls, Tony

2014-07-01

75

Un brote epidémico de endocarditis por Pseudomonas aeruginosa secundario a angiografía coronaria / An outbreak of Pseudomonas aeruginosa infective endocarditis subsequent to coronary angiography  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Objetivos: Describir un brote de endocarditis por Pseudomonas aeruginosa que afectó a tres pacientes tras habérseles efectuado una coronariografía en el Centro Médico de Cardiología y de Cirugía Cardiovascular (CMC-CCV) de un hospital privado. Métodos: Después de reconocer la aparición de un brote e [...] n un periodo de un mes, este hecho fue comunicado al Departamento de Salud de Antalya, iniciándose una exhaustiva investigación para precisar la más probable causa y/o fuente de las endocarditis nosocomiales. Se extrajo de los registros médicos los datos clínicos de los pacientes y se efectuaron entrevistas a los pacientes o sus familiares. Se extrajo 36 muestras medioambientales de vigilancia en busca de P. aeruginosa de diversos sitios dentro de la unidad de coronariografía. Un team que investigó el brote revisó los procedimientos en uso para la prevención de infecciones en el CMC-CCV. Se estudió la epidemiología de la P. aeruginosa mediante análisis de su fenotipos, incluyendo el perfil de susceptibilidad in vitro a antimicrobianos. Resultados: La auditoria comprobó el quiebre de diversas normas de control de infecciones. Sólo 1/36 de las muestras ambientales arrojó el cultivo de P. aeruginosa, a partir de una solución de medio radio-opaco dentro de una bomba inyectora empleada en las angiografías. Los aislados de P. aeruginosa desde la solución del medio radio-opaco tenían idéntico patrón de susceptibilidad antimicrobiana que las cepas recuperadas de los pacientes. Ambos tipos de muestras eran susceptibles a todos los antimicrobianos con actividad anti-pseudomonas. El brote pudo evitarse si se hubieran instaurado una serie de medidas de control de infecciones. Conclusiones: Este brote enfatiza la importancia de adherir a los estándares y prácticas de control de infecciones para la cateterización cardiaca, así como la necesidad de una estrecha colaboración entre el Comité de Control de Infecciones y el personal involucrado en el procedimiento de coronariografía. Abstract in english Objectives: To describe an endocarditis outbreak affecting three patients due to Pseudomonas aeruginosa infection post coronary angiography performed in the Cardiovascular Surgery and Cardiology Medical Center of a private hospital. Methods: After recognition of an infection cluster within a onemont [...] h period, the outbreak was reported to Antalya Department of Health and a broad investigation was initiated in order to determine the most probable cause and/or source of nosocomial pseudomonal endocarditis. Patient data were obtained by medical record review as well as interviews with patients or their next of kin. Thirty-six surveillance samples for P. aeruginosa were collected from various locations within the coronary angiography unit. The outbreak research team reviewed the private hospital's Cardiovascular Surgery and Cardiology Medical Center's infection control procedures. The epidemiology of P. aeruginosa was studied through analysis of phenotypic markers, including antimicrobial sensitivity profiles. Results: The infection control audit revealed multiple breaches of infection control procedures. Only 1/36 environmental samples yielded, which was isolated from a radio-opaque solution within an angiography injector pump. P. aeruginosa from the radio-opaque solution had an identical antimicrobial susceptibility pattern to the strain isolated from patients. Both samples were susceptible to all antipseudomonal agents. This outbreak could have been successfully controlled by instituting combined infection control measures. Conclusions: This outbreak emphasizes the important of adherence to infection control standards and practices for cardiac catheterization, as well as the need for closer collaboration between the Infection Control Committee and coronary angiography personnel.

Derya, Seyman; Dilara, Inan; Nevgun, Sepin Ozen; Dilara, Ogunc.

2014-06-01

76

New tricks from an old cow: Infective endocarditis caused by Streptococcus dysgalactiae subsp. dysgalactiae.  

Science.gov (United States)

We present a case of infective endocarditis caused by Streptococcus dysgalactiae subsp. dysgalactiae; a major cause of bovine mastitis and previously thought to be an animal restricted pathogen. The patient reported no direct contact with animals, and the clinical course was severe and complicated. PMID:25472489

Jordal, Stina; Glambek, Marte; Oppegaard, Oddvar; Kittang, Bård Reiakvam

2014-12-01

77

Cardiobacterium valvarum infective endocarditis and phenotypic/molecular characterization of 11 Cardiobacterium species strains  

DEFF Research Database (Denmark)

Cardiobacterium valvarum is a newly recognized human pathogen related to infective endocarditis. Cardiobacterium species are, however, only rarely the aetiology of infective endocarditis. An infective endocarditis case is presented and, additionally, phenotypic and phylogenetic comparison of a further 10 collection strains, representing the two species within the genus, was performed. C. valvarum was isolated from the blood and DNA was present in valvular tissue (partial 16S rRNA gene analysis) from a 64-year-old man with infective endocarditis of the mitral valve, rupture of chordae and prolapse of pulmonary valves in addition to a fluttering excrescence. A mechanical mitral valve and neochordae were inserted successfully. Phenotypically, the two species within the genus Cardiobacterium resemble each other greatly. When using the Vitek 2 Neisseria-Haemophilus identification card, the reaction for phenylphosphonate was positive for all Cardiobacterium hominis strains, but negative for all C. valvarum strains,thereby separating the two species. The two species made up two separate clusters by phylogenetic examination using 16S rRNA gene sequence analysis.

Chen, Ming; Kemp, Michael

2011-01-01

78

Infective endocarditis and cardiac surgery in intravenous drug abusers and HIV-1 infected patients.  

Science.gov (United States)

Infective endocarditis (IE) is one of the most severe complications of parenteral drug abuse. The incidence of IE in intravenous drug abusers (IVDAs) is 2% to 5% per year, being responsible for 5% to 10% of the overall death rate. The prevalence of HIV infection among IVDAs with IE ranges between 30% and 70% in developed countries and HIV-infection by itself increases the risk of IE in IVDAs. The incidence of IE in IVDAs is currently decreasing in some areas, probably due to changes in drug administration habits by addicts to avoid HIV transmission. Overall, Staphylococcus aureus is the most common etiological agent, being usually sensitive to methicillin (MSSA). The tricuspid valve is the most frequently affected (60% to 70%), followed by the mitral and aortic valves (20% to 30%). HIV-positive IVDAs have a higher ratio of right-sided IE and S aureus IE than HIV-negative IVDAs. Response to antibiotic therapy is similar. Drug addicts with non-complicated MSSA right-sided IE can be treated with an i.v. short-course regimen of nafcillin or cloxacillin for 2 weeks, with or without addition of an aminoglycoside during the first 3 to 7 days. The prognosis of right-sided endocarditis is generally good; overall mortality is less than 5%, and with surgery is less than 2%. In contrast, the prognosis of left-sided IE is less favorable; mortality is 20% to 30%, and even with surgery is 15% to 25%. IE caused by GNB or fungi has the worst prognosis. Mortality between HIV-infected or non-HIV-infected IVDAs with IE is similar. However, among HIV-infected IVDAs, mortality is significantly higher in those who are most severely immunosuppressed, with CD4+ cell count patients who are not drug abusers is rare. The epidemiology of cardiac surgery in IVDAs and/or HIV-infected patients has changed in recent years. There is a decrease in IE and an increase of patients undergoing surgery (CABS) for coronary artery disease secondary to the hyperlipidemia and lipodystrophy induced by highly active antiretroviral therapy (HAART). Cardiac surgery in HIV-infected patients with or without IE does not worsen the prognosis because extracorporeal circulation did not affect the immune status after surgery. Morbidity and mortality seems to stay within the same range as the non-infected patients. In our experience, in the IE in HIV-infected IVDA group, the 1-year survival is 65% and the 5 and 10-year actuarial survival is 35%. For patients operated on for coronary artery disease, the 5-year survival is 100%. PMID:12874891

Miró, José M; del Río, Ana; Mestres, Carlos A

2003-05-01

79

NICE guideline on antibiotic prophylaxis against infective endocarditis: attitudes to the guideline and implications for dental practice in Ireland.  

LENUS (Irish Health Repository)

To investigate attitudes of Irish dental practitioners, cardiologists and patients with cardiac lesions to the new NICE guideline for antibiotic prophylaxis against infective endocarditis and to determine the implications of this guideline for dental practice in Ireland.

2009-03-28

80

Multiresistant-MRSA tricuspid valve infective endocarditis with ancient osteomyelitis locus  

OpenAIRE

Abstract Background Methicillin-resistant S. aureus (MRSA) with low susceptibility to glycopeptides is uncommon. Case presentation The case of a 50-year-old non-drug addict patient presenting with tricuspid valve infective endocarditis (IE) by MRSA resistant to vancomycin and linezolid is presented. There was response only to quinupristin/dalfopristin. He had a motorcycling accident four years before undergoing right above-the-knee amputation and orthop...

Gambarati Gianpaolo; Mestres Carlos A; Colli Andrea; Chesi Giuseppe; Boni Fabrizio; Gherli Tiziano

2006-01-01

81

Red man syndrome during administration of prophylactic antibiotic against infective endocarditis  

OpenAIRE

Red man syndrome (RMS) is the occurrence flushing, pruritus, chest pain, muscle spasm or hypotension during vancomycin infusion. It usually happens as a result of rapid infusion of the drug but may also occur after slow administration. The frequency and severity of this phenomenon diminish with repeated administration of vancomycin. A case is presented whereby RMS occurred while prophylactic antibiotic against infective endocarditis was administered.

Ngeow, W. C.; Chai, W. L.; Moody, A. B.

2000-01-01

82

Infective endocarditis or myxoma? Description of a patient with new diagnosis of congestive heart failure.  

Science.gov (United States)

Infective endocarditis (IE) is an inflammatory disease which interests heart endothelium and mostly heart valves. IE is not a uniform disease, but presents in a variety of different forms that makes the diagnosis difficult. Echocardiography is a crucial diagnostic tool for the diagnosis, especially in those patients who have no typical symptoms as in the case here presented, in which the possibility of a myxoma was also considered. PMID:23167154

Testa, Marzia; Lombardo, Enrico; Avogadri, Enrico; Agostini, Marco; Forte, Giuseppe; Piccolo, Salvatore; Feola, Mauro

2012-06-01

83

Radiolabeled antibody in the detection of infection using endocarditis as a model  

International Nuclear Information System (INIS)

The authors have examined a method to detect infections using radiolabeled antibodies. Staphylococcal endocarditis was chosen as a model because it poses a common clinical diagnostic problem. The experiments demonstrate that biologically active antibodies may be extracted and efficiently labeled by a relatively simple process. This has the potential to make the specificity of the in vivo antigen-antibody reaction available through the use of autologously extracted, labeled ?-globulin

84

Infective Endocarditis Complicated with Progressive Heart Failure due to ?-Lactamase-Producing Cardiobacterium hominis  

OpenAIRE

We describe a 66-year-old woman with infective endocarditis due to Cardiobacterium hominis whose condition, complicated by severe aortic regurgitation and congestive heart failure, necessitated aortic valve replacement despite treatment with ceftriaxone followed by ciprofloxacin. The blood isolate of C. hominis produced ?-lactamase and exhibited high-level resistance to penicillin (MIC, ?256 ?g/ml) and reduced susceptibility to vancomycin (MIC, 8 ?g/ml).

Lu, Po-liang; Hsueh, Po-ren; Hung, Chien-ching; Teng, Lee-jene; Jang, Tsrang-neng; Luh, Kwen-tay

2000-01-01

85

Infective endocarditis complicated with progressive heart failure due to beta-lactamase-producing Cardiobacterium hominis.  

Science.gov (United States)

We describe a 66-year-old woman with infective endocarditis due to Cardiobacterium hominis whose condition, complicated by severe aortic regurgitation and congestive heart failure, necessitated aortic valve replacement despite treatment with ceftriaxone followed by ciprofloxacin. The blood isolate of C. hominis produced beta-lactamase and exhibited high-level resistance to penicillin (MIC, >==256 microgram/ml) and reduced susceptibility to vancomycin (MIC, 8 microgram/ml). PMID:10790145

Lu, P L; Hsueh, P R; Hung, C C; Teng, L J; Jang, T N; Luh, K T

2000-05-01

86

A mycotic forearm pseudoaneurym as an unusual complication of infective endocarditis.  

Science.gov (United States)

Introduction: Mycotic pseudoaneurysms are an infrequent complication of infective endocarditis; most cases are secondary to arterial trauma. The commonest site involved are the intracranial arteries, followed by the abdominal aorta and then the peripheral vessels. Case presentation: We report a case of a 36-year-old man, admitted in our institution for a subarachnoid haemorrhage, who presented with fever of unknown origin during his stay in the neurocritical care unit and whom was diagnosed infective endocarditis due to Meticilin Sensible Staphylococcus Aureus. Almost two weeks after antibiotic therapy was instituted, he presented a large, growing, pulsatile mass of the left forearm. A giant pseudoaneurysm arising from the radial artery was detected with ultrasound and surgical intervention was carried out. A large laceration of the radial artery was detected and an interposition of a vein graft was performed. Discussion: Forearm mycotic pseudoaneurysms are rare. A high index of suspicion is needed and they should always be borne in mind in the differential diagnosis of an extremity pain, swelling or motor-sensorial deficit after infective endocarditis. PMID:25177745

Rodrigues, Gonçalo M; Amaral, Carlos Oliveira; Valentim, Hugo Dias; Quintas, Anita; Ferreira, Maria Emília; Castro, João Albuquerque; Capitão, Luís Mota

2013-01-01

87

Endocarditis infecciosa en pacientes con daño hepático crónico: Serie de 4 casos clínicos / Infective endocarditis in patients with chronic hepatic failure: A four cases series  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish La asociación entre daño hepático y endocarditis infecciosa es infrecuente. Para analizar los factores predisponentes de esta asociación, la etiología microbiana y evolución clínica, se efectuó un análisis retrospectivo de los egresos por endocarditis infecciosa en pacientes con cirrosis hepática de [...] sde 1995 a junio de 2008. Se identificaron cuatro casos, asociados a categoría Child A en tres y en todos había una cardiopatía predisponente. Las manifestaciones clínicas fueron clásicas excepto en un caso que se presentó como descompensación hepática. Sólo un caso se asoció a un agente típico, otros a un agente nosocomial y Corynebacterium diphtheriae. En un caso no se identificó la etiología. Uno de los pacientes requirió cirugía de reemplazo valvular. Tres pacientes se recuperaron (Child A) y el paciente en categoría Child C falleció. Aunque infrecuente, la asociación cirrosis y endocarditis ocurre en la práctica clínica, se puede asociar a agentes inhabituales y tener manifestaciones encubiertas. Abstract in english Infective endocarditis and liver cirrhosis is an infrequent association. A retrospective study was performed in order to characterize predisposing factors, microbial causes and evolution. Medical records between 1995 and 2008 (June) were searched. Four cases were identified. In three cases liver cir [...] rhosis was in stage Child A, and in all 4 there was a predisposing cardiac disease. Clinical manifestations were classical in 3 cases and in one presented as hepatic failure. Only in one case a typical agent was recovered. Other cases were associated to a nosocomial agent or Corynebacterium diphtheriae, and in one no agent was identified. One patient required valve replacement. Three patients recovered satisfactorily, all of them in Child A stage. One died of non-infectious causes (Child C). Infective endocarditis and liver cirrhosis is an infrequent association in clinical practice, it can be associated to unusual agents or clinical manifestations.

Dan, Oksenberg R; Anna, Castelli T; Alberto, Fica C.

2009-06-01

88

Endocarditis infecciosa en pacientes con daño hepático crónico: Serie de 4 casos clínicos Infective endocarditis in patients with chronic hepatic failure: A four cases series  

Directory of Open Access Journals (Sweden)

Full Text Available La asociación entre daño hepático y endocarditis infecciosa es infrecuente. Para analizar los factores predisponentes de esta asociación, la etiología microbiana y evolución clínica, se efectuó un análisis retrospectivo de los egresos por endocarditis infecciosa en pacientes con cirrosis hepática desde 1995 a junio de 2008. Se identificaron cuatro casos, asociados a categoría Child A en tres y en todos había una cardiopatía predisponente. Las manifestaciones clínicas fueron clásicas excepto en un caso que se presentó como descompensación hepática. Sólo un caso se asoció a un agente típico, otros a un agente nosocomial y Corynebacterium diphtheriae. En un caso no se identificó la etiología. Uno de los pacientes requirió cirugía de reemplazo valvular. Tres pacientes se recuperaron (Child A y el paciente en categoría Child C falleció. Aunque infrecuente, la asociación cirrosis y endocarditis ocurre en la práctica clínica, se puede asociar a agentes inhabituales y tener manifestaciones encubiertas.Infective endocarditis and liver cirrhosis is an infrequent association. A retrospective study was performed in order to characterize predisposing factors, microbial causes and evolution. Medical records between 1995 and 2008 (June were searched. Four cases were identified. In three cases liver cirrhosis was in stage Child A, and in all 4 there was a predisposing cardiac disease. Clinical manifestations were classical in 3 cases and in one presented as hepatic failure. Only in one case a typical agent was recovered. Other cases were associated to a nosocomial agent or Corynebacterium diphtheriae, and in one no agent was identified. One patient required valve replacement. Three patients recovered satisfactorily, all of them in Child A stage. One died of non-infectious causes (Child C. Infective endocarditis and liver cirrhosis is an infrequent association in clinical practice, it can be associated to unusual agents or clinical manifestations.

Dan Oksenberg R

2009-06-01

89

Infective Endocarditis Related to a Coronary Artery Fistula with an Unusual Localization and Ectatic Coronary Arteries.  

Science.gov (United States)

Coronary artery fistulas (CAF) are a rare cardiac anomaly that can be either congenital or acquired. CAFs have clinical significance because of complications such as dyspnea on exertion, congestive heart failure, and cardiac tamponade. The literature also contains case reports of CAF presenting as bacterial endocarditis. We describe a 31-year-old man who presented with native valve infective endocarditis related to an unusual form of a CAF between the circumflex coronary artery and left ventricle. He also had giant coronary arteries, which were imaged with computed tomography angiography and transesophageal echocardiography. The diameter of the circumflex coronary artery and left main coronary artery was measured as 19 mm. Surgical intervention for heart valves was performed because of vegetations resistant to continued antibiotic treatment. At the same time, the CAF was treated with surgery. PMID:25362867

Gerede, Demet Menekse; Acibuca, Aynur; Uzun, Caglar; Goksuluk, Huseyin; Ongun, Aydan; Kilickap, Mustafa; Erol, Cetin

2014-11-01

90

Splenic abscess as a potential initial manifestation of quiescent infective endocarditis in a patient with bronchopneumonia.  

Science.gov (United States)

A 78-year-old woman presented to the acute medical unit with a productive cough, dyspnoea and decreased appetite of 4?days duration. Initial assessment supported a diagnosis of right-sided community-acquired pneumonia and she was started on antibiotics. In view of the clinical finding of splenomegaly, she had an ultrasound and, subsequently, a CT of the abdomen, which revealed a large splenic abscess. Pending cultures from a sample obtained from percutaneous drainage of the abscess, she was started on intravenous meropenem. The initial echocardiogram did not suggest any evidence of endocarditis. The pus drained from the abscess on cultures was subsequently positive for Staphylococcus aureus. An MRI of the spine excluded discitis as a source of infection. Owing to a high index of clinical suspicion a repeat echocardiogram was undertaken after 1-week, which confirmed acute endocarditis. The patient was treated with intravenous antibiotics for 6?weeks with improvement in clinical, radiological and biochemical parameters. PMID:25564586

McOwat, Lindsay; Wong, Kah Fai; Varughese, George I; Nayak, Ananth U

2015-01-01

91

Heart transplantation during active infective endocarditis: case report and review of the literature.  

Science.gov (United States)

Bacterial infections are a contraindication to organ transplantation, but infective endocarditis may require heart transplantation when otherwise untreatable. We describe a heart transplant patient with cardiomyopathy and ongoing defibrillator endocarditis due to Staphylococcus epidermidis. An initial attempt at percutaneous extraction of the 5 implanted leads was unable to eradicate the infection and was complicated by severe decompensation, requiring a new implant for biventricular pacing. Despite continuing bactericidal treatment, the patient showed persistent infection on the implanted leads with further hemodynamic deterioration. The decision was therefore made to list the patient for heart transplantation. The procedure was successful in removing all of the hardware. No recurrence of infection was observed despite persistence of large vegetations on the removed defibrillator leads. The patient had an uneventful postoperative course, remaining free of symptoms with negative blood cultures at 3 months' follow-up. Our experience showed that active infection of defibrillator leads may not represent an absolute contraindication to heart transplantation when all other medical and surgical treatments have been proven to be ineffective. PMID:21335210

Durante-Mangoni, E; Casillo, R; Pinto, D; Caianiello, C; Albisinni, R; Caprioli, V; Maiello, C; Utili, R

2011-01-01

92

[Tricuspid valve plasty using autologous pericardium in a patient with infective endocarditis].  

Science.gov (United States)

A 67-year-old woman was diagnosed with infective endocarditis. She had no history of any cardiac event or dental treatment. Echocardiography showed a large vegetation attached to the anterior leaflet of the tricuspid valve with severe tricuspid regurgitation. Surgery consisted of removal of the vegetation and tricuspid valve plasty with a glutaraldehyde-treated autologous pericardial patch and artificial chordae of the anterior leaflet. Her postoperative course was uneventful. Five years after surgery, neither recurrence of infection nor worsening of tricuspid regurgitation was noted. PMID:25434539

Hioki, Iwao; Sato, Tomoaki; Morimoto, Tamotsu

2014-12-01

93

From cat scratch disease to endocarditis, the possible natural history of Bartonella henselae infection  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Most patients with infectious endocarditis (IE due to Bartonella henselae have a history of exposure to cats and pre-existing heart valve lesions. To date, none of the reported patients have had a history of typical cat scratch disease (CSD which is also a manifestation of infection with B. henselae. Case presentation Here we report the case of a patient who had CSD and six months later developed IE of the mitral valve caused by B. henselae. Conclusion Based on this unique case, we speculate that CSD represents the primary-infection of B. henselae and that IE follows in patients with heart valve lesions.

Raoult Didier

2007-04-01

94

Niveles de péptido natriurético tipo B y su asociación con la morbimortalidad en endocarditis infecciosa / Association Levels of brain natriuretic peptide with morbidity and mortality in infective endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish La endocarditis infecciosa (EI) es una infección con alta morbimortalidad. Identificar a los pacientes con mayor riesgo de presentar complicaciones proporciona la oportunidad de establecer una terapéutica agresiva. El péptido natriurético tipo B es un estudio rápido y disponible, y se ha relacionado [...] a los niveles elevados con una mala evolución en la EI. Objetivos: Determinar la asociación entre los niveles de péptido natriurético tipo B y la morbimortalidad en pacientes con EI. Material y métodos: Se incluyeron pacientes ?15 años, durante el periodo de julio de 2010 a julio de 2012. Se dividieron en distintos grupos con base en los niveles de péptido natriurético tipo B: grupo 1, péptido natriurético tipo B Abstract in english Infective endocarditis (IE) is an infection with high morbidity and mortality. Identify patients with increased risk for complications, provides the opportunity to establish an aggressive therapeutic. B-type natriuretic peptide is a quick, available and high levels has been linked with poor outcome [...] in IE. Objectives: To determine the association between B-type natriuretic peptide levels and morbidity and mortality in patients with infective endocarditis. Material and methods: We included patients ? 15 years, during the period July 2010 to July 2012. They were divided into groups based on the levels of B-type natriuretic peptide, group 1 B-type natriuretic peptide

Oddir, Jáuregui Ruiz; Eduardo, Galván García; Cyntia Zulema, Machain Leyva.

2013-12-01

95

Severe infective endocarditis with systemic embolism due to community associated methicillin-resistant Staphylococcus aureus ST630.  

Science.gov (United States)

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) are increasingly causing infective endocarditis over the past decade. Here we report a healthy man who developed a severe acute infective endocarditis with systemic embolism caused by CA-MRSA. The strain was recovered from repeated blood cultures and was characterized using molecular detection and genotyping. The S. aureus isolate was typed as ST630 SCCmecV with spa-type t4549, agrI/IV and was PVL-negative. This is the only case report, to our knowledge, of CA-MRSA infective endocarditis in China. This case highlights the emergence and geographical spread of life-threatening CA-MRSA infection within China. PMID:25193080

Zheng, Beiwen; Jiang, Saiping; Xu, Zemin; Xiao, Yonghong; Li, Lanjuan

2015-01-01

96

Cool seasons are related to poor prognosis in patients with infective endocarditis  

Science.gov (United States)

Many cardiac diseases demonstrate seasonal variations in the incidence and mortality. This study was designed to investigate whether the mortality of infective endocarditis (IE) was higher in cool seasons and to evaluate the effects of cool climate for IE. We enrolled 100 IE patients with vegetations in our hospital. The temperatures of the IE episodes were defined as the monthly average temperatures of the admission days. The average temperatures in the cool (fall/winter) and warm seasons (spring/summer) were 19.2°C and 27.6°C, respectively. In addition, patients admitted with the diagnosis of IE were identified from the National Health Insurance Research Database (NHIRD) and the in-hospital mortality rates in cool and warm seasons were compared to validate the findings derived from the data of our hospital. The mortality rate for IE was significantly higher in fall/winter than in spring/summer which presents consistently in the patient population of our hospital (32.7% versus 12.5%, p = 0.017) and from NHIRD (10.4% versus 4.6%, p = 0.019). IE episodes which occurred during cool seasons presented with a higher rate of heart failure (44.2% versus 22.9%, p = 0.025) and D-dimer level (5.5 ± 3.8 versus 2.4 ± 1.8 ?g/ml, p = 0.017) at admission than that of warm seasons. These results may reflect the impact of temperatures during the pre-hospitalized period on the disease process. In the multivariate analysis, Staphylococcal infection, left ventricular hypertrophy, left ventricular systolic dysfunction and temperature were the independent predictors of mortalities in IE patients.

Chen, Su-Jung; Chao, Tze-Fan; Lin, Yenn-Jiang; Lo, Li-Wei; Hu, Yu-Feng; Tuan, Ta-Chuan; Hsu, Tsui-Lieh; Yu, Wen-Chung; Leu, Hsin-Bang; Chang, Shih-Lin; Chen, Shih-Ann

2012-09-01

97

Bartonella henselae Endocarditis in Laos – ‘The Unsought Will Go Undetected’  

Science.gov (United States)

Background Both endocarditis and Bartonella infections are neglected public health problems, especially in rural Asia. Bartonella endocarditis has been described from wealthier countries in Asia, Japan, Korea, Thailand and India but there are no reports from poorer countries, such as the Lao PDR (Laos), probably because people have neglected to look. Methodology/Principal Findings We conducted a retrospective (2006–2012), and subsequent prospective study (2012–2013), at Mahosot Hospital, Vientiane, Laos, through liaison between the microbiology laboratory and the wards. Patients aged >1 year admitted with definite or possible endocarditis according to modified Duke criteria were included. In view of the strong suspicion of infective endocarditis, acute and convalescent sera from 30 patients with culture negative endocarditis were tested for antibodies to Brucella melitensis, Mycoplasma pneumoniae, Bartonella quintana, B. henselae, Coxiella burnetii and Legionella pneumophila. Western blot analysis using Bartonella species antigens enabled us to describe the first two Lao patients with known Bartonella henselae endocarditis. Conclusions/Significance We argue that it is likely that Bartonella endocarditis is neglected and more widespread than appreciated, as there are few laboratories in Asia able to make the diagnosis. Considering the high prevalence of rheumatic heart disease in Asia, there is remarkably little evidence on the bacterial etiology of endocarditis. Most evidence is derived from wealthy countries and investigation of the aetiology and optimal management of endocarditis in low income countries has been neglected. Interest in Bartonella as neglected pathogens is emerging, and improved methods for the rapid diagnosis of Bartonella endocarditis are needed, as it is likely that proven Bartonella endocarditis can be treated with simpler and less expensive regimens than “conventional” endocarditis and multicenter trials to optimize treatment are required. More understanding is needed on the risk factors for Bartonella endocarditis and the importance of vectors and vector control. PMID:25503777

Rattanavong, Sayaphet; Fournier, Pierre-Edouard; Chu, Vang; Frichitthavong, Khamthavy; Kesone, Pany; Mayxay, Mayfong; Mirabel, Mariana; Newton, Paul N.

2014-01-01

98

Infective endocarditis in children with congenital heart disease: comparison of selected features in patients with surgical correction or palliation and those without.  

OpenAIRE

The diagnostic and prognostic features of 44 episodes of infective endocarditis in 42 children with congenital heart disease were reviewed. Endocarditis occurred in 18 patients who had not had surgical correction or palliation of the defect (non-operated group). There were 26 episodes in 24 patients who had been treated surgically (operated group) (16 open and eight closed cardiac operations). Endocarditis occurred soon after open heart surgery in eight patients and as a late complication in ...

Karl, T.; Wensley, D.; Stark, J.; Leval, M.; Rees, P.; Taylor, J. F.

1987-01-01

99

Primer reporte en Cuba de endocarditis infecciosa a consecuencia de brucelosis / First report of infective endocarditis in Cuba as a result of brucellosis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Introducción: las manifestaciones clínicas por brucelosis han sido muy poco investigadas y no se profundiza en los síntomas y las posibles complicaciones que puede causar. Objetivo: reportar por primera vez en Cuba un caso de endocarditis infecciosa a consecuencia de brucelosis. Métodos: hombre blan [...] co, de 57 años, campesino, remitido desde Vertientes, que ingresó en diciembre de 2009 en el Hospital Provincial "Manuel Ascunce Domenech" de Camagüey, con diagnóstico presuntivo de endocarditis infecciosa por Brucella e insuficiencia aórtica moderada, que refirió presentar fiebre, malestar general, decaimiento, dolores musculares, articulares, artritis, astenia marcada, anorexia, signos neurológicos, sudoración y fuerte dolor en el pecho. En anteriores ingresos fue tratado con antimicrobianos, indicándole entre los complementarios, serología lenta en busca de brucelosis, pero por no disponibilidad de reactivos no se realizaron estas pruebas hasta enero de 2010. Se precisaron como antecedentes epidemiológicos el contacto directo con ganado vacuno y porcino y la presencia de heridas y microtraumatismos en manos y pies, propios de su labor. Su finca colinda con otra donde hay ganado afectado de brucelosis. Resultados: los exámenes de laboratorio resultaron positivos con elevados títulos serológicos, y aunque no fue posible el aislamiento del agente etiológico mediante el cultivo, se confirmó serológicamente la enfermedad y la endocarditis infecciosa como complicación sobreañadida; esto llevó tratamiento con antimicrobianos y medicamentos para la afección cardíaca. Se diagnostican muy poco estas complicaciones a consecuencia de brucelosis en la literatura internacional, este es el primer reporte para Cuba. Conclusiones: la descripción de este caso, constituye una alerta en el diagnóstico de las endocarditis infecciosas quizá asociadas a antecedentes epidemiológicos de brucelosis. Abstract in english Introduction: the clinical manifestations of brucellosis have been poorly researched on and the symptoms and possible complications have not been deeply studied either. Objective: to report a case of infective endocarditis caused by brucellosis for the first time in Cuba. Methods: a Caucasian male f [...] armer aged 57 years was referred from Vertientes municipality to be admitted at "Manuel Ascunce Domenech" provincial hospital in Camaguey province in December,2009. He had been presumptively diagnosed with infectious endocarditis caused by Brucella and with moderate aortic failure since he presented with fever, general malaise, fatigue, muscle and joint pains, arthritis, marked asthenia, anorexia, neurological signs, sweating and strong chest pain. In his previous hospitalization, he had been treated with antimicrobials after indication of supplementary tests such as slow serology for brucellosis; however, specific reagents were not available,so these tests were not performed until January 2010.The epidemiological history of this case included his direct contact with cows and pigs as well as wounds and minor traumas inflicted on his hands and feet resulting from his type of work. His farm is next to another farm where the cattle is also affected with brucellosis. Results: the lab tests were positive with high serological titres, and although it was not possible to isolate the etiologic agent through culturing, the disease and the infective endocarditis were serologically confirmed as additional complication; this required antimicrobial treatment and drugs for the heart disease. These complications from brucellosis are barely diagnosed in the international literature, and in Cuba, this is the first report of the disease. Conclusions: the description of this case is an alert to diagnosis of infective endocarditis that may be associated with epidemiological history of brucellosis.

Gloria Sofía, García González; Iraida María, Saborido Pérez; Lázaro, Ramírez Lana; Isabel, Ponce de León Ávila.

2012-04-01

100

Endocarditis infecciosa izquierda por Pseudomonas aeruginosa tratada médicamente Left-sided infective endocarditis caused by Pseudomonas aeruginosa treated medically  

OpenAIRE

La endocarditis infecciosa por Pseudomonas aeruginosa es una entidad poco frecuente, de difícil diagnóstico y alta mortalidad. Se presenta a continuación el caso de un hombre de 51 años, sin antecedentes de uso de drogas intravenosas ni enfermedad valvular, con antecedentes de colecistectomía en el mes anterior, quien se presentó a urgencias con un cuadro febril asociado a síntomas gastrointestinales, y, posteriormen...

Alejandro Junca; Gladys Alfonso; María José López; Jorge Alberto Cortés; Odismar Andrea Hernández; Karen Melissa Ordóñez

2010-01-01

101

Complicaciones posoperatorias y mortalidad en pacientes operados por endocarditis infecciosa / Postoperative complications and mortality observed in patients operated on from infective endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Objetivo: describir las causas de morbilidad y mortalidad perioperatorias en los pacientes afectos de endocarditis infecciosa activa y significar cómo pueden ser disminuidas. Métodos: se realizó un estudio retrospectivo de las complicaciones posoperatorias y mortalidad en 139 pacientes operados por [...] presentar endocarditis infecciosa en un período de 16 años. Se efectuaron 147 operaciones a los 139 pacientes de las cuales 83 (57,1 %) fueron electivas y 64 (42,9 %) fueron de urgencia. El 24 % de los pacientes fueron remitidos de otros centros en los que habían sido sometidos a tratamiento médico no exitoso por más de 4 semanas. Resultados: las operaciones efectuadas fueron: Sustituciones valvulares aórticas,mitrales y tricuspídeas 75 (41,1 %), extracción de electrodos de marcapasos o desfibriladores automáticos implantables del ventrículo derecho 57 (41 %) , otras operaciones en número de 7 (4,9 %)y 8 reintervenciones. La complicación más frecuente fue la sepsis generalizada (10,07 % p Abstract in english Objective: To describe the causes of perioperative morbidity and mortality of patients suffering active infectious endocarditis and to explain how both aspects can be reduced. Methods: A retrospective study of postoperative complications and mortality observed in 139 patients operated on from infect [...] ious endocarditis in 16 years. One hundred forty seven surgeries were performed, of which 83 (57.1 %) were elective and 64 (42.9 %) were emergency surgeries. In this group, 24 % had been referred from other medical centers where they had been unsuccessfully treated for 4 weeks. Results: The performed surgeries comprised 15 aortic, mitral and tricuspid valve replacements, 57 (41 %) removals of pacemaker electrodes or of implanted automatic defibrillators in the right ventricle, seven other types of surgeries and 8 reoperations. The most frequent complication was generalized sepsis ((10.07 % p

Joaquín, Gómez Armando Gonga; Milvio B, Ramírez López; Horacio E, Pérez López; Fidel Manuel, Cáceres Loriga; José R, Llanes.

2013-03-01

102

Endocarditis infecciosa por S. aureus en la Argentina: EIRA 2. Análisis comparativo luego de 10 años de los estudios EIRA 1 y 2 / S. aureus Infective Endocarditis in Argentina: A Comparative Analysis after 10 Years of EIRA-1 and EIRA-2 Surveys  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Objetivo Comparar el perfil y la evolución de la endocarditis infecciosa (EI) en nuestro país a lo largo de 10 años, a través de los registros EIRA-1 y EIRA-2. Determinar las características clínicas y epidemiológicas y la evolución hospitalaria de la EI por Staphylococcus aureus (EISA) en la Argent [...] ina. Métodos El estudio EIRA-2 fue un registro prospectivo multicéntrico conducido en 82 hospitales de 16 provincias de la Argentina. En el presente análisis se incluyeron pacientes con EI definidas (clasificación de Duke) relevados en un período de 18 meses. Resultados Se registraron 390 episodios de EI definidas (108 EISA y 282 no EISA); edad media 58,5 ± 17,3 años, sexo masculino 70%. No existieron diferencias estadísticamente significativas entre las 108 EISA y las 282 no EISA con respecto a edad, sexo, endocarditis de válvula protésica, enfermedad valvular degenerativa, presencia de insuficiencia cardíaca y frecuencia de tratamiento quirúrgico. La comparación de los registros EIRA-2 y EIRA-1 demostró cambios importantes en el perfil de la enfermedad en la última década, actualmente caracterizada por pacientes de mayor edad (58 versus 51 años), mayor prevalencia de cardiopatía subyacente 67% versus 55% (en particular prótesis valvulares 19,2% versus 8,5%, enfermedades valvulares degenerativas 12,4% versus 4,8% y cardiopatías congénitas 9,5% versus 4,2%), mayor frecuencia de infección causada por S. aureus (30% versus 26%) y menor por Streptococcus viridans (30,8% versus 26,8%), con una reducción del tiempo hasta el diagnóstico definitivo (21,5 versus 33 días). No se encontraron modificaciones en la tasa de mortalidad de la enfermedad. Se observó una diferencia estadísticamente significativa (p Abstract in english Work Objective To analyze the evolution and profile of infective endocarditis (IE) in Argentina during the last 10 years through the comparison of EIRA-1 and EIRA-2 surveys. To determine the epidemiological and clinical characteristics, and in-hospital evolution of S. aureus IE (SAIE) in Argentina. [...] Research Design and Methods The EIRA-2 survey was a prospective, multicentric study performed in 82 hospitals belonging to 16 of the 24 Argentinean provinces. Patients with definitive diagnosis of IE (Duke criteria) were followed-up during an 18-month period. Results Three hundred and ninety episodes of definitive IE were reported (108 SAIE and 282 non-SAIE); mean age was 58.5±17.3 years, male sex 70%. No statistically significant differences were observed between SAIE and non-SAIE regarding mean age, sex, prosthetic valve IE, degenerative valve IE, prevalence of heart failure and surgical treatment. The comparison of the EIRA-2 and EIRA-1 surveys showed that IE profile has changed in the last decade in Argentina. Currently, patients are older (58 vs. 51 years), and have a higher prevalence of underlying heart disease (67% vs. 55%) particularly prosthetic valve (19.2% vs. 8.5%), degenerative valve disease (12.4% vs. 4.8%), and congenital heart disease (9.5% vs. 4.2%); infections were more frequently caused by S. aureus (30% vs. 26%) and less by S. viridans (30.8% vs. 26.8%) with a decreased time until final diagnosis (21.5 vs. 33 days). No significant changes were observed in the overall mortality rate. Patients with SAIE showed a significantly (p

Ernesto R., Ferreirós; José H., Casabé; Francisco, Nacinovich; Sandra, Swieszkowski; Hernán, Cohen Arazi; Claudia, Cortés; Juan Carlos, Modenesi; Sergio, Varini.

2006-02-01

103

Prosthetic valve endocarditis.  

OpenAIRE

During 1965 to 1982, 32 episodes of infective endocarditis on prosthetic valves in 30 patients were treated at this hospital. In early endocarditis (presenting within four months of operation) staphylococci were the organisms most commonly responsible. Early endocarditis appears to be declining in incidence and is largely preventable; sternal sepsis was the main predisposing factor, requiring urgent and effective treatment. Streptococci were the most common organisms in late onset disease, bu...

Mahesh, B.; Angelini, G.; Caputo, M.; Jin, Xy; Bryan, A.

1983-01-01

104

67Ga imaging in the patients with infective endocarditis after surgery for congenital heart disease  

International Nuclear Information System (INIS)

67Ga imaging was performed in sixteen patients (age: 8 m.-18 y.) who had persistent fever and positive acute phase reactants after surgery for congenital heart disease. Abnormal uptake of 67Ga over the heart and the lungs was evaluated with a computer. Abnormal uptake of 67Ga was observed in seven patients. Of them, three showed it in the area of peripheral pulmonary artery and the other four showed it in the area of artificial vessels for pulmonary artery reconstruction. In six patients with positive blood cultures, five showed abnormal uptake of 67Ga and in ten patients with negative blood cultures, two showed it. Vegetation was detected with 2D-echocardiography in four patients and all of them showed abnormal uptake of 67Ga, while in 12 patients without vegetation three showed it. In conclusion, 67Ga imaging was useful to detect the foci of infective endocarditis or pulmonary embolism caused by the vegetation in infective endocarditis in the patients after surgery for congenital heart disease, especially in the peripheral pulmonary arteries and artificial vessels which could not be detected with 2D-echo. (author)

105

Embolic Complications of Infective Endocarditis: Report of Two Cases and Review of National Literature  

Directory of Open Access Journals (Sweden)

Full Text Available All classical signs of infective endocarditis (IE such as fever, a new cardiac murmur, and splenomegaly are rarely found all together. IE should be considered in every patient with unexplained fever. In this report, two patients diagnosed initially as urosepsis and neuro-Behçet’s disease due to embolic complications of infective endocarditis (IE were presented. A 67-year-old male was admitted to the emergency room with fever, dysuria and flank pain. Both urinary and sequential blood cultures revealed methicillin-sensitive Staphylococcus aureus (MSSA. A 11x6 mm sized mitral valve vegetation was detected on transesophageal echocardiography (TEE. Findings of renal ultrasound were compatible with bilateral pyelonephritis. Mitral valve repair surgery was planned after subsequent TTE controls revealing enlargement of the vegetation. A 45-year-old male with Behçet’s disease was hospitalized in the Department of Neurology because of a speech disorder and weakness on left side of the body for two days, and his blood cultures yielded viridans streptococci. Mobile vegetation on the ventricular surface of the aortic valve and severe aortic regurgitation were detected on TEE. After antibiotic therapy, an aortic valve replacement was performed. Both patients showed an uneventful postoperative course.

Ay?egül Ulu-K?l?ç

2011-12-01

106

Effect of the hematological and biochemical parameters on outcomes of the patients with infective endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Objectives: This study was designed to examine haematological changes in infective endocarditis (IE and the association between laboratory findings and mortality or complications including events in IE.Materials and methods: Forty-four patients who were hospitalized with a diagnosis of IE at the Department of Cardiology, Dicle University, Ataturk University and Harran University, from June 2007 to June 2011, were retrospectively evaluated. The diagnosis of IE was made clinically and was confi rmed with Duke’s criteria. The haematological and biochemical parameters were recorded.Results: Age, white blood cell count, neutrophil count, neutrophil lymphocyte ratio, mean platelet volume and complication rate (p <0.004, p <0.05, p <0.03, p <0.05, p <0.01, p <0.004, respectively were elevated in patients who died due to infective endocarditis compared with patients who survived. However, platelet count were lower in patients died (p <0.05. Additionally, patients who developed complications were no difference laboratory findings compared with patients without complications.Conclusion: Age, MPV and presence of complications can be used as risk factors for mortality in IE. In addition, S.aureus is associated with complications.

Yahya ?slamo?lu

2011-12-01

107

Cases of active infective endocarditis in a university hospital during a 10-year period  

International Nuclear Information System (INIS)

Objective: To determine the features of patients with active infective endocarditis, and to identify causative microorganisms in blood and/or valve cultures. Methods: The retrospective study was conducted at the Surgical Intensive Care Unit of Istanbul University Cardiology Institute, Istanbul, Turkey, and comprised 22 patients with clinical evidence of the affliction who underwent operation between January 2001 and December 2010. Modified Duke Criteria was used for the diagnosis of the condition. Frequencies and percentages were calculated. Results: The mean age of the patients was 46.68±18 years, and 12 (54.5%) were male. Native valve endocarditis was present in 13 (59.1%) cases and prosthetic valve endocarditis was present in 9 (40.9%). Rheumatic heart disease was the commonest underlying heart disease (n=12; 54.5%). None of patient was intravenous drug abuser and positive for human immunodeficiency virus. Operative mortality was 18% (n=4). Vegetation and abscess formation were detected in 19 (86.3%) cases. Blood culture positivity was 50% (n=11). Staphylococci was the most common causative micro-organism (n=4; 36.3%), followed by Streptococci (n=3; 27.3%), and 1 (9.1%) each for Enterococci, Brucella species, Candida albicans and Stenotrophomonas maltophilia. Positive cultures from vegetations and tissue retrieved at the operation was not detected. Conclusion: Active IE remains a severe disease affecting the young population in our study and rheumatic heart diseasn in our study and rheumatic heart disease continues to be the most underlying heart disease. Culture negativity was found to be very high and prior antibiotic therapy may be the prime reason.

108

Infective endocarditis in a child caused by Cardiobacterium hominis after right ventricular outflow tract reconstruction using an expanded tetrafluoroethylene conduit.  

Science.gov (United States)

Cardiobacterium hominis, a member of the HACEK group of organisms, is a rare cause of endocarditis. We report a case of infective endocarditis caused by C. hominis in a male child who had undergone right ventricular outflow tract (RVOT) reconstruction using an expanded polytetrafluoroethylene conduit for tetralogy of Fallot with pulmonary atresia. Two days before admission, the patient suffered from exertional shortness of breath. Right ventricular hypertension was confirmed and RVOT stenosis was suspected based on the echocardiography findings. A CT scan revealed vegetation above the cusp of the conduit. An emergency operation was performed to avoid a pulmonary embolism due to large friable vegetation. C. hominis was cultured from the blood and the vegetation, prompting a diagnosis of prosthetic valve endocarditis. The patient was discharged after a 6-week course of intravenous ceftriaxone therapy. PMID:21674312

Maekawa, Yoshiyuki; Sakamoto, Takahiko; Umezu, Kentaroh; Ohashi, Noburoh; Harada, Yorikazu

2011-06-01

109

Endocarditis due to a co-infection of Candida albicans and Candida tropicalis in a drug abuser.  

Science.gov (United States)

In recent decades the incidence of Candida endocarditis has increased dramatically. Despite the application of surgery and antifungal therapy, Candida endocarditis remains a life-threatening infection with significant morbidity and mortality. We report a 37-year-old male drug abuser presenting with high fever, chest pain, loss of appetite and cardiac failure. His echocardiography revealed mobile large tricuspid valve vegetations. Fungal endocarditis was confirmed by culturing of the resected vegetation showing mixed growth of Candida albicans and Candida tropicalis, although three consecutive blood cultures were negative for Candida species. Phenotypic identification was reconfirmed by sequencing of the internal transcribed spacer (ITS rDNA) region. The patient was initially treated with intravenous fluconazole (6 mg kg(-1) per day), followed by 2 weeks of intravenous amphotericin B deoxycholate (1 mg kg(-1) per day). Although MICs were low for both drugs, the patient's antifungal therapy combined with valve replacement failed, and he died due to respiratory failure. PMID:23973985

Fesharaki, Shirinsadat Hashemi; Haghani, Iman; Mousavi, Bita; Kargar, Melika Laal; Boroumand, Mohammadali; Anvari, Maryam Sotoudeh; Abbasi, Kyomars; Meis, Jacques F; Badali, Hamid

2013-11-01

110

What is the optimal timing for surgery in infective endocarditis with cerebrovascular complications?  

Science.gov (United States)

Neurologic dysfunction complicates the course of 10-40% of left-side infective endocarditis (IE). In right-sided IE, instead, when systemic emboli occur, paradoxical embolism should be considered. The spectrum of neurologic events includes embolic cerebrovascular complication (CVC), intracranial haemorrhage, ruptured mycotic aneurysm, transient ischaemic attack (TIA), meningitis, encephalopathy and brain abscess. Cardiopulmonary bypass might exacerbate neurological deficits due to: heparinization and secondary cerebral haemorrhage; hypotension and cerebral oedema in areas of the disrupted blood brain barrier. A best evidence topic was written according to a structured protocol. The question addressed was, whether there is an optimal timing for surgery in IE with CVCs. One hundred papers were found using the reported search criteria, and out of these 20 papers, provided the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results were tabulated. We found that evidence is conflicting because of lack of controlled studies. The optimal timing for the valve replacement depends on the type of neurological complication and the urgency of the operation. The new 2009 Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (IE) recommend a multidisciplinary approach and to wait for 1-2 weeks of antibiotics treatment before performing cardiac surgery. However, early surgery is indicated in: heart failure (class 1 B), uncontrolled infection (class 1 B) and prevention of embolic events (class 1B/C). After a stroke, surgery should not be delayed as long as coma is absent and cerebral haemorrhage has been excluded by cranial CT (class IIa level B). After a TIA or a silent cerebral embolism, surgery is recommended without delay (class 1 level B). In intracranial haemorrhage (ICH), surgery must be postponed for at least 1 month (class 1 level C). Surgery for prosthetic valve endocarditis (PVE) follows the general principles outlined for native valve IE. Every patient should have a repeated head CT scan immediately before the operation to rule out a preoperative haemorrhagic transformation of a brain infarction. The presence of a haematoma warrants neurosurgical consultation and consideration of cerebral angiography to rule out a mycotic aneurysm. PMID:22108925

Rossi, Michele; Gallo, Alina; De Silva, Ravi Joseph; Sayeed, Rana

2012-01-01

111

Infective endocarditis epidemiology and consequences of prophylaxis guidelines modifications: the dialectical evolution.  

Science.gov (United States)

Historically, infective endocarditis (IE) affected patients with predisposing cardiac conditions and community-acquired bacteremia. Over the past 30 years, significant changes have occurred, regarding microorganisms, underlying valvular heart diseases, portals of entry, and patients' comorbidities. Given these epidemiological changes and unproven prophylaxis efficacy, experts in most countries currently limit antibiotic indications to patients with high-risk cardiac conditions having oral procedures and, in the UK, recommend discontinuing their use altogether. To date, no epidemiological impact on streptococcal IE incidence has been observed. Policy must now address these epidemiological modifications, focus on community-acquired and health care-associated staphylococcal bacteremia prevention, and prompt the adoption of broader and nonexclusively antibiotic-based strategies. PMID:25233804

Chirouze, C; Hoen, B; Duval, X

2014-11-01

112

Infective endocarditis of the aortic valve in a Border collie dog with patent ductus arteriosus.  

Science.gov (United States)

Infective endocarditis (IE) in dogs with cardiac shunts has not been reported previously. However, we encountered a dog with concurrent patent ductus arteriosus (PDA) and IE. The dog was a 1-year-old, 13.9-kg female Border collie and presented with anorexia, weight loss, pyrexia (40.4°C) and lameness. A continuous murmur with maximal intensity over the left heart base (Levine 5/6) was detected on auscultation. Echocardiography revealed a PDA and severe aortic stenosis (AS) caused by aortic-valve vegetative lesions. Corynebacterium spp. and Bacillus subtilis were isolated from blood cultures. The dog responded to aggressive antibiotic therapy, and the PDA was subsequently surgically corrected. After a series of treatments, the dog showed long-term improvement in clinical status. PMID:25391395

Aoki, Takuma; Sunahara, Hiroshi; Sugimoto, Keisuke; Ito, Tetsuro; Kanai, Eiichi; Fujii, Yoko

2014-11-12

113

[Septic shock due to infective endocarditis of stimulation system of implantable cardioverter-defibrillator].  

Science.gov (United States)

We present a case of a 60-year old patient hospitalized at the Department of Infectious Diseases and Travel Medicine, Medical faculty of UPJS and L. Pasteurs University Hospital in Kosice with suspected gastroenteritis. The patient was admitted to an intensive care unit because of the signs of septic shock. Within one hour from admission, the patient was administered early goal directed therapy for septic shock. Subsequently, infectious endocarditis of stimulation electrodes and tricuspid valve was identified as the origin of the infection. The stimulation system was then explanted from a stabilized and afebrile patient at the Department of cardiac Surgery of Eastern Slovak Institute of Cardiac and Vascular Diseases in Kosice. This case should emphasise frequently atypical course of this serious disease and the need for early identification of severe sepsis to enable timely management to affect mortality. PMID:22448703

Porub?inová, I; Porub?in, S; Stan?ák, B; Be?a, M; Sabol, F

2012-01-01

114

Use of corticosteroids in glomerulonephritis related to infective endocarditis: three cases and review.  

Science.gov (United States)

We report the cases of three patients treated for infective endocarditis (IE) for whom corticosteroids were added to the antibiotic treatment. They all had clinical and biological evidence of immune-mediated glomerulonephritis. The microorganisms responsible for IE were Coxiella burnetii, Streptococcus bovis, and Cardiobacterium hominis. Median duration of IE before antimicrobial therapy was 7 months. In all patients, renal function deteriorated despite appropriate antimicrobial treatment for a mean duration of 16 days, but it improved after addition of corticosteroid therapy. All patients were cured of IE. A literature review revealed four additional cases of IE-related glomerulonephritis in which adjunctive immunosuppressive therapy was considered to be effective. Although corticosteroid therapy is generally not recommended for IE, it should be considered for patients whose renal dysfunction secondary to glomerulonephritis does not improve with appropriate antimicrobial treatment, especially if the duration of the illness is long. PMID:10452634

Le Moing, V; Lacassin, F; Delahousse, M; Duval, X; Longuet, P; Leport, C; Vildé, J L

1999-05-01

115

Use of echocardiography in the diagnosis and management of infective endocarditis.  

Science.gov (United States)

The first use of echocardiography in infective endocarditis (IE) was described in 1973. Since then, echocardiography has emerged as a major tool for the diagnosis and management of this disease. In general, transthoracic echocardiography (TTE) is adequate for diagnosing IE in cases where cardiac structures-of-interest are well visualized. Specific situations where transesophageal echocardiography is preferred over TTE include the presence of a prosthetic device, suspected periannular complications, children with complex congenital cardiac lesions, selected patients with Staphylococcus aureus bacteremia, and certain pre-existing valvular abnormalities that make TTE interpretation problematic (eg, calcific aortic stenosis). Echocardiography is also useful for risk stratification. Evidence suggests that vegetation size can predict embolic complications, although the data are inconsistent. Careful clinical assessment is essential to the proper use of echocardiography in diagnosing IE, visualizing complications related to IE, and evaluating candidacy for surgical intervention. PMID:17618547

Chu, Vivian H; Bayer, Arnold S

2007-07-01

116

Patient selection criteria and management guidelines for outpatient parenteral antibiotic therapy for native valve infective endocarditis.  

Science.gov (United States)

Outpatient parenteral antibiotic therapy (OPAT) for infective endocarditis (IE) is being applied widely, despite the absence of controlled data that demonstrates that outcomes are equivalent to those with standard inpatient antibiotic therapy. We review existing OPAT guidelines, published data on the timing of complications from IE, and data on risk factors that can be used to predict complications. These data are used to propose more stringent criteria for patient selection and clinical management of OPAT for native valve IE. We recommend a conservative approach (inpatient or daily outpatient follow-up) during the critical phase (weeks 0-2 of treatment), when complications are most likely, and we recommend consideration of OPAT for the continuation phase (weeks 2-4 or 2-6 of treatment) when life-threatening complications are less likely. PMID:11418880

Andrews, M M; von Reyn, C F

2001-07-15

117

Endocardite infecciosa num recém-nascido pré-termo / Infective endocarditis in a preterm newborn  

Scientific Electronic Library Online (English)

Full Text Available SciELO Portugal | Language: Portuguese Abstract in portuguese Introdução: A endocardite infecciosa é uma situação rara mas grave no período neonatal. Caso clínico: Os autores descrevem o caso clínico de um recém-nascido, pré-termo de 31 semanas que ao 15º dia de vida apresentou quadro séptico pelo que iniciou antibioticoterapia. Nas hemoculturas efectuadas iso [...] lou-se Staphylococus aureus, sensível aos antibióticos prescritos e o cateter epicutâneo-cava introduzido no sexto dia de vida foi nesta altura substituído. Ao 25º dia detectou-se sopro sistólico grau II/VI, tendo o ecocardiograma mostrado imagem sugestiva de vegetação na válvula tricúspide (dimensões-8,5x4mm). Por suspeita de endocardite bacteriana, efectuou tratamento com vancomicina, gentamicina e rifampicina. As hemoculturas posteriores foram estéreis e não se verificou aumento do tamanho da vegetação. Em ambulatório manteve-se clinicamente bem e actualmente, com nove meses de idade corrigida apresenta vegetação de 3x3mm. Conclusão: A suspeita de endocardite bacteriana deve ser considerada nos recém-nascidos com sépsis hospitalar, internados numa Unidade de Cuidados Intensivos, com colocação de cateter venoso central, sobretudo se os agentes envolvidos são o Staphylococcus aureus ou fungos. A base do tratamento é um curso prolongado de antibioticoterapia com um regime bactericida apropriado. Contudo a mortalidade permanece elevada. Abstract in english Background: Infective endocarditis is a rare but serious illness in neonatal period. Case report: The authors describe the case of a preterm newborn, 31 weeks of gestation who presented at 15th day of life a condition consistent with neonatal sepsis and antibiotic therapy was administered. Staphyloc [...] ocus aureus, sensitive to antibiotics that were prescribed, were detected in blood cultures and the central venous line introduced at 6th day of life was replaced at this point. At 25th day an II/VI grade blowing systolic murmur was heard and the echocardiography showed a suggestive image of vegetation (size-8,5x4mm) in the tricuspid valve. Bacterial endocarditis was suspected and the newborn was treated with vancomycin, gentamicin and rifampicin. The subsequent blood cultures were negative and no increase on vegetation size was observed. In ambulatory, he remained clinically well and actually, with nine months of corrected age, the size of vegetation is 3x3mm. Conclusion: Suspicion of infective endocarditis must be considered in newborns with hospital sepsis in an intensive care setting, with an indwelling catheter, especially if the agents involved are Staphylococcus aureus or fungi. The cornerstone of treatment is a prolonged course of antibiotic treatment with an appropriate bactericidal regimen. However mortality remains high.

Cristiana, Ribeiro; Marta, Rios; Luísa, Lopes; Sílvia, Álvares; Elisa, Proença; Ana, Guedes.

118

Infective Endocarditis  

Science.gov (United States)

... with residual defects, such as persisting leaks or abnormal flow at or adjacent to a prosthetic patch or ... with residual defects, such as persisting leaks or abnormal flow at or adjacent to a prosthetic patch or ...

119

Utility of 16S ribosomal DNA sequencing in the diagnosis of Staphylococcus lugdunensis native valve infective endocarditis: case report and literature review.  

Science.gov (United States)

We report a case of possible infective endocarditis without fever presenting with an acutely ischemic limb with prior antimicrobial therapy preventing identification by culture of a microorganism. 16S ribosomal DNA sequencing led to the identification of Staphylococcus lugdunensis from an embolus removed at surgery and subsequent successful antibiotic treatment. We review the utility of 16S ribosomal DNA sequencing in diagnosing infective endocarditis and other infectious conditions. PMID:19447659

Pada, Surinder; Lye, David C; Leo, Yee Sin; Barkham, Timothy

2009-11-01

120

Short-term intramuscular therapy with procaine penicillin plus streptomycin for infective endocarditis due to viridans streptococci.  

Science.gov (United States)

Thirty-three patients with viridans streptococcal infective endocarditis were treated for two weeks with intramuscular procaine pencillin, 1.2 million units every 6 hours, plus streptomycin, 500 mg intramuscularly every 12 hours. Nine patients (27%) had infections with relatively penicillin-resistant microorganisms (MIC greater than 0.1 microgram/ml or MBC greater than or equal 3.12 microgram/ml). Follow-up ranged from 2 months to 3.5 years. There were no relapses; Mild vestibular toxicity developed in one patient. One patient died two months after completion of antimicrobial therapy from sudden onset of severe congestive heart failure; Seven patients required cardiac valve replacement after completion of antimicrobial therapy. None died. We believe that this therapeutic regimen is effective antimicrobial therapy for infective endocarditis caused by viridans streptococci, irrespective of in vitro microbiologic data. PMID:639238

Wilson, W R; Geraci, J E; Wilkowske, C J; Washington, J A

1978-06-01

121

{sup 18}F-FDG PET/CT for early detection of embolism and metastatic infection in patients with infective endocarditis  

Energy Technology Data Exchange (ETDEWEB)

In the acute setting of endocarditis it is very important to assess both the vegetation itself, as well as potential life-threatening complications, in order to decide whether antibiotic therapy will be sufficient or urgent surgery is indicated. A single whole-body scan investigating inflammatory changes could be very helpful to achieve a swift and efficient assessment. In this study we assessed whether {sup 18}F-FDG can be used to detect and localize peripheral embolism or distant infection. Twenty-four patients with 25 episodes of endocarditis, enrolled between March 2006 and February 2008, underwent {sup 18}F-FDG PET/CT imaging on a dedicated PET/CT scanner. PET/CT imaging revealed a focus of peripheral embolization and/or metastatic infection in 11 episodes (44%). One episode had a positive PET/CT scan result for both embolism and metastatic infection. PET/CT detected seven positive cases (28%) in which there was no clinical suspicion. Valve involvement of endocarditis was seen only in three patients (12%). PET/CT may be an important diagnostic tool for tracing peripheral embolism and metastatic infection in the acute setting of infective endocarditis, since a PET/CT scan detected a clinically occult focus in nearly one third of episodes. (orig.)

Riet, Jelle van; Gheysens, Olivier; Mortelmans, Luc [University Hospital KU Leuven, Department of Nuclear Medicine, Leuven (Belgium); Hill, Evelyn E.; Herregods, Marie-Christine [University Hospital KU Leuven, Department of Cardiology, Leuven (Belgium); Dymarkowski, Steven [University Hospital KU Leuven, Department of Radiology, Leuven (Belgium); Herijgers, Paul [University Hospital KU Leuven, Department of Cardiac Surgery, Leuven (Belgium); Peetermans, Willy E. [University Hospital KU Leuven, Department of Internal Medicine, Leuven (Belgium)

2010-06-15

122

Endocarditis infecciosa de alto riesgo embolígeno durante el embarazo: ¿manejo conservador o quirúrgico? / High risk infective endocarditis embolism during pregnancy: Medical or surgical management?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish Presentamos el caso de una paciente de 22 años de edad con embarazo de 14 semanas y endocarditis infecciosa de válvula mitral nativa con una vegetación de 15 mm con amplia movilidad, acompañada de insuficiencia valvular severa. Inicialmente, y pese al riesgo embolígeno, se dio tratamiento antibiótic [...] o durante 4 semanas. Por persistencia del tamaño de la vegetación se decide llevar a cirugía para reparación mitral y remoción de la lesión en la semana 18 de gestación, considerando que el balance entre el riesgo fetal y materno estaba a favor del procedimiento quirúrgico. Se usaron técnicas de protección fetal intraoperatoria y se colocó una prótesis biológica previo intento de reparación. La evolución postintervención fue satisfactoria, lográndose parto por cesárea a las 30 semanas. Abstract in english A 22-year-old pregnant woman was seen at 14 weeks of pregnancy for infective endocarditis with a vegetation of 15 mm and wide mobility, which affected the native mitral valve accompanied by severe valvular insufficiency. Antibiotic treatment was given for 4 weeks despite the embolism risk. Due to pe [...] rsistence of vegetation size and after considering the fetal and maternal risk, the surgical procedure was favored. We decided to perform valvuloplasty and removal of lesion at 18 weeks of pregnancy. Fetal protection techniques were used and a bioprosthesis was placed before attempting a repair. The postoperative follow-up was satisfactory, achieving a successful birth by cesarean section at 30 weeks.

Luis Eduardo, Echeverría; Antonio, Figueredo; Juan Carlos, Gómez; Leonardo Alberto, Salazar; Jaime Alberto, Rodriguez; Camilo Ernesto, Pizarro; Carlos Eduardo, Riaño; Addy, Perroni; Alba Lucía, Cuadros; María Cristina, Villamizar; Edwin Uriel, Suárez.

2013-09-01

123

Apuntes sobre la fisiopatología, etiología, diagnóstico, tratamiento y profilaxis de la endocarditis infecciosa / Notes on the physiopathology, etiology, diagnosis, treatment and prophylaxis of infective endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish La endocarditis infecciosa es una afección de difícil diagnóstico en Cardiología, con características clínicas muy variadas y una epidemiología cambiante en los últimos años. En la presente revisión se tratan aspectos novedosos sobre su clasificación, etiología y fisiopatología; además, se presentan [...] las herramientas fundamentales para su diagnóstico, punto de partida para su tratamiento médico basado primordialmente en la terapia antimicrobiana, así como los criterios quirúrgicos y la conducta actual en la profilaxis antimicrobiana de esta compleja entidad. Abstract in english Infective endocarditis is a disease of difficult diagnosis in cardiology, with highly variable clinical characteristics and changing epidemiology in the last few years. The present review dealt with novel aspects on classification, etiology and physiopathology of the disease in addition to the prese [...] ntation of the fundamental tools for diagnosis, which is the starting point for the medical treatment basically supported on the antimicrobial therapy. It also set forth the surgical criteria and the present performance in the antimicrobial prophylaxis of this complex disease.

Hiram, Tápanes Daumy; Elsa, Fleitas Ruisanchez; Eliobert, Díaz Bertot; Andrés, Savío Benavides; Maylin, Peña Fernández.

2014-09-01

124

First reported case of infective endocarditis caused by community-acquired methicillin-resistant Staphylococcus aureus not associated with healthcare contact in Brazil  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english We report here the first case of endocarditis due to CA-MRSA not associated with healthcare contact in Brazil in Brazil. A previously healthy patient presented with history of endocarditis following a traumatic wound infection. Patient had multiple positive blood cultures within 72 h of admission an [...] d met modified Duke's criterion for infective endocarditis. The isolate was typed as Staphylococcal cassette chromosome (SCC) mec type IV and was positive for presence of Panton-Valentine leukocidin (PVL). Increased incidence of CA-MRSA endocarditis is a challenge for the internist to choose the best empirical therapy. Several authors have suggested an empirical therapy with both a beta-lactam and an anti-MRSA agent for serious S. aureus infections. Our patient was treated with Vancomycin and made complete recovery in 3 months.

Claudio Querido, Fortes; Claudia Adelino, Espanha; Flavio Pedreira, Bustorff; Bruno Cordeiro, Zappa; Adriana Lucia Pires, Ferreira; Regina Barbosa, Moreira; Nelson Gonçalves, Pereira; Vance G., Fowler Jr.; Hitesh, Deshmukh.

2008-12-01

125

First reported case of infective endocarditis caused by community-acquired methicillin-resistant Staphylococcus aureus not associated with healthcare contact in Brazil  

Directory of Open Access Journals (Sweden)

Full Text Available We report here the first case of endocarditis due to CA-MRSA not associated with healthcare contact in Brazil in Brazil. A previously healthy patient presented with history of endocarditis following a traumatic wound infection. Patient had multiple positive blood cultures within 72 h of admission and met modified Duke's criterion for infective endocarditis. The isolate was typed as Staphylococcal cassette chromosome (SCC mec type IV and was positive for presence of Panton-Valentine leukocidin (PVL. Increased incidence of CA-MRSA endocarditis is a challenge for the internist to choose the best empirical therapy. Several authors have suggested an empirical therapy with both a beta-lactam and an anti-MRSA agent for serious S. aureus infections. Our patient was treated with Vancomycin and made complete recovery in 3 months.

Claudio Querido Fortes

2008-12-01

126

Gemella morbillorum endocarditis.  

Directory of Open Access Journals (Sweden)

A case of Gemella morbillorum (G.morbillorum endocarditis of the mitral valve in a patient with previously normal heart valves is reported. The presentation was subacute, and the infection was complicated by perforation of the posterior mitral leaflet that necessitated valve repair. Gemella morbillorum infections are uncommon, and endocarditis is the most common presentation. G.morbillorum endocarditis is probably under recognized, and has not been reported from our region. The case is described, and problems in the identification of the organism are discussed.

Hussam Al Soub

2003-10-01

127

From cat scratch disease to endocarditis, the possible natural history of Bartonella henselae infection  

OpenAIRE

Abstract Background Most patients with infectious endocarditis (IE) due to Bartonella henselae have a history of exposure to cats and pre-existing heart valve lesions. To date, none of the reported patients have had a history of typical cat scratch disease (CSD) which is also a manifestation of infection with B. henselae. Case presentation Here we report the case of a patient who had CSD and six months later developed IE of the mitral valve cau...

Raoult Didier; Collart Frédéric; Habib Gilbert; Lepidi Hubert; Gouriet Frédérique

2007-01-01

128

Detection of Cardiobacterium valvarum in a patient with aortic valve infective endocarditis by broad-range PCR.  

Science.gov (United States)

Cardiobacterium valvarum, a fastidious Gram-negative bacterium, was detected in the aortic valve of a previously healthy 63-year-old man by broad-range PCR and 16S rRNA gene sequencing. In contrast to the patients in five previously published cases, our patient had neither a congenital bicuspid nor a prosthetic aortic valve. Here, we present a case of C. valvarum native tricuspid aortic valve infective endocarditis and a review of the literature. PMID:19797468

Vanerková, Martina; Zaloudíková, Barbora; Nemcová, Eva; Juránková, Jana; Pol, Jirí; Cerný, Jan; Nemec, Petr; Freiberger, Tomás

2010-02-01

129

Outcome of Patients with Infective Endocarditis who were Treated with Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy  

Science.gov (United States)

Infective endocarditis is a potentially life threatening condition. It is associated with high mortality and morbidity resulting mostly due to cardiorespiratory failure. Extracorporeal membrane oxygenation is a modality of treatment used to support hypoxic respiratory failure especially in patients who are already on mechanical ventilation. Continuous renal replacement therapy is added mainly for maintaining fluid and electrolyte balance. Here we report a case series of patients diagnosed with infective endocarditis who were treated with combined extracorporeal membrane oxygenation and continuous renal replacement therapy. Three patients in the age group 20-60 years were admitted with clinical features suggestive of infective endocarditis. During the course of hospital stay they developed cardiorespiratory failure requiring mechanical ventilation and extracorporeal membrane oxygenation support for refractory hypoxia. It was complicated by heart failure, renal failure and fluid overload which required initiation of continuous renal replacement therapy. All the three patients succumbed in spite of the aggressive treatment. In addition to the role played by each complication, delayed start of continuous renal replacement therapy might have also contributed to the high mortality. Early initiation of continuous renal replacement therapy for management of fluid overload needs to be considered in the management of these critically ill patients.

John, Santhosh G.; William, Preethi; Murugapandian, Sangeetha; Thajudeen, Bijin

2014-01-01

130

Outcome of patients with infective endocarditis who were treated with extracorporeal membrane oxygenation and continuous renal replacement therapy  

Directory of Open Access Journals (Sweden)

Full Text Available Infective endocarditis is a potentially life threatening condition. It is associated with high mortality and morbidity resulting mostly due to cardiorespiratory failure. Extracorporeal membrane oxygenation is a modality of treatment used to support hypoxic respiratory failure especially in patients who are already on mechanical ventilation. Continuous renal replacement therapy is added mainly for maintaining fluid and electrolyte balance. Here we report a case series of patients diagnosed with infective endocarditis who were treated with combined extracorporeal membrane oxygenation and continuous renal replacement therapy. Three patients in the age group 20-60 years were admitted with clinical features suggestive of infective endocarditis. During the course of hospital stay they developed cardiorespiratory failure requiring mechanical ventilation and extracorporeal membrane oxygenation support for refractory hypoxia. It was complicated by heart failure, renal failure and fluid overload which required initiation of continuous renal replacement therapy. All the three patients succumbed in spite of the aggressive treatment. In addition to the role played by each complication, delayed start of continuous renal replacement therapy might have also contributed to the high mortality. Early initiation of continuous renal replacement therapy for management of fluid overload needs to be considered in the management of these critically ill patients.

Santhosh G. John

2014-10-01

131

Multiresistant-MRSA tricuspid valve infective endocarditis with ancient osteomyelitis locus  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Methicillin-resistant S. aureus (MRSA with low susceptibility to glycopeptides is uncommon. Case presentation The case of a 50-year-old non-drug addict patient presenting with tricuspid valve infective endocarditis (IE by MRSA resistant to vancomycin and linezolid is presented. There was response only to quinupristin/dalfopristin. He had a motorcycling accident four years before undergoing right above-the-knee amputation and orthopaedic fixation of the left limb. There were multiple episodes of left MRSA-osteomyelitis controlled after surgery and vancomycin therapy. MRSA isolated from the blood at the time of IE presented with the same profile than the isolated four years earlier. Sequential treatment with teicoplanin-cotrimoxazole and Linezolid associated to vancomycin – rifampicin – cotrimoxazole had no improvement. Infection was controlled after 28 days of therapy with quinupristin/dalfopristin. Conclusion The literature presents only a few cases of MRSA IE not susceptible to glycopeptides in not drug addicted patients. This case shows the comparison of a highly-resistant MRSA after previous S. aureus osteomyelitis treated with glycopeptides. This is the first description of successful treatment of resistant-MRSA IE of the tricuspid valve complicated by multiple pulmonary septic infarction with quinupristin/dalfopristin

Gambarati Gianpaolo

2006-07-01

132

Once versus twice daily gentamicin dosing for infective endocarditis : a randomized clinical trial  

DEFF Research Database (Denmark)

Objectives: The aim of this randomized study was to investigate the effects of once versus twice daily gentamicin dosing on renal function and measures of infectious disease in a population with infective endocarditis (IE). Methods: Seventy-one IE patients needing gentamicin treatment according to guidelines were randomized to either once (n = 37) or twice daily (n = 34) doses of gentamicin. Kidney function (glomerular filtration rate, GFR) was measured with an isotope method ( 51 Cr-EDTA) at the beginning of treatment and at discharge. Treatment efficacy was assessed by C-reactive protein (CRP) time to half-life, mean CRP and leukocytes. Results: Baseline GFR was similar in the two groups. Both groups displayed a significant fall in GFR from admission to discharge. The mean decrease in GFR was as follows: with once daily gentamicin, 17.0% (95% confidence interval 7.5– 26.5), and with twice daily gentamicin, 20.4% (95% confidence interval 12.0–28.8). However, there was no significant difference in the GFR decrease between the once and twice daily regimens (p = 0.573). No difference in infection parameters was demonstrated between the two dosing regimens. Conclusions: A twice daily gentamicin dosing regimen is neither less nephrotoxic nor more efficient than a once daily regimen in the treatment of IE patients. When indicated, gentamicin may therefore also be administered as a singledose regimen in the treatment of IE patients.

Buchholtz, Kristine; Larsen, Carsten Toftager

2011-01-01

133

Prosthetic Valve Endocarditis Caused by Bartonella quintana  

OpenAIRE

We describe the first case of Bartonella quintana endocarditis affecting a prosthetic valve in a person with no known risk factors for this infection. Bartonella should be considered as a cause of endocarditis in any clinical setting.

Klein, John L.; Nair, Sukumaran K.; Harrison, Tim G.; Hunt, Ian; Fry, Norman K.; Friedland, Jon S.

2002-01-01

134

Yersinia enterocolitica endocarditis on a prosthetic valve.  

OpenAIRE

Yersinia entercolitica endocarditis has rarely been described before. This is the first report of prosthetic valve Yersinia enterocolitis endocarditis, complicated by infected brain embolization. The patient, however, completely recovered after 6 weeks of combined therapy with ceftriaxone and gentamicin.

Pras, E.; Arber, N.; Pinkhas, J.; Sidi, Y.

1992-01-01

135

Infective endocarditis (IE first diagnosed at autopsy: analysis of 31 cases in Ribeirão Preto, Brazil Endocardite infecciosa (EI com diagnóstico feito apenas à necrópsia: análise de 31 casos ocorridos entre 1992 e 1997, em Ribeirão Preto, Brasil  

Directory of Open Access Journals (Sweden)

Full Text Available Thirty one infective endocarditis (IE fatal cases whose diagnosis was first obtained at autopsy were studied. The clinical data of these patients (Group 1 showed significant differences compared to other 141 IE cases (Group 2. The average age of 53 years in Group 1 patients was 18 years higher than that of Group 2. The Group 1 patients had a low frequency of IE predisposing heart disease. Both patient groups presented fever (about 87%, but a significant low frequency of cardiac murmur (25.8% was observed in Group 1 patients and echocardiography tests were performed in only 16.1%, suggesting that IE diagnosis was not suspected. Likewise, although most Group 1 patients appeared with severe acute illness, they did not present the classic IE clinical presentation. Blood cultures were performed in only 64.5% of the Group 1 patients. However, bacteria were isolated in 70% of these blood cultures and Staphylococcus aureus was isolated in 71.4%. The bacteria attacked mitral and aortic valves. Complications such as embolizations and cardiac failure occurred in almost half of the cases and they also presented with infections of the lungs, urinary tract, and central nervous system. Medical procedures were performed in practically all fatal cases whose diagnosis was first obtained at autopsy. Sepsis occurred in about half of the patients and it was followed by shock in more than 25%. This form of IE must be suspected in mature and in old febrile hospitalized patients having infection predisposing diseases, embolization, and suffering medical procedures.Trinta e um casos fatais de EI, que tiveram este diagnóstico apenas à necrópsia, foram analisados. Os dados clínicos destes pacientes (Grupo 1 mostrou diferenças significantes quando comparados aos de outros 141 casos de EI (Grupo 2. A idade média de 53 anos nos pacientes do Grupo 1 foi 18 anos mais alta que nos do Grupo 2. Os pacientes do Grupo 1 tiveram uma baixa freqüência de cardiopatias predisponentes à EI. Ambos os grupos de pacientes apresentaram febre (aproximadamente 87%, mas uma significante baixa freqüência de sopro cardíaco (25,8% foi observado no Grupo 1, provavelmente, em conseqüência disto, o ecocardiograma foi efetuado em apenas 16,1% dos casos, não sendo, portanto, suspeitada EI. Os pacientes do Grupo 1, embora tivessem grave enfermidade aguda, não apresentaram apresentação clínica compatível com EI clássica. Hemoculturas foram feitas em apenas 64,5% dos pacientes do Grupo 1, porém, isolou-se bactérias em 70% e dentre os isolados, predominou o Staphylococcus aureus (71,4%. Foram predominantemente acometidas as válvulas mitral e aórtica. Complicações como embolização e insuficiência cardíaca ocorreram em quase metade dos casos e eles também apresentaram infecções pulmonares, urinárias e do sistema nervoso central. Praticamente todos os casos fatais de EI, que tiveram este diagnóstico apenas à necrópsia, foram submetidos a procedimentos médicos. Sepse aconteceu em aproximadamente metade dos pacientes e mostrou-se acompanhada de choque em mais de 25%. Esta forma de EI deve ser suspeitada em pacientes de idade madura ou idosos, hospitalizados, com doenças que predispõem a infecções, com embolização e que sofreram procedimentos médicos.

Luiz Tadeu M. FIGUEIREDO

2001-08-01

136

Infective endocarditis (IE) first diagnosed at autopsy: analysis of 31 cases in Ribeirão Preto, Brazil / Endocardite infecciosa (EI) com diagnóstico feito apenas à necrópsia: análise de 31 casos ocorridos entre 1992 e 1997, em Ribeirão Preto, Brasil  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Trinta e um casos fatais de EI, que tiveram este diagnóstico apenas à necrópsia, foram analisados. Os dados clínicos destes pacientes (Grupo 1) mostrou diferenças significantes quando comparados aos de outros 141 casos de EI (Grupo 2). A idade média de 53 anos nos pacientes do Grupo 1 foi 18 anos ma [...] is alta que nos do Grupo 2. Os pacientes do Grupo 1 tiveram uma baixa freqüência de cardiopatias predisponentes à EI. Ambos os grupos de pacientes apresentaram febre (aproximadamente 87%), mas uma significante baixa freqüência de sopro cardíaco (25,8%) foi observado no Grupo 1, provavelmente, em conseqüência disto, o ecocardiograma foi efetuado em apenas 16,1% dos casos, não sendo, portanto, suspeitada EI. Os pacientes do Grupo 1, embora tivessem grave enfermidade aguda, não apresentaram apresentação clínica compatível com EI clássica. Hemoculturas foram feitas em apenas 64,5% dos pacientes do Grupo 1, porém, isolou-se bactérias em 70% e dentre os isolados, predominou o Staphylococcus aureus (71,4%). Foram predominantemente acometidas as válvulas mitral e aórtica. Complicações como embolização e insuficiência cardíaca ocorreram em quase metade dos casos e eles também apresentaram infecções pulmonares, urinárias e do sistema nervoso central. Praticamente todos os casos fatais de EI, que tiveram este diagnóstico apenas à necrópsia, foram submetidos a procedimentos médicos. Sepse aconteceu em aproximadamente metade dos pacientes e mostrou-se acompanhada de choque em mais de 25%. Esta forma de EI deve ser suspeitada em pacientes de idade madura ou idosos, hospitalizados, com doenças que predispõem a infecções, com embolização e que sofreram procedimentos médicos. Abstract in english Thirty one infective endocarditis (IE) fatal cases whose diagnosis was first obtained at autopsy were studied. The clinical data of these patients (Group 1) showed significant differences compared to other 141 IE cases (Group 2). The average age of 53 years in Group 1 patients was 18 years higher th [...] an that of Group 2. The Group 1 patients had a low frequency of IE predisposing heart disease. Both patient groups presented fever (about 87%), but a significant low frequency of cardiac murmur (25.8%) was observed in Group 1 patients and echocardiography tests were performed in only 16.1%, suggesting that IE diagnosis was not suspected. Likewise, although most Group 1 patients appeared with severe acute illness, they did not present the classic IE clinical presentation. Blood cultures were performed in only 64.5% of the Group 1 patients. However, bacteria were isolated in 70% of these blood cultures and Staphylococcus aureus was isolated in 71.4%. The bacteria attacked mitral and aortic valves. Complications such as embolizations and cardiac failure occurred in almost half of the cases and they also presented with infections of the lungs, urinary tract, and central nervous system. Medical procedures were performed in practically all fatal cases whose diagnosis was first obtained at autopsy. Sepsis occurred in about half of the patients and it was followed by shock in more than 25%. This form of IE must be suspected in mature and in old febrile hospitalized patients having infection predisposing diseases, embolization, and suffering medical procedures.

Luiz Tadeu M., FIGUEIREDO; Everaldo, RUIZ-JUNIOR; Tarciso, SCHIRMBECK.

2001-08-01

137

Endocarditis infecciosa por Listeria monocytogenes: revisión de la literatura a partir de un caso clínico / Infective endocarditis caused by Listeria monocytogenes: review of the literature and a case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish La endocarditis infecciosa por Listeria monocytogenes es una enfermedad extremadamente infrecuente, pero usualmente agresiva. Se ha observado en los últimos años un aumento en la edad de presentación y una predilección por pacientes con enfermedad valvular, especialmente válvula protésica. El tratam [...] iento de elección es ampicilina combinada con un aminoglucósido para obtener sinergismo. Aun con un tratamiento adecuado, la mortalidad es elevada y mayor que en otros tipos de endocarditis bacteriana. Con una terapia óptima, incluyendo la resolución quirúrgica, la mortalidad ha disminuido significativamente en los últimos años. Se presenta una revisión de la literatura científica a partir de un caso clínico de un paciente con un síndrome febril en el que se diagnosticó una endocarditis por L. monocytogenesque fue tratada en forma médica con un resultado exitoso. Abstract in english Infective endocarditis caused by Listeria monocytogenesis an extremely rare but usually aggressive disease. We have seen in recent years an increase in age of onset of this disease and a predilection for patients with valvular disease, especially prosthetic valve. The treatment of choice is ampicill [...] in, which is combined with gentamicin for synergy. It is known that even with treatment the mortality is very high and higher than in other types of bacterial endocarditis. With optimal therapy, that is medical-surgical, mortality has declined significantly in recent years. We presents a review of the literature and a clinical case of a patient with a febrile syndrome diagnosed as a infective endocarditis caused by L. monocytogenestreated medically with successful outcome to date.

Arnaldo, Marín; Nicole, Lustig; Ricardo, Cruz; Samuel, Córdova.

2013-08-01

138

Infective endocarditis in children: A 5 year experience from Al-Zahra Hospital, Isfahan, Iran  

Science.gov (United States)

Background: Considering that there are no regional published data regarding the epidemiologic findings of infective endocarditis (IE) in children, in this study we reviewed the epidemiologic and clinical features and treatment and outcome of children diagnosed with IE at Al-Zahra hospital over a 5-year period. Materials and Methods: In this retrospective study, medical records of patients (Zahra Hospital (Pediatrics Infectious or Cardiology Departments) reviewed. The medical files reviewed regarding demographic, clinical, diagnostic (laboratory, microbiological and echocardiographic details) and treatment and outcome details. Obtained data were recorded in a questionnaire. The diagnosis of IE was determined based on Duke criteria. Results: In this study, 17 patients fulfill the Duke criteria for definite or the possible IE. The most common causes of IE was non-cyanotic heart disease (ventricular septal defect and AS; 64.8%). From cyanotic hearth disease, Tetralogy of Fallot (TOF) was the most frequent causes (11.8%). In this study, 41% of patients with IE aged < 2 years and 70% aged < 6 years. In this study, 76.5% of patients had a history of congenital heart disease or cardiac surgery. Blood cultures were positive in 10 patients (58.8%). Coagulase-negative staphylococci (23.5%) and Staphylococcus aureus (11.7%) were the most common organisms that cause IE. Conclusion: It seems that in order to provide a regional comprehensive guideline for appropriate management and prevention of IE related complications further advanced studies with larger sample size and evaluation is recommended. PMID:25538914

Ahmadi, Alireza; Daryushi, Hooman

2014-01-01

139

Balloon aortic valvuloplasty in pregnancy with severe aortic stenosis and infective endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Twenty seven year old lady, previously diagnosed to have aortic stenosis, presented to the obstetric outpatient department at 19 weeks of gestation with fever and breathlessness, NYHA class 4, for one week. Two D Echo revealed left ventricular hypertrophy, a severely stenosed, calcified bicuspid aortic valve, with vegetations on aortic and mitral valves and severe mitral regurgitation. Blood cultures grew nutrionally variant streptococci and she was treated with crystalline penicillin and gentamicin. She stabilised clinically by 21 weeks, by which time, the risk of termination of pregnancy was comparable to continuing the pregnancy. She underwent balloon aortic valvuloplasty. Post balloon aortic valvuloplasty, she was stable. At 34+2 weeks, she underwent emergency LSCS, the indication being intrauterine growth restriction with fetal compromise and breech presentation. She delivered a baby girl, 1.6 kg, Apgar 9 & 10. Our case report highlights the fact that a timely, balloon aortic valvuloplasty can be life saving for patients with pregnancy complicated by severe aortic stenosis and infective endocarditis. [Int J Reprod Contracept Obstet Gynecol 2012; 1(1.000: 69-71

Vinotha

2012-12-01

140

Pascal's Wager, infective endocarditis and the "no-lose" philosophy in medicine.  

Science.gov (United States)

Doctors and dentists have traditionally used antibiotic prophylaxis in certain patient groups in order to prevent infective endocarditis (IE). New guidelines, however, suggest that the risk to patients from using antibiotics is higher than the risk from IE. This paper analyses the relative risks of prescribing and not prescribing antibiotic prophylaxis against the background of Pascal's Wager, the infamous assertion that it is better to believe in God regardless of evidence, because of the prospective benefits should He exist. Many doctors seem to believe the parallel proposition that it is better to prescribe antibiotics, regardless of evidence, because of the prospective benefit conferred upon the patient. This has been called the "no lose philosophy" in medicine: better safe than sorry, even if the evidence inconveniently suggests that following this mantra is potentially more likely to result in sorry than safe. It transpires that, just as Pascal's Wager fails to convince because of a lack of evidence to support it and the costs incurred by trying to believe, so the "belts and braces" approach of prescribing antibiotic prophylaxis is unjustifiable given the actual evidence of potential risk and benefit to the patient. Ultimately, there is no no-lose if your clinical decisions, like Pascal's Wager, are based on faith rather than evidence. PMID:20019208

Shaw, D; Conway, D I

2010-01-01

141

ENDOCARDITIS WITH AN UNCOMMON GERM  

Directory of Open Access Journals (Sweden)

Full Text Available Enterococci are normal inhabitants of gastrointestinal tract, being responsible for 5 to 18% of infective endocarditis and the incidence appears to be increasing. Eleven patients with enterococcal endocarditis were studied. In a case series group, 10 men (average 57 years and one woman (37 years were studied. Two patients had rheumatic heart disease, 5 patients arteriosclerotic disease and one patient chronic renal failure on hemodialysis. Ten patients were treated with ampicillin and gentamycin. Valve replacement was performed in 3 patients with aortic valve endocarditis, one on 8th day and two at the end of the treatment. Overall clinical cure was achieved in 9 patients. Two relapses occurred and 2 patients died as a result of refractory congestive heart failure and cerebral emboli. All of the enterococcal endocarditis cases were community acquired. In conclusion, infective endocarditis in patients with preexistent valvular heart disease, community acquisition and non specific symptoms with bacteriuria should be considered as enterococcal endocarditis.

M. Gharouni

2006-07-01

142

[A septic pulmonary embolism associated with right-sided infective endocarditis and a ventricular septal defect in a patient with atopic dermatitis].  

Science.gov (United States)

A 30-year-old woman was admitted to our hospital with high fever and chest pain. She had a ventricular septal defect, but was asymptomatic and had not undergone surgical repair. She also had had atopic dermatitis since childhood that had not been adequately treated. Chest computed tomography showed multiple peripheral nodules and infiltrates in both lungs. A transthoracic echocardiogram detected vegetation on the wall of the right ventricle, and Staphylococcus aureus was cultured from a peripheral blood sample. She was diagnosed as having a septic pulmonary embolism associated with right-sided infective endocarditis caused by S. aureus. She was treated with Cefazolin, resulting in gradual improvement of laboratory and chest radiographic findings. Recent studies have revealed that atopic dermatitis is one of the risk factors for infective endocarditis. In this case, uncontrolled atopic dermatitis might have caused the right-sided infective endocarditis. PMID:22746050

Fukumitsu, Kensuke; Suzuki, Yujiro

2012-05-01

143

Direct Detection of Cardiobacterium hominis in Serum from a Patient with Infective Endocarditis by Broad-Range Bacterial PCR  

OpenAIRE

Bacterial DNA was detected directly in the serum of a patient with endocarditis by broad-range 16S rRNA PCR followed by sequencing and analysis of the results by the BLAST search. Using these methods, Cardiobacterium hominis was identified in 2 days from the date of serum collection. The microorganism was also isolated and identified using conventional methods (bacterial culture and biochemical tests) 17 days from the date of sample collection. This is the first report showing the direct dete...

Gatselis, N.; Malli, E.; Papadamou, G.; Petinaki, E.; Dalekos, G. N.

2006-01-01

144

Endocarditis Due to Rare and Fastidious Bacteria  

OpenAIRE

The etiologic diagnosis of infective endocarditis is easily made in the presence of continuous bacteremia with gram-positive cocci. However, the blood culture may contain a bacterium rarely associated with endocarditis, such as Lactobacillus spp., Klebsiella spp., or nontoxigenic Corynebacterium, Salmonella, Gemella, Campylobacter, Aeromonas, Yersinia, Nocardia, Pasteurella, Listeria, or Erysipelothrix spp., that requires further investigation to establish the relationship with endocarditis, ...

Brouqui, P.; Raoult, D.

2001-01-01

145

Usefulness of 16S rDNA sequencing for the diagnosis of infective endocarditis caused by Corynebacterium diphtheriae.  

Science.gov (United States)

We report a rare case of infective endocarditis caused by Corynebacterium diphtheriae in an 8-year-old boy, 2 years after a right ventricular outflow tract reconstruction with a bovine Contegra valved conduit. The patient recovered well after an RV-PA conduit enblock explantation and replacement with an aortic homograft with antibiotic treatment. All bacteriological cultures of excised tissue and blood were negative. The aetiological agent was identified as C. diphtheriae subsp. gravis by 16s rDNA sequencing. PMID:22538997

Pathipati, Padmaja; Menon, Thangam; Kumar, Naveen; Francis, Thara; Sekar, Prem; Cherian, Kotturathu Mammen

2012-08-01

146

Impact of harmonic imaging on transthoracic echocardiographic identification of infective endocarditis and its complications  

Science.gov (United States)

Objective: To evaluate the comparative diagnostic value of harmonic imaging (HI) in the assessment of patients with suspected infective endocarditis (IE). Setting: Tertiary referral centre. Design: 139 consecutive patients were evaluated with three imaging modalities: transthoracic echocardiography with fundamental imaging (FI); HI; and transoesophageal echocardiography (TOE). Image quality was assessed for each modality by semiquantitative scoring (0, poor, to 3, excellent). Presence, dimension, and characteristics of vegetations were assessed separately for each imaging modality, as well as presence of abscesses. Results: 35 patients had definite IE. TOE was positive in 33 patients, HI in 28, and FI in 12 (p < 0.001 for FI v HI and v TOE). Mean image quality was 1.4 (0.7) for FI, 2.1 (0.6) for HI (p < 0.01 v FI), and 2.6 (0.4) for TOE (p < 0.001 v HI). The association between FI and TOE findings was ? ?=? 0.35 (?2 ?=? 17.57, p ?=? 0.0014) and between HI and TOE it was ? ?=? 0.95 (?2 ?=? 125.72, p < 0.0001; p < 0.0001 v FI). The global echo score of vegetations was 7.1 (3.3) with FI, 8.5 (3.4) with HI, and 11.3 (3.9) with TOE (p < 0.001 v HI). Compared with TOE, FI identified only one of seven abscesses (sensitivity 14%) and HI identified two of seven abscesses (sensitivity 28%). Conclusions: HI provides an accurate assessment of suspected IE. TOE achieves superior definition of IE related abnormalities. PMID:15710712

Chirillo, F; Pedrocco, A; De Leo, A; Bruni, A; Totis, O; Meneghetti, P; Stritoni, P

2005-01-01

147

Prevalence of infective endocarditis in patients with Staphylococcus aureus bacteraemia : the value of screening with echocardiography  

DEFF Research Database (Denmark)

Aims Staphylococcus aureus infective endocarditis (IE) is a critical medical condition associated with a high morbidity and mortality. In the present study, we prospectively evaluated the importance of screening with echocardiography in an unselected S. aureus bacteraemia (SAB) population. Methods and results From 1 January 2009 to 31 August 2010, a total of 244 patients with SAB at six Danish hospitals underwent screening echocardiography. The inclusion rate was 73% of all eligible patients (n= 336), and 53 of the 244 included patients (22%; 95% CI: 17–27%) were diagnosed with definite IE. In patients with native heart valves the prevalence was 19% (95% CI: 14–25%) compared with 38% (95% CI: 20–55%) in patients with prosthetic heart valves and/or cardiac rhythm management devices (P= 0.02). No difference was found between Main Regional Hospitals and Tertiary Cardiac Hospitals, 20 vs. 23%, respectively (NS). The prevalence of IE in high-risk patients with one or more predisposing condition or clinical evidence of IE were significantly higher compared with low-risk patients with no additional risk factors (38 vs. 5%; P < 0.001). IE was associated with a higher 6 months mortality, 14(26%) vs. 28(15%) in SAB patients without IE, respectively (P < 0.05). Conclusion SAB patients carry a high risk for development of IE, which is associated with a worse prognosis compared with uncomplicated SAB. The presenting symptoms and clinical findings associated with IE are often non-specific and echocardiography should always be considered as part of the initial evaluation of SAB patients.

Rasmussen, Rasmus V; HØst, Ulla

2011-01-01

148

Achromobacter species endocarditis: A case report and literature review.  

Science.gov (United States)

Endocarditis due to Achromobacter species is a rare, yet serious, endovascular infection. Achromobacter species infective endocarditis is associated with underlying immunodeficiencies or prosthetic heart valves and devices. A case of prosthetic pulmonary valve endocarditis secondary to Achromobacter xylosoxidans subspecies denitrificans is described in the present report. This life-threatening infection was successfully treated with combined valve replacement and prolonged antibiotic therapy. A Medline/PubMed literature review of Achromobacter endocarditis was also performed. Achromobacter species are an uncommon, yet important, cause of nosocomial endocarditis. Given the significant associated morbidity and mortality, along with a high degree of intrinsic antibiotic resistance, Achromobacter species infective endocarditis remains a clinical treatment challenge. PMID:22942890

Derber, Catherine; Elam, Kara; Forbes, Betty A; Bearman, Gonzalo

2011-01-01

149

Predictive risk factors for periannular extension of native valve endocarditis. Clinical and echocardiographic analyses.  

Science.gov (United States)

The study objective is to identify clinical, microbiologic, and/or echocardiographic risk factors present early in the course of native valve endocarditis that predict subsequent development of periannular extension of infection. A multivariate computer-generated analysis of 21 clinical-microbiologic parameters and 11 two-dimensional echocardiographic parameters in patients with native valve endocarditis was designed. These parameters were statistically compared in operated-on patients with native valve endocarditis with and without periannular extension of infection. The study took place in a 600-bed acute-care, nonreferral, municipal hospital primarily servicing an indigent patient population. Seventy-three documented episodes of native valve endocarditis occurred between the years of 1973 and 1987, including 29 operated-on patients with surgically confirmed periannular extension of infection and 44 operated-on patients without periannular extension of infection. Multivariate logistic-regression analyses of multiple clinical, microbiologic, and echocardiographic parameters which are potentially predictive of eventual periannular extension of native valve endocarditis were carried out. The only two independent parameters that significantly predicted periannular infection among patients with native valve endocarditis were (1) aortic valve involvement and (2) abuse of intravenous (IV) drugs (p less than 0.01; p less than 0.01, respectively, multivariate analysis). The relative risk of developing periannular extension of endocarditis among patients with aortic valve involvement and/or IV drug abuse was increased by approximately 2.5-fold compared with patients without these characteristics. Factors not significantly associated with increased risk of periannular extension of native valve endocarditis included the following: prolonged febrile morbidity; Staphylococcus aureus etiology; or two-dimensional echocardiographic demonstration of vegetations, large vegetations (greater than or equal to 1 cm), multiple vegetations, or enlargement of aortic root or annulus. These data suggest that patients with native aortic valve endocarditis, particularly in the setting of IV drug abuse, should be considered for routine, serial noninvasive evaluation for the early detection of periannular extension of their infection. PMID:2582833

Omari, B; Shapiro, S; Ginzton, L; Robertson, J M; Ward, J; Nelson, R J; Bayer, A S

1989-12-01

150

Small Colony variants of Staphylococcus aureus isolated from a patient with infective endocarditis: a case report and review of the literature  

Directory of Open Access Journals (Sweden)

Full Text Available Staphylococcus aureus produces a particular morphological variant called small colony variant(SCV which is responsible for persistent subclinical infections in predisposed individuals and is usually resistant to aminoglycosides and cell wall active antibiotics. Infections by SCV of S. aureus is an upcoming problem due to difficulty in laboratory diagnosis and resistance to antimicrobial chemotherapy. We here report a case of infective endocarditis caused by SCV of Staphylococcus aureus in a pediatric patient.

Sayan Bhattacharyya

2012-06-01

151

Achromobacter species endocarditis: A case report and literature review  

OpenAIRE

Endocarditis due to Achromobacter species is a rare, yet serious, endovascular infection. Achromobacter species infective endocarditis is associated with underlying immunodeficiencies or prosthetic heart valves and devices. A case of prosthetic pulmonary valve endocarditis secondary to Achromobacter xylosoxidans subspecies denitrificans is described in the present report. This life-threatening infection was successfully treated with combined valve replacement and prolonged antibiotic therapy....

Derber, Catherine; Elam, Kara; Forbes, Betty A.; Bearman, Gonzalo

2011-01-01

152

Bacteremia and Infective Endocarditis Caused by a Non-Daptomycin-Susceptible, Vancomycin-Intermediate, and Methicillin-Resistant Staphylococcus aureus Strain in Taiwan?  

OpenAIRE

We describe the development of nonsusceptibility to daptomycin and vancomycin during treatment for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia associated with infective endocarditis and probable septic thrombophlebitis in a uremic patient. MRSA bacteremia persisted during glycopeptide and subsequent daptomycin treatment but cleared after 5 days' treatment with linezolid and fusidic acid.

Huang, Yu-tsung; Hsiao, Cheng-hsiang; Liao, Chun-hsing; Lee, Chung-wei; Hsueh, Po-ren

2008-01-01

153

Echocardiographic findings suggestive of infective endocarditis in asymptomatic Danish injection drug users attending urban injection facilities.  

Science.gov (United States)

Injection drug users (IDUs) account for a considerable number of the hospitalizations for infective endocarditis (IE), but the prevalence of diagnosed and unrecognized IE in IDUs is unknown. The aim of the present study was to assess the prevalence of valvular abnormalities suggestive of IE in IDUs attending a supervised injection facility. We performed transthoracic echocardiographic examinations on-site in the injection facilities. A total of 206 IDUs (mean age 43 ± 9 years, 23% women) with a median injection drug abuse of 18 years (interquartile range 10 to 26) were included. Fourteen IDUs (14 of 206, 7%, 95% confidence interval [CI] 4% to 11%) had a previous history of IE. IDUs with a history of IE were significantly older than IDUs without a history of IE (48 ± 8 vs 42 ± 9 years, respectively, p = 0.03) and had a longer duration of injection drug use (27 [18 to 36] vs 17 years [10 to 25], p = 0.008). In the subgroup of IDUs with a history of IE, 4 subjects (4 of 14, 29%, 95% CI 11% to 55%) had persistent or relapse vegetations. Of the remaining 10 IDUs with a history of IE, 5 (5 of 10, 50%, 95% CI 24% to 76%) had moderate-to-severe regurgitation. In the subgroup of IDUs without a history of IE, vegetations were seen in 9 subjects (9 of 192, 5%, 95% CI 2% to 9%). This group of IDUs with possibly unrecognized IE was older than IDUs without vegetations (48 ± 12 vs 42 ± 9, respectively, p = 0.04). Among the IDUs without a history of IE who did not have vegetations, 30 IDUs (30 of 183, 16%, 95% CI 11% to 22%) had moderate-to-severe regurgitation with or without concomitant thickening of leaflets. Thus, in IDUs without a history of IE, some extent of valvular abnormalities was seen in 20% (39 of 192, 95% CI 15% to 27%) of subjects. None of the IDUs with valvular vegetations had current symptoms consistent with active IE. In conclusion, valvular abnormalities assessed by echocardiography were prevalent in asymptomatic IDUs without a medical history of IE, and vegetations were seen in 5% of subjects. PMID:24819896

Axelsson, Anna; Søholm, Helle; Dalsgaard, Morten; Helweg-Larsen, Jannik; Ihlemann, Nikolaj; Bundgaard, Henning; Køber, Lars; Iversen, Kasper

2014-07-01

154

Update on blood culture-negative endocarditis.  

Science.gov (United States)

Blood culture-negative endocarditis is often severe, and difficult to diagnose. The rate of non-documented infective endocarditis has decreased with the advent of molecular biology - improved performance for the diagnosis of bacterial endocarditis with blood cultures sterilized by previous antibacterial treatment - and cardiac surgery - access to the main infected focus, the endocardium, for half of the patients. Blood culture-negative endocarditis are classified in 3 main categories: (i) bacterial endocarditis with blood cultures sterilized by previous antibacterial treatment (usually due to usual endocarditis-causing bacteria, i.e. streptococci, more rarely staphylococci, or enterococci); (ii) endocarditis related to fastidious microorganisms (e.g. HACEK bacteria; defective streptococci - Gemella, Granulicatella, and Abiotrophia sp. - Propionibacterium acnes, Candida sp.): in these cases, prolonged incubation will allow identifying the causative pathogen in a few days; (iii) and the "true" blood culture-negative endocarditis, due to intra-cellular bacteria that cannot be routinely cultured in blood with currently available techniques: in France, these are most frequently Bartonella sp., Coxiella burnetti (both easily diagnosed by ad hoc serological tests), and Tropheryma whipplei (usually diagnosed by PCR on excised cardiac valve tissue). Non-infective endocarditis is rare, mostly limited to marantic endocarditis, and the rare endocarditis related to systemic diseases (lupus, Behçet). PMID:25480453

Tattevin, P; Watt, G; Revest, M; Arvieux, C; Fournier, P-E

2014-11-15

155

Aneurisma infectado de artéria braquial após endocardite infecciosa de valva mitral / Infected aneurysm of brachial artery after mitral valve infective endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Apresentamos um caso de aneurisma infectado de artéria braquial em paciente com endocardite infecciosa por Streptococcus bovis. Homem de 49 anos de idade se apresentou com febre, dispnéia e sopro regurgitativo em foco mitral com irradiação para axila. O ecocardiograma demonstrou vegetação em valva m [...] itral nativa. Após troca valvar mitral com implante de prótese biológica, observou-se massa pulsátil de cinco centímetros de diâmetro em fossa antecubital direita. Foi feito o diagnóstico de aneurisma infectado de artéria braquial, e o tratamento cirúrgico foi realizado com sucesso. O objetivo desse relato de caso é apresentar uma complicação pouco comum após endocardite infecciosa. Abstract in english We present a case of brachial artery infected aneurysm in a patient with infective endocarditis caused by Streptococcus bovis. A 49-year-old man presented with fever dyspnea and a pansystolic murmur with irradiation to axilla. The echocardiogram revealed vegetation in native mitral valve. After mitr [...] al valve replacement with bioprosthesis, it was observed pulsatile mass of five centimeters in diameter at antecubital fossa of right upper limb. It was made the diagnosis of infected aneurysm of the brachial artery, and the surgery was performed successfully. The aim of this case report is to show a rare complication after infective endocarditis.

Heraldo Guedis, Lobo Filho; Eduardo Rebouças, Carvalho; José Glauco, Lobo Filho; Patrícia Leal Dantas, Lobo.

2011-03-01

156

Aneurisma infectado de artéria braquial após endocardite infecciosa de valva mitral Infected aneurysm of brachial artery after mitral valve infective endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Apresentamos um caso de aneurisma infectado de artéria braquial em paciente com endocardite infecciosa por Streptococcus bovis. Homem de 49 anos de idade se apresentou com febre, dispnéia e sopro regurgitativo em foco mitral com irradiação para axila. O ecocardiograma demonstrou vegetação em valva mitral nativa. Após troca valvar mitral com implante de prótese biológica, observou-se massa pulsátil de cinco centímetros de diâmetro em fossa antecubital direita. Foi feito o diagnóstico de aneurisma infectado de artéria braquial, e o tratamento cirúrgico foi realizado com sucesso. O objetivo desse relato de caso é apresentar uma complicação pouco comum após endocardite infecciosa.We present a case of brachial artery infected aneurysm in a patient with infective endocarditis caused by Streptococcus bovis. A 49-year-old man presented with fever dyspnea and a pansystolic murmur with irradiation to axilla. The echocardiogram revealed vegetation in native mitral valve. After mitral valve replacement with bioprosthesis, it was observed pulsatile mass of five centimeters in diameter at antecubital fossa of right upper limb. It was made the diagnosis of infected aneurysm of the brachial artery, and the surgery was performed successfully. The aim of this case report is to show a rare complication after infective endocarditis.

Heraldo Guedis Lobo Filho

2011-03-01

157

Awareness of Iranian’s General Dentists Regarding the Latest Prophylaxis Guideline for Prevention of Infective Endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Statement of Problem: Dental procedures leading to oral tissue injuries may provoke bacterial release to the blood stream causing infective endocarditis (IE in vulnerable patients. The guideline which was proposed by AHA has been updated 9 times having the last update published in 2007. This study was endeavored to uncover the level of knowledge of general dental practitioners in Shiraz, concerning the 2007 AHA guidelines for endocarditis prophylaxis in patients with cardiac problems receiving dental treatments.Materials and Method: This cross- sectional and descriptive analytical study included 150 dentists as participants. All practitioners were given a self –report questionnaire which consisted of three sections. Questions were designed to assess their knowledge of antibiotic prophylaxis in patients with cardiac disease. Results: Almost all participants (93% were aware of antibiotic prophylaxis to be essential for tooth extraction. Most participants did not believe in prophylaxis for noninvasive procedures (such as shedding of primary teeth, impression, intraoral radiography. From all of the respondents, 75% considered Amoxicillin to be the anti-biotic of choice and 57% were acquainted with the correct dose of Amoxicillin for high risk patients.Conclusion: The study identified a potential for under/over prescription of antibiotic prophylaxis under the current guideline. Burden of IE necessitates more accurate knowledge of antibiotic prophylaxis in the undergraduate curriculum and continuing education programs of dentistry.

Ghaderi F.

2013-03-01

158

Meningite como complicação de endocardite infecciosa Meningitis as a complication of infective endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available As complicações neurológicas estão presentes em aproximadamente 30% dos pacientes com endocardite infecciosa; no entanto, a meningite apresenta-se como uma complicação rara. Apresenta-se aqui o caso de paciente do gênero feminino com quadro de meningite decorrente de endocardite em valva mitral, que necessitou de procedimento cirúrgico em razão de quadro agudo de insuficiência cardíaca por ruptura de cordoalha valvar.Although approximately 30% of patients with endocarditis present with neurological complications, the development of meningitis in these patients is rare. This case report describes a female patient who developed meningitis as a complication of mitral valve endocarditis, and surgery was required for this patient due to acute heart failure resulting from the rupture of the chordae tendineae.

Viviane Cordeiro Veiga

2012-09-01

159

Septal endocarditis, bone infection and severe leg ischemia detected in Tc-99m labelled monoclonal anti granulocyte scan  

International Nuclear Information System (INIS)

Patient 28 years old has continued to have a persistent fever (39.2OC), despite ten days treatment by specific antibiotics for bacterial endocarditis associated to a recent claudication of the right lower leg. The persistent fever has motivated a 99mTc-labelled monoclonal anti granulocyte scan which has showed an important uptake in the myocardial septum, and other infection locations in temporal bone and in right tibial arteries. Two days after, a nanocolloids-99mTc WBS showed no uptake in the heart area, a total absence of uptake of the nanocolloids in the bone marrow of right tibia b and cranial SPECT views confirmed the infectious site in the right temporal bone. New antibiotic strategy was adopted successfully associated with surgical amputation of the right lower leg (au)

160

A randomised clinical trial of comprehensive cardiac rehabilitation versus usual care for patients treated for infective endocarditis--the CopenHeartIE trial protocol  

DEFF Research Database (Denmark)

INTRODUCTION: Infective endocarditis (IE) is among the most serious infectious diseases in the western world. Treatment requires lengthy hospitalisation, high-dosage antibiotic therapy and possible valve replacement surgery. Despite advances in treatment, the 1-year mortality remains at 20-40%. Studies indicate that patients experience persisting physical symptoms, diminished quality of life and difficulties returning to work up to a year postdischarge. No studies investigating the effects of rehabilitation have been published. We present the rationale and design of the CopenHeart(IE) trial, which investigates the effect of comprehensive cardiac rehabilitation versus usual care for patients treated for IE. METHODS AND ANALYSIS: We will conduct a randomised clinical trial to investigate the effects of comprehensive cardiac rehabilitation versus usual care on the physical and psychosocial functioning of patients treated for IE. The trial is a multicentre, parallel design trial with 1?:?1 individual randomisation to either the intervention or control group. The intervention consists of five psychoeducational consultations provided by specialised nurses and a 12-week exercise training programme. The primary outcome is mental health (MH) measured by the standardised Short Form 36 (SF-36). The secondary outcome is peak oxygen uptake measured by the bicycle ergospirometry test. Furthermore, a number of exploratory analyses will be performed. Based on sample size calculation, 150 patients treated for left-sided (native or prosthetic valve) or cardiac device endocarditis will be included in the trial. A qualitative and a survey-based complementary study will be undertaken, to investigate postdischarge experiences of the patients. A qualitative postintervention study will explore rehabilitation participation experiences. ETHICS AND DISSEMINATION: The study complies with the Declaration of Helsinki and was approved by the regional research ethics committee (no H-1-2011-129) and the Danish Data Protection Agency (no 2007-58-0015). Study findings will be disseminated widely through peer-reviewed publications and conference presentations. REGISTRATION: Clinicaltrials.gov identifier: NCT01512615.

Rasmussen, Trine Bernholdt; Zwisler, Ann-Dorthe

2012-01-01

161

Complicaciones posoperatorias y mortalidad en pacientes operados por endocarditis infecciosa Postoperative complications and mortality observed in patients operated on from infective endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Objetivo: describir las causas de morbilidad y mortalidad perioperatorias en los pacientes afectos de endocarditis infecciosa activa y significar cómo pueden ser disminuidas. Métodos: se realizó un estudio retrospectivo de las complicaciones posoperatorias y mortalidad en 139 pacientes operados por presentar endocarditis infecciosa en un período de 16 años. Se efectuaron 147 operaciones a los 139 pacientes de las cuales 83 (57,1 % fueron electivas y 64 (42,9 % fueron de urgencia. El 24 % de los pacientes fueron remitidos de otros centros en los que habían sido sometidos a tratamiento médico no exitoso por más de 4 semanas. Resultados: las operaciones efectuadas fueron: Sustituciones valvulares aórticas,mitrales y tricuspídeas 75 (41,1 %, extracción de electrodos de marcapasos o desfibriladores automáticos implantables del ventrículo derecho 57 (41 % , otras operaciones en número de 7 (4,9 %y 8 reintervenciones. La complicación más frecuente fue la sepsis generalizada (10,07 % pObjective: To describe the causes of perioperative morbidity and mortality of patients suffering active infectious endocarditis and to explain how both aspects can be reduced. Methods: A retrospective study of postoperative complications and mortality observed in 139 patients operated on from infectious endocarditis in 16 years. One hundred forty seven surgeries were performed, of which 83 (57.1 % were elective and 64 (42.9 % were emergency surgeries. In this group, 24 % had been referred from other medical centers where they had been unsuccessfully treated for 4 weeks. Results: The performed surgeries comprised 15 aortic, mitral and tricuspid valve replacements, 57 (41 % removals of pacemaker electrodes or of implanted automatic defibrillators in the right ventricle, seven other types of surgeries and 8 reoperations. The most frequent complication was generalized sepsis ((10.07 % p< 0.01, followed by the low heart output and postoperative bleeding. The main causes of death were congestive heart failure in 13 patients (9.3 %, p< 0. 02 and generalized sepsis in 5 patients (3.6 %. The mortality rates presented in this study (16.4 % were associated to several factors such as functional class, since 12.2 % of patients were classified into the functional class III-IV of the New York Heart Association. The mortality rate was higher in those patients who had been unsuccessfully treated for over 4 years (n= 13, 56.5 %. Low mortality is noticeable (2.1 % in patients with infectious endocarditis as a result of pacemaker electrodes or cables, or of implanted automatic defibrillators. Conclusions: Early diagnosis, implementation of an intensive antibiotic treatment, early performance of surgery together with rigorous homeostasis results in a stagger reduction of mortality and morbidity in infectious endocarditis surgeries.

Joaquín Gómez Armando Gonga

2013-03-01

162

Corynebacterium endocarditis species-specific risk factors and outcomes  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Corynebacterium species are recognized as uncommon agents of endocarditis, but little is known regarding species-specific risk factors and outcomes in Corynebacterium endocarditis. Methods Case report and Medline search of English language journals for cases of Corynebacterium endocarditis. Inclusion criteria required that cases be identified as endocarditis, having persistent Corynebacterium bacteremia, murmurs described by the authors as identifying the affected valve, or vegetations found by echocardiography or in surgical or autopsy specimens. Cases also required patient-specific information on risk factors and outcomes (age, gender, prior prosthetic valve, other prior nosocomial risk factors (infected valve, involvement of native versus prosthetic valve, need for valve replacement, and death to be included in the analysis. Publications of Corynebacterium endocarditis which reported aggregate data were excluded. Univariate analysis was conducted with chi-square and t-tests, as appropriate, with p = 0.05 considered significant. Results 129 cases of Corynebacterium endocarditis involving nine species met inclusion criteria. Corynebacterium endocarditis typically infects the left heart of adult males and nearly one third of patients have underlying valvular disease. One quarter of patients required valve replacement and one half of patients died. Toxigenic C. diphtheriae is associated with pediatric infections (p C. amycolatum has a predilection for women (p = 0.024, while C. pseudodiphtheriticum infections are most frequent in men (p = 0.023. C. striatum, C. jeikeium and C. hemolyticum are associated with nosocomial risk factors (p C. pseudodiphtheriticum is associated with a previous prosthetic valve replacement (p = 0.004. C. jeikeium infections are more likely to require valve replacement (p = 0.026. Infections involving toxigenic C. diphtheriae and C. pseudodiphtheriticum are associated with decreased survival (p = 0.001 and 0.032, respectively. Conclusion We report the first analysis of species-specific risk factors and outcomes in Corynebacterium endocarditis. In addition to species-specific associations with age, gender, prior valvular diseases, and other nosocomial risk factors, we found differences in rates of need for valve replacement and death. This review highlights the seriousness of these infections, as up to 28% of patients required valve replacement and 43.5% died.

Pak Janet B

2007-02-01

163

[Prevention of infectious endocarditis in surgical diseases].  

Science.gov (United States)

Case histories of 220 patients with infective endocarditis were studied. Groups of patients with high risk of the disease were established. "Risk coefficient" was calculated. A system of measures for prevention of infective endocarditis in surgical patients is proposed. PMID:3564299

Shikhverdiev, N I; Lytkin, A M

1986-07-01

164

Actinobacillus endocarditis associated with hypertrophic cardiomyopathy  

OpenAIRE

Infective endocarditis can be associated with complex clinical presentations, sometimes with a difficult multi-disciplinary management. Actinobacillus actinomycetemcomitans belongs to the Haemophilus species, Actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens and Kingella species group, responsible for 5% to 10% of infective endocarditis in native heart valves. These organisms have slow fastidious growth pattern, often associated with negative cultures, and cause systemic emb...

Jorge, Vanda Cristina; Arau?jo, Ana Carolina; Grilo, Ana; Noronha, Carla; Panarra, Anto?nio; Riso, Nuno; Vaz Riscado, Manuel

2012-01-01

165

Endocardite infecciosa por Haemophilus aphrophilus: relato de caso / Infective endocarditis due to Haemophilus aphrophilus: a case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Descrever o caso de uma criança com endocardite infecciosa causada por Haemophilus aphrophilus. DESCRIÇÃO: Menino com febre e calafrios há 20 dias. À internação, apresentava-se febril, descorado e sem sinais de instabilidade hemodinâmica; à ausculta cardíaca, tinha sopro holosistólico em f [...] oco mitral. Os exames laboratoriais identificaram anemia (hemoglobina = 9,14 g/dL), leucócitos totais de 11.920 mm³, plaquetas de 250.000 mm³, velocidade de sedimentação das hemácias e proteína C reativa elevadas. O ecocardiograma revelou imagem em válvula mitral, sugestiva de vegetação. Com a hipótese de endocardite, foi iniciada antibioticoterapia com penicilina cristalina (200.000 UI/kg/dia) associada à gentamicina (4 mg/kg/dia). No terceiro dia de tratamento, foi identificado Haemophilus aphrophilus em hemoculturas, sendo então trocado o esquema antibiótico para ceftriaxona (100 mg/kg/dia). No 20º dia de internação, encontrava-se pálido, mas sem febre e sem outras queixas. Os exames mostravam hemoglobina = 7,0 g/dL, leucócitos = 2.190 mm³, plaquetas = 98.000 mm³, razão normatizada internacional = 1,95 e R = 1,89. Foi feita hipótese de reação adversa ao ceftriaxona, que foi substituído por ciprofloxacina, 20 mg/kg/dia, até completar 6 semanas de tratamento. Após 72 horas da troca, houve normalização dos exames. Durante seguimento ambulatorial, apresentou insuficiência mitral grave, sendo submetido a troca de válvula por prótese metálica 9 meses após quadro agudo. Há 3 anos encontra-se bem, em acompanhamento ambulatorial. COMENTÁRIOS: É rara a identificação de agentes do grupo HACEK (Haemophilus ssp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens e Kingella kingae) em crianças com endocardite infecciosa. O caso apresentado, sem fatores de risco relacionados a esses agentes, reafirma a necessidade de tentar sempre identificar o agente etiológico das endocardites para adequação do tratamento. Abstract in english OBJECTIVE: To report the case of a child with infective endocarditis caused by Haemophilus aphrophilus. DESCRIPTION: Boy with 20 days of fever and chills. On admission, he was febrile, pale and with no signs of hemodynamic instability; on cardiac auscultation, a mitral-related holosystolic murmur wa [...] s observed. Laboratory examination identified anemia (hemoglobin = 9.14 g/dL), total leukocytes of 11,920 mm³, platelets of 250,000 mm³, elevated sedimentation velocity of red cells and elevated C-reactive protein. The echocardiogram revealed image on mitral valve, resembling vegetation. Considering endocarditis, antibiotic therapy was started with crystalline penicillin (200,000 UI/kg/day) in association with gentamicin (4 mg/kg/day). On the third day of treatment, Haemophilus aphrophilus was identified in the blood cultures and the antibiotic scheme was replaced with ceftriaxone (100 mg/kg/day). On the 20th day of evolution, the patient was pale but with no fever or other complaints. Examinations showed hemoglobin = 7.0 g/dL, leukocytes = 2,190 mm³, platelets = 98,000 mm³, international normalized ratio = 1.95 and R = 1.89. Considering the hypothesis of adverse reaction to ceftriaxone, a 6-week replacement treatment with ciprofloxacin (20 mg/kg/day) was started. Examination results normalized after 72 hours of the replacement therapy. During ambulatory follow-up, patient presented with severe mitral regurgitation, undergoing a valve replacement with a metallic prosthetic valve 9 months after acute event. Patient has done well throughout the 3-year ambulatory follow-up. COMMENTS: Identification of agents of the HACEK group (Haemophilus ssp, Actinobacillus actinomycetemcomitans,Cardiobacterium hominis, Eikenella corrodens and Kingella kingae) in children with infective endocarditis is rare. This case report, with no HACEK agent-related risk factors, reinforces the need for identification of the etiological agent of endocarditis to ensure a

Ricardo M., Pereira; Fabio, Bucaretchi; Antonia T., Tresoldi.

2008-04-01

166

Endocardite infecciosa por Haemophilus aphrophilus: relato de caso Infective endocarditis due to Haemophilus aphrophilus: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Descrever o caso de uma criança com endocardite infecciosa causada por Haemophilus aphrophilus. DESCRIÇÃO: Menino com febre e calafrios há 20 dias. À internação, apresentava-se febril, descorado e sem sinais de instabilidade hemodinâmica; à ausculta cardíaca, tinha sopro holosistólico em foco mitral. Os exames laboratoriais identificaram anemia (hemoglobina = 9,14 g/dL, leucócitos totais de 11.920 mm³, plaquetas de 250.000 mm³, velocidade de sedimentação das hemácias e proteína C reativa elevadas. O ecocardiograma revelou imagem em válvula mitral, sugestiva de vegetação. Com a hipótese de endocardite, foi iniciada antibioticoterapia com penicilina cristalina (200.000 UI/kg/dia associada à gentamicina (4 mg/kg/dia. No terceiro dia de tratamento, foi identificado Haemophilus aphrophilus em hemoculturas, sendo então trocado o esquema antibiótico para ceftriaxona (100 mg/kg/dia. No 20º dia de internação, encontrava-se pálido, mas sem febre e sem outras queixas. Os exames mostravam hemoglobina = 7,0 g/dL, leucócitos = 2.190 mm³, plaquetas = 98.000 mm³, razão normatizada internacional = 1,95 e R = 1,89. Foi feita hipótese de reação adversa ao ceftriaxona, que foi substituído por ciprofloxacina, 20 mg/kg/dia, até completar 6 semanas de tratamento. Após 72 horas da troca, houve normalização dos exames. Durante seguimento ambulatorial, apresentou insuficiência mitral grave, sendo submetido a troca de válvula por prótese metálica 9 meses após quadro agudo. Há 3 anos encontra-se bem, em acompanhamento ambulatorial. COMENTÁRIOS: É rara a identificação de agentes do grupo HACEK (Haemophilus ssp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens e Kingella kingae em crianças com endocardite infecciosa. O caso apresentado, sem fatores de risco relacionados a esses agentes, reafirma a necessidade de tentar sempre identificar o agente etiológico das endocardites para adequação do tratamento.OBJECTIVE: To report the case of a child with infective endocarditis caused by Haemophilus aphrophilus. DESCRIPTION: Boy with 20 days of fever and chills. On admission, he was febrile, pale and with no signs of hemodynamic instability; on cardiac auscultation, a mitral-related holosystolic murmur was observed. Laboratory examination identified anemia (hemoglobin = 9.14 g/dL, total leukocytes of 11,920 mm³, platelets of 250,000 mm³, elevated sedimentation velocity of red cells and elevated C-reactive protein. The echocardiogram revealed image on mitral valve, resembling vegetation. Considering endocarditis, antibiotic therapy was started with crystalline penicillin (200,000 UI/kg/day in association with gentamicin (4 mg/kg/day. On the third day of treatment, Haemophilus aphrophilus was identified in the blood cultures and the antibiotic scheme was replaced with ceftriaxone (100 mg/kg/day. On the 20th day of evolution, the patient was pale but with no fever or other complaints. Examinations showed hemoglobin = 7.0 g/dL, leukocytes = 2,190 mm³, platelets = 98,000 mm³, international normalized ratio = 1.95 and R = 1.89. Considering the hypothesis of adverse reaction to ceftriaxone, a 6-week replacement treatment with ciprofloxacin (20 mg/kg/day was started. Examination results normalized after 72 hours of the replacement therapy. During ambulatory follow-up, patient presented with severe mitral regurgitation, undergoing a valve replacement with a metallic prosthetic valve 9 months after acute event. Patient has done well throughout the 3-year ambulatory follow-up. COMMENTS: Identification of agents of the HACEK group (Haemophilus ssp, Actinobacillus actinomycetemcomitans,Cardiobacterium hominis, Eikenella corrodens and Kingella kingae in children with infective endocarditis is rare. This case report, with no HACEK agent-related risk factors, reinforces the need for identification of the etiological agent of endocarditis to ensure adequate treatment.

Ricardo M. Pereira

2008-04-01

167

Utilidad diagnóstica de los nódulos de Osler en la endocarditis infecciosa en usuarios de drogas por vía parenteral (UDVP) / Diagnostic utility of Osler´s nodes in the infective endocarditis in intravenous drug users  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Fundamento: Se describen los datos clínicos, microbiológicos e histológicos de cinco episodios de endocarditis infecciosa (EI) con nódulos de Osler en usuarios de drogas por vía parenteral (UDVP). Pacientes y métodos: Se han estudiado de forma prospectiva 43 casos de EI en UDVP. En 4 pacientes se re [...] alizó punción aspiración y en otro biopsia de un nódulo de Osler, con tinción de Gram y cultivo de la muestra. Resultados: De los 43 episodios de EI 33 fueron derechas, 9 izquierdas y 1 mixta. Cinco de los 10 (50%) pacientes con endocarditis izquierda o mixta presentaron nódulos de Osler, pero no se encontraron en ninguno de los pacientes con EI derecha. En todas las muestras tomadas por punción aspiración se observaron cocos grampositivos en racimos en la tinción de Gram y se obtuvo crecimiento de Staphylococcus aureus con el mismo antibiotipo que los aislados en los hemocultivos. En el único caso en el que se realizo biopsia del nódulo se apreciaba trombos sépticos en la microcirculación. Conclusiones: La tinción de Gram y el cultivo del material aspirado de los nódulos de Osler tiene una alta rentabilidad en el diagnóstico etiológico de la EI en los usuarios a drogras por vía parenteral. La presencia de nódulos de Osler en un paciente con EI nos debe sugerir que la localización es izquierda. Estos datos sugieren que los nódulos de Osler, en la EI por S. aureus en los UDVP se origina como consecuencia de embolismos sépticos microvasculares. Abstract in english Background: The objective of study is to describe of clinic, microbiological and histological data of five cases of infective endocarditis (IE) with Osler's nodes in intravenous drug users . Patients y methods: Prospectively, 43 cases of IE in intravenous drugs users was revised. In 4 patients, a as [...] pirate puncture of Osler's node was performed and in one patient a biopsy of Osler's node was done with Gram's stain and culture of specimen. Results: From 43 episodes of IE, 33 were right-side IE, 9 left-side y 1 right and left side. No patients with right-side IE presented Osler's nodes, however five of 10 (50%) patients with left-side endocarditis. In all of cases grampositive cocci were observed in Gram's strain and Staphylococcus aureus growth on culture of lesion with the same antibiotype than isolated from blood culture. One case a cutaneous biopsy was performed, and inflammatory infiltrate with necrosis was found. Conclusions: The Gram's strain and culture of specimen aspirated from Osler's nodes were of high utility in the diagnosis of IE in intravenous drugs users. The presence of Osler's nodes in a patient with infective endocarditis must be suggest that the location in left-side. These data suggest that Osler's nodes in infective endocarditis by S. aureus in intravenous drugs users was originated by microvascular septic emboli.

F. J., Espinosa Parra; J. M., Ramos Rincón; F., Herrero Huerta; L., Pretel Serrano; A. A., Lorenzo.

2002-06-01

168

Bacterial mural endocarditis. A case series.  

Science.gov (United States)

Mural endocarditis represents a rare subset of intracardiac infections, with potentially life threatening sequelae. Clinically alike, with many shared aetiologies, substrates and risk factors such as valvular endocarditis, it can be difficult to differentiate without the use of sophisticated cardiovascular imaging techniques. Despite high rates of complications, there are no definite strategies for management. Herein we present three interesting cases of left ventricular mural endocarditis, without valvular involvement, due to staphylococcus aureus. PMID:24816290

Adel, Alexander; Jones, Elizabeth; Johns, Jennifer; Farouque, Omar; Calafiore, Paul

2014-08-01

169

Rise of CC398 Lineage of Staphylococcus aureus among Infective Endocarditis Isolates Revealed by Two Consecutive Population-Based Studies in France  

OpenAIRE

Staphylococcus aureus isolates from two prospective studies on infective endocarditis (IE) conducted in 1999 and 2008 and isolated from non-IE bacteremia collected in 2006 were spa-typed and their virulence factors were analyzed with a microarray. Both populations were genetically diverse, with no virulence factors or genotypes significantly more associated with the IE isolates compared with the non-IE isolates. The population structure of the IE isolates did not change much between 1999 and ...

Tristan, Anne; Rasigade, Jean-philippe; Ruizendaal, Esme?e; Laurent, Fre?de?ric; Bes, Miche?le; Meugnier, He?le?ne; Lina, Ge?rard; Etienne, Jerome; Celard, Marie; Tattevin, Pierre; Monecke, Stefan; Le Moing, Vincent; Vandenesch, Franc?ois

2012-01-01

170

Direct detection of Cardiobacterium hominis in serum from a patient with infective endocarditis by broad-range bacterial PCR.  

Science.gov (United States)

Bacterial DNA was detected directly in the serum of a patient with endocarditis by broad-range 16S rRNA PCR followed by sequencing and analysis of the results by the BLAST search. Using these methods, Cardiobacterium hominis was identified in 2 days from the date of serum collection. The microorganism was also isolated and identified using conventional methods (bacterial culture and biochemical tests) 17 days from the date of sample collection. This is the first report showing the direct detection of C. hominis in a patient's serum using molecular-based methods, emphasizing their potential usefulness as additional and rapid diagnostic tools for the detection and identification of fastidious bacteria. PMID:16455944

Gatselis, N; Malli, E; Papadamou, G; Petinaki, E; Dalekos, G N

2006-02-01

171

Staphylococcus aureus bacteremia and endocarditis.  

Science.gov (United States)

Staphylococcus aureus bacteremia is a serious and common disease often associated with infective endocarditis. It occurs in both healthy, immunologically competent people in the community and compromised patients in the hospitals. For S. aureus bacteremia, questions on clinical issues such as antimicrobial treatment are raised. Is nafcillin/oxacillin superior to vancomycin? Does the addition of rifampin improve outcome? Does addition of aminoglycoside improve the outcome? Does increasing duration of therapy (> 4 weeks versus endocarditis on admission? What are the risk factors that would separate bacteremia from endocarditis? What is the role of echocardiography? What are the indications for routine echocardiography? Are methicillin-resistant S. aureus (MRSA) more virulent than methicillin-susceptible S. aureus (MSSA)? What factors predict mortality in S. aureus bacteremia? Herein, the above important issues on S. aureus bacteremia and endocarditis are critically reviewed. PMID:10917874

Chang, F Y

2000-06-01

172

Molecular Identification of Gemella Species from Three Patients with Endocarditis  

OpenAIRE

Gemella morbillorum and Gemella haemolysans are opportunistic pathogens which cause endocarditis and other severe infections. We report on three patients with endocarditis, one with endocarditis caused by G. haemolysans and two with endocarditis caused by G. morbillorum. The paucity of reports concerning these bacteria is probably related to the difficulties associated with their identification. For example, one of the strains reported in this study was originally sent to our laboratory with ...

La Scola, Bernard; Raoult, Didier

1998-01-01

173

Bivalvular Bartonella henselae Prosthetic Valve Endocarditis?  

OpenAIRE

Prosthetic valve endocarditis is an uncommon manifestation of infection with Bartonella species. Herein, we report a case of Bartonella henselae endocarditis involving prosthetic mitral and aortic valves. The patient had a favorable outcome with combined medical and surgical therapy. Concomitant crescentic glomerulonephritis led to an initial mistaken diagnosis of Wegener's granulomatosis.

Vikram, Holenarasipur R.; Bacani, A. Kirstin; Devaleria, Patrick A.; Cunningham, Scott A.; Cockerill, Franklin R.

2007-01-01

174

Unusual case of Aeromonas hydrophila endocarditis.  

OpenAIRE

We describe a case of Aeromonas hydrophila endocarditis in a 66-year-old man with myelodysplastic syndrome and non-A, non-B hepatitis, The infection resolved with antibiotic therapy, but the patient succumbed to complications of his underlying illness. This is the second case of Aeromonas endocarditis reported in the world literature.

Ong, K. R.; Sordillo, E.; Frankel, E.

1991-01-01

175

Successful repair for a giant coronary artery aneurysm with coronary arteriovenous fistula complicated by both right- and left-sided infective endocarditis.  

Science.gov (United States)

We report a rare case of a 65-year-old woman who underwent an emergent lifesaving heart operation for an undiagnosed right coronary artery aneurysm with a coronary arteriovenous fistula complicated by active infective endocarditis, which affected the aortic valve, mitral valve, and coronary sinus. We performed direct closure of the coronary arteriovenous fistula, ligation of the right coronary artery aneurysm, double coronary artery bypass grafting, and double valvular replacement. Five years after the operation, she had no sign of congestive heart failure or infection, and was not receiving antibiotics. PMID:19830518

Umezu, Kentaro; Hanayama, Naoji; Toyama, Akihiko; Hobo, Kyoko; Takazawa, Arifumi

2009-10-01

176

Infective endocarditis: long-term reversibility of kidney function impairment. A 1-y post-discharge follow-up study  

DEFF Research Database (Denmark)

The aim of this study was to quantify the long-term reversibility of kidney function decrease occurring during hospitalization and treatment for infective endocarditis (IE). A prospective observational cohort study was performed at a tertiary university hospital in Copenhagen from October 2002 through May 2008; 223 consecutive IE patients were included. Forty patients died in hospital and 38 within 1 y of discharge. Of the 145 patients called in for the 1-y follow-up, 111 accepted. Kidney function was assessed by estimated endogenous creatinine clearance (EECC). Statistical correlation between EECC at admission, discharge and follow-up, as well as correlations between gentamicin and EECC changes, were analyzed. In the 111 follow-up patients, the bacteriological aetiologies were: Streptococcus species (47.7%), Enterococcus (16.2%) and Staphylococcus aureus (11.7%). The mean EECC decrease from admission to discharge was 8.4% (95% confidence interval 1.6-15.2; p 22%. In conclusion, kidney function impairment occurring during hospitalization for IE is potentially reversible within the first y post-discharge.

Buchholtz, Kristine; Larsen, Carsten T

2010-01-01

177

18FDG-positron emission tomography (PET) has a role to play in the diagnosis and therapy of infective endocarditis and cardiac device infection.  

Science.gov (United States)

In recent years, molecular imaging with positron emission tomography (PET) and more recently, PET coupled with computed tomography (CT) have made a valuable impact in various clinical arenas, primarily within the field of oncology, but also in cardiovascular medicine, particularly in detecting coronary artery disease and myocardial viability. More recently, PET imaging has been proven useful in the diagnosis and evaluation of inflammation and infection at different organ sites. Application of PET in the case of Infective Endocarditis (IE) is still in its infancy and indeed the value of this application in the detection of vegetations is debated primarily due to sensitivity issues of the tracer in cardiac tissue and small vegetations. Interestingly, however, reports are now emerging highlighting the role that this application has played in the diagnosis, assessment of complications such as emboli and metastatic infection and the monitoring of therapeutic treatment of IE. More recently, PET/CT has proven valuable in the diagnosis and assessment of cardiac implantable electronic device (CIED)-related infection and its use has highlighted the contribution that this imaging modality may play in assessing the need for surgery in patients with such infections. This article reviews the literature with regard to the potential value of 2-deoxy-2-[(18)F]fluoro-D-glucose ((18)FDG)-PET, as well as the pitfalls and limitations of this imaging modality, in relation to cardiac infection. The emerging role (18)FDG-PET/CT has in the diagnosis and monitoring of IE, particularly prosthetic valve IE and CIED-related infections should be considered, particularly in difficult cases. PMID:23313465

Millar, B Cherie; Prendergast, Bernard D; Alavi, Abass; Moore, John E

2013-09-01

178

Endocarditis del marcapasos / Pacemaker endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish En los últimos años se ha producido un incremento en las indicaciones de marcapasos y desfibriladores autoimplantables que tendrá como consecuencia un aumento de la prevalencia de la endocarditis asociada a dispositivos intravasculares, por lo que adquiere especial relevancia para el clínico conocer [...] esta entidad e incluirla en sus diagnósticos diferenciales. El objetivo de este articulo es describir la epidemiología, características clínicas, diagnóstico, tratamiento y pronóstico de la endocarditis asociada al marcapasos. Abstract in english In the last years an increment has taken place in the pacemaker and implantable cardioverter-defibrillator indications that will have as consequence an increase of the prevalencia of the endocarditis associated to intravascular devices, for what acquires special relevance for the clinical one to kno [...] w this entity and to include it in his differential diagnoses. The objetive of this article is to describe the epidemiology, clinic characteristics, diagnosis, treatment and outcome of the pacemaker endocarditis.

R., López Rodríguez; M., Rodríguez Framil; A., Hermida Ameijeiras; F. L., Lado Lado.

2006-04-01

179

Efficacies of Vancomycin, Arbekacin, and Gentamicin Alone or in Combination against Methicillin-Resistant Staphylococcus aureus in an In Vitro Infective Endocarditis Model  

OpenAIRE

We adopted an in vitro infective endocarditis model (IVIEM) to compare the efficacy of vancomycin (VAN), arbekacin (ABK), and gentamicin (GEN) alone or in combination. Using two strains of clinically isolated methicillin-resistant Staphylococcus aureus, one GEN susceptible (GS171) and one GEN resistant (GR153), fibrin clots were prepared and suspended in the IVIEM. Antibiotics were given as boluses every 6 h (q6h), q12h, or q24h or by continuous infusion with VAN, q12h or q24h with ABK, and q...

Lee, Dong-gun; Chun, Hye-sun; Yim, Dong-seok; Choi, Su-mi; Choi, Jung-hyun; Yoo, Jin-hong; Shin, Wan-shik; Kang, Moon-won

2003-01-01

180

Identification of Cardiobacterium hominis by broad-range bacterial polymerase chain reaction analysis in a case of culture-negative endocarditis.  

Science.gov (United States)

Culture-negative bacterial endocarditis may be attributed to fastidious microorganisms, prior institution of antibiotic treatment, or both. We describe a case of culture-negative endocarditis in which a modified Steiner stain revealed bacterial structures in the resected heart valve material. Prompted by this finding, broad-range polymerase chain reaction (PCR) amplification of small-subunit ribosomal DNA (16S rDNA) was performed, and Cardiobacterium hominis sequences were detected. This case demonstrates the usefulness of both the Steiner stain and broad-range direct molecular amplification as supplemental diagnostic tools in identification of otherwise unexplained infections. PMID:11863484

Nikkari, Simo; Gotoff, Robert; Bourbeau, Paul P; Brown, Robert E; Kamal, Nazmi R; Relman, David A

2002-02-25

181

Increasing incidence and mortality of infective endocarditis: a population-based study through a record-linkage system  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Few population-based studies provide epidemiological data on infective endocarditis (IE. Aim of the study is to analyze incidence and outcomes of IE in the Veneto Region (North-Eastern Italy. Methods Residents with a first hospitalization for IE in 2000-2008 were extracted from discharge data and linked to mortality records to estimate 365-days survival. Etiology was retrieved in subsets of this cohort by discharge codes and by linkage to a microbiological database. Risk factors for mortality were assessed through logistic regression. Results 1,863 subjects were hospitalized for IE, with a corresponding crude rate of 4.4 per 100,000 person-years, increasing from 4.1 in 2000-2002 to 4.9 in 2006-2008 (p = 0.003. Median age was 68 years; 39% of subjects were hospitalized in the three preceding months. 23% of patients underwent a cardiac valve procedure in the index admission or in the following year. Inhospital mortality was 14% (19% including hospital transfers; 90-days and 365-days mortality rose through the study years. Mortality increased with age and the Charlson comorbidity index, in subjects with previous hospitalizations for heart failure, and (in the subcohort with microbiological data in IE due to Staphylococci (40% of IE. Conclusions The study demonstrates an increasing incidence and mortality for IE over the last decade. Analyses of electronic archives provide a region-wide picture of IE, overcoming referral biases affecting single clinic or multicentric studies, and therefore represent a first fundamental step to detect critical issues related to IE.

Buonfrate Dora

2011-02-01

182

Heterogeneous vancomycin-intermediate susceptibility in a community-associated methicillin-resistant Staphylococcus aureus epidemic clone, in a case of Infective Endocarditis in Argentina  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Community-Associated Methicillin Resistant Staphylococcus aureus (CA-MRSA has traditionally been related to skin and soft tissue infections in healthy young patients. However, it has now emerged as responsible for severe infections worldwide, for which vancomycin is one of the mainstays of treatment. Infective endocarditis (IE due to CA-MRSA with heterogeneous vancomycin-intermediate susceptibility-(h-VISA has been recently reported, associated to an epidemic USA 300 CA-MRSA clone. Case Presentation We describe the occurrence of h-VISA phenotype in a case of IE caused by a strain belonging to an epidemic CA-MRSA clone, distinct from USA300, for the first time in Argentina. The isolate h-VISA (SaB2 was recovered from a patient with persistent bacteraemia after a 7-day therapy with vancomycin, which evolved to fatal case of IE complicated with brain abscesses. The initial isolate-(SaB1 was fully vancomycin susceptible (VSSA. Although MRSA SaB2 was vancomycin susceptible (?2 ?g/ml by MIC (agar and broth dilution, E-test and VITEK 2, a slight increase of MIC values between SaB1 and SaB2 isolates was detected by the four MIC methods, particularly for teicoplanin. Moreover, Sab2 was classified as h-VISA by three different screening methods [MHA5T-screening agar, Macromethod-E-test-(MET and by GRD E-test] and confirmed by population analysis profile-(PAP. In addition, a significant increase in cell-wall thickness was revealed for SaB2 by electron microscopy. Molecular typing showed that both strains, SaB1 and SaB2, belonged to ST5 lineage, carried SCCmecIV, lacked Panton-Valentine leukocidin-(PVL genes and had indistinguishable PFGE patterns (subtype I2, thereby confirming their isogenic nature. In addition, they were clonally related to the epidemic CA-MRSA clone (pulsotype I detected in our country. Conclusions This report demonstrates the ability of this epidemic CA-MRSA clone, disseminated in some regions of Argentina, to produce severe and rapidly fatal infections such as IE, in addition to its ability to acquire low-level vancomycin resistance; for these reasons, it constitutes a new challenge for the Healthcare System of this country.

Vindel Ana

2011-04-01

183

Bartonella endocarditis-associated glomerulonephritis: a case report and review of the literature.  

Science.gov (United States)

Infectious endocarditis is associated with a number of systemic manifestations, including kidney disease. Kidney manifestations, including hematuria, parenchymal infarction, and glomerulonephritis, may affect as many as 40%-50% of patients with infective endocarditis. In a minority of cases of infective endocarditis, routine bacterial cultures do not yield an offending organism. Bartonella species are a known and relatively common cause of culture-negative endocarditis and have been associated with the development of endocarditis-associated glomerulonephritis. We present a case of Bartonella endocarditis-associated glomerulonephritis in which recognition of a characteristic immunofluorescent pattern and thorough investigation of the clinical history led to this uncommon diagnosis. PMID:24332768

Khalighi, Mazdak A; Nguyen, Stephanie; Wiedeman, Jean A; Palma Diaz, Miguel F

2014-06-01

184

Lyme endocarditis.  

Science.gov (United States)

Lyme borreliosis is a common tick-borne disease with a wide variety of clinical manifestations. Cardiac involvement has been reported during both the acute phase (atrioventricular block, pericarditis) and the chronic stage (dilated cardiomyopathy), but is rare (Lyme endocarditis, in a 61-year-old man living in an endemic area of France. The diagnosis was confirmed by detection of B. afzelii DNA in the mitral valve by specific real-time PCR. He was treated empirically with amoxicillin for 6 weeks and remains well 12 months later. PMID:23043635

Hidri, N; Barraud, O; de Martino, S; Garnier, F; Paraf, F; Martin, C; Sekkal, S; Laskar, M; Jaulhac, B; Ploy, M-C

2012-12-01

185

Corynebacterium diphtheriae endocarditis Corynebacterium diphtheriae endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available nuloThe authors report the case of a 69-year-old man with an acute toxemic and febrile syndrome. Immediately after admission, the patient’s mental status rapidly deteriorated. A faint mitral systolic murmur was detected and splenomegaly wasobserved on ultrasound examination. Laboratory screening revealed azotemia, AST and ALT elevation, leukocytosis, thrombocytopenia, elevated erythrocyte sedimentation rate as well as C-reactive-protein. Urinalysis showed proteinuria,leukocyturia and hematuria. A transesophageal echocardiogram showed large vegetations attached to both mitral leaflets with mild regurgitation. Blood culture yielded slow-growing Gram-positive bacillus which was later identified as a nontoxigenic Corynebacterium diphtheriae sorovar gravis. The authors emphasize the importance of identifying any bacteria isolated in blood samples particularly when an infective endocarditis diagnosis is suspected and call attention to theincreasing number of reports related to this pathogen. Patient’s clinical outcome was favorable after a long period of antibiotic therapy.

Fernando Peixoto Ferraz de Campos

2012-08-01

186

Challenge in the management of infective endocarditis with multiple valvular involvement / Desafio no manejo clínico da endocardite infecciosa com acometimento multivalvar  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Paciente do sexo masculino, 41 anos, portador de cardiopatia congênita apresentando-se com endocardite infecciosa (EI) e vegetações nas valvas pulmonar, aórtica e mitral. Três trocas valvares foram realizadas, mas o paciente evoluiu com recidiva da infecção, desenvolvendo abscesso na região da fibro [...] sa intervalvar mitro-aórtica progredindo para sépsis e óbito. Nesse relato, discutimos brevemente as indicações para a cirurgia na EI, destacando sua indicação no tratamento da infecção não controlada. Abstract in english We describe the case of a 41-year-old man with congenital heart disease and infective endocarditis (IE), who presented multiple vegetations attached to the pulmonary, mitral, and aortic valves. Three valve replacements were performed, but the patient developed an abscess at the mitral-aortic interva [...] lvular fibrosa and died due to sepsis. We briefly discuss the indications for surgery in IE, emphasizing its role in the treatment of uncontrolled infection.

Izabella Rodrigues de, Araújo; Maria do Carmo Pereira, Nunes; Claudio Leo, Gelape; Vinicius Tostes, Carvalho; Benone Evaristo Rezende Araújo, Lacerda; Gustavo Brandão de, Oliveira; Luiza Caldeira, Brant; Teresa Cristina Abreu, Ferrari.

2012-04-01

187

Challenge in the management of infective endocarditis with multiple valvular involvement Desafio no manejo clínico da endocardite infecciosa com acometimento multivalvar  

Directory of Open Access Journals (Sweden)

Full Text Available We describe the case of a 41-year-old man with congenital heart disease and infective endocarditis (IE, who presented multiple vegetations attached to the pulmonary, mitral, and aortic valves. Three valve replacements were performed, but the patient developed an abscess at the mitral-aortic intervalvular fibrosa and died due to sepsis. We briefly discuss the indications for surgery in IE, emphasizing its role in the treatment of uncontrolled infection.Paciente do sexo masculino, 41 anos, portador de cardiopatia congênita apresentando-se com endocardite infecciosa (EI e vegetações nas valvas pulmonar, aórtica e mitral. Três trocas valvares foram realizadas, mas o paciente evoluiu com recidiva da infecção, desenvolvendo abscesso na região da fibrosa intervalvar mitro-aórtica progredindo para sépsis e óbito. Nesse relato, discutimos brevemente as indicações para a cirurgia na EI, destacando sua indicação no tratamento da infecção não controlada.

Izabella Rodrigues de Araújo

2012-04-01

188

Endocarditis due to Chryseobacterium meningosepticum  

Directory of Open Access Journals (Sweden)

Full Text Available Chryseobacterium meningosepticum is a gram negative rod widely distributed in nature. It is known to cause meningitis in neonates and premature infants. Adult infections are not common and are usually nosocomially acquired. We report an unusual case of native valve endocarditis in a 58-year-old man due to this organism. A high degree of suspicion and correct identification and sensitivity testing is required to diagnose infections by this rare isolate.

Bomb K

2007-01-01

189

Mycotic aneurysm of the tibioperoneal trunk: a first manifestation of an infected endocarditis / Aneurisma micótico de tronco tíbio-fibular: a primeira manifestação de uma endocardite infecciosa  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Aneurisma micótico infra-poplíteo resultante de endocardite infecciosa é raro, com apenas alguns casos relatados. Descrevemos o caso de um paciente de 28 anos do sexo masculino que apresentou dor e edema na perna direita. A ultrassonografia demonstrou um aneurisma do tronco tíbio-fibular e trombose [...] venosa profunda do membro inferior direito. O paciente foi internado e desenvolveu falência cardíaca aguda, sendo diagnosticado de endocardite bacteriana. Um pseudo-aneurisma foi evidenciado na arteriografia. Antibioticoterapia agressiva foi iniciada e cirurgia aberta confirmou um pseudo-aneurisma micótico do tronco tibio-fibular. Para o nosso conhecimento, este é o oitavo caso relatado de aneurisma infectado localizado especificamente nesta região. Abstract in english Infrapopliteal mycotic aneurysm resulting from endocarditis is rare, with only a few reported cases. We describe the case of a 28-year-old male patient who was suffering with pain and edema in the right leg. The ultrasound revealed an aneurysm of the right tibioperoneal trunk and a deep vein thrombo [...] sis (DVT). The patient was admitted and developed acute congestive heart failure, being diagnosed with possible endocarditis. A pseudo-aneurysm was revealed by arteriography. Aggressive antibiotic treatment was initiated, and open surgery confirmed a mycotic pseudo-aneurysm of the tibioperoneal trunk. To our knowledge, this is the 8th case reported of an infected aneurysm in this particular location.

Sergio Quilici, Belczak; Igor Rafael, Sincos; Marcelo Passos, Teivelis; Carlos Alberto Sian de, Oliveira; Hélio, Fragoso; Ricardo, Aun.

2012-06-01

190

Group B streptococcus endocarditis associated with multiple pulmonary septic emboli  

OpenAIRE

Endocarditis is a rare presentation of group B streptococcal infection. Its association with pulmonary septic embolism was only barely studied and limited data is available up to date. Multiple septic emboli is a common complication of bacterial endocarditis, but only a few cases have been documented in relation to group B streptococcus. We present the case of an 87 year old female patient with multiple underlying conditions that predisposed the development of bacterial endocarditis secondary...

Deborah Abaitey; Jerome Salvani; Teran, Carlos G.; Antezana, Ariel O.

2011-01-01

191

Management of Gram-negative and fungal endocarditis  

OpenAIRE

Abstract Infective endocarditis is infrequently caused by Gram-negative bacteria or fungi. Gram-negative organisms are responsible for <4% of cases, while fungal endocarditis accounts for <1.5% of culture-positive cases worldwide. Endocarditis due to Gram-negative organisms or fungi is a rare but severe disease. It often has a nosocomial origin, is caused by virulent and often resistant organisms and presents a high rate of complications and high mortality. In this article we prese...

Durante-mangoni, Emanuele; Tripodi, Marie-franc?oise; Albisinni, Rosina; Utili, Riccardo

2010-01-01

192

Vancomycin-Resistant Enterococcus faecalis Endocarditis: Linezolid Failure and Strain Characterization of Virulence Factors?  

OpenAIRE

Infective endocarditis due to vancomycin-resistant (VR) Enterococcus faecalis has only rarely been reported. We report a case of VR E. faecalis endocarditis that failed to respond to linezolid therapy, outline the virulence traits of the isolate, and review previously published cases of VR E. faecalis endocarditis.

Tsigrelis, Constantine; Singh, Kavindra V.; Coutinho, Thais D.; Murray, Barbara E.; Baddour, Larry M.

2006-01-01

193

Changes in the treatment of Enterococcus faecalis infective endocarditis in Spain in the last 15 years: from ampicillin plus gentamicin to ampicillin plus ceftriaxone.  

Science.gov (United States)

The aim of this study was to assess changes in antibiotic resistance, epidemiology and outcome among patients with Enterococcus faecalis infective endocarditis (EFIE) and to compare the efficacy and safety of the combination of ampicillin and gentamicin (A+G) with that of ampicillin plus ceftriaxone (A+C). The study was a retrospective analysis of a prospective cohort of EFIE patients treated in our centre from 1997 to 2011. Thirty patients were initially treated with A+G (ampicillin 2 g/4 h and gentamicin 3 mg/kg/day) and 39 with A+C (ampicillin 2 g/4 h and ceftriaxone 2 g/12 h) for 4-6 weeks. Increased rates of high-level aminoglycoside resistance (HLAR; gentamicin MIC ?512 mg/L, streptomycin MIC ?1024 mg/L or both) were observed in recent years (24% in 1997-2006 and 49% in 2007-2011; p 0.03). The use of A+C increased over time: 1997-2001, 4/18 (22%); 2002-2006, 5/16 (31%); 2007-2011, 30/35 (86%) (p <0.001). Renal failure developed in 65% of the A+G group and in 34% of the A+C group (p 0.014). Thirteen patients (43%) in the A+G group had to discontinue treatment, whereas only one patient (3%) treated with A+C had to discontinue treatment (p <0.001). Only development of heart failure and previous chronic renal failure were independently associated with 1-year mortality, while the individual antibiotic regimen (A+C vs. A+G) did not affect outcome (OR, 0.7; 95% CI, 0.2-2.2; p 0.549). Our study shows that the prevalence of HLAR EFIE has increased significantly in recent years and that alternative treatment with A+C is safer than A+G, with similar clinical outcomes, although the sample size is too small to draw firm conclusions. Randomized controlled studies are needed to confirm these results. PMID:25040215

Pericas, J M; Cervera, C; Del Rio, A; Moreno, A; Garcia de la Maria, C; Almela, M; Falces, C; Ninot, S; Castañeda, X; Armero, Y; Soy, D; Gatell, J M; Marco, F; Mestres, C A; Miro, J M

2014-12-01

194

Fatal myocarditis-associated Bartonella quintana endocarditis: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Bartonella spp. infection is not rare and must be considered with great care in patients with suspected infective endocarditis, particularly if regular blood cultures remain sterile. Management of these infections requires knowledge of the identification and treatment of these bacteria. Case presentation A 50-year-old Senegalese man was admitted to our Department of Cardiac Surgery with a culture-negative endocarditis. Despite valvular surgery and adequate antibiotic treatment, recurrence of the endocarditis was observed on the prosthetic mitral valve. Heart failure required circulatory support. Weaning off the circulatory support could not be attempted owing to the absence of heart recovery. Bacteriological diagnosis of Bartonella quintana endocarditis was performed by molecular methods retrospectively after the death of the patient. Conclusions This case report underlines the severity and difficulty of the diagnosis of Bartonella quintana endocarditis. The clinical picture suggested possible Bartonella quintana associated myocarditis, a feature that should be considered in new cases.

Montcriol Ambroise

2009-07-01

195

Management of Gram-negative and fungal endocarditis.  

Science.gov (United States)

Infective endocarditis is infrequently caused by Gram-negative bacteria or fungi. Gram-negative organisms are responsible for <4% of cases, whilst fungal endocarditis accounts for <1.5% of culture-positive cases worldwide. Endocarditis due to Gram-negative organisms or fungi is a rare but severe disease. It often has a nosocomial origin, is caused by virulent and often resistant organisms and presents a high rate of complications and high mortality. In this article we present the most recent literature data and address the current management of Gram-negative and fungal infective endocarditis. We also discuss the major challenges of antimicrobial treatment and discuss some issues related to surgical decision-making in difficult-to-manage cases. We finally present our centre's experience with Gram-negative infective endocarditis, with a special focus on the demanding issues that the management of these complex and severely ill patients raise. PMID:21129927

Durante-Mangoni, Emanuele; Tripodi, Marie-Françoise; Albisinni, Rosina; Utili, Riccardo

2010-12-01

196

Winning the Battle Against Pseudomonas aeruginosa Endocarditis: A Case Report  

Directory of Open Access Journals (Sweden)

Full Text Available Infective endocarditis is a major risk for patients with congenital heart disease and has high mortality and morbidity rates, even though there have been many advances in antimicrobial therapy and surgical intervention techniques. Gram positive microorganisms, such as staphylococcus and streptococcus species, are the most commonly isolated organisms. Pseudomonas aeruginosa is a rare causative organism for infective endocarditis. It usually affects the right side of the heart, which is usually seen in intravenous drug users. Incidence of pseudomonas endocarditis has increased due to a higher frequency of drug abuse, heart surgery and bacteremia. Mortality from pseudomonas infective endocarditis remains high despite optimal use of available antibacterial agents and also the treatment plan is very challenging as there is no consensus to date. We report a patient with tetralogy of Fallot and recurrent P. aeruginosa endocarditis after corrective cardiac surgery. We wish to emphasize the importance of surgical intervention and also recall the significance of lenghtening the antipseudomonal combination therapy.

Asl?nur Özkaya Parlakay

2010-09-01

197

Partial oral treatment of endocarditis  

DEFF Research Database (Denmark)

Guidelines for the treatment of left-sided infective endocarditis (IE) recommend 4 to 6 weeks of intravenous antibiotics. Conversion from intravenous to oral antibiotics in clinically stabilized patients could reduce the side effects associated with intravenous treatment and shorten the length of hospital stay. Evidence supporting partial oral therapy as an alternative to the routinely recommended continued parenteral therapy is scarce, although observational data suggest that this strategy may be safe and effective.

Iversen, Kasper; HØst, Nis Baun

2013-01-01

198

Bacterial Endocarditis: A Short Overview  

OpenAIRE

Bacterial (infective) endocarditis is a potentially fatal illness which may follow transient bacteremia induced by certain dental procedures. It is the purpose of this article to discuss the rationale behind the American Heart Association's current guidelines on antibiotic prophylaxis for this disease, to consider the dentist's role in implementing these recommendations, and to identify how the physician and dentist can act in the patient's best interests to prevent this illness.

Kilmartin, C.

1988-01-01

199

Perfil clínico-epidemiológico de pacientes con endocarditis infecciosa, período 2003-2010 en el hospital de Temuco, Chile Profile of patients with infective endocarditis admitted to a Chilean regional hospital  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Mortality due to infective endocarditis (IE in Chile is close to 30%. Aim: To report the experience with patients admitted with the diagnosis of IE in a regional tertiary hospital. Material and Methods: Retrospective study of 107 patients aged 50 ± 16years (75% males discharged with a definitive diagnosis of IE according to modified DUKE criteria, between years 2003 and 2010. Demographic variables, severity scores, clinical characteristics, bacteriology and hospital evolution were recorded. Results: Fifty nine percent of patients had concomitant cardiovascular problems. APACHE II and Sequential Organ Failure Assessment (SOFA scores on admission were 8.4 ± 4.7 and 2.7 ± 2.8 respectively. Native valves were affected in 91% of cases (aortic and mitral valves in 62% and 50% of cases respectively. Prosthetic valves were affected in 9.3% of cases. Rheumatic heart disease was the predominant primary lesion in 10% of patients. Antibiotics were used in 45.1% before blood cultures were performed. In 68% of patients blood cultures were positive. S. viridans (30.8%, S.aureus (18.6% and coagulase negative Streptocicci (5.6% were the identified microorganisms. Intensive care unit admission was required in 48% of patients. Renal, heart and neurological deterioration was observed in 53, 34 and 14% of patients, respectively. Twenty percent of patients developed systemic embolism and 37% required heart surgery. Mean hospital stay was 28.3 ± 19.1 days and 27% of patients died. Conclusions: In this series of patients, IE has a high mortality. Most patients studied were admitted in bad conditions.

Benjamín Stockins

2012-10-01

200

Fatal bioprosthetic aortic valve endocarditis due to Cardiobacterium valvarum.  

Science.gov (United States)

Cardiobacterium valvarum was isolated from the blood of a 71-year-old man with fatal aortic valve endocarditis. The API NH system was used for phenotypic characterization of the C. valvarum strain. This is the first case of infective endocarditis caused by C. valvarum in Germany and the first case worldwide affecting a prosthetic valve and lacking an obvious dental focus. PMID:17475754

Geissdörfer, Walter; Tandler, René; Schlundt, Christian; Weyand, Michael; Daniel, Werner G; Schoerner, Christoph

2007-07-01

201

Fatal Bioprosthetic Aortic Valve Endocarditis Due to Cardiobacterium valvarum?  

OpenAIRE

Cardiobacterium valvarum was isolated from the blood of a 71-year-old man with fatal aortic valve endocarditis. The API NH system was used for phenotypic characterization of the C. valvarum strain. This is the first case of infective endocarditis caused by C. valvarum in Germany and the first case worldwide affecting a prosthetic valve and lacking an obvious dental focus.

Geißdo?rfer, Walter; Tandler, Rene?; Schlundt, Christian; Weyand, Michael; Daniel, Werner G.; Schoerner, Christoph

2007-01-01

202

Technetium 99m-labeled annexin v scintigraphy of platelet activation in vegetations of experimental endocarditis  

Energy Technology Data Exchange (ETDEWEB)

Background: The pathophysiology of infective endocarditis involves a pathogen/host tissue interaction, leading to formation of infected thrombotic vegetations. Annexin V is a ligand of phosphatidyl-serines exposed by activated platelets and apoptotic cells. Because vegetations are platelet-fibrin clots in which platelet pro-aggregant activity is enhanced by bacterial colonization, we investigated the ability of annexin V labeled with technetium {sup 99m}Tc ({sup 99m}Tc-ANX) to provide functional imaging of these vegetations in experimental models of infective endocarditis. This ability was assessed in rabbits and rats because of the different interest of these 2 species in preclinical analysis. Methods and Results: Non-bacterial thrombotic endocarditis was induced with the use of a catheter left indwelling through the aortic or tricuspid valve, and animals were injected with either a bacterial inoculum or saline. Scintigraphic investigations were performed 5 days later and showed a higher {sup 99m}Tc-ANX uptake by vegetations in infected versus non-infected animals (ratio,1.3 for in vivo acquisitions and 2 for autoradiography; P {<=} 0.0001 for all), whereas no significant uptake was present in controls. Right-sided endocarditis was associated with pulmonary uptake foci corresponding to emboli. Histological analysis of vegetations showed a specific uptake of {sup 99m}Tc-ANX at the interface between circulating blood and vegetation. In parallel, underlying myocardial tissue showed myocyte apoptosis and mucoid degeneration, without extracellular matrix degradation at this stage. Conclusions: {sup 99m}Tc-ANX is suitable for functional imaging of platelet-fibrin vegetations in endocarditis, as well as embolic events. {sup 99m}Tc-ANX uptake reflects mainly platelet activation in the luminal layer of vegetations. This uptake is enhanced by bacterial colonization. (authors)

Rouzet, F.; Sarda-Mantel, L.; Le Guludec, D. [Nucl Med Serv, Grp Hosp Bichat Claude Bernard, AP-HP, Paris (France); Rouzet, F.; Sarda-Mantel, L.; LeGuludec, D. [Univ Denis Diderot Paris 7, UMR S773, Paris (France); Rouzet, F.; Sarda-Mantel, L.; Le Guludec, D. [INSERM, U773, Paris (France); Hernandez, M.D.; Louedec, L.; Michel, J.B. [Univ Paris 07, CHU Xavier Bichat, INSERM, U698, Paris (France); Hervatin, F. [CEA, DSV, DRM, SHFJ, Orsay (France); Lefort, A.; Fantin, B. [Univ Denis Diderot Paris 7, EA 3964, Paris (France); Duval, X. [Univ Denis Diderot Paris 7, INSERM, CIC 007, Paris (France); Duval, X. [Univ Denis Diderot Paris 7, AP-HP, Grp Hosp Bichat Claude Bernard, Ctr Invest Clin, Paris (France); Hernandez, M.D. [Univ Guadalajara, DeptPathol, Guadalajara 44430, Jalisco (Mexico)

2008-07-01

203

Technetium 99m-labeled annexin v scintigraphy of platelet activation in vegetations of experimental endocarditis  

International Nuclear Information System (INIS)

Background: The pathophysiology of infective endocarditis involves a pathogen/host tissue interaction, leading to formation of infected thrombotic vegetations. Annexin V is a ligand of phosphatidyl-serines exposed by activated platelets and apoptotic cells. Because vegetations are platelet-fibrin clots in which platelet pro-aggregant activity is enhanced by bacterial colonization, we investigated the ability of annexin V labeled with technetium 99mTc (99mTc-ANX) to provide functional imaging of these vegetations in experimental models of infective endocarditis. This ability was assessed in rabbits and rats because of the different interest of these 2 species in preclinical analysis. Methods and Results: Non-bacterial thrombotic endocarditis was induced with the use of a catheter left indwelling through the aortic or tricuspid valve, and animals were injected with either a bacterial inoculum or saline. Scintigraphic investigations were performed 5 days later and showed a higher 99mTc-ANX uptake by vegetations in infected versus non-infected animals (ratio,1.3 for in vivo acquisitions and 2 for autoradiography; P ? 0.0001 for all), whereas no significant uptake was present in controls. Right-sided endocarditis was associated with pulmonary uptake foci corresponding to emboli. Histological analysis of vegetations showed a specific uptake of 99mTc-ANX at the interface between circulating blood and vegetation. In parallel, unde blood and vegetation. In parallel, underlying myocardial tissue showed myocyte apoptosis and mucoid degeneration, without extracellular matrix degradation at this stage. Conclusions: 99mTc-ANX is suitable for functional imaging of platelet-fibrin vegetations in endocarditis, as well as embolic events. 99mTc-ANX uptake reflects mainly platelet activation in the luminal layer of vegetations. This uptake is enhanced by bacterial colonization. (authors)

204

Prosthetic valve endocarditis caused by Pseudomonas luteola  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Pseudomonas luteola has been recognized as an uncommon cause of bacteremia and of infections in patients with underlying medical disorders Case presentation We isolated P. luteola from blood cutures in a patient with prosthetic valve endocarditis developed 16 months after cardiac surgery. Conclusion P. luteola is a rare opportunistic agent, with a propensity of infecting valvular prostheses.

Riberi Alberto

2005-10-01

205

Streptococcus dysgalactiae endocarditis presenting as acute endophthalmitis  

Directory of Open Access Journals (Sweden)

Full Text Available Endogenous endophthalmitis is a rare ocular infection affecting the vitreous and/or aqueous humours. It is associated with poor visual prognosis and its commonest endogenous aetiology is infective endocarditis. The causative organisms of endogenous endophthalmitis complicating endocarditis are mainly Group A or B streptococci. The identification of Group C and G streptococci such as Streptococcus dysgalactiae is comparatively uncommon and has only been reported in a few case reports or series. We therefore report a case of infective endocarditis caused by Streptococcus dysgalactiae first presenting with endogenous endophthalmitis, the most likely source being bilateral feet osteomyelitis in a patient with type I diabetes. The patient was treated with a course of intravenous benzylpenicillin, intravitreal antibiotics, bilateral below knee amputations and mitral valve replacement. She survived all surgical procedures and regained partial visual acuity in the affected eye.

Tsung Han Woo

2012-01-01

206

Acute Haemophilus parainfluenzae endocarditis: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Numerous pathogens can cause infective endocarditis, including Haemophilus parainfluenzae. H. parainfluenzae is part of the H. aphrophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae group that may cause about 3% of the total endocarditis cases, and is characterized by a subacute course and large vegetations. Case presentation Acute H. parainfluenzae endocarditis developed in a 54-year-old woman, with no underlying predisposing factors. The patient presented with fever of 3 days duration and a severe headache. Magnetic resonance imaging of the brain revealed multiple cerebral emboli with hemorrhagic foci. Upon suspicion of endocarditis, cardiac transesophageal ultrasonography was performed and revealed massive vegetations. The patient underwent emergency mitral valve replacement, and was further treated with ceftriaxone. Blood cultures grew H. parainfluenzae only after valve replacement, and a 6-week course of ceftriaxone was prescribed. Conclusion We underline the typical presentation of large vegetations in H. parainfluenzae endocarditis, which are associated with embolic phenomena and resulting severity. Although the majority of the few cases reported in the literature are subacute in progress, our case further underlines the possibility that H. parainfluenzae endocarditis may develop rapidly. Thus, awareness of the imaging characteristics of the pathogen may enhance early appropriate diagnosis and therapeutic response.

Christou Leonidas

2009-07-01

207

Actinobacillus endocarditis associated with hypertrophic cardiomyopathy.  

Science.gov (United States)

Infective endocarditis can be associated with complex clinical presentations, sometimes with a difficult multi-disciplinary management. Actinobacillus actinomycetemcomitans belongs to the Haemophilus species, Actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens and Kingella species group, responsible for 5% to 10% of infective endocarditis in native heart valves. These organisms have slow fastidious growth pattern, often associated with negative cultures, and cause systemic embolism with abscess formation. The authors present the case of a 59-year-old man, admitted due to fever of unknown origin, with a personal history of obstructive hypertrophic cardiomyopathy and recent dental manipulation. The diagnosis of mitral valve's endocarditis was established after a transoesophageal ecocardiography, with a late isolation of A actinomycetemcomitans in blood culture. Despite the institution of antibiotic therapy, the patient suffered from multiple episodes of septic embolism: skin, mucosae, cerebral abscesses, spondylodiscitis and uveitis. He was submitted to heart surgery with miectomy and replacement of the native mitral valve by a mechanical prosthesis, while on antibiotics. PMID:22891010

Jorge, Vanda Cristina; Araújo, Ana Carolina; Grilo, Ana; Noronha, Carla; Panarra, António; Riso, Nuno; Vaz Riscado, Manuel

2012-01-01

208

Candida albicans isolated from human fungaemia induces apoptosis in an experimental endocarditis model  

OpenAIRE

Candida albicans is the most common fungal pathogen known to cause endovascular infections, such as vascular catheter sepsis, infections of vascular prostheses and infective endocarditis. A C. albicans isolate was used to determine the apoptotic potential of the fungus in a rat endocarditis model. This study confirms the ability of C. albicans to induce apoptosis in myocardial tissue.

Iván Hernández-Cañaveral; Gerardo Becerra; Alberto Jiménez-Cordero; Jean-Baptiste Michel; Arturo Plascencia; Miguel Domínguez-Hernández

2009-01-01

209

Lactococcus garvieae endocarditis: first case report in Latin America.  

Science.gov (United States)

Lactococcus garvieae, an emerging zoonotic pathogen, is responsible for mastitis in rodents and sepsis in fish. Although deemed opportunistic and hardly ever causing infections in humans, its incidence is probably underestimated due to the difficulty in diagnosis. There are very few reports of osteomyelitis, liver abscess, and peritonitis, and only nine cases of endocarditis described in worldwide literature. We describe the first case of Lactococcus garvieae endocarditis in Latin America, in a female patient with metallic prosthetic heart valve who presented with daily fever, chills, Osler nodes and six positive blood cultures for Lactococcus garvieae, which met Duke's criteria for the diagnosis of "definitive infective endocarditis" PMID:22189614

Hirakawa, Tatiana Franco; Costa, Fernando Augusto Alves da; Vilela, Marcos Cairo; Rigon, Micheli; Abensur, Henry; Araújo, Maria Rita Elmor de

2011-11-01

210

Q Fever Endocarditis in Romania: The First Cases Confirmed by Direct Sequencing  

OpenAIRE

Infective endocarditis (IE) is a serious, life-threatening disease with highly variable clinical signs, making its diagnostic a real challenge. A diagnosis is readily made if blood cultures are positive, but in 2.5 to 31% of all infective endocarditis cases, routine blood cultures are negative. In such situations, alternative diagnostic approaches are necessary. Coxiella burnetii and Bartonella spp. are the etiological agents of blood culture-negative endocarditis (BCNE) most frequently ident...

Monica Straut; Mirela Flonta; Adina Ionac; Minodora Dobreanu; Dan Dobreanu; Sorin Dinu; Daniela Badescu; Otilia Banu; Mihaela Oprea; Ani Ioana Cotar

2011-01-01

211

Invasion of endothelial cells and arthritogenic potential of endocarditis-associated Corynebacterium diphtheriae.  

Science.gov (United States)

Although infection by Corynebacterium diphtheriae is a model of extracellular mucosal pathogenesis, different clones have been also associated with invasive infections such as sepsis, endocarditis, septic arthritis and osteomyelitis. The mechanisms that promote C. diphtheriae infection and haematogenic dissemination need further investigation. In this study we evaluated the association and invasion mechanisms with human umbilical vein endothelial cells (HUVECs) and experimental arthritis in mice of endocarditis-associated strains and control non-invasive strains. C. diphtheriae strains were able to adhere to and invade HUVECs at different levels. The endocarditis-associated strains displayed an aggregative adherence pattern and a higher number of internalized viable cells in HUVECs. Transmission electron microscopy (TEM) analysis revealed intracellular bacteria free in the cytoplasm and/or contained in a host-membrane-confined compartment as single micro-organisms. Data showed bacterial internalization dependent on microfilament and microtubule stability and involvement of protein phosphorylation in the HUVEC signalling pathway. A high number of affected joints and high arthritis index in addition to the histopathological features indicated a strain-dependent ability of C. diphtheriae to cause severe polyarthritis. A correlation between the arthritis index and increased systemic levels of IL-6 and TNF-? was observed for endocarditis-associated strains. In conclusion, higher incidence of potential mechanisms by which C. diphtheriae may access the bloodstream through the endothelial barrier and stimulate the production of pro-inflammatory cytokines such as IL-6 and TNF-?, in addition to the ability to affect the joints and induce arthritis through haematogenic spread are thought to be related to the pathogenesis of endocarditis-associated strains. PMID:24344208

Peixoto, Renata Stavracakis; Pereira, Gabriela Andrade; Sanches dos Santos, Louisy; Rocha-de-Souza, Cláudio Marcos; Gomes, Débora Leandro Rama; Silva Dos Santos, Cintia; Werneck, Lucia Maria Correa; Dias, Alexandre Alves de Souza de Oliveira; Hirata, Raphael; Nagao, Prescilla Emy; Mattos-Guaraldi, Ana Luíza

2014-03-01

212

Spondylodiscitis and endocarditis caused by S. vestibularis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Streptococcus vestibularis is a recently described member of the viridans group that was first isolated from the vestibular mucosa of the human oral cavity and described as a new species in 1988. It has been rarely associated with human infections. In few papers, it has been reported as a causal age [...] nt of systemic infection in immunosupressed adults and in those with other severe underlying diseases, like coronary valve diseases. A 65-year-old woman was admitted to the hospital with complaints of fever for three months, general malaise, effort dyspnea, weight loss, back pain and myalgia. Both native aortic valve endocarditis and spondylodiscitis due to Streptococcus vestibularis were detected. The patient was successfully treated with intravenous potassium penicillin G and gentamicin for six weeks, followed by oral amoxicillin for three months, in addition to aortic valve replacement. In all patients with spondylodiscitis, infective endocarditis should be considered, particularly in patients with heart valve disease history, since spondylodiscitis may be the presenting sign of an infective endocarditis. Cardiac valve replacement surgery should be performed if the course of fever and inflammatory syndrome is unfavorable after appropriate antibiotic treatment. We report the first case with both native aortic valve endocarditis and spondylodiscitis due to Streptococcus vestibularis.

Muge Aydin, Tufan; Kart-Koseoglu, Hamide; Ersozlu-Bozkirli, Duygu; Azap, Ozlem; Tufan, Kadir; Yucel Ahmet, Eftal.

2010-08-01

213

Achados clínico-laboratoriais de uma série de casos com endocardite infecciosa Clinical and laboratory findings in a series of cases of infective endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Descrever os achados clínico-laboratoriais da endocardite infecciosa (EI em 28 crianças, em Vitória/ES. MÉTODO: Estudo retrospectivo dos prontuários de 28 crianças, com idade abaixo de 18 anos e diagnóstico de endocardite infecciosa, internadas no serviço de infectologia do Hospital Infantil Nossa Senhora da Glória, em Vitória - Espírito Santo, no período de janeiro de 1993 a dezembro de 2001. Os critérios para diagnóstico de endocardite infecciosa foram os do Duke Endocarditis Service (Duke University, Durham, North Carolina - USA: critérios maiores (hemoculturas e ecocardiograma positivos e critérios menores (febre, doença cardíaca prévia, sopro cardíaco recente, fenômenos vasculares e imunológicos. Através de protocolo específico, preenchido pelos médicos-residentes e acadêmicos do serviço de infectologia, e revisados pelos médicos da equipe, foram anotadas as idades, sexo, achados clínicos e laboratoriais, e os resultados da ecocardiografia transtorácica das 28 crianças que preenchiam os critérios clínicos e laboratoriais. Em todos os casos, as hemoculturas foram realizadas com coleta do sangue (três amostras, sob condições assépticas e com inoculação em meios aeróbicos e anaeróbicos, incubados a uma temperatura de 37ºC e testados com sistema automatizado Vitec System® (Biolab. RESULTADOS: Das 28 crianças, 16 eram do sexo masculino, com idade entre 3 e 180 meses (média 70,6±59,2 m, e a maioria (68% era procedente da região metropolitana de Vitória. Metade apresentava cardiopatia prévia. Os achados clínicos mais freqüentes que levaram à suspeita de EI foram: febre prolongada (100%, sopro cardíaco (67,9%, dispnéia (57,1%, hepatomegalia (57,1%, fenômenos vasculares (32,2%, esplenomegalia (28,6% e nódulos de Osler (7,1%. Foram colhidas hemoculturas dos 28 casos, sendo 16 (57,1% positivas. O S. aureus adquirido na comunidade foi o germe mais freqüentemente isolado (9/16-56,6%. Houve persistência da febre, apesar do tratamento, duração da febre de 2,5 a 30 dias, mediana de 18,0 dias. O valor médio de leucócitos à internação foi de 11.657±7.085mm³. O ecocardiograma transtorácico, realizado em todos os pacientes, evidenciou vegetações, principalmente nas válvulas tricúspide (25,0%, mitral (25,0% e na borda de CIV (28,6%. Treze (46,4% crianças apresentaram sepse concomitante, e três (10,7% infecção hospitalar. Houve um óbito (3,6%. CONCLUSÕES: A endocardite infecciosa em nosso meio é freqüente em crianças abaixo de dois anos de idade e com uma cardiopatia congênita. O S. aureus de origem comunitária foi o microorganismo isolado mais freqüentemente, e em crianças sem lesão cardíaca prévia. Endocardite infecciosa aguda, endocardite bacteriana, Staphylococcus aureus, ecocardiografia transtorácica.OBJECTIVE: To describe clinical and laboratory data of infective endocarditis (IE in 28 children from Vitória, state of Espírito Santo, Brazil. METHODS: We reviewed the medical records of 28 children aged 18 years and under admitted to the Infectious Diseases Unit of Nossa Senhora da Glória Children's Hospital with a diagnosis of IE from January 1993 to December 2001. The diagnosis of IE was based on the criteria established by the Duke Endocarditis Service (Duke University, Durham, North Carolina, USA: positive blood cultures and echocardiogram (primary criteria; and fever, history of heart disease, recent heart murmur, and vascular and immunological phenomena (secondary criteria. A specific protocol was filled out by interns and medical students and revised by physicians from the hospital medical team to obtain the following data: age, sex, clinical and laboratory findings, and results of transthoracic echocardiography. In all cases, three blood samples were collected under aseptic conditions and inoculated in aerobic and anaerobic environments. The samples were then incubated at 37º C and tested with the VITEC SYSTEM® automatized system (BIOLAB. RESULTS: Among 28 patients, 16 were boys. Age w

Carla A.Z. Pereira

2003-10-01

214

Conhecimento dos pais sobre profilaxia de endocardite infecciosa em crianças portadoras de cardiopatias congênitas / Parents' knowledge of infective endocarditis in children with congenital heart disease  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese INTRODUÇÃO: As diretrizes para profilaxia de endocardite infecciosa mudaram, mas muitas cardiopatias congênitas seguem sendo consideradas de alto risco para o desenvolvimento da doença. OBJETIVO: Avaliar o conhecimento dos pais ou responsáveis pelas crianças e adolescentes portadores de cardiopatias [...] atendidos em um serviço de referência no estado do Rio Grande do Sul, Brasil, sobre endocardite infecciosa e sua profilaxia. MÉTODOS: Estudo transversal com 90 pacientes portadores de cardiopatias congênitas em acompanhamento ambulatorial regular. O conhecimento dos pais foi avaliado com o uso de questionário específico e os demais dados foram obtidos por meio da revisão de prontuários. RESULTADOS: A mediana da idade dos pacientes foi de 5,6 anos (3 meses - 14 anos e 7 meses), sendo 57,7% do sexo masculino. A mediana de tempo de acompanhamento no serviço foi de 3,49 anos (1,20-7,38 anos). Os anos de estudo formal dos pais apresentaram média de 7,67 ± 3,25 anos. De acordo com o escore previamente estabelecido, o conhecimento dos pais entrevistados foi considerado satisfatório em 37,7% dos casos, regular, em 33,3% e insatisfatório, em 28,8%. Houve correlação significativa entre o índice de conhecimento dos pais e tempo de acompanhamento das crianças no serviço (r=0,584; P Abstract in english INTRODUCTION: The guidelines to prophylaxis of infectious endocarditis changed, but many congenital heart diseases continue to be considered as high risk for the development of the disease. OBJECTIVE: To evaluate the knowledge of parents or guardians of children and adolescents with congenital heart [...] disease seen at a referral center in Rio Grande do Sul, Brazil on infective endocarditis and its prevention. METHODS: Cross-sectional study with 90 patients with congenital heart defects in regular outpatient treatment. The parents' knowledge was assessed using a specific questionnaire and other data were obtained through medical records. RESULTS: The median age of patients was 5.6 years (3 months -14 years), being 57,7% males. The median follow-up time in service was 3.49 years (1.20-7.38). The years of formal schooling of the parents had a mean of 7.67 ± 3.25 years. According to the score previously established, the knowledge of the interviewed parents was considered satisfactory in 37.7%, regular in 33.3% and unsatisfying in 28,8%. There was significant correlation between the index of parents' knowledge and monitoring of children at service (r=0.584; P=0.796). There was no correlation between parents' education and knowledge of them (r=0.028; P=0.796). CONCLUSION: The parents' knowledge about endocarditis and its prevention was inadequate, requiring greater attention to the orientations passed in consultations

Fabiana, Haag; Sílvia, Casonato; Fernanda, Varela; Cora, Firpo.

2011-09-01

215

Conhecimento dos pais sobre profilaxia de endocardite infecciosa em crianças portadoras de cardiopatias congênitas Parents' knowledge of infective endocarditis in children with congenital heart disease  

Directory of Open Access Journals (Sweden)

Full Text Available INTRODUÇÃO: As diretrizes para profilaxia de endocardite infecciosa mudaram, mas muitas cardiopatias congênitas seguem sendo consideradas de alto risco para o desenvolvimento da doença. OBJETIVO: Avaliar o conhecimento dos pais ou responsáveis pelas crianças e adolescentes portadores de cardiopatias atendidos em um serviço de referência no estado do Rio Grande do Sul, Brasil, sobre endocardite infecciosa e sua profilaxia. MÉTODOS: Estudo transversal com 90 pacientes portadores de cardiopatias congênitas em acompanhamento ambulatorial regular. O conhecimento dos pais foi avaliado com o uso de questionário específico e os demais dados foram obtidos por meio da revisão de prontuários. RESULTADOS: A mediana da idade dos pacientes foi de 5,6 anos (3 meses - 14 anos e 7 meses, sendo 57,7% do sexo masculino. A mediana de tempo de acompanhamento no serviço foi de 3,49 anos (1,20-7,38 anos. Os anos de estudo formal dos pais apresentaram média de 7,67 ± 3,25 anos. De acordo com o escore previamente estabelecido, o conhecimento dos pais entrevistados foi considerado satisfatório em 37,7% dos casos, regular, em 33,3% e insatisfatório, em 28,8%. Houve correlação significativa entre o índice de conhecimento dos pais e tempo de acompanhamento das crianças no serviço (r=0,584; PINTRODUCTION: The guidelines to prophylaxis of infectious endocarditis changed, but many congenital heart diseases continue to be considered as high risk for the development of the disease. OBJECTIVE: To evaluate the knowledge of parents or guardians of children and adolescents with congenital heart disease seen at a referral center in Rio Grande do Sul, Brazil on infective endocarditis and its prevention. METHODS: Cross-sectional study with 90 patients with congenital heart defects in regular outpatient treatment. The parents' knowledge was assessed using a specific questionnaire and other data were obtained through medical records. RESULTS: The median age of patients was 5.6 years (3 months -14 years, being 57,7% males. The median follow-up time in service was 3.49 years (1.20-7.38. The years of formal schooling of the parents had a mean of 7.67 ± 3.25 years. According to the score previously established, the knowledge of the interviewed parents was considered satisfactory in 37.7%, regular in 33.3% and unsatisfying in 28,8%. There was significant correlation between the index of parents' knowledge and monitoring of children at service (r=0.584; P=0.796. There was no correlation between parents' education and knowledge of them (r=0.028; P=0.796. CONCLUSION: The parents' knowledge about endocarditis and its prevention was inadequate, requiring greater attention to the orientations passed in consultations

Fabiana Haag

2011-09-01

216

Achados clínico-laboratoriais de uma série de casos com endocardite infecciosa / Clinical and laboratory findings in a series of cases of infective endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Descrever os achados clínico-laboratoriais da endocardite infecciosa (EI) em 28 crianças, em Vitória/ES. MÉTODO: Estudo retrospectivo dos prontuários de 28 crianças, com idade abaixo de 18 anos e diagnóstico de endocardite infecciosa, internadas no serviço de infectologia do Hospital Infan [...] til Nossa Senhora da Glória, em Vitória - Espírito Santo, no período de janeiro de 1993 a dezembro de 2001. Os critérios para diagnóstico de endocardite infecciosa foram os do Duke Endocarditis Service (Duke University, Durham, North Carolina - USA): critérios maiores (hemoculturas e ecocardiograma positivos) e critérios menores (febre, doença cardíaca prévia, sopro cardíaco recente, fenômenos vasculares e imunológicos). Através de protocolo específico, preenchido pelos médicos-residentes e acadêmicos do serviço de infectologia, e revisados pelos médicos da equipe, foram anotadas as idades, sexo, achados clínicos e laboratoriais, e os resultados da ecocardiografia transtorácica das 28 crianças que preenchiam os critérios clínicos e laboratoriais. Em todos os casos, as hemoculturas foram realizadas com coleta do sangue (três amostras), sob condições assépticas e com inoculação em meios aeróbicos e anaeróbicos, incubados a uma temperatura de 37ºC e testados com sistema automatizado Vitec System® (Biolab). RESULTADOS: Das 28 crianças, 16 eram do sexo masculino, com idade entre 3 e 180 meses (média 70,6±59,2 m), e a maioria (68%) era procedente da região metropolitana de Vitória. Metade apresentava cardiopatia prévia. Os achados clínicos mais freqüentes que levaram à suspeita de EI foram: febre prolongada (100%), sopro cardíaco (67,9%), dispnéia (57,1%), hepatomegalia (57,1%), fenômenos vasculares (32,2%), esplenomegalia (28,6%) e nódulos de Osler (7,1%). Foram colhidas hemoculturas dos 28 casos, sendo 16 (57,1%) positivas. O S. aureus adquirido na comunidade foi o germe mais freqüentemente isolado (9/16-56,6%). Houve persistência da febre, apesar do tratamento, duração da febre de 2,5 a 30 dias, mediana de 18,0 dias. O valor médio de leucócitos à internação foi de 11.657±7.085mm³. O ecocardiograma transtorácico, realizado em todos os pacientes, evidenciou vegetações, principalmente nas válvulas tricúspide (25,0%), mitral (25,0%) e na borda de CIV (28,6%). Treze (46,4%) crianças apresentaram sepse concomitante, e três (10,7%) infecção hospitalar. Houve um óbito (3,6%). CONCLUSÕES: A endocardite infecciosa em nosso meio é freqüente em crianças abaixo de dois anos de idade e com uma cardiopatia congênita. O S. aureus de origem comunitária foi o microorganismo isolado mais freqüentemente, e em crianças sem lesão cardíaca prévia. Endocardite infecciosa aguda, endocardite bacteriana, Staphylococcus aureus, ecocardiografia transtorácica. Abstract in english OBJECTIVE: To describe clinical and laboratory data of infective endocarditis (IE) in 28 children from Vitória, state of Espírito Santo, Brazil. METHODS: We reviewed the medical records of 28 children aged 18 years and under admitted to the Infectious Diseases Unit of Nossa Senhora da Glória Childre [...] n's Hospital with a diagnosis of IE from January 1993 to December 2001. The diagnosis of IE was based on the criteria established by the Duke Endocarditis Service (Duke University, Durham, North Carolina, USA): positive blood cultures and echocardiogram (primary criteria); and fever, history of heart disease, recent heart murmur, and vascular and immunological phenomena (secondary criteria). A specific protocol was filled out by interns and medical students and revised by physicians from the hospital medical team to obtain the following data: age, sex, clinical and laboratory findings, and results of transthoracic echocardiography. In all cases, three blood samples were collected under aseptic conditions and inoculated in aerobic and anaerobic environments. The samples were then incubated at 37º C and test

Carla A.Z., Pereira; Scheila C.G.P., Rocio; Maria-Fátima R., Ceolin; Ana-Paula N.B., Lima; Felippe, Borlot; Roberto S.T., Pereira; Sandra F., Moreira-Silva.

2003-10-01

217

Ventricular septal defect and bivalvular endocarditis  

Science.gov (United States)

A 63-year-old man presented with generalized fatigue, chills, malaise, dyspnea, intermittent fevers, and 50-pound weight loss of 4 months' duration. Blood cultures were positive for pan-sensitive Streptococcus anginosus. Transesophageal echocardiography showed an 11 mm × 3 mm mobile mass attached to the mitral valve, a 16 mm × 16 mm mobile mass attached to the pulmonary valve, and a small membranous ventricular septal defect. The patient received 12 weeks of intravenous (IV) antibiotics with eventual resolution of the masses. Multi-valve endocarditis involving both the left and right chambers is rarely reported without prior history of IV drug use or infective endocarditis. Our case emphasizes the importance of careful assessment for ventricular septal defects or extra-cardiac shunts in individuals who present with simultaneous right and left-sided endocarditis.

Birkenkamp, Kate E.; Jin, Jay J.; Shivashankar, Raina; Jouni, Hayan; Baddour, Larry M.; Blauwet, Lori A.

2015-01-01

218

Fusobacterium necrophorum causing infective endocarditis and liver and splenic abscesses / Fusobacterium necrophorum causando endocardite infecciosa e abscesso hepático e esplênico  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Homem de 25 anos de idade, sem antecedentes mórbidos foi admitido ao hospital com bacteremia por Fusobacterium necrophorum e abscessos no fígado e no baço. Avaliação posterior com ecografia revelou válvula aórtica bicúspide com insuficiência severa e vegetação de 1,68 x 0,86 cm. Foi feita drenagem d [...] os abscessos, terapia antimicrobiana intravenosa e substituição da válvula aórtica. Resolução completa da infecção foi conseguida após substituição valvular e curso prolongado de terapêutica intravenosa antimicrobiana. É apresentada breve análise do curso clínico do paciente e revisão da literatura. Abstract in english A 25-year-old male without prior co-morbidities was admitted to hospital with Fusobacterium necrophorum bacteremia, where he was found to have liver and splenic abscesses. Further evaluation with echocardiography revealed a bicuspid aortic valve with severe insufficiency and a 1.68 x 0.86 cm vegetat [...] ion. The patient required abscess drainage, intravenous antimicrobial therapy and aortic valve replacement. Complete resolution of the infection was achieved after valve replacement and a prolonged course of intravenous antimicrobial therapy. A brief analysis of the patient's clinical course and review of the literature is presented.

Marc Zac, Handler; Benjamin, Miriovsky; Howard E., Gendelman; Uriel, Sandkovsky.

2011-06-01

219

Native Valve Endocarditis Due to Citrobacter Chronic Prostatitis  

Science.gov (United States)

Introduction: Citrobacter koseri is a gram-negative bacillus that rarely causes infection in immunocompetent hosts and typically is associated with urinary or respiratory tract infections. Rarely will Citrobacter be a cause of infective endocarditis. Case Report: We present a case of a 77-year-old man with no known immunocompromising conditions who was hospitalized for infective aortic endocarditis due to Citrobacter koseri originating from a chronically infected prostate. Unusually, he also developed a C. koseri diskitis and phlegmon, which, along with the aortic vegetations, increased in size despite appropriate antibiotics. The patient thus met indications for aortic valve replacement and had improved appearance of lesions in follow-up imaging.

Lum, Corey; Bolger, Dennis; Bello, Erlaine

2014-01-01

220

Native valve endocarditis due to Pseudallescheria boydii in a patient with AIDS: case report and review.  

Science.gov (United States)

A 53-year-old man with AIDS developed mitral valve endocarditis due to infection with the fungus Pseudallescheria boydii. A limited number of cases of prosthetic valve endocarditis caused by this organism have been described. We report a unique case of pseudallescheria infection of a native valve and describe this disease in a patient with AIDS. PMID:2267494

Raffanti, S P; Fyfe, B; Carreiro, S; Sharp, S E; Hyma, B A; Ratzan, K R

1990-01-01

221

Neisseria meningitidis endocarditis: A case report and review of the literature.  

LENUS (Irish Health Repository)

Abstract Neisseria meningitidis is the leading cause of bacterial meningitis in children and young adults, with an overall mortality rate of up to 25%, but it is a rare cause of infective endocarditis. We present herein a case of N. meningitidis meningitis complicated with infective endocarditis.

Ali, Mohammed

2011-04-08

222

Neisseria meningitidis endocarditis: a case report and review of the literature.  

LENUS (Irish Health Repository)

Neisseria meningitidis is the leading cause of bacterial meningitis in children and young adults, with an overall mortality rate of up to 25%, but it is a rare cause of infective endocarditis. We present herein a case of N. meningitidis meningitis complicated with infective endocarditis.

Ali, Mohammed

2012-02-01

223

The first reported case of Bartonella endocarditis in Thailand  

Directory of Open Access Journals (Sweden)

Full Text Available Bartonella species have been shown to cause acute, undifferentiated fever in Thailand. A study to identify causes of endocarditis that were blood culture-negative using routine methods led to the first reported case in Thailand of Bartonella endocarditis A 57 year-old male with underlying rheumatic heart disease presented with severe congestive heart failure and suspected infective endocarditis. The patient underwent aortic and mitral valve replacement. Routine hospital blood cultures were negative but B. henselae was identified by serology, PCR, immunohistochemistry and specific culture techniques.

George Watt

2011-03-01

224

Left atrial endocarditis as a rare complication of mitral valve endocarditis: a clinical case  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Infective Endocarditis (IE is considered as a multifaceted problem in every aspect from etiology and presentation to diagnosis and management. Early recognition of this disease and especially its complications, remain a critical task for the cardiologist. Atrial endocarditis is a rare and sometimes unrecognized complication of mitral valve endocarditis. Case presentation We present a 48 year-old male patient who was admitted to our clinic because of recent onset of malaise, fever, jaundice and peripheral edema. Important physical findings were peripheral stigmata of IE in addition to holosystolic murmur over the left sternal border. Transthoracic and transesophageal echocardiophy revealed a severe eccentric MR due to a flailed posterior mitral valve caused by IE. The presence of atrial septal endocarditis caused by jet streaming was also observed. Blood culture was positive for streptococcus oralis and antibiotic therapy was immediately initiated. Considering the large burden of infective tissue, the patient was planned for an early surgical intervention. A minimally invasive resection of the atrial mass, direct closure of the defect, resection of the diseased portions of mitral leaflets and implantation of a biological mitral valve prosthesis was performed. Intra-operative and histological findings confirmed provisional diagnosis by echocardiography. Conclusions Together with comprehensive echocardiographic evaluation, attention should be placed on mural vegetations and excluded among all cases of mitral valve endocarditis, particularly those with severe eccentric regurgitant jets.

Hamadanchi Ali

2012-11-01

225

Role of 18F-FDG PET/CT in the diagnosis of infective endocarditis in patients with an implanted cardiac device: a prospective study  

International Nuclear Information System (INIS)

Infective endocarditis (IE) is widely underdiagnosed or diagnosed after a major delay. The diagnosis is currently based on the modified DUKE criteria, where the only validated imaging technique is echocardiography, and remains challenging especially in patients with an implantable cardiac device. The aim of this study was to assess the incremental diagnostic role of 18F-FDG PET/CT in patients with an implanted cardiac device and suspected IE. We prospectively analysed 27 consecutive patients with an implantable device evaluated for suspected device-related IE between January 2011 and June 2013. The diagnostic probability of IE was defined at presentation according to the modified DUKE criteria. PET/CT was performed as soon as possible following the clinical suspicion of IE. Patients then underwent medical or surgical treatment based on the overall clinical evaluation. During follow-up, we considered: lead cultures in patients who underwent extraction, direct inspection and lead cultures in those who underwent surgery, and a clinical/instrumental reevaluation after at least 6 months in patients who received antimicrobial treatment or had an alternative diagnosis and were not treated for IE. After the follow-up period, the diagnosis was systematically reviewed by the multidisciplinary team using the modified DUKE criteria and considering the new findings. Among the ten patients with a positive PET/CT scan, seven received a final diagnosis of ''definite IE'', one of ''possible IE'' and two of ''IE rejected''. Among the 17 patients with a negative PET/CT scan, four were false-negative and received a final diagnosis of definite IE. These patients underwent PET/CT after having started antibiotic therapy (?48 h) or had a technically suboptimal examination. In patients with a cardiac device, PET/CT increases the diagnostic accuracy of the modified Duke criteria for IE, particularly in the subset of patients with possible IE in whom it may help the clinician manage a challenging situation. (orig.)

226

Clinical impact of 18F-FDG-PET/CT in the extra cardiac work-up of patients with infective endocarditis  

DEFF Research Database (Denmark)

OBJECTIVE: The purpose of this study was to assess the clinical importance of (18)F-FDG-PET/CT used in the extra cardiac work-up of patients with infective endocarditis (IE). BACKGROUND: IE is a serious condition with a significant mortality. Besides the degree of valvular involvement, the prognosis relies crucially on the presence of systemic infectious embolism. METHODS: Seventy-two patients (71% males and mean age 63 ± 17 years) with IE were evaluated with (18)F-FDG-PET/CT in addition to standard work-up including patient history, physical examination, conventional imaging modalities, and weekly interdisciplinary conferences. When previous unknown lesions detected by (18)F-FDG-PET/CT were confirmed by succeeding examinations, they were considered true positive new findings and were further assessed for their clinical importance. Number needed to investigate was calculated as the number of patients who needed to undergo (18)F-FDG-PET/CT to find at least one clinical important true positive new finding, not identified by standard work-up prior to (18)F-FDG-PET/CT. RESULTS: (18)F-FDG-PET/CT detected 114 lesions and 64 were true positive, of which 25 were new findings and detected in 17 patients. In 11 patients, the lesions were considered to have a clinical importance; osteomyelitis (n = 7), iliopsoas abscess (n = 1), gastrointestinal lesions (n = 2), and vascular prosthetic graft (n = 1). Number needed to investigate was 7 (11 of 72 patients). CONCLUSIONS: (18)F-FDG-PET/CT detected lesions of clinical importance in one of seven IE patients and may be a substantial imaging technique for tracing peripheral infectious embolism due to IE. Thus, (18)F-FDG-PET/CT may help to guide adequate therapy and thereby improve the prognosis of patients with IE.

Asmar, Ali; Ozcan, Cengiz

2014-01-01

227

Capnocytophaga canimorsus endocarditis with root abscess in a patient with a bicuspid aortic valve  

Directory of Open Access Journals (Sweden)

Full Text Available Infective endocarditis caused by a zoonotic micro organism is a rare clinical condition. Capnocytophaga canimorsus is a commensal bacterium living in the saliva of dogs and cats which produces rarely reported endocarditis whose incidence may be underestimated, considering its failure to grow on standard media. We reported the case of a 65-year-old man with bicuspid aortic valve endocarditis and multiple abscesses of the aortic wall caused by the canine bacteria C. canimorsus.

Guillaume Coutance

2009-04-01

228

Cardiobacterium hominis endocarditis: two cases and a review of the literature  

OpenAIRE

Cardiobacterium hominis, a member of the HACEK group (Haemophilus parainfluenzae, Haemophilus aphrophilus, and Haemophilus paraphrophilus, Actinobacillus actinomycetemcomitans, C. hominis, Eikenella corrodens, and Kingella species), is a rare cause of endocarditis. There are 61 reported cases of C. hominis infective endocarditis in the English-language literature, 15 of which involved prosthetic valve endocarditis. There is one reported case of C. hominis after upper endoscopy and none report...

Malani, A. N.; Aronoff, D. M.; Bradley, S. F.; Kauffman, C. A.

2006-01-01

229

Prevención de la Endocarditis Bacteriana :: Revisión de la Literatura  

Scientific Electronic Library Online (English)

Full Text Available SciELO Venezuela | Language: Spanish Abstract in spanish La endocarditis infecciosa es una infección del revestimiento de las cavidades del corazón y de las válvulas cardíacas, causadas por bacterias, hongos virus u otros microorganismos. La endocarditis bacteriana se refiere específicamente a la infección por agentes bacterianos. La mayoría de las person [...] as que desarrollan la endocarditis han padecido una enfermedad cardíaca previa. El origen de la infección podría ser una bacteremia transitoria, la cual es común durante diagnósticos y procedimientos quirúrgicos; ya sean dentales, urológicos, del tracto respiratorio o gastrointestinal. La endocarditis es una enfermedad que amenaza a la vida a pesar de ser poco frecuente, por lo que la prevención es lo más importante. La Asociación Americana del Corazón, realizó algunos cambios en las pautas a seguir para la prevención de esta enfermedad, como son: una reducción de la antibioticoterapia para la protección del paciente, tanto bajando la dosis de ataque como eliminando la dosis posterior al tratamiento. De igual forma se limitaron los tratamientos que ameritan la profilaxis antibiótica. Estas nuevas recomendaciones definen mejor a los pacientes en riesgo y los procedimientos dentales que requieren protección con antibióticos. Abstract in english Infective endocarditis is an infection of the lining of the heart and heart valves. Caused by bacterias, fungus, viruses or other micro-organisms. Bacterial endocarditis is refered especially to infection for bacterial agents. The most people that developes endocarditis has sufered a prior cardiac d [...] isease. Cardiac source may be a transient bacteremia, common during diagnosis and surgical procedures, such dental, genitourinary, upper respiratory tract or gastrointestinal. Endocarditis is a life-threatening disease, although it is relatively uncommon so prevention is the most important. The American Heart Association, made some changes in guidelines for prevention of this disease: an antibioticoterapy decrease for pacients’cover, as much as lowering attack dosis and eliminating the follow doses to treatment. This new recommendations define better pacients at risk and dental procedures that require antibiotic cover.

Patricia R, Guzmán H; Sonia M, Corte F; Mónica P., Delgado O..

2000-09-01

230

Fusobacterium necrophorum causing infective endocarditis and liver and splenic abscesses Fusobacterium necrophorum causando endocardite infecciosa e abscesso hepático e esplênico  

OpenAIRE

A 25-year-old male without prior co-morbidities was admitted to hospital with Fusobacterium necrophorum bacteremia, where he was found to have liver and splenic abscesses. Further evaluation with echocardiography revealed a bicuspid aortic valve with severe insufficiency and a 1.68 x 0.86 cm vegetation. The patient required abscess drainage, intravenous antimicrobial therapy and aortic valve replacement. Complete resolution of the infection was achieved after valve replacement and a prolonged...

Marc Zac Handler; Benjamin Miriovsky; Gendelman, Howard E.; Uriel Sandkovsky

2011-01-01

231

Medical dental prophylaxis of endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Antibiotics have long been the main reason for the increase in man's longevity. Since their discovery, man has tried to reduce the level of infection by treating with antibiotics. At the same time, prophylactic use has been suggested, although this is controversial. Their routine use is not recommended, and empirical treatments at non-therapeutic doses, and indiscriminately, should be avoided, because they may become dangerous and harmful, causing among other things, the prevalence of resistant microorganisms and the eventual potentiation of an increase in morbid states. Infectious endocarditis is a systemic pathology that can start with a bacteremia, which comes either from dental procedures or/and chronic processes that already existed. Its etiopathogeny consists of a combination of bacteremia and two other factors: Cardiac injury, which can be congenital or/and acquired, and a debilitated immunological system (patients who have transplanted organs, or those who have auto-immune diseases, such as pemphigus vulgaris, systemic lupus erythematosus. The main goal is to prevent or to fight against the transient bacteremia, reducing its intensity and duration, and also to kill the bacteria in at-risk patients. In this way, infectious endocarditis can be prevented; the dental surgeon plays an important role in the prevention of this condition, which joins medical and dental aspects. This can be done by antibiotic prophylaxis. The dentist needs to be acquainted with the medical protocols of the heart health societies.

Regina C. Basilio

2004-10-01

232

Medical dental prophylaxis of endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Antibiotics have long been the main reason for the increase in man's longevity. Since their discovery, man has tried to reduce the level of infection by treating with antibiotics. At the same time, prophylactic use has been suggested, although this is controversial. Their routine use is not recommen [...] ded, and empirical treatments at non-therapeutic doses, and indiscriminately, should be avoided, because they may become dangerous and harmful, causing among other things, the prevalence of resistant microorganisms and the eventual potentiation of an increase in morbid states. Infectious endocarditis is a systemic pathology that can start with a bacteremia, which comes either from dental procedures or/and chronic processes that already existed. Its etiopathogeny consists of a combination of bacteremia and two other factors: Cardiac injury, which can be congenital or/and acquired, and a debilitated immunological system (patients who have transplanted organs, or those who have auto-immune diseases, such as pemphigus vulgaris, systemic lupus erythematosus). The main goal is to prevent or to fight against the transient bacteremia, reducing its intensity and duration, and also to kill the bacteria in at-risk patients. In this way, infectious endocarditis can be prevented; the dental surgeon plays an important role in the prevention of this condition, which joins medical and dental aspects. This can be done by antibiotic prophylaxis. The dentist needs to be acquainted with the medical protocols of the heart health societies.

Regina C., Basilio; Francisco E., Loducca; Paulo C., Haddad.

2004-10-01

233

Surgical intervention in staphylococcal endocarditis.  

Science.gov (United States)

Uncomplicated endocarditis is cured by medical treatment at a rate of 80% (75% 5-year survival rate). If incompensated, only 12% has shown to be curable without surgery. With valve replacement, on the other hand, the rate of success will be 80%. Of those surgically treated cases, less than 10% will develop recrudescent infection. Left heart vegetations predict the risk of congestive heart failure and/or embolism. It is assumed that 7-10 days of efficient antibiotic therapy without effect should lead to surgery. We have made valve replacement in six cases during recent years in staphylococcal endocarditis. The main indication for operation was congestive heart failure, and the valve used was the Björk-Shiley tilting disc. All patients had vegetations on the leaflets. One patient had a mitral insufficiency, and the other five had aortic insufficiency. Two cases were lost within four months after surgery. In general, indications for valve replacement are heart incompensation or vegetations on leaflets. PMID:6589758

Kugelberg, J; Eskilsson, J; Jögi, P; Ståhl, E

1983-01-01

234

Group B streptococcus endocarditis associated with multiple pulmonary septic emboli  

Directory of Open Access Journals (Sweden)

Full Text Available Endocarditis is a rare presentation of group B streptococcal infection. Its association with pulmonary septic embolism was only barely studied and limited data is available up to date. Multiple septic emboli is a common complication of bacterial endocarditis, but only a few cases have been documented in relation to group B streptococcus. We present the case of an 87-year-old female patient with multiple underlying conditions that predisposed the development of bacterial endocarditis secondary to group B streptococcus and subsequently multiple pulmonary septic emboli. The patient was treated with ceftriaxone and azythromycin with good response and complete recovery without any further complications. In the event of a diagnosed case of group B streptococcus endocarditis, there should be a low threshold for the suspicion of septic pulmonary emboli especially in cases with right valves involvement.

Deborah Abaitey

2011-03-01

235

A case of Kingella kingae endocarditis complicated by native mitral valve rupture  

Directory of Open Access Journals (Sweden)

Full Text Available We report a case of Kingella kingae endocarditis in a patient with a history of recent respiratory tract infection and dental extraction. This case is remarkable for embolic and vasculitic phenomena in association with a large valve vegetation and valve perforation. Kingella kingae is an organism known to cause endocarditis, however early major complications are uncommon. Our case of Kingella endocarditis behaved in a virulent fashion necessitating a combined approach of intravenous antibiotic therapy and a valve replacement. It highlights the importance of expedited investigation for endocarditis in patients with Kingella bacteraemia.

Mohammad Bagherirad

2013-04-01

236

Association of Bartonella spp bacteremia with Chagas cardiomyopathy, endocarditis and arrythmias in patients from South America  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Infection with Bartonella spp may cause cardiac arrhythmias, myocarditis and endocarditis in humans. The aim of the present study was to evaluate a possible association between Bartonella spp bacteremia and endocarditis, arrhythmia and Chagas cardiomyopathy in patients from Brazil and Argentina. We [...] screened for the presence of bacterial 16S rRNA in human blood by PCR using oligonucleotides to amplify a 185-bp bacterial DNA fragment. Blood samples were taken from four groups of subjects in Brazil and Argentina: i) control patients without clinical disease, ii) patients with negative blood-culture endocarditis, iii) patients with arrhythmias, and iv) patients with chronic Chagas cardiomyopathy. PCR products were analyzed on 1.5% agarose gel to visualize the 185-bp fragment and then sequenced to confirm the identity of DNA. Sixty of 148 patients (40.5%) with cardiac disease and 1 of 56 subjects (1.8%) from the control group presented positive PCR amplification for Bartonella spp, suggesting a positive association of the bacteria with these diseases. Separate analysis of the four groups showed that the risk of a Brazilian patient with endocarditis being infected with Bartonella was 22 times higher than in the controls. In arrhythmic patients, the prevalence of infection was 45 times higher when compared to the same controls and 40 times higher for patients with Chagas cardiomyopathy. To the best of our knowledge this is the first report of the association between Bartonella spp bacteremia and Chagas disease. The present data may be useful for epidemiological and prevention studies in Brazil and Argentina.

F.G., Corrêa; C.L.S., Pontes; R.M.M., Verzola; J.C.P., Mateos; P.E.N.F., Velho; A.G., Schijman; H.S., Selistre-de-Araujo.

2012-07-01

237

Association of Bartonella spp bacteremia with Chagas cardiomyopathy, endocarditis and arrythmias in patients from South America  

Directory of Open Access Journals (Sweden)

Full Text Available Infection with Bartonella spp may cause cardiac arrhythmias, myocarditis and endocarditis in humans. The aim of the present study was to evaluate a possible association between Bartonella spp bacteremia and endocarditis, arrhythmia and Chagas cardiomyopathy in patients from Brazil and Argentina. We screened for the presence of bacterial 16S rRNA in human blood by PCR using oligonucleotides to amplify a 185-bp bacterial DNA fragment. Blood samples were taken from four groups of subjects in Brazil and Argentina: i control patients without clinical disease, ii patients with negative blood-culture endocarditis, iii patients with arrhythmias, and iv patients with chronic Chagas cardiomyopathy. PCR products were analyzed on 1.5% agarose gel to visualize the 185-bp fragment and then sequenced to confirm the identity of DNA. Sixty of 148 patients (40.5% with cardiac disease and 1 of 56 subjects (1.8% from the control group presented positive PCR amplification for Bartonella spp, suggesting a positive association of the bacteria with these diseases. Separate analysis of the four groups showed that the risk of a Brazilian patient with endocarditis being infected with Bartonella was 22 times higher than in the controls. In arrhythmic patients, the prevalence of infection was 45 times higher when compared to the same controls and 40 times higher for patients with Chagas cardiomyopathy. To the best of our knowledge this is the first report of the association between Bartonella spp bacteremia and Chagas disease. The present data may be useful for epidemiological and prevention studies in Brazil and Argentina.

F.G. Corrêa

2012-07-01

238

Role of {sup 18}F-FDG PET/CT in the diagnosis of infective endocarditis in patients with an implanted cardiac device: a prospective study  

Energy Technology Data Exchange (ETDEWEB)

Infective endocarditis (IE) is widely underdiagnosed or diagnosed after a major delay. The diagnosis is currently based on the modified DUKE criteria, where the only validated imaging technique is echocardiography, and remains challenging especially in patients with an implantable cardiac device. The aim of this study was to assess the incremental diagnostic role of {sup 18}F-FDG PET/CT in patients with an implanted cardiac device and suspected IE. We prospectively analysed 27 consecutive patients with an implantable device evaluated for suspected device-related IE between January 2011 and June 2013. The diagnostic probability of IE was defined at presentation according to the modified DUKE criteria. PET/CT was performed as soon as possible following the clinical suspicion of IE. Patients then underwent medical or surgical treatment based on the overall clinical evaluation. During follow-up, we considered: lead cultures in patients who underwent extraction, direct inspection and lead cultures in those who underwent surgery, and a clinical/instrumental reevaluation after at least 6 months in patients who received antimicrobial treatment or had an alternative diagnosis and were not treated for IE. After the follow-up period, the diagnosis was systematically reviewed by the multidisciplinary team using the modified DUKE criteria and considering the new findings. Among the ten patients with a positive PET/CT scan, seven received a final diagnosis of ''definite IE'', one of ''possible IE'' and two of ''IE rejected''. Among the 17 patients with a negative PET/CT scan, four were false-negative and received a final diagnosis of definite IE. These patients underwent PET/CT after having started antibiotic therapy (?48 h) or had a technically suboptimal examination. In patients with a cardiac device, PET/CT increases the diagnostic accuracy of the modified Duke criteria for IE, particularly in the subset of patients with possible IE in whom it may help the clinician manage a challenging situation. (orig.)

Graziosi, Maddalena; Lorenzini, Massimiliano; Diemberger, Igor; Pasquale, Ferdinando; Ziacchi, Matteo; Biffi, Mauro; Martignani, Cristian; Boriani, Giuseppe; Rapezzi, Claudio [Alma Mater-University of Bologna, and S. Orsola-Malpighi Hospital, Cardiology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Bologna (Italy); Nanni, Cristina; Bonfiglioli, Rachele; Fanti, Stefano [Alma Mater-University of Bologna, and S. Orsola-Malpighi Hospital, Nuclear Medicine Unit, Department of Experimental, Diagnostic and Specialty Medicine, Bologna (Italy); Bartoletti, Michele; Tumietto, Fabio; Viale, Pier Luigi [Alma Mater-University of Bologna, and S. Orsola-Malpighi Hospital, Infectious Diseases Unit, Department of Medical and Surgical Sciences, Bologna (Italy)

2014-08-15

239

Mitral valve endocarditis during brucellosis relapse  

OpenAIRE

Introduction. Endocarditis is the most common cardiovascular manifestation of brucellosis with high mortality rate. Brucella is less accesable to antibiotic (but not for all) and relapse can occur after a various period of clinical latency. Case report. A 55-year-old farmer was diagnozed with acute systemic Brucella infection in May 2008 and treated with antibiotic therapy in regional hospital for two months and for three months after discharge. He began to feel myalgia, arthralgia, mal...

Obrenovi?-Kir?anski Biljana; Velinovi? Miloš; Vraneš Mile; Pavlovi? Milorad; Kova?evi?-Kosti? Nataša; Karan Radmila; Parapid Biljana; Miki? Aleksandar; Risti? Arsen; Seferovi? Petar

2012-01-01

240

Modified commissural patch repair in a child with active mitral endocarditis.  

Science.gov (United States)

A 9-year-old patient with massive destruction of the mitral apparatus caused by active infective endocarditis underwent mitral valve plasty using a modified commissural autologous pericardial patch repair. This procedure is a clinically relevant and feasible technique for pediatric patients with active mitral valve endocarditis. PMID:24842454

Ishimaru, Kazuhiko; Nishigaki, Kyoichi; Kanaya, Tomomitsu; Araki, Kanta; Shibata, Toshihiko

2014-05-19

241

Acute Haemophilus parainfluenzae endocarditis: a case report  

OpenAIRE

Abstract Introduction Numerous pathogens can cause infective endocarditis, including Haemophilus parainfluenzae. H. parainfluenzae is part of the H. aphrophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae group that may cause about 3% of the total endocarditis cases, and is characterized by a subacute course and large vegetations. Case presentation ...

Christou Leonidas; Economou Georgios; Zikou Anastasia K; Saplaoura Kaiti; Argyropoulou Maria I; Tsianos Epameinondas V

2009-01-01

242

Comparison of heart valve culture between two Danish endocarditis centres  

DEFF Research Database (Denmark)

Background: The degree to which the results of valve culture depend on different laboratory procedures as well as other factors is unknown. The aim of this study was to compare the results of heart valve culture at 2 different endocarditis centres in order to clarify this. Methods: The study included 223 patients with definitive endocarditis undergoing heart valve surgery at 2 Danish endocarditis centres (96 at the East centre and 127 at the West centre). The following data related to the samples were registered: transportation, time to inoculation, culture media used and duration of incubation, species distribution, and preoperative duration of appropriate antimicrobial treatment (DAAT). 16S polymerase chain reaction (PCR) of valve tissue was used to estimate the frequency of non-cultivable bacteria. Results: Valve culture was positive in 12.5% of cases at the East centre and 36.2% at the West centre (p <0.001). Valve cultures were positive in 10%, 45%, and 58% of cases of streptococcal, staphylococcal, and enterococcal infections, respectively. The median DAAT was 3 days for valve culture-positive cases and 11 days for valve culture-negative cases (p <0.001). By logistic regression analysis, DAAT, species distribution, and laboratory protocol were identified as independent risk determinants for positive valve culture. The adjusted odds ratio for positive culture by the West centre protocol was 3.0 (confidence interval 1.3-6.9; East = 1, p <0.01). The valve culture contamination rate was 4% at the East centre and 31% at the West centre (p <0.01). Conclusions: Our study showed that the duration of preoperative antibiotic treatment and species distribution must be taken into account when comparing valve culture results. Differences in laboratory protocol explained the 3-fold higher sensitivity of heart valve culture observed in the West centre compared to the East centre.

Voldstedlund, Marianne; Fuursted, Kurt

2012-01-01

243

Health Care–Associated Native Valve Endocarditis in Patients with no History of Injection Drug Use: Current Importance of Non-Nosocomial Acquisition  

Science.gov (United States)

Background The clinical profile and outcome of nosocomial and non-nosocomial health care–associated native valve endocarditis are not well defined. Objective To describe the prevalence, clinical characteristics, and outcomes of nosocomial and non-nosocomial health care–associated native valve endocarditis. Design Prospective observational study. Setting 61 hospitals in 28 countries. Patients Patients with definite native valve endocarditis and no history of injection drug use who were enrolled in the International Collaboration on Endocarditis–Prospective Cohort Study from June 2000 to August 2005. Measurements Characteristics of nosocomial and non-nosocomial health care–associated native valve endocarditis cases were described and compared with those cases acquired in the community. Results Health care–associated native valve endocarditis was present in 557 (34%) of 1622 patients with native valve endocarditis and no history of injection drug use (nosocomial native valve endocarditis 303 patients [54%]; non-nosocomial health care–associated native valve endocarditis 254 patients [46%]). Staphylococcus aureus was the most common cause of health care-associated native valve endocarditis (nosocomial native valve endocarditis, 47%; non-nosocomial health care–associated native valve endocarditis, 42%; p=0.3), with a notable proportion of methicillin-resistant S. aureus (nosocomial native valve endocarditis, 57%; non-nosocomial health care–associated native valve endocarditis, 41%; p=0.014). Patients with health care–associated native valve endocarditis had lower rates of cardiac surgery (41% health care–associated native valve endocarditis vs 51% community-acquired native valve endocarditis, p<0.001) and higher in-hospital mortality rates than patients with community-acquired native valve endocarditis (25% health care–associated native valve endocarditis vs. 13% community-acquired native valve endocarditis vs., p<0.001). Multivariable analysis confirmed a higher mortality associated with health care–associated native valve endocarditis (incidence risk ratio=1.20 (CI 95%, 1.03–1.61). Limitations This study involves tertiary hospitals with cardiac surgery programs. The results may not be generalized to patient populations receiving care in other types of facility. Conclusions More than one-third of all cases of native valve endocarditis in non-drug users involve contact with health care. S. aureus is the leading cause of health care–associated native valve endocarditis. Non-nosocomial health care–associated native valve endocarditis is common, especially in the US. Patients with health care-associated and community-acquired native valve endocarditis differ in their presentation, microbiology, and outcome. By contrast, patients with nosocomial and non-nosocomial healthcare-associated endocarditis are similar. PMID:19414837

Benito, Natividad; Miró, José M.; de Lazzari, Elisa; Cabell, Christopher H; del Río, Ana; Altclas, Javier; Commerford, Patrick; Delahaye, Francois; Dragulescu, Stefan; Giamarellou, Helen; Habib, Gilbert; Kamarulzaman, Adeeba; Kumar, A. Sampath; Nacinovich, Francisco M.; Suter, Fredy; Tribouilloy, Christophe; Venugopal, K; Moreno, Asuncion; Fowler, Vance G.

2013-01-01

244

Mitral valve endocarditis during brucellosis relapse  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. Endocarditis is the most common cardiovascular manifestation of brucellosis with high mortality rate. Brucella is less accesable to antibiotic (but not for all and relapse can occur after a various period of clinical latency. Case report. A 55-year-old farmer was diagnozed with acute systemic Brucella infection in May 2008 and treated with antibiotic therapy in regional hospital for two months and for three months after discharge. He began to feel myalgia, arthralgia, malaise, shortness of breath, abdominal pain, vomiting, diarrhoea and lost weight eight months after initial symptoms occured. Because symptoms progressed he was admitted to our hospital in February 2009. Based on a combination of epidemiological, clinical data (on admission he was catchetic, adynamic, dyspneic, hypotensive 80/50 mmHg, fever up to 39.50C, positive serological Wright test for brucellosis (1 : 5,120, and echocardiographic examination findings, the diagnosis of very severe relapse of brucellosis with mitral valve endocarditis, complicated with perforation of anterior mitral leaflet, severe mitral regurgitation and pulmonary hypertension was established. He was treated with a combined triple antibiotic therapy (vancomycin, ciprofloxacin and gentamicin, and swiched to regimen with doxycycline, gentamicin and imipenem, replacing gentamicin by rifampicin for 4 weeks and for the next 2 weeks was receiving trimetoprime/sulfamethoxazole and rifampicin. The patients' condition was improved and he was operated. The diagnosis of infective endocarditis was confirmed intraoperatively. Mitral valve replacement was performed, and combined triple antibiotic treatment (amikacin + ciprofloxacin + cefazolin, for 2 weeks and cephazolin + doxycycline + rifampicin, for 2 weeks was continued, following with two antibiotics (doxycycline + rifampicin for 5 months. The patient completely recovered without any signs of infection 30 months postoperatively. Conclusion. A combined antibiotic therapy and surgery reduce complications and mortality associated with Brucella endocarditis and improve quality of patients' life.

Obrenovi?-Kir?anski Biljana

2012-01-01

245

Nonsurgical Management of Mitral Valve Endocarditis Due to Cardiobacterium valvarum in a Patient with a Ventricular Septal Defect  

OpenAIRE

Cardiobacterium valvarum is a relatively novel agent of infective endocarditis. We describe the first case of infective endocarditis due to this pathogen in the Asian Pacific. This case is unique in its involvement of the mitral valve as well as its clinical resolution exclusively resulting from treatment with antibiotics without resorting to valve replacement/explantation.

Choudhury, Saugata; Isais, Florante Santos; Lee, Cheng Chuan

2013-01-01

246

Nonsurgical management of mitral valve endocarditis due to Cardiobacterium valvarum in a patient with a ventricular septal defect.  

Science.gov (United States)

Cardiobacterium valvarum is a relatively novel agent of infective endocarditis. We describe the first case of infective endocarditis due to this pathogen in the Asian Pacific. This case is unique in its involvement of the mitral valve as well as its clinical resolution exclusively resulting from treatment with antibiotics without resorting to valve replacement/explantation. PMID:23576538

Choudhury, Saugata; Isais, Florante Santos; Lee, Cheng Chuan

2013-06-01

247

Candida albicans isolated from human fungaemia induces apoptosis in an experimental endocarditis model  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Candida albicans is the most common fungal pathogen known to cause endovascular infections, such as vascular catheter sepsis, infections of vascular prostheses and infective endocarditis. A C. albicans isolate was used to determine the apoptotic potential of the fungus in a rat endocarditis model. T [...] his study confirms the ability of C. albicans to induce apoptosis in myocardial tissue.

Iván, Hernández-Cañaveral; Gerardo, Becerra; Alberto, Jiménez-Cordero; Jean-Baptiste, Michel; Arturo, Plascencia; Miguel, Domínguez-Hernández.

2009-09-01

248

Fungal endocarditis after homograft valve replacement: difficulties in diagnosis and treatment.  

OpenAIRE

Fungal endocarditis is an uncommon but important problem after cardiac surgery. Two cases of fungal endocarditis after homograft valve replacement are reported. In both patients prolonged periods of antifungal chemotherapy with apparently satisfactory clinical responses ultimately failed to eradicate the infection. Both patients remain free of infection two years after excision of the infected valves and further chemotherapy. The value of serial estimations of fungal antibody titres in diagno...

Rudd, R. M.; Hill, P. R.; Kopelman, P.; Parker, D. J.

1980-01-01

249

Adherence of Staphylococcus aureus in experimental endocarditis and osteomyelitis  

OpenAIRE

Staphylococcus aureus has persisted and is now resurging as an important hospital and community pathogen. The microorganism can cause a wide spectrum of diseases ranging from cutaneous infections to more specific infections such as osteomyelitis and infective endocarditis (IE). Infections of bone, or osteomyelitis, remain a clinical challenge. With the difficulty of treatment and the emergence of resistant pathogens in mind, recent research has focused on the pathog...

Hienz, Stefan A.

1996-01-01

250

The Role of Endocarditis, Myocarditis and Pericarditis in Qualitative and Quantitative Data Analysis  

Directory of Open Access Journals (Sweden)

Full Text Available The current study is the first scientometric analysis of research activity and output in the field of inflammatory disorders of the heart (endo-, myo- and pericarditis. Scientometric methods are used to compare scientific performance on national and on international scale to identify single areas of research interest. Interest and research productivity in inflammatory diseases of the heart have increased since 1990. The majority of publications about inflammatory heart disorders were published in Western Europe and North America. The United States of America had a leading position in terms of research productivity and quality; half of the most productive authors in this study came from American institutions. The analysis of international cooperation revealed research activity in countries that are less established in the field of inflammatory heart disorder research, such as Brazil, Saudi Arabia and Tunisia. These results indicate that future research of heart inflammation may no longer be influenced predominantly by a small number of countries. Furthermore, this study revealed weaknesses in currently established scientometric parameters (i.e., h-index, impact factor that limit their suitability as measures of research quality. In this respect, self-citations should be generally excluded from calculations of h-index and impact factor.

David A. Groneberg

2009-11-01

251

Endocarditis aguda estafilococcica fatal con periodontitis severa  

Scientific Electronic Library Online (English)

Full Text Available SciELO Costa Rica | Language: Spanish Abstract in spanish La endocarditis infecciosa usualmente está asociada con una alteración del endocardio, la cual promueve los depósitos de fibrina donde las bacterias, en su mayoría Streptococcus spp., se establecen y de ahí se descargan a la sangre. El diagnóstico se hace empleando imágenes de ecocardiografía, reali [...] zando hemocultivos e investigando los síntomas clínicos. El presente caso corresponde a una niña de un año y nueve meses de edad, que desarrolló una endocarditis asociada con una infección por Staphylococcus aureus. La causa de muerte se debió a un choque séptico con múltiples embolias sépticas en diversos órganos. La posible puerta de entrada la constituyó una sepsis oral con gingivitis sangrante y caries. Este caso indica que una higiene oral pobre representa un riesgo de invasión bacteriana con infección en tejidos cardiacos previamente normales. En nuestro país frecuentemente hay casos de niños con lesiones orales como las observadas en el presente caso. Por esta razón es importante una atención apropiada y el cuidado de estos pacientes. Abstract in english Infectious endocarditis is usually associated with alteration of the cardiac tissues that promotes deposits of fibrin in which bacteria, mainly Streptococcus spp., establish and shed to blood. The diagnosis is made with ecocardiograph images, blood cultures, clinical syntoms and signs. The present c [...] ase correspond to a child less than two years old that developed an endocarditis associated with Staphylococcus aureus infection. The cause of dead was due to a septic shock with multiple septic emboli in diverse organs. The possible entrance of the bacteria to the blood stream was a severe bleeding gingivitis. This case indicates that a poor oral hygiene represented a risk of bacterial invasion and infection of the normal cardiac tissues. In our country frequently there are cases of children with oral lesions like those observed in the present case. For this reason it is important a proper attention and care of these patients.

Alfonso, Carranza; Patricia, Rivera; Rafael, Gutiérrez; Francisco, Hernández.

2000-12-01

252

Pacing lead endocarditis due to Aspergillus fumigatus  

Directory of Open Access Journals (Sweden)

Full Text Available Invasive aspergillosis is an opportunistic infection with a high mortality rate that usually occurs in the immunocompromised host. Several cases of fungal infections have been reported after cardiac surgery. We present here a case of Aspergillus fumigatus tricuspid valve endocarditis associated with permanent pacemaker leads. Tricuspid valve vegetectomy was done and the pacing leads were also removed. Culture from the excised vegetation grew Aspergillus fumigatus. The patient was started on IV Amphotericin B for eight weeks. The patient was subsequently followed up in the out-patient clinic, and remains afebrile after one year, with no evidence of any vegetation.

Kothari A

2010-01-01

253

Evaluación de 61 episodios de endocarditis infecciosa en pacientes adictos a drogas intravenosas e infección por el virus de la inmunodeficiencia humana tipo-1 / Evaluation of 61 episodes of infective endocarditis in intravenous drug abusers and human immunodeficiency tipe-1 virus infection  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Se evaluaron las características clínicas y de laboratorio de 61 episodios de endocarditis infecciosa (EI) en adictos a drogas intravenosas (ADIV) infectados por el virus de la inmunodeficiencia humana tipo-1 (HIV-1). Cuarenta y nueve hombres y 6 mujeres con edades comprendidas entre 15 y 55 años. L [...] a totalidad de los pacientes estudiados presentó 61 episodios de EI, los que tuvieron fiebre y soplo cardíaco. Cuarenta y tres (70,4%) presentaron hepatomegalia y 29 (47,5%) esplenomegalia. Treinta y ocho (62,3%) tuvieron tos, que en 9 (14,7%) resultó hemoptoica. En 25 casos (41%) se observó disnea y en 5 (8,2%) ingurgitación yugular. El fondo de ojo mostró alteraciones en 3 pacientes (4,9%). La confirmación bacteriológica se obtuvo en 41 episodios (67,2%). Se identificaron por hemocultivos: Staphylococcus aureus en 30 casos (73,1%), Streptococcus viridans en 8 (19,5%), Staphylococcus epidermidis en 1 (2,4%), Staphylococcus hominis en 1 (2,4%) y Streptococcuspneumoniae en 1 (2,4%). Se comprobó compromiso de la válvula tricúspide en 51 episodios (83,6%), aórtica en 6 (9,8%), mitral en 3 (4,9%) y pulmonar en 1 (1,6%). En 3 pacientes la afectación fue bivalvular: en 2 (3,2%) de la tricúspide y pulmonar y en 1 (1,6%) de la tricúspide y mitral. En 19 episodios (31,1%) se detectó derrame pericárdico. En la etapa aguda de la enfermedad fallecieron 6 (10,9%) pacientes. Abstract in english We conducted a retrospective evaluation to determine the clinical and microbiological characteristics of 61 episodes of infective endocarditis (IE) in intravenous drug abusers (IDA), HIV seropositive patients. Forty-nine males and 6 females between 15 and 42 years of age were included in the study. [...] All the included patients presented 61 episodes of IE. Fever and cardiac murmur were present in all episodes; 43 (70,4%) had hepatomegaly; 29 (47,5%) had splenomegaly. Thirty-eight (62,3%) presented cough (9 with hemoptysis); 25 (41%) had dyspnea, and 5 (8,2%) had jugular ingurgitation. Fundoscopy showed alterations in 3 patients (4,9%). Bacteriological confirmation was obtained in 41 episodes (67,2%); blood cultures revealed Staphylococcus aureus in 30 cases (73,1%), Streptococcus viridans in 8 (19,5%) patients, Staphylococcus epidermidis in 1 (2,4%), Staphylococcus hominis in 1 (2,4%) and Streptococcuspneumoniae in one case (2,4%). The tricuspid valve was involved in 51 episodes (83,6%), the aorta in 6 (9,8%), the mitral valve in 3 (4,9%) and the pulmonary valve in one (1,6%). There was evidence of right bivalvular involvement in 2 patients (3,2%) and tricuspid and mitral involvement in another (1,6%). Pericardial effusion was detected in 19 episodes (31,1%). Six patients (10,9%) died during the acute episode of IE.

M.E., Corti; O.J., Palmieri; M.F., Villafañe; N., Trione.

2004-06-01

254

Bacteriemia de brecha y endocarditis infecciosa. estudio cunico de dos formas de bacteriemia persistente  

OpenAIRE

OF THE THESISThe thesis presented is a made up of two works that have as a common characteristic to be both a report about persistent bacteremia. The first study analyses aetiology, microbiological associations and prognosis of breakthrough bacteraemia. The second one states the characteristics of a series of infective endocarditis in a teaching hospital without cardiac surgery facilities and analyses the effect of a multidisciplinary group working at infective endocarditis. The objective of...

Lo?pez Dupla, Jesus Miguel

2008-01-01

255

Cardiac Device-Related Endocarditis Caused by Paenibacillus glucanolyticus  

OpenAIRE

We report the first case of Paenibacillus glucanolyticus infection in a 65-year-old patient with type 2 diabetes who developed a cardiac device-related endocarditis. The identification of the isolate was performed using phenotypic methods, including mass spectrometry-based methods, and 16S rRNA gene sequencing.

Ferrand, Janina; Hadou, Tahar; Selton-suty, Christine; Goehringer, Franc?ois; Sadoul, Nicolas; Alauzet, Corentine; Lozniewski, Alain

2013-01-01

256

Replacement of an aortic valve cusp after neonatal endocarditis.  

OpenAIRE

Septic arthritis developed in a neonate after an infection of her hand. Despite medical and surgical treatment endocarditis of her aortic valve developed and the resultant regurgitation required emergency surgery. At operation a new valve cusp was fashioned from preserved calf pericardium. Nine years later she was well and had full exercise tolerance with minimal aortic regurgitation.

Tulloh, R. M.; Silove, E. D.; Abrams, L. D.

1990-01-01

257

Cardiobacterium hominis endocarditis associated with very severe thrombocytopenia and platelet autoantibodies.  

Science.gov (United States)

Severe thrombocytopenia is a life-threatening condition. It is often associated with immune-mediated platelet destruction or myeloablative chemotherapy. Infective endocarditis has been associated with thrombocytopenia, which, as in sepsis, tends to be mild and is often the result of several pathological mechanisms. We report a case of Cardiobacterium hominis endocarditis associated with very severe thrombocytopenia and bleeding in a patient who refused platelet transfusion. Platelet autoantibodies directed against glycoprotein (Gp) IIb/IIIa and Gp Ib/IX were detected during active infection using a glycoprotein-specific assay. Successful treatment of C. hominis endocarditis was associated with loss of platelet autoantibodies and recovery of the platelet count. This report illustrates that the development of platelet autoantibodies can contribute to very severe thrombocytopenia in occasional patients with infective endocarditis. PMID:15282672

Arnold, Donald M; Smaill, Fiona; Warkentin, Theodore E; Christjanson, Lisa; Walker, Irwin

2004-08-01

258

[Endocarditis due to an alga of the genus Prototheca sp. A saprophyte of water and of tree sap?].  

Science.gov (United States)

We report a case of a preterm neonate with very low birth weight (775 grs), He stayed 77 days in a neonatal care unit due to respiratory distress syndrome, with respiratory support for 27 days, and complications in gastrointestinal and nervous systems. In a structural normal heart, he developed infective endocarditis that was treated with good bacteriologic results. An echocardiogram showed the persistence of a mass in the right atrium, the mass was a thrombus and it was resected. Histopathological analysis and cultures of the thrombus reported Prototheca sp. that is an algae. The patient received medical treatment with amphothericin B with satisfactory clinical evolution. He is doing well 6 months later. This is the first report of literature of an algae causing endocarditis. PMID:9810371

Buendía, A; Patiño, E; Rijlaarsdam, M; Loredo, M L; Rivera, E; Ramírez, S; Attie, F

1998-01-01

259

Bartonella vinsonii subsp. berkhoffii as an Agent of Afebrile Blood Culture-Negative Endocarditis in a Human  

OpenAIRE

We report a case of endocarditis in a human infected with Bartonella vinsonii subsp. berkhoffii, which causes bacteremia and endocarditis in dogs. Bacterial identification was established by PCR amplification and sequencing of an intergenic spacer region (ITS1), 16S ribosomal DNA, and a gene encoding citrate synthase (gltA). Bartonella antibodies were detected by immunofluorescence.

Roux, Ve?ronique; Eykyn, Susannah J.; Wyllie, Sarah; Raoult, Didier

2000-01-01

260

[Cardiobacterium hominis endocarditis. A case report].  

Science.gov (United States)

We report the case of a Cardiobacterium hominis endocarditis causing an acute mitral insufficiency complicated of left heart failure. The patient has been treated after a few days by surgical valvuloplasty. Cardiobacterium hominis is a bacteria of the HACCEK group, bacille gram-negative, sometimes anaerobic, difficult to isolate. Recently, Polymerase Chain Reaction analysis appears to be effective for the the diagnosis in the identification of fastidious micro-organisms like Cardiobacterium hominis. We have reviewed in the literature 71 cases of Cardiobacterium hominis endocarditis; clinical presentation is often sub-acute, the bacteriological diagnosis is based on hemocultures for which the culture is slow and require enriched environments. Hemodynamic and thrombo-embolic complications are frequent because of the high pathogenicity of the bacteria which provides big and friable vegetations. Despite a high sensibility to antibiotherapy, surgical intervention is often required. PMID:14571648

Balcou-Leroy, E; Bera, J; Fugére, A S; Gabez, V; Boldron-Ghaddar, A; Werquin, S

2003-09-01

261

Bacterial endocarditis prophylaxis.  

Science.gov (United States)

Bacterial endocarditis (BE) is a disease resulting from the association of morphological alterations of the heart and bacteraemia originating from different sources that at times can be indiscernible (infectious endocarditis). It is classified on the basis of the morphological alteration involved, depending on the clinical manifestations and course of illness, which varies according to the causative microorganism and host conditions (for example, it is characteristic in I.V. drug users). The most common microorganisms involved are: Streptococcus viridans (55%), Staphylococcus aureus (30%), Enterococcus (6%) and HACEK bacteria (corresponding to the initials: Haemophilus, Actinobacillus, Cardiobacterium, Eikenella and Kingella), although on occasions it can also be caused by fungi. The oral microbiological flora plays a very important role in the aetiopathogenesis of BE, given that the condition may be of oral or dental origin. This paper will deal with the prevention of said bacteraemia. Prophylaxis will be undertaken using amoxicillin or clindamycin according to action protocols, with special emphasis placed on oral hygiene in patients with structural defects of the heart. PMID:15580136

Blanco-Carrión, Andrés

2004-01-01

262

A case of endocarditis caused by Lactococcus garvieae and suggested methods for identification.  

Science.gov (United States)

Lactococcus garvieae is a Gram-positive coccus that has morphological and biochemical similarities to enterococci. L. garvieae strains rare human pathogens, with only a few cases reported in the literature, mainly as a cause of infective endocarditis. L. garvieae is well known as a fish pathogen, and in some of the reported cases, the patients had a history of contact with raw fish. Some of the reported endocarditis patients had valvular damage as a predisposing condition. We report a case of L. garvieae endocarditis in a patient with no history of contact with raw fish and with history of valvular repair in an unaffected heart valve. PMID:23554190

Navas, Maria Eugenia; Hall, Geraldine; El Bejjani, Dalia

2013-06-01

263

Endocarditis with ruptured cerebral aneurysm caused by Cardiobacterium valvarum sp. nov.  

Science.gov (United States)

A fastidious gram-negative bacterium was isolated from the blood of a 37-year-old man who had insidious endocarditis with a sudden rupture of a cerebral aneurysm. Characterization of the organism through phylogenetic and phenotypic analyses revealed a novel species of Cardiobacterium, for which the name Cardiobacterium valvarum sp. nov. is proposed. C. valvarum will supplement the current sole species Cardiobacterium hominis, a known cause of endocarditis. Surgeries and antibiotic treatment cured the patient's infection and associated complications. During cardiac surgery, a congenital bicuspid aortic valve was found to be the predisposing factor for his endocarditis. PMID:15071009

Han, Xiang Y; Meltzer, Michelle C; Woods, Joan T; Fainstein, Victor

2004-04-01

264

Genotypic Diversity of Coagulase-Negative Staphylococci Causing Endocarditis: a Global Perspective?  

Science.gov (United States)

Coagulase-negative staphylococci (CNS) are important causes of infective endocarditis (IE), but their microbiological profiles are poorly described. We performed DNA target sequencing and susceptibility testing for 91 patients with definite CNS IE who were identified from the International Collaboration on Endocarditis—Microbiology, a large, multicenter, multinational consortium. A hierarchy of gene sequences demonstrated great genetic diversity within CNS from patients with definite endocarditis that represented diverse geographic regions. In particular, rpoB sequence data demonstrated unique genetic signatures with the potential to serve as an important tool for global surveillance. PMID:18367572

Petti, Cathy A.; Simmon, Keith E.; Miro, Jose M.; Hoen, Bruno; Marco, Francesc; Chu, Vivian H.; Athan, Eugene; Bukovski, Suzana; Bouza, Emilio; Bradley, Suzanne; Fowler, Vance G.; Giannitsioti, Efthymia; Gordon, David; Reinbott, Porl; Korman, Tony; Lang, Selwyn; Garcia-de-la-Maria, Cristina; Raglio, Annibale; Morris, Arthur J.; Plesiat, Patrick; Ryan, Suzanne; Doco-Lecompte, Thanh; Tripodi, Francesca; Utili, Riccardo; Wray, Dannah; Federspiel, J. Jeffrey; Boisson, K.; Reller, L. Barth; Murdoch, David R.; Woods, Christopher W.

2008-01-01

265

Native valve endocarditis and femoral embolism due to Granulicatella adiacens: a rare case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english The fastidious Gram-positive cocci Granulicatella adiacens, previously known as nutritionally variant streptococci (NVS) are unusual but significant cause of endocarditis due to increased mortality and morbidity. Difficulties in reaching correct bacteriological identification, increased resistance t [...] o beta-lactam antibiotics and macrolides and complicated clinical course have contributed to problems in management of cases of infective endocarditis caused by this bacterium. We present the first Indian case of endocarditis with arterial embolus by G. adiacens in an elderly male with no preexisting cardiac abnormality

KE, Vandana; C, Mukhopadhyay; NR, Rau; V, Ajith; P, Rajath.

2010-12-01

266

Analysis of the Impact of Early Surgery on In-hospital Mortality of Native Valve Endocarditis: Use of Propensity Score and Instrumental Variable Methods to Adjust for Treatment Selection Bias  

Science.gov (United States)

Background The impact of early surgery on mortality in patients with native valve endocarditis (NVE) is unresolved. This study seeks to evaluate valve surgery compared to medical therapy for NVE, and to identify characteristics of patients who are most likely to benefit from early surgery. Methods and Results Using a prospective, multinational cohort of patients with definite NVE, the effect of early surgery on in-hospital mortality was assessed using propensity-based matching adjusting for survivor bias, and instrumental variable analysis. Patients were stratified by propensity quintile, paravalvular complications, valve perforation, systemic embolization, stroke, Staphylococcus aureus infection and congestive heart failure. Of the 1552 patients with NVE, 720 (46%) underwent early surgery and 832 (54%) were treated with medical therapy. Compared to medical therapy, early surgery was associated with a significant reduction in mortality in the overall cohort (12.1% [87/720] vs. 20.7% [172/832]) and after propensity-based matching and adjustment for survivor bias (absolute risk reduction (ARR) = -5.9 %; p<0.001). Using a combined instrument, the instrumental variable adjusted ARR in mortality associated with early surgery was -11.2% (p<0.001). In sub-group analysis, surgery was found to confer a survival benefit compared to medical therapy among patients with a higher propensity for surgery (ARR= -10.9% for quintiles 4 and 5; p=0.002); those with paravalvular complications (ARR= -17.3 %; p<0.001), systemic embolization (ARR= -12.9%; p=0.002), S aureus NVE (ARR= -20.1%; p<0.001) and stroke (ARR= -13%; p=0.02) but not with valve perforation or congestive heart failure. Conclusions Early surgery for NVE is associated with an in-hospital mortality benefit compared to medical therapy alone. PMID:20159831

Lalani, Tahaniyat; Cabell, Christopher H; Benjamin, Daniel K; Lasca, Ovidiu; Naber, Christoph; Fowler, Vance G.; Corey, G Ralph; Chu, Vivian H; Fenely, Michael; Pachirat, Orathai; Tan, Ru-San; Watkin, Richard; Ionac, Adina; Moreno, Asuncion; Mestres, Carlos A; Casabé, José; Chipigina, Natalia; Eisen, Damon P; Spelman, Denis; Delahaye, Francois; Peterson, Gail; Olaison, Lars; Wang, Andrew

2013-01-01

267

Bartonella henselae Endocarditis in Laos – ‘The Unsought Will Go Undetected’  

OpenAIRE

Infection of heart valves (endocarditis) with bacteria is an important condition, especially afflicting those with rheumatic heart disease, and has a high mortality if untreated. Most of the evidence for optimal antibiotic and surgical management comes from wealthy countries. There are no published data from poorer countries in SE Asia despite a high burden of rheumatic heart disease. We investigated the bacterial infections of heart valves in the Lao PDR (Laos) through heart ultrasound scans...

Rattanavong, Sayaphet; Fournier, Pierre-edouard; Chu, Vang; Frichitthavong, Khamthavy; Kesone, Pany; Mayxay, Mayfong; Mirabel, Mariana; Newton, Paul N.

2014-01-01

268

High Frequency of Tropheryma whipplei in Culture-Negative Endocarditis  

OpenAIRE

“Classical” Whipple's disease (cWD) is caused by Tropheryma whipplei and is characterized by arthropathy, weight loss, and diarrhea. T. whipplei infectious endocarditis (TWIE) is rarely reported, either in the context of cWD or as isolated TWIE without signs of systemic infection. The frequency of TWIE is unknown, and systematic studies are lacking. Here, we performed an observational cohort study on the incidence of T. whipplei infection in explanted heart valves in two German university...

Geißdo?rfer, Walter; Moos, Verena; Moter, Annette; Loddenkemper, Christoph; Jansen, Andreas; Tandler, Rene?; Morguet, Andreas J.; Fenollar, Florence; Raoult, Didier; Bogdan, Christian; Schneider, Thomas

2012-01-01

269

Endocarditis due to Chryseobacterium meningosepticum  

OpenAIRE

Chryseobacterium meningosepticum is a gram negative rod widely distributed in nature. It is known to cause meningitis in neonates and premature infants. Adult infections are not common and are usually nosocomially acquired. We report an unusual case of native valve endocarditis in a 58-year-old man due to this organism. A high degree of suspicion and correct identification and sensitivity testing is required to diagnose infections by this rare isolate.

Bomb K; Arora A; Trehan N

2007-01-01

270

Tricuspid Valve Endocarditis With Group B Streptococcus After an Elective Abortion: The Need for New Data  

Directory of Open Access Journals (Sweden)

Full Text Available Streptococcus agalactiae, commonly known as Group B streptococcus (GBS, was originally discovered as a cause of bovine mastitis. GBS colonizes the genital tract of up to 40% of women and has become a major pathogen in neonatal meningitis. GBS endocarditis is thought to be an uncommon manifestation of this infection and carries a higher mortality compared to other streptococcal pathogens. Studies have shown that endocarditis after abortion has an incidence of about one per million. However, this figure was published prior to routine use of echocardiography for diagnosis. The American Heart Association has recently declared transesophageal echocardiography the gold standard for endocarditis diagnosis. This case report illustrates that, given the potentially devastating consequences of endocarditis, there is a need for updated studies to adequately assess the true incidence of this infection. Pending the outcome of these studies, routine GBS screening and prophylactic antibiotics prior to abortion should be recommended.

W. David Hardy

2006-11-01

271

Kingella kingae endocarditis: A rare case of mitral valve perforation.  

Science.gov (United States)

Kingella kingae, a HACEK (Haemophilus parainfluenzae, Aggregatibacter actinomycetemcomitans, Aggregatibacter aphrophilus, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae) organism, is a common resident of the upper airway in children; it has been associated with endocarditis in children with pre-existing heart conditions. This case report describes K. kingae endocarditis leading to valvular damage in a previously healthy 18-month-old child. Our patient developed a K. kingae bacteremia that was later complicated by meningitis, septic embolic stroke, and endocarditis of the mitral valve, leading to perforation of the posterolateral leaflet. The patient was initially treated conservatively with cefotaxime but, subsequently, required a mitral valve repair with a pericardial patch and annuloplasty. This report draws attention to the need for clinicians to be aware of the potentially serious complications of K. kingae infection in young children. If K. kingae infection is suspected then therapy should be initiated promptly with a ?-lactam, followed by early echocardiographic assessment. This case also highlights the lack of specific guidelines available for K. kingae endocarditis. PMID:21976892

Holmes, Anthony A; Hung, Tawny; Human, Derek G; Campbell, Andrew I M

2011-07-01

272

Corpuscular antigenic microarray for the serodiagnosis of blood culture-negative endocarditis.  

Science.gov (United States)

Blood culture-negative endocarditis is due to fastidious bacteria, including Coxiella burnetii and Bartonella spp. Diagnosis of such infection relies on serology and microimmunofluorescence is therefore the reference method. We developed a multiplex serology test featuring automatic incubation and reading and incorporating internal controls. Preliminary results indicate that this new serologic test is valuable for the rapid, automated serological diagnosis of blood culture-negative endocarditis. PMID:17114786

Samson, Laurent; Drancourt, Michel; Casalta, Jean-Paul; Raoult, Didier

2006-10-01

273

Mycobacterium neoaurum causing prosthetic valve endocarditis: a case report and review of the literature  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Mycobacterium neoaurum is a rare cause of bacteremia, and infection usually occurs in an immunocompromised host in the setting of an indwelling catheter. Prosthetic valve endocarditis due to non-tuberculous mycobacteria typically carries a dismal prognosis; we report a case ofM. neoaurum prosthetic [...] valve endocarditis with favorable response to antimicrobial therapy without surgical intervention.

Anupam, Kumar; George S., Pazhayattil; Aparna, Das; Harry A., Conte.

2014-04-01

274

[Role of ceftaroline fosamil in the treatment of bacteremia and infectious endocarditis].  

Science.gov (United States)

Ceftaroline fosamil is a new subclass of cephalosporins with high intrinsic activity against various multi-resistant Gram-positive organisms, including Staphylococcus aureus and Streptococcus pneumoniae, as well as against Enterobacteriaceae causing bacteremia and infective endocarditis. Because of its pharmacokinetic profile and pharmacodynamic characteristics, this drug is a good therapeutic option for these infections. Experimental studies have shown good clinical efficacy for the treatment of endocarditis caused by S. aureus, regardless of their sensitivity to methicillin or vancomycin. Clinical experience is limited, although clinical trials and case series have reported a favorable clinical response in patients with bacteremia associated with skin and soft tissue infections, pneumonia, or infective endocarditis. Future studies should define more precisely the role of this new antibiotic in the treatment of these infections. PMID:24702979

Almirante, Benito; Pericás, Juan M; Miró, José M

2014-03-01

275

High frequency of Tropheryma whipplei in culture-negative endocarditis.  

Science.gov (United States)

"Classical" Whipple's disease (cWD) is caused by Tropheryma whipplei and is characterized by arthropathy, weight loss, and diarrhea. T. whipplei infectious endocarditis (TWIE) is rarely reported, either in the context of cWD or as isolated TWIE without signs of systemic infection. The frequency of TWIE is unknown, and systematic studies are lacking. Here, we performed an observational cohort study on the incidence of T. whipplei infection in explanted heart valves in two German university centers. Cardiac valves from 1,135 patients were analyzed for bacterial infection using conventional culture techniques, PCR amplification of the bacterial 16S rRNA gene, and subsequent sequencing. T. whipplei-positive heart valves were confirmed by specific PCR, fluorescence in situ hybridization, immunohistochemistry, histological examination, and culture for T. whipplei. Bacterial endocarditis was diagnosed in 255 patients, with streptococci, staphylococci, and enterococci being the main pathogens. T. whipplei was the fourth most frequent pathogen, found in 16 (6.3%) cases, and clearly outnumbered Bartonella quintana, Coxiella burnetii, and members of the HACEK group (Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae). In this cohort, T. whipplei was the most commonly found pathogen associated with culture-negative infective endocarditis. PMID:22135251

Geissdörfer, Walter; Moos, Verena; Moter, Annette; Loddenkemper, Christoph; Jansen, Andreas; Tandler, René; Morguet, Andreas J; Fenollar, Florence; Raoult, Didier; Bogdan, Christian; Schneider, Thomas

2012-02-01

276

Back pain, leg swelling and a cardiac arrest: an interesting case of endocarditis.  

Science.gov (United States)

A 66-year-old woman with a history of tissue aortic valve replacement and chronic back pain presented to the emergency department with a suspected right leg deep vein thrombosis. A recent outpatient MRI had revealed discitis. A ventricular fibrillation cardiac arrest occurred in the emergency department. Cardiac output was restored on the fifth defibrillation. A transthoracic echocardiogram showed large aortic valve vegetations. Clinical impression was of infective endocarditis with cardiac arrest secondary to coronary artery embolisation. Peripheral blood cultures grew Cardiobacterium hominis, and appropriate intravenous antibiotic therapy was administered. The infected prosthetic valve was excised. The patient experienced postoperative complete heart block and a right hemisphere cerebrovascular accident, however she is now recovering well. This case describes an unusual case of infective endocarditis secondary to C. hominis, with disc, leg, coronary artery and brain septic embolisation. Infective endocarditis is an important differential diagnosis in multisystem presentations. PMID:24859548

Donovan, Joseph; Hatcher, James; Riddell, Anna; Tiberi, Simon

2014-01-01

277

Tratamento ambulatorial da endocardite bacteriana estreptocócica Tratamiento clínico de la endocarditis bacteriana estreptocócica Ambulatory treatment of streptococcal bacterial endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available A endocardite bacteriana é uma grave doença infecciosa cujo tratamento é tradicionalmente feito com o paciente internado. recebendo medicação intravenosa. A possibilidade de tratamento domiciliar ou ambulatorial. em casos estritamente selecionados. é atraente tanto do ponto de vista social quanto do econômico. Apresentamos o relato de 6 pacientes com diagnóstico de endocardite bacteriana por Streptococcus. tratados parcial ou integralmente em regime ambulatorial. Todos evoluíram sem complicações e com resolução completa do quadro infeccioso.La endocarditis bacteriana es una severa enfermedad infecciosa cuyo tratamiento se hace tradicionalmente con el paciente internado, recibiendo medicación intravenosa. La posibilidad de tratamiento domiciliar o clínico, en casos estrictamente seleccionados, es atractivo desde el punto de vista social como del económico. Presentamos el caso clínico de 6 pacientes con diagnóstico de endocarditis bacteriana por streptococcus, tratados parcial o integralmente en régimen ambulatorio. Todos evolucionaron sin complicaciones y con resolución completa del cuadro infeccioso.Bacterial endocarditis is a severe infectious disease. of which treatment is traditionally carried out in hospitalized patients through intravenous medication. The possibility of at-home or ambulatory treatment. for stringently selected cases. is attractive from the social as well as from the economic point of view. We report 6 patients with a diagnosis of bacterial endocarditis caused by Streptococcus. treated partially or completely on an outpatient basis. All of them evolved without complications and presented complete resolution of the infection.

Sirio Hassem Sobrinho

2010-04-01

278

Bioprosthetic valve endocarditis: factors affecting bad outcome.  

Science.gov (United States)

Prosthetic valve endocarditis (PVE) remains an uncommon but serious complication of cardiac valve replacement. We analysed several risk factors (active or healed, early or late endocarditis, congestive heart failure, arterial emboli etc.) in order to identify the factors which may predict bad outcome. The overall mortality rate was 46.8% (15/32 patients). There was a significantly higher mortality rate in patients with early endocarditis (80%) than in those with late endocarditis (38%) (p less than 0.01). In the group of patients who underwent reoperation, the mortality rate was higher in those with active endocarditis (70%) than in those with healed endocarditis (28.5%) (p less than 0.05). We believe that combined medical and surgical treatment is the best management for bioprosthetic valve endocarditis, with the institution of appropriate preoperative antibiotic therapy, to attempt to achieve sterilization. PMID:1752903

Gagliardi, C; Di Tommaso, L; Mastroroberto, P; Stassano, P; Spampinato, N

1991-01-01

279

Pacemaker endocarditis caused by Propionibacterium acnes in an adult patient with Ebstein's anomaly: a report of a rare case.  

Science.gov (United States)

We report a rare case of a Brazilian adult woman with Ebstein's Anomaly who presented with pacemaker endocarditis caused by Propionibacterium acnes. Ebstein's Anomaly is a rare congenital malformation of the heart. Infective endocarditis is defined as an infection of heart valves, of the mural endocardium, of a septal defect, or of a cardiac electronic implantable device. Propionibacterium acnes is a skin commensal bacterium, that is usually considered as a contaminant, but can, on rare occasions, cause serious infections including endocarditis of prosthetic valves, native valves and cardiac electronic implantable devices. Diagnosis was made after nearly two years of investigation by identification of the organism by the MALDI-TOF technique and transoesophageal echocardiogram. The patient was successfully treated with daptomycin and device removal. She remains free of endocarditis after 32 months of follow-up. PMID:25047281

Santo, Karla R E; Franceschi, Vinicius; Campos, André C B; Monteiro, Thaíssa S; Barbosa, Giovanna I F; Dantas, Angela; Lamas, Cristiane C

2014-10-01

280

[Proceedings: Results of early surgery in infectious endocarditis].  

Science.gov (United States)

23 patients with infective endocarditis have been treated surgically during the period 1965 to 1975. 20 patients underwent operation for intractable heart failure, complicated in 4 instances by systemic embolization and in 4 others by intractable infection. Two patients were operated upon only for intractable infection and one patient for severe hemolysis. There were 5 early deaths within 12 days and 2 late deaths 2 and 21 months after operation. Four months to 9 1/2 years after operation 16 patients were alive, only one of whom had mild heart failure. The best prognosis (1 death) was apparent in the 12 patients who underwent operation for intractable heart failure only. PMID:1215940

Dorschner, F; Forouzan, A; Messmer, B J; Rothlin, M; Senning, A

1975-11-01

281

Healthcare-Associated Infective Endocarditis: a Case Series in a Referral Hospital from 2006 to 2011 / Endocardite Infecciosa Associada aos Cuidados de Saúde: Série de Casos em Hospital de Referência entre 2006 e 2011  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Fundamento: A endocardite infecciosa associada aos cuidados de saúde (EI-ACS) é uma complicação grave associada aos cuidados médico-hospitalares, com uma incidência crescente na população. Objetivo: Avaliar a EI-ACS com relação à sua epidemiologia, etiologia, fatores de risco de aquisição, compli [...] cações, tratamento cirúrgico e quadro clínico. Métodos: Este estudo de caráter observacional e prospectivo avaliou uma série de casos reportados entre 2006 e 2011 em um hospital público no Rio de Janeiro. Resultados: Cinquenta e três pacientes com EI-ACS de um total de 151 casos de endocardite infecciosa (EI) foram incluídos no estudo, dos quais 26 (49%) eram do sexo masculino (idade média de 47 ± 18,7 anos), e 27 (51%) eram sexo feminino (idade média de 42 ± 20,1 anos). Quadros clínicos agudos de EI ocorreram em 37 casos (70%) e quadros subagudos em 16 casos (30%). A válvula mitral foi afetada em 19 casos (36%), e a valva aórtica em 12 casos (36%). As válvulas cardíacas protéticas foram afetadas em 23 casos (43%), e as válvulas cardíacas nativas em 30 casos (57%). O acesso venoso profundo foi usado em 43 pacientes (81%). Hemoculturas negativas foram observadas em amostras de 11 pacientes (21%). Nas hemoculturas positivas, Enterococcus faecalis foi identificado em 10 casos (19%), Staphylococcus aureus em 9 casos (17%) e Candida sp. em 7 casos (13%). Febre ocorreu em 49 pacientes (92%), esplenomegalia em 12 pacientes (23%), novo sopro de regurgitação valvar em 31 pacientes (58%) e proteína C reativa elevada em 44 pacientes (83%). O ecocardiograma apresentou critérios principais em 46 casos (87%). Trinta e quatro pacientes (64%) foram submetidos à cirurgia cardíaca. A mortalidade ocorreu em 17 casos (32%). Conclusão: EI-ACS afeta pacientes mais jovens no Brasil. As válvulas cardíacas protéticas e nativas foram afetadas em proporção semelhante. A cirurgia não cardíaca foi um fator predisponente pouco frequente, ao passo que o acesso intravenoso foi um fator predisponente comum. Infecções por S. aureus foram significativamente mais frequentes em casos de EI-ACS envolvendo a válvula cardíaca nativa. A mortalidade por EI-ACS é elevada. Abstract in english Background: Healthcare-associated infective endocarditis (HCA-IE), a severe complication of medical care, shows a growing incidence in literature. Objective: To evaluate epidemiology, etiology, risk factors for acquisition, complications, surgical treatment, and outcome of HCA-IE. Methods: Obse [...] rvational prospective case series study (2006-2011) in a public hospital in Rio de Janeiro. Results: Fifty-three patients with HCA-IE from a total of 151 cases of infective endocarditis (IE) were included. There were 26 (49%) males (mean age of 47 ± 18.7 years), 27 (51%) females (mean age of 42 ± 20.1 years). IE was acute in 37 (70%) cases and subacute in 16 (30%) cases. The mitral valve was affected in 19 (36%) patients and the aortic valve in 12 (36%); prosthetic valves were affected in 23 (43%) patients and native valves in 30 (57%). Deep intravenous access was used in 43 (81%) cases. Negative blood cultures were observed in 11 (21%) patients, Enterococcus faecalis in 10 (19%), Staphylococcus aureus in 9 (17%), and Candida sp. in 7 (13%). Fever was present in 49 (92%) patients, splenomegaly in 12 (23%), new regurgitation murmur in 31 (58%), and elevated C-reactive protein in 44/53 (83%). Echocardiograms showed major criteria in 46 (87%) patients, and 34 (64%) patients were submitted to cardiac surgery. Overall mortality was 17/53 (32%). Conclusion: In Brazil HCA-IE affected young subjects. Patients with prosthetic and native valves were affected in a similar proportion, and non-cardiac surgery was an infrequent predisposing factor, whereas intravenous access was a common one. S. aureus was significantly frequent in native valve HCA-IE, and overall mortality was high.

Oslan, Francischetto; Luciana Almenara Pereira da, Silva; Katia Marie Simões e, Senna; Marcia Regina, Vasques; Giovanna Ferraiuoli, Barbosa; Clara, Weksler; Rosana Grandelle, Ramos; Wilma Felix, Golebiovski; Cristiane da Cruz, Lamas.

2014-10-01

282

Prosthetic Valve Endocarditis Caused by a Pasteurella dagmatis-Like Isolate Originating from a Patient's Cat  

OpenAIRE

Pasteurella species are part of the oral flora of cats and dogs. In humans, they are frequently found in infected animal bite wounds, but invasive infections are rare. This is the first report of prosthetic-valve endocarditis with a Pasteurella dagmatis-like species, which originated from the patient's cat.

Strahm, Carol; Goldenberger, Daniel; Gutmann, Marc; Kuhnert, Peter; Graber, Peter

2012-01-01

283

Service evaluation to establish the sensitivity, specificity and additional value of broad-range 16S rDNA PCR for the diagnosis of infective endocarditis from resected endocardial material in patients from eight UK and Ireland hospitals.  

Science.gov (United States)

Infective endocarditis (IE) can be diagnosed in the clinical microbiology laboratory by culturing explanted heart valve material. We present a service evaluation that examines the sensitivity and specificity of a broad-range 16S rDNA polymerase chain reaction (PCR) assay for the detection of the causative microbe in culture-proven and culture-negative cases of IE. A clinical case-note review was performed for 151 patients, from eight UK and Ireland hospitals, whose endocardial specimens were referred to the Microbiology Laboratory at Great Ormond Street Hospital (GOSH) for broad-range 16S rDNA PCR over a 12-year period. PCR detects the causative microbe in 35/47 cases of culture-proven IE and provides an aetiological agent in 43/69 cases of culture-negative IE. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the 16S rDNA PCR assay were calculated for this series of selected samples using the clinical diagnosis of IE as the reference standard. The values obtained are as follows: sensitivity?=?67 %, specificity?=?91 %, PPV?=?96 % and NPV?=?46 %. A wide range of organisms are detected by PCR, with Streptococcus spp. detected most frequently and a relatively large number of cases of Bartonella spp. and Tropheryma whipplei IE. PCR testing of explanted heart valves is recommended in addition to culture techniques to increase diagnostic yield. The data describing the aetiological agents in a large UK and Ireland series of culture-negative IE will allow future development of the diagnostic algorithm to include real-time PCR assays targeted at specific organisms. PMID:24930039

Harris, K A; Yam, T; Jalili, S; Williams, O M; Alshafi, K; Gouliouris, T; Munthali, P; NiRiain, U; Hartley, J C

2014-11-01

284

[Recurrent prosthetic endocarditis in a 21-year old patient with renal transplantation treated with allogeneic homograft].  

Science.gov (United States)

Prosthetic infective endocarditis is a possible complication of implantation of a prosthetic cardiac valve. Without early and effective treatment, it can have fatal consequences. One treatment option is use of an allogeneic cryopreserved homograft. This case report presents a 21-year old patient after kidney transplantation due to hereditary nephrotic syndrome and aortic valve replacement with aortic conduits. After fever was noted in the patient, prosthetic infective endocarditis was diagnosed by echocardiography and also confirmed by CT-3D examination. The cryopreserved aortic homograft was implanted at the Department of Cardiac Surgery. This along with additional conservative management effectively treated the infection. Based on literature data and our own experience, we believe that the treatment of prosthetic endocarditis after aortic valve replacement with cryopreserved homograft can be a method of choice. PMID:22913243

Sabol, F; Jakubová, M; Kolesár, A; Stan?ák, B; Be?a, M; Podracký, J; Podracká, L; Cadník, P; Spatenka, J

2012-06-01

285

Haemophilus aphrophilus associated spleen abscess: an unusual presentation of subacute endocarditis.  

Science.gov (United States)

The HACEK group of bacteria (Haemophilus spp., Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella spp.), is uncommon pathogens of infective endocarditis, but can cause life-threatening events such as heart failure or formation of lethal emboli. Here we report a 58-year-old Asian man with a past history of congenital valvular heart disease who presented with sudden onset of left flank pain followed by fever with chills for 2 weeks. Abdominal computed tomography (CT) indicated a 1.6 cm abscess in the spleen. Culturing indicated the presence of Haemophilus aphrophilus. We diagnosed the patient with subacute endocarditis complicated with spleen abscess. The patient recovered fully after two weeks antibiotic (Ceftriaxone) treatment. Clinicians should give further attention to infective endocarditis caused by bacteria in the HACEK group in patients with metastatic infection such as spleen abscess with suspected valvular heart disease. PMID:22719808

Tien, Ya-Chih; Chang, Chia-Chu; Liu, Yuan-Meng

2012-06-01

286

Endocarditis in a large district general hospital: A study of the microbiological spectrum between 2000 and 2011.  

Science.gov (United States)

Infective endocarditis is one of three common cardiac infections in the United Kingdom, in addition to myocarditis and pericarditis, with a reported incidence of 1.7 to 6.2 cases per 100,000 patient years. Infective endocarditis can often have serious consequences and a wide variety of organisms may be the causative pathogen. There are little published data regarding the exact spectrum of organisms that cause endocarditis in the United Kingdom and whether organisms such as streptococci still dominate. In the present study, all cases of endocarditis at the authors' institution, representing a typical nontertiary centre, were retrospectively examined and audited to provide a snapshot of the organism spectrum in these patients. The cases of more than 120 patients who were coded as having endocarditis by the institution's clinical coding department during the period between December 2000 and January 2011 were examined. Microbiological tests and clinical case notes of all patients were reviewed. Of the 101 patients diagnosed with and treated for endocarditis, 64 were male, with a mean age of 60.57 years. The most common organisms identified were Streptococcus species (31%), Staphylococcus aureus (27%) and Enterococcus faecalis (21%). The organisms with the highest associated mortality rate were S aureus and the 'other organism' group, which included non-HACEK group (Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens and Kingella species) pathogens such as Candida albicans. Streptococcus species and S aureus remain the main cause of endocarditis in a typical hospital setting in the United Kingdom, although in a smaller proportion of cases than historical data suggests. Overall, mortality remains high, and the clinician should remain vigilant to endocarditis in any patient with a positive blood culture because the number of cases of endocarditis caused by less typical organisms are increasing. PMID:23592930

Ashrafi, Reza; McKay, Ewan; Ebden, Lloyd; Jones, Julia; Davis, Gershan K; Burgess, Malcolm I

2012-01-01

287

Endocarditis caused by Cardiobacterium valvarum.  

Science.gov (United States)

A fastidious, gram-negative bacterium was isolated from the blood of a 51-year-old man who had acute infectious endocarditis (IE). Characterization of the organism through phenotypic and genotypic analyses revealed the causative role of Cardiobacterium valvarum. This is the third reported case of IE caused by C. valvarum. PMID:16455940

Bothelo, Elisabeth; Gouriet, Frédérique; Fournier, Pierre-Edouard; Roux, Véronique; Habib, Gilbert; Thuny, Franck; Metras, Dominique; Raoult, Didier; Casalta, Jean-Paul

2006-02-01

288

Endocarditis Caused by Cardiobacterium valvarum  

OpenAIRE

A fastidious, gram-negative bacterium was isolated from the blood of a 51-year-old man who had acute infectious endocarditis (IE). Characterization of the organism through phenotypic and genotypic analyses revealed the causative role of Cardiobacterium valvarum. This is the third reported case of IE caused by C. valvarum.

Bothelo, Elisabeth; Gouriet, Fre?de?rique; Fournier, Pierre-edouard; Roux, Ve?ronique; Habib, Gilbert; Thuny, Franck; Metras, Dominique; Raoult, Didier; Casalta, Jean-paul

2006-01-01

289

Cardiobacterium hominis endocarditis: Two cases and a review of the literature.  

Science.gov (United States)

Cardiobacterium hominis, a member of the HACEK group (Haemophilus parainfluenzae, Haemophilus aphrophilus, and Haemophilus paraphrophilus, Actinobacillus actinomycetemcomitans, C. hominis, Eikenella corrodens, and Kingella species), is a rare cause of endocarditis. There are 61 reported cases of C. hominis infective endocarditis in the English-language literature, 15 of which involved prosthetic valve endocarditis. There is one reported case of C. hominis after upper endoscopy and none reported after colonoscopy. Presented here are two cases of C. hominis prosthetic valve endocarditis following colonoscopy and a review of the microbiological and clinical features of C. hominis endocarditis. Patients with C. hominis infection have a long duration of symptoms preceding diagnosis (138+/-128 days). The most common symptoms were fever (74%), fatigue/malaise (53%), weight loss/anorexia (40%), night sweats (24%), and arthralgia/myalgia (21%). The most common risk factors were pre-existing cardiac disease (61%), the presence of a prosthetic valve (28%), and history of rheumatic fever (20%). Of the 61 cases reviewed here, the aortic valve was infected in 24 (39%) and the mitral valve in 19 (31%) patients. The average duration of blood culture incubation before growth was detected was 6.3 days (range, 2-21 days). Complications were congestive heart failure (40%), central nervous system (CNS) emboli (21%), arrhythmia (16%), and mycotic aneurysm (9%). C. hominis is almost always susceptible to beta-lactam antibiotics. Ceftriaxone is recommended by the recently published American Heart Association guidelines. The prognosis of C. hominis native valve and prosthetic valve endocarditis is favorable. The cure rate among 60 patients reviewed was 93% (56/60). For prosthetic valve endocarditis, the cure rate was 16/17 (94%). Valve replacement was required in 27 (45%) cases. PMID:16955250

Malani, A N; Aronoff, D M; Bradley, S F; Kauffman, C A

2006-09-01

290

Tropheryma whipplei tricuspid endocarditis: a case report and review of the literature  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction The main clinical manifestations of Whipple's disease are weight loss, arthropathy, diarrhea and abdominal pain. Cardiac involvement is frequently described. However, endocarditis is rare and is not usually the initial presentation of the disease. To the best of our knowledge, this is the first reported case of a patient with Tropheryma whipplei tricuspid endocarditis without any other valve involved and not presenting signs of arthralgia and abdominal involvement. Case presentation We report a case of a 50-year-old Caucasian man with tricuspid endocarditis caused by Tropheryma whipplei, showing signs of severe shock and an absence of other more classic clinical signs of Whipple's disease, such as arthralgia, abdominal pain and diarrhea. Tropheryma whipplei was documented by polymerase chain reaction of the blood and pleural fluid. The infection was treated with a combined treatment of doxycycline, hydroxychloroquine and sulfamethoxazole-trimethoprim for one year. Conclusion Tropheryma whipplei infectious endocarditis should always be considered when facing a blood-culture negative endocarditis particularly in right-sided valves. Although not standardized yet, treatment of Tropheryma whipplei endocarditis should probably include a bactericidal antibiotic (such as doxycycline and should be given over a prolonged period of time (a minimum of one year.

Greub Gilbert

2010-08-01

291

[Endocarditis complicated by an aneurysm of the superior mesenteric artery].  

Science.gov (United States)

Infective endocarditis (IE) is a rare, polymorphic disease in children. Mycotic aneurysm is a rare condition that complicates about 2.5 to 10% of cases of endocarditis. It is responsible for significant morbidity and mortality [1,2]. Mycotic aneurysms are often asymptomatic, physical examination is poor, but the diagnosis should be considered with the triad including fever, abdominal pain, and abdominal mass beating. Abdominal ultrasound and computed tomography are the most useful for the identification of the aneurysmal mass. However, angiography is an interesting addition to confirm the diagnosis and implement a treatment procedure [3]. The treatment of SMA aneurysms is largely surgical. IE treatment is based on antibiotic therapy combined with surgical repair. We report the case of a 15-year-old patient, first operated for an SMA aneurysm complicating the course of IE, who secondarily underwent mitral valve repair. We review the epidemiology, diagnosis, and care principles of mycotic aneurysms of the SMA. PMID:24947109

Hatim, E G A; Hachimi, M-A; Madani, H; Atmani, N; Moutakillah, Y; Bamous, M; Abdou, A; Drissli, M; Aithoussa, M; Wahid, F-A; Boulahya, A; Haimer, C; Drissi Kamili, N

2014-07-01

292

Prosthetic ball valve endocarditis due to Gemella species.  

Science.gov (United States)

A case is presented of endocarditis that was affecting a prosthetic ball valve (Starr-Edwards) and which was caused by Gemella species. A 57-year-old man was admitted with a 3-day history of abdominal pain with fever. At the time of admission, his temperature was 37.7 degrees C and laboratory tests showed elevated inflammatory parameters and an increased neutrophil count. However, transthoracic echocardiogram showed no vegetation. During hospitalization, Gemella spp. were detected by blood culture, and a transesophageal echocardiogram showed vegetation on the prosthetic valve. He was treated with intravenous ampicillin and astromycin, and also underwent valve replacement. This is the first case in Japan of infective endocarditis of a prosthetic valve due to Gemella spp. PMID:9741744

Ukimura, A; Nishihara, S; Suwa, M; Hirota, Y; Kitaura, Y; Kawamura, K; Sasaki, S

1998-08-01

293

Fungal Prosthetic Valve Endocarditis by Candida parapsilosis: A Case Report  

Science.gov (United States)

Introduction: Fungal prosthetic valve endocarditis (PVE) is rare but serious complication of valve replacement surgery. Candida species, particularly Candida albicans is the most common isolated pathogen in fungal PVE (1–6%of cases). Case Presentation: We describe a 35-year-old woman who underwent mechanical mitral valve replacement about 3 years ago. She was admitted with neurological symptoms and later with dyspnea and hypotension. Transesophageal echocardiography showed large and mobile prosthetic valve vegetation. She underwent mitral valve surgery. The explanted valve and vegetation revealed lots of budding yeasts and the isolated yeast was identified as C. parapsilosis. Amphotericin B and broad spectrum antibiotic were started immediately. Unfortunately, the patient died two days after surgery, due to sepsis probably related to the candidemia. Conclusions: Fungal endocarditis is uncommon infection, but it is a serious problem in patients with prosthetic valve. Fungal PVE can occur years after the surgery, thus long-term follow-up is essential. PMID:25147692

Shokohi, Tahereh; Nouraei, Seyed Mahmood; Afsarian, Mohammad Hosein; Najafi, Narges; Mehdipour, Shirin

2014-01-01

294

A Pediatric Case of Cardiobacterium Hominis Endocarditis  

OpenAIRE

Gram negative endocarditis is relatively rare in pediatrics but when they occur they are most frequently caused by one of the HACEK (Haemophilus species, Actinobacillus actinomycetemcomitans, C. hominis, Eikenella corrodens and Kingella kingae) group of microorganisms. Within the HACEK group of microorganisms there have been approximately 100 cases of Cardiobacterium hominis endocarditis reported in the literature, but only 2 previous cases of endocarditis and one c...

Priyanka Suresh; Alexander Blackwood, R.

2013-01-01

295

Identification of Streptococcus sanguinis Genes Required for Biofilm Formation and Examination of Their Role in Endocarditis Virulence?  

OpenAIRE

Streptococcus sanguinis is one of the pioneers in the bacterial colonization of teeth and is one of the most abundant species in the oral biofilm called dental plaque. S. sanguinis is also the most common viridans group streptococcal species implicated in infective endocarditis. To investigate the association of biofilm and endocarditis, we established a biofilm assay and examined biofilm formation with a signature-tagged mutagenesis library of S. sanguinis. Four genes that have not previousl...

Ge, Xiuchun; Kitten, Todd; Chen, Zhenming; Lee, Sehmi P.; Munro, Cindy L.; Xu, Ping

2008-01-01

296

Community-associated Methicillin-resistant Staphylococcus aureus Bacteremia and Endocarditis among HIV Patients: A cohort study  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background HIV patients are at increased risk of development of infections and infection-associated poor health outcomes. We aimed to 1 assess the prevalence of USA300 community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA among HIV-infected patients with S. aureus bloodstream infections and. 2 determine risk factors for infective endocarditis and in-hospital mortality among patients in this population. Methods All adult HIV-infected patients with documented S. aureus bacteremia admitted to the University of Maryland Medical Center between January 1, 2003 and December 31, 2005 were included. CA-MRSA was defined as a USA300 MRSA isolate with the MBQBLO spa-type motif and positive for both the arginine catabolic mobile element and Panton-Valentin Leukocidin. Risk factors for S. aureus-associated infective endocarditis and mortality were determined using logistic regression to calculate odds ratios (OR and 95% confidence intervals (CI. Potential risk factors included demographic variables, comorbid illnesses, and intravenous drug use. Results Among 131 episodes of S. aureus bacteremia, 85 (66% were MRSA of which 47 (54% were CA-MRSA. Sixty-three patients (48% developed endocarditis and 10 patients (8% died in the hospital on the index admission Patients with CA-MRSA were significantly more likely to develop endocarditis (OR = 2.73, 95% CI = 1.30, 5.71. No other variables including comorbid conditions, current receipt of antiretroviral therapy, pre-culture severity of illness, or CD4 count were significantly associated with endocarditis and none were associated with in-hospital mortality. Conclusions CA-MRSA was significantly associated with an increased incidence of endocarditis in this cohort of HIV patients with MRSA bacteremia. In populations such as these, in which the prevalence of intravenous drug use and probability of endocarditis are both high, efforts must be made for early detection, which may improve treatment outcomes.

Stine Oscar C

2011-10-01

297

Reemplazo de válvula mitral consecutivo a endocarditis micótica Mitral valve replacement due to mycotic endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Se presenta el caso clínico de un niño de 15 meses de edad, el cual experimentó varias infecciones en la etapa neonatal (entre ellas por Candida albicans y otras complicaciones; sin embargo, no pudo recibir el esquema terapéutico completo contra la candidiasis sistémica por habérsele diagnosticado un daño funcional hepático. Posteriormente, al detectársele una endocarditis micótica, se le reemplazó la válvula mitral. En su último ingreso padecía, además, broncoespasmo asociado a neumonía bacteriana, anemia carencial, deshidratación isotónica moderada, acidosis metabólica e inmunodeficiencia mixta, causantes de una insuficiencia multiorgánica que le produjo la muerte al día siguiente de su admisión hospitalaria.A case report of a child aged 15 months who underwent several infections (i.e. due to Candida albicans and other complications during the neonatal stage is presented. However, he could not receive the complete treatment against systemic candidiasis because of an impairment of liver function. Subsequently, mitral valve was replaced when detecting mycotic endocarditis. In addition, while being hospitalized for the last time, he underwent bronchial spasm associated with bacterial pneumonia, deficiency anemia, mild isotonic dehydration, non-respiratory acidosis, and mixed immunodeficiency which caused multiple organ failure and death the day after his hospital admission.

Yalili Pouymiró Brooks

2011-07-01

298

Reemplazo de válvula mitral consecutivo a endocarditis micótica / Mitral valve replacement due to mycotic endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se presenta el caso clínico de un niño de 15 meses de edad, el cual experimentó varias infecciones en la etapa neonatal (entre ellas por Candida albicans) y otras complicaciones; sin embargo, no pudo recibir el esquema terapéutico completo contra la candidiasis sistémica por habérsele diagnosticado [...] un daño funcional hepático. Posteriormente, al detectársele una endocarditis micótica, se le reemplazó la válvula mitral. En su último ingreso padecía, además, broncoespasmo asociado a neumonía bacteriana, anemia carencial, deshidratación isotónica moderada, acidosis metabólica e inmunodeficiencia mixta, causantes de una insuficiencia multiorgánica que le produjo la muerte al día siguiente de su admisión hospitalaria. Abstract in english A case report of a child aged 15 months who underwent several infections (i.e. due to Candida albicans) and other complications during the neonatal stage is presented. However, he could not receive the complete treatment against systemic candidiasis because of an impairment of liver function. Subseq [...] uently, mitral valve was replaced when detecting mycotic endocarditis. In addition, while being hospitalized for the last time, he underwent bronchial spasm associated with bacterial pneumonia, deficiency anemia, mild isotonic dehydration, non-respiratory acidosis, and mixed immunodeficiency which caused multiple organ failure and death the day after his hospital admission.

Yalili, Pouymiró Brooks; Iarmila, Pouymiró Brooks; Pedro Omar, Pouymiró Pubillones.

1008-10-01

299

Austrian syndrome in the context of a fulminant pneumococcal native valve endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english This is the case of a young male suffering from Austrian syndrome, which is the triad of endocarditis, meningitis, and pneumonia due to invasive S. pneumoniae infection. He reported recurrent fever for six months without any antibiotic treatment, which may have determined the further course of the s [...] yndrome. Echocardiography revealed massive native valve endocarditis, and the patient was considered for ultima-ratio cardiac surgery. Intraoperative aspect presented extensive affection of the aortic root with full destruction of aortic valve, mitral valve, and aortomitral continuity. The myocardium showed a phlegmonlike infiltration. Microbiologic testing of intraoperatively collected specimens identified penicillin-sensitive Streptococcus pneumoniae. S. pneumoniae is a very uncommon cause for infective infiltrative endocarditis and is associated with severe clinical courses. Austrian syndrome is even more rare, with only a few reported cases worldwide. In those patients, only early diagnosis, immediate antibiotic treatment, and emergent cardiac surgery can save lives.

Manuel, Wilbring; Sems-Malte, Tugtekin; Klaus, Matschke; Utz, Kappert.

2012-10-01

300

Austrian syndrome in the context of a fulminant pneumococcal native valve endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available This is the case of a young male suffering from Austrian syndrome, which is the triad of endocarditis, meningitis, and pneumonia due to invasive S. pneumoniae infection. He reported recurrent fever for six months without any antibiotic treatment, which may have determined the further course of the syndrome. Echocardiography revealed massive native valve endocarditis, and the patient was considered for ultima-ratio cardiac surgery. Intraoperative aspect presented extensive affection of the aortic root with full destruction of aortic valve, mitral valve, and aortomitral continuity. The myocardium showed a phlegmonlike infiltration. Microbiologic testing of intraoperatively collected specimens identified penicillin-sensitive Streptococcus pneumoniae. S. pneumoniae is a very uncommon cause for infective infiltrative endocarditis and is associated with severe clinical courses. Austrian syndrome is even more rare, with only a few reported cases worldwide. In those patients, only early diagnosis, immediate antibiotic treatment, and emergent cardiac surgery can save lives.

Manuel Wilbring

2012-10-01

301

Artritis séptica como manifestación inicial de endocarditis bacteriana por Staphylococcus aureus / Septic arthritis as an initial manifestation of bacterial endocarditis caused by Staphylococcus aureus  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Comunicamos un caso de endocarditis bacteriana por Staphylococcus aureus, sobre válvula mitral nativa, en un varón de 80 años, que debutó con una monoartritis séptica, de la articulación glenohumeral, sin manifestaciones cardiológicas iniciales. La respuesta clínica inicial tras drenaje articular y [...] tratamiento antibiótico fue apropiada, pero la aparición de insuficiencia cardiaca recomendó el recambio quirúrgico de la válvula mitral. El paciente falleció súbitamente, el día previo a la intervención. En la literatura médica (Index Medicus, Medline, Embase, Excerpta Medica hasta 08/2005) están descritos 26 casos, de endocarditis bacteriana con afectación articular inicial, ninguno de ellos séptica, y solamente uno en la articulación glenohumeral. Queremos incidir en la necesidad de investigar la existencia de endocarditis bacteriana en toda artritis séptica, sin factores de riesgo evidentes, dadas las implicaciones pronosticas y terapéuticas. Abstract in english We describe a case of Staphylococcus aureus mitral valve endocarditis, in a 80-year-old man who presented with abrupt onset of septic arthritis of the glenohumeral joint, whithout cardiac sintomatology. Fever and articular infection recovery after articular drainage and antimicrobial therapy, but wo [...] rsening caused by heart failure made valve replacement surgery urgent.He died sudendly before surgery could be done, Until august 2005, in medical literature (Index Medicus, Medline, Embase, Excerpta Medica), we have found 26 cases of bacterial endocarditis with articular infection, as initial manifestation, but none whith septic arthritis and only one in the glenohumeral joint. This report highligths that unexplained arthritis should alert us to the possibility of bacterial endocarditis because their influence on the clinical management and pronostic implications.

A., Martínez Oviedo; P., Gracia Sánchez; E., Pueo; J. M., Chopo.

2006-04-01

302

Risk factors for severe bacterial infections after valve replacement and aortocoronary bypass operations: analysis of 246 cases by logistic regression.  

Science.gov (United States)

Risk factors for severe bacterial infections, that is, deep sternal wound infection, pneumonia, septicemia, and prosthetic valve endocarditis, were evaluated in 246 consecutive patients undergoing valve replacement (N = 84) or aortocoronary bypass operation (N = 162). Multiple logistic regression analysis was applied to determine the ability of putative risk factors to predict infection. The risk factors considered were age, sex, diabetes mellitus, duration of cardiopulmonary bypass (CPB), duration of operation, amount of blood restored on the day of operation, repeat thoracotomy for bleeding, intraaortic balloon pumping, reoperation, emergency operation, and the professional status of the surgeon. Severe infections occurred in similar frequency after valve replacement (8/84; 9.5%) and aortocoronary bypass (11/162; 6.8%). For patients who had a bypass procedure, repeat thoracotomy was the only factor significantly associated with infection (p = 0.0004). However, the classification analysis revealed that this variable alone is too unspecific for a reliable prediction. Univariate analysis indicated that restoration of more than 2,500 ml of blood (p = 0.0001), reoperation (p = 0.0821), duration of operation (p = 0.0061), duration of CPB (p = 0.0318), and intraaortic balloon pumping (p = 0.0281) were associated with infection following valve replacement. A model with three variables emerged from the multiple logistic regression: after correction for blood restoration, reoperation, and duration of CPB, no other variable was of additional predictive value. For patients who underwent valve replacement, the model performed well in predicting complications. The classification analysis revealed a high correspondence between observed and predicted instances of infection: it correctly predicted 75% of the patients with infection and 96% of those without infection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3876084

Miholic, J; Hudec, M; Domanig, E; Hiertz, H; Klepetko, W; Lackner, F; Wolner, E

1985-09-01

303

Heart transplantation in a patient with recurrent early extensive endocarditis  

Science.gov (United States)

Active valvular endocarditis could be considered a contraindication to heart transplantation. Nevertheless, there have been some reports of success with this form of treatment, despite the characteristics of the infection and its aggressive nature. Here, we describe the case of a patient with acute bicuspid aortic valvular endocarditis caused by Staphylococcus aureus and with a periannular abscess. Cryopreserved aortic homograft replacement of the aortic root was initially carried out, in addition to debridement and reconstruction of the interventricular septum with a pericardial patch. Early recurrence occurred, however, with extensive tissue destruction, a periaortic abscess and involvement of multiple valves, associated with severe sepsis. In view of the failure of ‘conventional’ surgery, an emergency heart transplantation was decided on after discussing the case with the Spanish National Transplant Organization (ONT), because of the theoretical contraindication of transplantation in this case. Transplantation was finally carried out after a waiting period of 3 days, in emergency code conditions, and the postoperative course proved uneventful, with no reinfection during the follow-up period. The present case suggests that heart transplantation may be an alternative option in patients suffering aggressive endocarditis with extensive involvement of the heart structures. PMID:23667065

Valencia Nuñez, Diana M.; Merino Cejas, Carlos; Alados Arboledas, Pedro; Muñoz Carvajal, Ignacio

2013-01-01

304

Brucella Endocarditis Caused By Brucella Melitensis  

OpenAIRE

Brucellosis is a zoonotic disease endemically seen in Turkey, which occurs with various clinical findings. It can lead to complications affecting many systems. Endocarditis is an infrequent, but serious complication of brucellosis.The aim of this case presentation is to remind that endocarditis can be a complication of brucellosis and if is undiagnosed or misdiagnosed, progresses fatal in a high rate.

Suzan Saçar; Derya H?rç?n Cenger; Semra Toprak Kavas; Ali Asan; Melek Demir; Mustafa Saçar; Hüseyin Turgut

2008-01-01

305

Visceral cat scratch disease with endocarditis in an immunocompetent adult: a case report and review of the literature.  

Science.gov (United States)

Infective endocarditis and hepatosplenic abscesses are rare manifestations of cat scratch disease (CSD), especially among immunocompetent adults. An otherwise healthy woman who presented with fever and abdominal pain was diagnosed with multiple abscesses in the spleen and the liver, as well as a mitral valve vegetation. PCR on spleen tissue was positive for Bartonella henselae. Prolonged treatment with doxycycline and gentamicin led to complete recovery. Review of the literature revealed 18 cases of hepatosplenic CSD in immunocompetent adults; the majority presented with fever of unknown origin and abdominal pain. In most cases the causative organism was B. henselae and the pathological findings were necrotizing granulomas, similar to the pathological features in classic CSD. Concomitant endocarditis was diagnosed in one case. Because Bartonella is one of the leading pathogens of culture-negative endocarditis, we raise the question of whether a comprehensive evaluation for endocarditis is needed in cases of systemic CSD. PMID:24575798

Shasha, David; Gilon, Dan; Vernea, Fiona; Moses, Allon E; Strahilevitz, Jacob

2014-03-01

306

Propionibacterium acnes endocarditis on an annuloplasty ring in an adolescent boy  

OpenAIRE

Propionibacterium acnes, a constituent of the human cutaneous flora, infected both the native mitral valve and a Carpentier mitral annuloplasty ring in an adolescent patient. In the case of culture negative endocarditis, the incubation period of blood cultures should be prolonged to identify this pathogen.

Vanagt, W. Y.; Daenen, W. J.; Delhaas, T.

2004-01-01

307

First Case of Fusobacterium necrophorum Endocarditis To Have Presented after the 2nd Decade of Life  

OpenAIRE

Fusobacterium necrophorum, an obligate, anaerobic, filamentous, gram-negative rod, is thought to be a normal inhabitant of the mucous membranes in human beings. Fusobacterium species have been implicated in cases of Lemierre syndrome and other pathologic conditions. Their reported association with infective endocarditis is extremely rare.

Moore, Curtiss; Addison, Daniel; Wilson, James M.; Zeluff, Barry

2013-01-01

308

Concomitant Gerbode-like defect and anterior mitral leaflet perforation after aortic valve replacement for endocarditis.  

Science.gov (United States)

We present a case of concomitant left ventricle (LV) to right atrial shunt (Gerbode-like defect) and anterior mitral leaflet perforation in a 32-year-old male after aortic valve replacement for infective endocarditis of bicuspid aortic valve. This case emphasises that intra-operative transesophageal echocardiography is a sine qua non for valvular surgical procedures. PMID:23710761

Toprak, Cüneyt; Kahveci, Gokhan; Akpinar, Suzan; Tabakçi, Mehmet Mustafa; Güler, Yeliz

2013-09-01

309

Lactococcus garvieae endocarditis in a patient with colonic diverticulosis: first case report in Italy and review of the literature.  

Science.gov (United States)

Lactococcus garvieae is a human opportunistic pathogen with low virulence, but it is a well-known pathogen in aquaculture. A total of 21 human infections have been reported in the literature, mostly endocarditis. Automated methods can wrongly identify this microorganism as Enterococcus spp with a non-standard phenotype, leading to an underestimation of the incidence of this infection. The route of infection could be the ingestion of raw fish, grilled fish or fresh dairy products. We describe the first case of L. garvieae mitral valve endocarditis in Italy, in a patient with mitral valve repair with autologous pericardium, mechanic prosthetic aortic valve and colonic diverticulosis. PMID:23109019

Russo, Gianluca; Iannetta, Marco; D'Abramo, Alessandra; Mascellino, Maria Teresa; Pantosti, Annalisa; Erario, Linda; Tebano, Gianpiero; Oliva, Alessandra; D'Agostino, Claudia; Trinchieri, Vito; Vullo, Vincenzo

2012-10-01

310

Brucellosis with p-ANCA-associated renal failure, leukocytoclastic vasculitis and endocarditis: Case report  

Directory of Open Access Journals (Sweden)

Full Text Available The relationship between brucellosis and p-antinuclear cytoplasmic antibody (p-ANCA-associated vasculitis (pAAV is a rare condition. Herein, we report a 52-year-old man who was diagnosed as rapidly progressive glomerulonephritis (RPGN and endocarditis due to brucellosis. He was treated with antimicrobial agents, steroids, plasmapheresis, renal replacement therapy and aortic valve replacement. According to our best of knowledge, no similar case has been reportedpreviously in the literature in regard to p-ANCA anti-lactoferrin antibodies associated-glomerulonephritis with brucellosis and endocarditis. J Microbiol Infect Dis 2011;1(1:31-34.

Murat Turgay, Esin Ertu?rul, Orhan Küçük?ahin, Ali ?ahin

2011-06-01

311

Late prosthetic valve endocarditis due to Cardiobacterium hominis, an unusual complication  

Directory of Open Access Journals (Sweden)

Full Text Available We report a case of prosthetic valve endocarditis caused by Cardiobacterium hominis in a patient who had undergone atrial septal defect closure and mitral valve replacement of the heart in 1978. He presented with pyrexia of unknown origin and congestive cardiac failure. Investigations revealed infective endocarditis of prosthetic valve in mitral portion. Blood culture samples grew C. hominis . The patient was empirically started on vancomycin and gentamicin intravenously and ceftriaxone was added after isolation of the organism. Though subsequent blood cultures were negative, patient remained in congestive cardiac failure and died due to complications.

Shivaprakasha S

2007-01-01

312

Multi-embolic ST-elevation Myocardial Infarction Secondary to Aortic Valve Endocarditis.  

Science.gov (United States)

We present the case of a 42 year-old woman admitted to hospital with ST-elevation myocardial infarction involving two separate coronary territories. Angiography revealed multi-embolic occlusions of her left anterior descending (LAD) and first obtuse marginal (OM1) coronary arteries. Transoesophageal echocardiogram (TOE) showed a lesion attached to the left cusp of the aortic valve and she was treated for infective endocarditis. We discuss the management issues raised from this unique patient, including reperfusion strategies in endocarditis-associated myocardial infarction. PMID:25150649

Rischin, Adam P; Carrillo, Philip; Layland, Jamie

2015-01-01

313

Teicoplanin versus vancomycin for prophylaxis of experimental Enterococcus faecalis endocarditis in rats.  

OpenAIRE

Teicoplanin was compared with vancomycin for the prophylaxis of experimental Enterococcus faecalis endocarditis in rats. Single intravenous doses of teicoplanin (7 mg/kg of body weight) or vancomycin (15 mg/kg) were given 30 min before bacterial challenge. Two strains of E. faecalis (309 and 1209) isolated from patients with endocarditis were tested. Bacterial inocula ranged from 10(4) (i.e., the inoculum infecting 90% of the control rats [ID90]) to 10(7) CFU/ml. The MICs and MBCs of teicopla...

Entenza, J. M.; Calandra, T.; Moosmann, Y.; Malinverni, R.; Glauser, M. P.

1992-01-01

314

FimA, a major virulence factor associated with Streptococcus parasanguis endocarditis.  

OpenAIRE

Adherence of microorganisms to damaged heart tissue is a crucial event in the pathogenesis of infective endocarditis. In the present study, we investigated the role of the FimA protein as a potential virulence factor associated with Streptococcus parasanguis endocarditis. FimA is a 36-kDa surface protein that is a recognized adhesin in the oral cavity where it mediates adherence to the salivary pellicle. An insertion mutant and a deletion mutant of S. parasanguis were employed in the rat mode...

Burnette-curley, D.; Wells, V.; Viscount, H.; Munro, C. L.; Fenno, J. C.; Fives-taylor, P.; Macrina, F. L.

1995-01-01

315

Immunization with FimA protects against Streptococcus parasanguis endocarditis in rats.  

OpenAIRE

FimA, a surface-associated protein of Streptococcus parasanguis, is associated with initial colonization of damaged heart tissue in an endocarditis model (D. Burnette-Curley, V. Wells, H. Viscount, C. Munro, J. Fenno, P. Fives-Taylor, and F. Macrina, Infect. Immun. 63:4669-4674, 1995). We have evaluated the efficacy of recombinant FimA as a vaccine in the rat model of endocarditis and investigated in vitro the mechanism for the protective role of immunization. FimA-immunized and nonimmunized ...

Viscount, H. B.; Munro, C. L.; Burnette-curley, D.; Peterson, D. L.; Macrina, F. L.

1997-01-01

316

Late prosthetic valve endocarditis due to Cardiobacterium hominis, an unusual complication.  

Science.gov (United States)

We report a case of prosthetic valve endocarditis caused by Cardiobacterium hominis in a patient who had undergone atrial septal defect closure and mitral valve replacement of the heart in 1978. He presented with pyrexia of unknown origin and congestive cardiac failure. Investigations revealed infective endocarditis of prosthetic valve in mitral portion. Blood culture samples grew C. hominis. The patient was empirically started on vancomycin and gentamicin intravenously and ceftriaxone was added after isolation of the organism. Though subsequent blood cultures were negative, patient remained in congestive cardiac failure and died due to complications. PMID:17377358

Shivaprakasha, S; Radhakrishnan, K; Kamath, P; Karim, Pms

2007-01-01

317

A case of Brucella endocarditis in association with subclavian artery thrombosis.  

Science.gov (United States)

Brucellosis is a common zoonosis, endemic in Mediterranean countries, and caused by bacteria of Brucella genus. Brucellosis is a systemic infection and the clinical presentation varies widely from asymptomatic and mild to severe disease. Cardiovascular complications are extremely rare. We present a case of arterial thrombosis in a previously healthy young patient with Brucella endocarditis. Careful attention must be paid to any sign or symptom of thrombosis in patients affected by brucellosis, regardless of the presence of endocarditis and cardiovascular risk factors. PMID:22844622

Colomba, Claudia; Siracusa, Lucia; Rubino, Raffaella; Trizzino, Marcello; Scarlata, Francesco; Imburgia, Claudia; Titone, Lucina

2012-01-01

318

Successful management of multiple permanent pacemaker complications – infection, 13 year old silent lead perforation and exteriorisation following failed percutaneous extraction, superior vena cava obstruction, tricuspid valve endocarditis, pulmonary embolism and prosthetic tricuspid valve thrombosis  

OpenAIRE

Abstract A 59 year old man underwent mechanical tricuspid valve replacement and removal of pacemaker generator along with 4 pacemaker leads for pacemaker endocarditis and superior vena cava obstruction after an earlier percutaneous extraction had to be abandoned, 13 years ago, due to cardiac arrest, accompanied by silent, unsuspected right atrial perforation and exteriorisation of lead. Postoperative course was complicated by tricuspid valve thrombosis and secondary pulmonary emboli...

Javangula Kalyana; Adluri Krishna; Kaul Pankaj; Baig Wasir

2009-01-01

319

Ulcerative dermatitis and valvular endocarditis associated with Staphylococcus aureus in a hyacinth macaw (Anadorhynchus hyacinthinus).  

Science.gov (United States)

An 18-yr-old male hyacinth macaw (Anadorhynchus hyacinthinus) was found dead in his aviary with no preexisting signs. The bird had a chronic history of feather damaging behavior, with severe ulcerative dermatitis. Pathologic findings revealed a vegetative valvular endocarditis, myocarditis, septicemia, chronic severe glomerulonephritis, and thyroid dysplasia. Staphylococcus aureus was isolated from the valve, the liver, and the skin. Repeated trauma and low-rate bacteriemia may have contributed to the development of endocarditis. Translocation of S. aureus skin infection in the bloodstream may lead to subacute endocarditis in humans and such mechanism is suspected in this case. This case suggests that endocarditis associated with S. aureus septicemia is a potential complication of feather damaging behavior. This case also reports a systemic complication of ulcerative dermatitis secondary to feather damaging behavior. Endocarditis has been poorly reported in psittacine species, and such medical complication of feather damaging behavior has never been reported to our knowledge. Furthermore, S. aureus is a bacteria of public health concern and should be integrated into the differential when pet parrots with dermatitis are in proximity to owners. PMID:25055625

Huynh, Minh; Carnaccini, Silvia; Driggers, Todd; Shivaprasad, H L

2014-06-01

320

A rare native mitral valve endocarditis successfully treated after surgical correction.  

Science.gov (United States)

Mycobacterium abscessus and Kocuria species are rare causes of infections in humans. Endocarditis by these agents has been reported in only 11 cases. M. abscessus is a particularly resistant organism and treatment requires the association of antibiotics for a prolonged period of time. We report a case of native mitral valve bacterial endocarditis due to M. abscessus and Kocuria species in a 48-year-old man with a history of intravenous drug use. The case was complicated by a perforation of the posterior mitral valve leaflet, leading to surgical mitral valve replacement. Cultures from the blood and mitral valve disclosed M. abscessus and Kocuria species. The patient was treated for 6 months with clarithromycin, imipenem and amikacin, with resolution of symptoms. Repeated blood cultures were negative. Acid-fast staining should be done in subacute endocarditis in order to identify rapidly growing mycobacteria. PMID:25270154

Garcia, Daniel C; Nascimento, Rhanderson; Soto, Victor; Mendoza, Cesar E

2014-01-01

321

Rothia aeria endocarditis in a patient with a bicuspid aortic valve: case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Rothia aeria is an uncommon pathogen mainly associated with endocarditis in case reports. In previous reports, endocarditis by R. aeria was complicated by central nervous system embolization. In the case we report herein, endocarditis by R. aeria was diagnosed after acute self-limited diarrhea. In a [...] ddition to the common translocation of R. aeria from the oral cavity, we hypothesize the possibility of intestinal translocation. Matrix-assisted laser desorption ionization-time of flight mass spectrometry and genetic sequencing are important tools that can contribute to early and more accurate etiologic diagnosis of severe infections caused by Gram-positive rods.

Antonio Carlos, Nicodemo; Luiz Guilherme, Gonçalves; Fatuma Catherine Atieno, Odongo; Marines Dalla Valle, Martino; Jorge Luiz Mello, Sampaio.

2014-09-01

322

[Successful treatment using recombinant thrombomodulin for disseminated intravascular coagulation associated with recurrent prosthetic valve endocarditis].  

Science.gov (United States)

Prosthetic valve endocarditis(PVE)occasionally evokes sepsis and disseminated intravascular coagulation(DIC). A 46-year-old man developed relapsing active PVE with an annular abscess and suffered from exacerbating sepsis and DIC. Despite the administration of antibiotics, his DIC score increased. Anti-DIC treatment with recombinant thrombomodulin (rTM) was initiated, and his DIC was remarkably resolved. Accordingly, the abscess cavity was closed by using a homograft anterior mitral leaflet, and the aortic root was replaced with the homograft. He is doing well without an evidence of recurrent endocarditis 18 months after the operation. rTM is a new and promising drug for the treatment of DIC with infective endocarditis. PMID:23381354

Masuda, Shinya; Adachi, Osamu; Ito, Koki; Matsuo, Satoshi; Hayatsu, Yukihiro; Suzuki, Yusuke; Saito, Takeshi; Akiyama, Masatoshi; Kumagai, Kiichiro; Motoyoshi, Naotaka; Kawamoto, Shunsuke; Saiki, Yoshikatsu

2013-02-01

323

[Endocarditis due to HACEK bacteria. A case report of endocarditis due to Kingella kingae].  

Science.gov (United States)

Endocarditis is a common disease in hospital practice. Identification of the microorganism responsible for the valvular damage is essential to establish the prognosis and to determine the optimal antibiotic treatment. In some cases of endocarditis the diagnosis is laborious, especially when the responsible microorganism is difficult to detect using standard culture techniques. Here we report a case of native aortic valve endocarditis due to Kingella kingae, a Gram negative organism of the HACEK group. In addition we review 6 other cases of endocarditis caused by organism belonging to this group, treated in our hospital between 1983 and 1999. Epidemiological studies show that less than 5% of all cases of endocarditis are caused by organisms of the HACEK group. The diagnosis is often delayed because their slow growth on a standard culture medium. We describe clinical and microbiological characteristics of this group of endocarditis. PMID:11234709

Lepori, M; Bochud, P Y; Owlya, R; Broccard, A; Schaller, M D

2001-01-01

324

Serological diagnosis of experimental Enterococcus faecalis endocarditis  

DEFF Research Database (Denmark)

A modified rat model of endocarditis with catheterization for 2 days was established in female Lewis rats using different inocula of Enterococcus faecalis (strain no. EF 19) in order to measure IgG antibodies in serum during the course of infection. Increasing the inocula intravenously resulted in an increase in the CFU/g vegetation and the CFU/g spleen, the ID50 being about 10 CFU/ml and the ID90 about 1x10(2) CFU/ml. The lowest bacterial inoculum infecting 100% of the rats was 3x10(3) CFU/ml, and for further investigations we used this inoculum size. Rats were sacrificed on day 2, 5, 7, 9, 11 and 28 after infection. The CFU/g vegetation and the CFU/g spleen increased until day 7 and then decreased. Serum samples were collected from 129 rats at different times after challenge. Three different ELISA systems were established to measure the IgG antibody responses: E. faecalis sonicate ELISA (a pool of four sonicates of strain no. EF 10, EF 11, EF 19 and EF 48), E. faecalis whole cell ELISA (strain no. EF 19) and E. faecalis purified cell wall ELISA (strain no. EF 19). An IgG antibody response was detected already on day 2, and except for a minor decrease on day 6/7 the antibody response continued to increase until day 14 (whole cell ELISA and sonicate ELISA) and day 21 (purified cell wall ELISA) when a plateau was reached. Significant increases in IgG antibody responses (p

Kjerulf, A; Espersen, F

1998-01-01

325

Efficacy of ticarcillin-clavulanic acid for treatment of experimental Staphylococcus aureus endocarditis in rats.  

OpenAIRE

The efficacy of ticarcillin-clavulanic acid was compared with the efficacies of standard antistaphylococcal agents (flucloxacillin, oxacillin, nafcillin, and vancomycin) and ticarcillin in an experimental model of Staphylococcus aureus endocarditis. Therapy was either initiated soon (8 h) after infection, when numbers of bacteria in aortic valve vegetations were relatively low (approximately 6 to 8 log10 CFU/g), or delayed until 24 h after infection, when the vegetations usually contained gre...

Catherall, E. J.; Gillon, V.; Hurn, S.; Irwin, R.; Mizen, L.

1992-01-01

326

Relapse of Tropheryma whipplei endocarditis treated by trimethoprim/sulfamethoxazole, cured by hydroxychloroquine plus doxycycline.  

Science.gov (United States)

The best treatment for Tropheryma whipplei infections is controversial. We report a patient who suffered from T. whipplei aortic native valve endocarditis that relapsed despite surgery and four weeks of intravenous ceftriaxone followed by several months of oral trimethoprim/sulfamethoxazole. Cure was achieved after replacement of the prosthesis with a homograft and 18 months of oral doxycycline-hydroxychloroquine. We discuss the need for a change in treatment guidelines for T. whipplei infections. PMID:25461667

Emonet, Stephane; Wuillemin, Timothee; Harbarth, Stephan; Wassilew, Nasstasja; Cikirikcioglu, Mustafa; Schrenzel, Jacques; Lagier, Jean-Christophe; Raoult, Didier; van Delden, Christian

2015-01-01

327

Candida glabrata meningitis and endocarditis: a late severe complication of candidemia.  

Science.gov (United States)

We report an unusual case of Candida glabrata meningitis and endocarditis in a young Caucasian woman with a prosthetic aortic valve and suffering from a dissecting thoraco-abdominal aortic aneurysm. C. glabrata was isolated from culture of the cerebrospinal fluid. Candida infection of the central nervous system is an uncommon manifestation of disseminated infection due to Candida species. Our case report also highlights the intrinsic resistance of C. glabrata to azoles. PMID:25449253

Colomba, Claudia; Trizzino, Marcello; Imburgia, Claudia; Madonia, Simona; Siracusa, Lucia; Giammanco, Giovanni Maurizio

2014-12-01

328

High-dose daptomycin and fosfomycin treatment of a patient with endocarditis caused by daptomycin-nonsusceptible Staphylococcus aureus: Case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Emergence of daptomycin-nonsusceptible (DNS Staphylococcus aureus is a dreadful problem in the treatment of endocarditis. Few current therapeutic agents are effective for treating infections caused by DNS S. aureus. Case presentation We describe the emergence of DNS S. aureus. in a patient with implantable cardioverter-defibrillator (ICD device -related endocarditis who was priorily treated with daptomycin. Metastatic dissemination as osteomyelitis further complicated the management of endocarditis. The dilemma was successfully managed by surgical removal of the ICD device and combination antimicrobial therapy with high-dose daptomycin and fosfomycin. Conclusions Surgical removal of intracardiac devices remains an important adjunctive measure in the treatment of endocarditis. Our case suggests that combination therapy is more favorable than single-agent therapy for infections caused by DNS S. aureus.

Hsiao Chen-Yuan

2011-05-01

329

Bartonella endocarditis complicating congenital heart disease  

OpenAIRE

The present report describes a case of Bartonella henselae endocarditis affecting an adolescent with congenital heart disease. A teenager from Eastern Europe was referred to for surgical treatment of aortic endocarditis. She admitted close contact with cats. Blood culture was negative. Diagnosis of B henselae was established on direct PCR amplification and 16SrRNA gene sequencing of the aortic valve tissue and confirmed after 4 weeks by valve culture isolate. The patient underwent extended ro...

Al-attar, Nawwar; Ruimy, Raymond; Baron, Franck; Hvass, Ulrik

2009-01-01

330

Brucella Endocarditis Caused By Brucella Melitensis  

Directory of Open Access Journals (Sweden)

Full Text Available Brucellosis is a zoonotic disease endemically seen in Turkey, which occurs with various clinical findings. It can lead to complications affecting many systems. Endocarditis is an infrequent, but serious complication of brucellosis.The aim of this case presentation is to remind that endocarditis can be a complication of brucellosis and if is undiagnosed or misdiagnosed, progresses fatal in a high rate.

Suzan Saçar

2008-01-01

331

Association between HACEK bacteraemia and endocarditis.  

Science.gov (United States)

We retrospectively examined medical records of 87 patients with bacteraemia caused by members of the HACEK group (Haemophilus parainfluenzae, Aggregatibacter actinomycetemcomitans, Aggregatibacter aphrophilus, Aggregatibacter paraphrophilus, Cardiobacterium spp., Eikenella corrodens and Kingella spp.) to determine whether endocarditis was present, as defined by the Duke criteria. The overall positive predictive value (PPV) of HACEK bacteraemia for endocarditis was 60?%. The PPV varied with different HACEK species from 0?% (E. corrodens) to 100?% (A. actinomycetemcomitans). PMID:24681996

Yew, Haur Sen; Chambers, Stephen T; Roberts, Sally A; Holland, David J; Julian, Kylie A; Raymond, Nigel J; Beardsley, Justin; Read, Kerry M; Murdoch, David R

2014-06-01

332

Prosthetic Valve Endocarditis: Early Outcome following Medical or Surgical Treatment  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Prosthetic valve endocarditis (PVE is an important cause of morbidity and mortality associated with heart valve replacement surgery. The aim of the present study was to describe the early outcome of treatment in patients with PVE in a single center. Methods: The data of all the episodes of PVE registered at our institution between 2002 and 2007 were collected and analyzed retrospectively. The patients were assessed using clinical criteria defined by Durack and colleagues (Duke criteria. The analysis included a detailed study of hospital records. The continuous variables were expressed as mean ± standard deviation, and the discrete variables were presented as percentages.Results: Thirteen patients with PVE were diagnosed and treated at our center during the study period. In all the cases, mechanical prostheses were utilized. The patients' mean age was 46.9±12.8 years. Women made up 53.8% of all the cases. Early PVE was detected in 6 (46.2% patients, and late PVE occurred in 7 (53.8 %. Eleven (84.6% patients were treated with intravenous antimicrobial therapy, and the other two (15.4% required surgical removal and replacement of the infected prosthesis in addition to antibiotic therapy. Blood cultures became positive in 46.2% of the patients. Mortality rate was 15.4% (2 patients. Conclusion: It seems that in selected cases with PVE, i.e. in those who remain clinically stable and respond well to antimicrobial therapy, a cure could be achieved by antimicrobial treatment alone with acceptable morbidity and mortality risk.

Banafsheh Alinejad

2008-12-01

333

Estudos sobre thrombose cardiaca e endocardite parietal de origem não valvular / On thrombosis of heart and on mural endocarditis of non-valvular origin  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese [...] Abstract in english 1.-Since the parietal endocarditis represents a chapter generally neglected, owing to the relative lack of cases, and somewhat confused because there various terms have been applied to a very same morbid condition, it justifies the work which previously we tried to accomplish, of nosographic classif [...] ication. Taking into account the functional disturbances and the anatomical changes, all cases of parietal endocarditis referred to in the litterature were distributed by the following groups: A-Group-Valvulo-parietal endocarditis. 1st . type-Valvulo-parietal endocarditis per continuum. 2nd. type-Metastatic valvulo-parietal endocarditis. 3rd. type-Valvulo-parietal endocarditis of the mitral stenosis. B-Group-Genuine parietal endocarditis. a) with primary lesions in the myocardium. b) with primary lesions in the endocardium. 4th type-Fibrous chronic parietal endocarditis (B A Ü M L E R), « endocarditis parietalis simplex». 5th type-Septic acute parietal endocarditis (LESCHKE), «endocarditis parietalis septica». 6th type-Subacute parietal endocarditis (MAGARINOS TORRES), «endocarditis muralis lenta». 2.-Studying a group of 14 cases of fibrous endomyocarditis with formation of thrombi, and carrying together pathological and bacteriological examinations it has been found that some of such cases represent an infectious parietal endocarditis, sometimes post-puerperal, of subacute or slow course, the endocardic vegetations being contamined by pathogenic microörganisms of which the most frequent is the Diplococcus pneumoniae, in most cases of attenuated virulence. Along with the infectious parietal endocarditis, there occur arterial and venous thromboses (abdominal aorta, common illiac and femural arteries and external jugular veins). The case 5,120 is a typical one of this condition which we name subacute parietal endocarditis (endocarditis parietalis s. muralis lenta). 3.-The endocarditis muralis lenta encloses an affection reputed to be of rare occurrence, the «myocardite subaigüe primitive», of which JOSSERAND and GALLAVARDIN published in 1901 the first cases, and ROQUE and LEVY, another, in 1914. The «myocardite subaigüe primitive» was, wrongly, in our opinion, included by WALZER in the syndrome of myocardia of LAUBRY and WALZER, considering that, in the refered cases of JOSSERAND and GALLAVARDIN and in that of ROQUE and LEVY, there are described rather considerable inflammatory changes in the myocardium and endocardium. The designation «myocardia» was however especially created by LAUBRY and WALZER for the cases of heart failure in which the most careful aetiologic inquiries and the most minucious clinical examination were unable to explain, and in which, yet, the post-mortem examination did not reveal any anatomical change at all, it being forcible to admit, then, a primary functional change of the cardiac muscle fibre. This special cardiac condition is thoroughly exemplified in the observation that WALZER reproduces on pages 1 to 7 of his book. 4.-The clinical picture of the subacute parietal endocarditis is that of heart failure with oedemas, effusion in the serous cavities and passive chronic congestion of the lungs, liver, kideys and spleen associated, to that of an infectious disease of subacute course. The fever is rather transient oscillating around 99.5 F., being intersected with apyretic periods of irregular duration; it is not dependent on any evident extracardiac septic infection. In other cases the fever is slight, particularly in the final stage of the disease, when the heart failure is well established. The rule is to observe then, hypothermy. The cardiac-vascular signs consist of enlargement of the cardiac dullness, smoothing of the cardiac sounds, absence of organic murmurs and accentuated and persistent tachycardia up to a certain point independent of fever. The galloprhythm is present, in most cases. The signs of the pulmonary infarct are rather expressed by the aspect of the sputum,

C. Magarinos, Torres.

334

Estudos sobre thrombose cardiaca e endocardite parietal de origem não valvular On thrombosis of heart and on mural endocarditis of non-valvular origin  

Directory of Open Access Journals (Sweden)

Full Text Available 1.-Since the parietal endocarditis represents a chapter generally neglected, owing to the relative lack of cases, and somewhat confused because there various terms have been applied to a very same morbid condition, it justifies the work which previously we tried to accomplish, of nosographic classification. Taking into account the functional disturbances and the anatomical changes, all cases of parietal endocarditis referred to in the litterature were distributed by the following groups: A-Group-Valvulo-parietal endocarditis. 1st . type-Valvulo-parietal endocarditis per continuum. 2nd. type-Metastatic valvulo-parietal endocarditis. 3rd. type-Valvulo-parietal endocarditis of the mitral stenosis. B-Group-Genuine parietal endocarditis. a with primary lesions in the myocardium. b with primary lesions in the endocardium. 4th type-Fibrous chronic parietal endocarditis (B A Ü M L E R, « endocarditis parietalis simplex». 5th type-Septic acute parietal endocarditis (LESCHKE, «endocarditis parietalis septica». 6th type-Subacute parietal endocarditis (MAGARINOS TORRES, «endocarditis muralis lenta». 2.-Studying a group of 14 cases of fibrous endomyocarditis with formation of thrombi, and carrying together pathological and bacteriological examinations it has been found that some of such cases represent an infectious parietal endocarditis, sometimes post-puerperal, of subacute or slow course, the endocardic vegetations being contamined by pathogenic microörganisms of which the most frequent is the Diplococcus pneumoniae, in most cases of attenuated virulence. Along with the infectious parietal endocarditis, there occur arterial and venous thromboses (abdominal aorta, common illiac and femural arteries and external jugular veins. The case 5,120 is a typical one of this condition which we name subacute parietal endocarditis (endocarditis parietalis s. muralis lenta. 3.-The endocarditis muralis lenta encloses an affection reputed to be of rare occurrence, the «myocardite subaigüe primitive», of which JOSSERAND and GALLAVARDIN published in 1901 the first cases, and ROQUE and LEVY, another, in 1914. The «myocardite subaigüe primitive» was, wrongly, in our opinion, included by WALZER in the syndrome of myocardia of LAUBRY and WALZER, considering that, in the refered cases of JOSSERAND and GALLAVARDIN and in that of ROQUE and LEVY, there are described rather considerable inflammatory changes in the myocardium and endocardium. The designation «myocardia» was however especially created by LAUBRY and WALZER for the cases of heart failure in which the most careful aetiologic inquiries and the most minucious clinical examination were unable to explain, and in which, yet, the post-mortem examination did not reveal any anatomical change at all, it being forcible to admit, then, a primary functional change of the cardiac muscle fibre. This special cardiac condition is thoroughly exemplified in the observation that WALZER reproduces on pages 1 to 7 of his book. 4.-The clinical picture of the subacute parietal endocarditis is that of heart failure with oedemas, effusion in the serous cavities and passive chronic congestion of the lungs, liver, kideys and spleen associated, to that of an infectious disease of subacute course. The fever is rather transient oscillating around 99.5 F., being intersected with apyretic periods of irregular duration; it is not dependent on any evident extracardiac septic infection. In other cases the fever is slight, particularly in the final stage of the disease, when the heart failure is well established. The rule is to observe then, hypothermy. The cardiac-vascular signs consist of enlargement of the cardiac dullness, smoothing of the cardiac sounds, absence of organic murmurs and accentuated and persistent tachycardia up to a certain point independent of fever. The galloprhythm is present, in most cases. The signs of the pulmonary infarct are rather expressed by the aspect of the sputum, which is foamy and blood-streaked than by the classic signs. Cerebral embolism was a terminal accid

C. Magarinos Torres

1928-01-01

335

Teicoplanin versus vancomycin for prophylaxis of experimental Enterococcus faecalis endocarditis in rats.  

Science.gov (United States)

Teicoplanin was compared with vancomycin for the prophylaxis of experimental Enterococcus faecalis endocarditis in rats. Single intravenous doses of teicoplanin (7 mg/kg of body weight) or vancomycin (15 mg/kg) were given 30 min before bacterial challenge. Two strains of E. faecalis (309 and 1209) isolated from patients with endocarditis were tested. Bacterial inocula ranged from 10(4) (i.e., the inoculum infecting 90% of the control rats [ID90]) to 10(7) CFU/ml. The MICs and MBCs of teicoplanin and vancomycin were, respectively, 0.25 to greater than 128 mg/liter and 2 to greater than 128 mg/liter for strain 309 and 0.5 to greater than 128 mg/liter and 0.5 to greater than 128 mg/liter for strain 1209. Vancomycin prevented endocarditis only in 60% (strain 309) and in 87% (strain 1209) of rats challenged with the smallest bacterial-inoculum size (ID90), whereas teicoplanin prevented endocarditis in 100% of rats challenged with the same inoculum (strain 309; P = 0.05), in 87% of rats challenged with 10 times the ID90 (strain 309; P = 0.02), and in 95% of rats challenged with 100 times the ID90 (strain 1209; P = 0.0003). The combination of teicoplanin plus gentamicin (4 mg/kg) extended the protection to inocula 100 times the ID90 (strain 309; 96% of sterile animals) and 1,000 times the ID90 (strain 1209; 100% of sterile animals). Prevention of endocarditis was likely to be due to a prolonged inhibition of bacterial growth by sustained levels of teicoplanin in serum and not to bacterial killing. Indeed, teicoplanin did not exhibit any bactericidal activity either in vitro (time-kill curves) or in vivo (serum bactericidal activity). Teicoplanin proved to be superior to vancomycin in the prophylaxis of experimental E. faecalis endocarditis in rats. PMID:1416824

Entenza, J M; Calandra, T; Moosmann, Y; Malinverni, R; Glauser, M P

1992-01-01

336

Calcific left atrium: A rare consequence of endocarditis  

Science.gov (United States)

Usually, cardiac calcifications are observed in aortic and mitral valves, atrio-ventricular plane, mitral annulus, coronary arteries, pericaridium (usually causing constrictive pericarditis) and cardiac masses. Calcifications of atrial walls are unusual findings that can be identified only using imaging with high spatial resolution, such as cardiac magnetic resonance and computed tomography. We report a case of a 43-year-old patient with no history of heart disease that underwent cardiac evaluation for mild dyspnoea. The echocardiogram showed a calcific aortic valve and a hyper-echogenic lesion located in atrio-ventricular plane. The patient was submitted to cardiac magnetic resonance and to computed tomography imaging to better characterize the localization of mass. The clinical features and location of calcified lesion suggest an infective aetiology causing an endocarditis involving the aortic valve, atrio-ventricular plane and left atrium. Although we haven’t data to support a definite and clear diagnosis, the clinical features and location of the calcified lesion suggest an infective aetiology causing an endocarditis involving the aortic valve, atrio-ventricular plane and left atrium. The patient was followed for 12 mo both clinically and by electrocardiogram and echocardiography without worsening of clinical, electrocardiographic and echocardiographic data. Cardiac magnetic resonance imaging and computed tomography are ideal methods for identifying and following over time patients with calcific degeneration in the heart. PMID:25276304

Dattilo, Giuseppe; Anfuso, Carmelo; Casale, Matteo; Giugno, Vincenza; Camarda, Lorenzo; Laganà, Natascia; Di Bella, Gianluca

2014-01-01

337

Calcific left atrium: A rare consequence of endocarditis.  

Science.gov (United States)

Usually, cardiac calcifications are observed in aortic and mitral valves, atrio-ventricular plane, mitral annulus, coronary arteries, pericaridium (usually causing constrictive pericarditis) and cardiac masses. Calcifications of atrial walls are unusual findings that can be identified only using imaging with high spatial resolution, such as cardiac magnetic resonance and computed tomography. We report a case of a 43-year-old patient with no history of heart disease that underwent cardiac evaluation for mild dyspnoea. The echocardiogram showed a calcific aortic valve and a hyper-echogenic lesion located in atrio-ventricular plane. The patient was submitted to cardiac magnetic resonance and to computed tomography imaging to better characterize the localization of mass. The clinical features and location of calcified lesion suggest an infective aetiology causing an endocarditis involving the aortic valve, atrio-ventricular plane and left atrium. Although we haven't data to support a definite and clear diagnosis, the clinical features and location of the calcified lesion suggest an infective aetiology causing an endocarditis involving the aortic valve, atrio-ventricular plane and left atrium. The patient was followed for 12 mo both clinically and by electrocardiogram and echocardiography without worsening of clinical, electrocardiographic and echocardiographic data. Cardiac magnetic resonance imaging and computed tomography are ideal methods for identifying and following over time patients with calcific degeneration in the heart. PMID:25276304

Dattilo, Giuseppe; Anfuso, Carmelo; Casale, Matteo; Giugno, Vincenza; Camarda, Lorenzo; Laganà, Natascia; Di Bella, Gianluca

2014-09-26

338

Methicillin-Susceptible Staphylococcus aureus Endocarditis Isolates Are Associated With Clonal Complex 30 Genotype and a Distinct Repertoire of Enterotoxins and Adhesins  

OpenAIRE

Background.?Using multinational collections of methicillin-susceptible Staphylococcus aureus (MSSA) isolates from infective endocarditis (IE) and soft tissue infections (STIs), we sought to (1) validate the finding that S. aureus in clonal complex (CC) 30 is associated with hematogenous complications and (2) test the hypothesis that specific genetic characteristics in S. aureus are associated with infection severity.

Nienaber, Juhsien J. C.; Sharma Kuinkel, Batu K.; Clarke-pearson, Michael; Lamlertthon, Supaporn; Park, Lawrence; Rude, Thomas H.; Barriere, Steve; Woods, Christopher W.; Chu, Vivian H.; Mari?n, Mercedes; Bukovski, Suzana; Garcia, Patricia; Corey, G. Ralph; Korman, Tony; Doco-lecompte, Thanh

2011-01-01

339

Endocarditis and risk of cancer : a danish nationwide cohort study  

DEFF Research Database (Denmark)

Endocarditis may be a marker for bacteremia-associated occult cancer. Intensive antibiotic treatment in endocarditis is suggested to reduce long-term cancer risk. We examined these hypotheses in a nationwide cohort study.

Thomsen, Reimar Wernich; Farkas, Dóra Körmendiné

2013-01-01

340

Aspergillus flavus endocarditis of the native mitral valve in a bone marrow transplant patient.  

Science.gov (United States)

Background Infective endocarditis due to Aspergillus species is an uncommon infection with a high mortality rate. It mostly occurs after the implantation of prosthetic heart valves. Parenteral nutrition, immunosuppression, broad-spectrum antibiotic regimens, and illegal intravenous drug use are the risk factors for developing infection. Case Report We report a case of Aspergillus flavus native mitral valve endocarditis in a patient who had allogeneic stem cell transplantation in the past due to myelodysplastic syndrome. Conclusions Although it is rare and there is limited experience available with the diagnosis and treatment, early recognition and therapeutic intervention with systemic antifungal therapy and aggressive surgical intervention are critical to prevent further complications that may eventually lead to death. In addition, better novel diagnostic tools are needed to facilitate more accurate identification of patients with invasive Aspergillus and to permit earlier initiation of antifungal treatment. PMID:25603977

Demir, Tolga; Ergenoglu, Mehmet Umit; Ekinci, Abdurrahman; Tanrikulu, Nursen; Sahin, Mazlum; Demirsoy, Ergun

2015-01-01

341

Afasia post acv de acm unilateral por embolia infecciosa en endocarditis bacteriana / Aphasia post unilateral cerebral media stroke associated to infectious embolism in acute bacterial endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish Se reporta el caso de un paciente con endocarditis infecciosa que sufre un accidente cerebro vascular (ACV) isquémico a nivel parieto-occipital e ínsula posterior izquierda, con manifestaciones afásicas de rasgos mixtos, donde prima la fluidez y los problemas de repetición, agresividad, agrafia y di [...] ficultades de lectura. Es un caso llamativo por la singularidad de los hallazgos y la mejoría funcional posterior al evento. Son escasos reportes en la literatura que muestren una complicación afásica por una endocarditis infecciosa con vegetaciones aórticas por Streptococo mitis versus S. oralis. El origen de la endocarditis infecciosa fue atribuido a procedimiento de endodoncia, y justificado en hallazgos de RMN, punción lumbar y ECO-TE. En la actualidad, el paciente posee un lenguaje funcional, con ciertas dificultades a nivel del lenguaje expresivo y de la comprensión. Abstract in english We present a clinical report of a patient with infective endocarditis who suffered an ischemic stroke at the parietal occipital and posterior insula, with aphasic demonstrations including mixed features, primordially exhibiting fluency and repetition problems, aggression, dysgraphia, and reading dif [...] ficulties. It is a striking case because of the uniqueness of the findings and the functional improvement after the event. There are few previous reports describing an association between these bacteria and this injury and the patient's improvement. The cause of the endocarditis was attributed to an endodontic procedure because other paraclinical tests made during medical care showed no other apparent cause. Currently the patient only has difficulty with expressive language and understanding certain commands.

Germán, Cantillo Mackenzie; Andersson L, Rozo A.; Juan Camilo, Suárez-Escudero.

2014-04-01

342

Endocarditis por Bartonella henselae: Presentación de un caso y revisión de la literatura / Bartonella henselae endocarditis: Report of a case and review of the literature  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Bartonella spp son bacilos Gran negativos aerobios, difíciles de aislar con los medios empleados habitualmente en los laboratorios, considerados patógenos humanos emergentes. Desde 1993, tres especies del género Bartonella (B. quintana, B. henselae y B. elizabethae) se han descrito como agentes caus [...] ales de endocarditis bacteriana. En el presente trabajo se describe el caso de una paciente de 43 años, con valvulopatía previa de posible origen reumático y dueña de gatos, que sufrió una endocarditis infecciosa por B. henselae sobre válvula aórtica. La paciente presentó un título de IgG frente a B. henselae de 1/4096 y de 1/256 frente a B. quintana detectándose IgM frente a ambas bacterias a título débil (1/64 y 1/32 respectivamente). La paciente fue tratada con antibióticos durante 12 semanas y sometida a recambio válvular ante la grave lesión existente en la válvula aórtica. En tejido endocárdico procedente de la válvula escindida se detectó DNA de B. henselae (reacción en cadena de la polimerasa). La evolución clínica fue buena. El diagnóstico de infección por Bartonella spp debe ser considerado en todos los pacientes con endocarditis infecciosa y hemocultivo negativo, y en particular B. henselae en pacientes con valvulopatía previa y contacto habitual con gatos Abstract in english Bartonella spp are small Gram-negative rods, aerobic and highly fastidious. They are difficult to culture, in the routine bacterial cultures. They are considered as emergent human pathogens. Since 1993, three species of Bartonella (B. quintana, B. henselae, and B. elizabethae) have been described as [...] causative agents of infectious endocarditis. In this paper we describe the case of a 43 year-old woman with a previous valvular heart disease, probably of rheumatic origin, owner of cats, that suffered an infectious endocarditis by Bartonella henselae in the aortic valve. This patient presented IgG titers against B. henselae of 1/4096 and against B. quintana of 1/256. She also had low IgM titers against B. henselae and B. quintana: 1/64 and 1/32, respectively. The patient received antibiotics for 12 weeks and suffered a valvular replacement due to the severe lesion on the aortic valve. On the endocardic tissue of the removed valve DNA of B. henselae was detected (polymerase chain reaction-based assay). Clinical evolution of the patient was good. Diagnosis of Bartonella spp infection must be considered in every patient with infectious endocarditis and negative blood cultures, and particularly B. henselae in patients with previous válvular heart disease and regular contact with cats

G., Cilla Eguiluz; M., Montes Ros; D., López García; B., Iraola Sierra; V., Aramburu Soraluce.

2001-05-01

343

Bacteroides fragilis endocarditis: a case report and review of literature  

Directory of Open Access Journals (Sweden)

Full Text Available Endocarditis due to Bacteroides fragilis is a rare disorder. This article describes a case of Bacteroides fragilis endocarditis associated with portal and superior mesenteric venous thrombosis in a patient without preexisting valvular heart disease and review the cases of endocarditis due to this anaerobic bacterium in medical literature since 1980.

Cristhieni Rodrigues

2012-02-01

344

Cardiobacterium hominis bioprosthetic mitral valve endocarditis presenting as septic arthritis.  

Science.gov (United States)

We report an unusual case of Cardiobacterium hominis bioprosthetic valve endocarditis presenting as septic arthritis. This remarkable presentation had clinical features consistent with endocarditis generally associated with highly virulent pathogens. A literature search has failed to disclose a report of septic arthiritis as a manifestation of C. hominis endocarditis. PMID:11821177

Apisarnthanarak, Anucha; Johnson, Raymond M; Braverman, Alan C; Dunne, William Michael; Little, J Russell

2002-01-01

345

Successful single-dose teicoplanin prophylaxis against experimental streptococcal, enterococcal, and staphylococcal aortic valve endocarditis.  

Science.gov (United States)

Teicoplanin is a glycopeptide antibiotic that is administered both intramuscularly and intravenously. It has a prolonged half-life and a less toxic profile in comparison to those of vancomycin. The efficacy of a single dose of teicoplanin (18 mg/kg of body weight given intramuscularly) for the prevention of endocarditis due to Streptococcus oralis, Enterococcus faecium, and methicillin-resistant Staphylococcus aureus (MRSA) was evaluated after applying the rabbit model. Vancomycin at a single dose of 30 mg/kg given intravenously was used as the comparative agent for the prevention of endocarditis due to MRSA and E. faecium, while ampicillin at a single dose of 40 mg/kg given intravenously was used as the comparative agent for the prevention of endocarditis due to S. oralis. Rabbits in the teicoplanin group were infected at 1 h postdosing with approximately 10(7) CFU of each strain. Rabbits in the other groups were infected at 0.5 h postdosing with approximately 10(7) CFU of S. oralis (ampicillin group) or E. faecium and MRSA (vancomycin group). All rabbits were sacrificed 5 days later. Teicoplanin and vancomycin protected the animals challenged with E. faecium by 87.5 and 50%, respectively, and protected the animals challenged with MRSA by 100 and 92%, respectively. Teicoplanin and ampicillin protected the animals challenged with S. oralis by 100 and 77%, respectively. Prevention of endocarditis by teicoplanin was likely to be due to a prolonged inhibition of bacterial growth by the sustained supra-MICs. It is concluded that teicoplanin is very effective in preventing experimental streptococcal, enterococcal, and staphylococcal endocarditis and may be an attractive alternative antibiotic in patients allergic to beta-lactams, especially in the outpatient setting. PMID:9303384

Perdikaris, G S; Pefanis, A; Giamarellou, H; Nikolopoulos, A; Margaris, E P; Donta, I; Tsitsika, A; Karayiannakos, P

1997-01-01

346

Fungal pericarditis and endocarditis secondary to porcupine quill migration in a dog.  

Science.gov (United States)

A dog evaluated for acute onset of neurologic clinical signs was discovered to have a porcupine quill traversing the left atrium with fungal endocarditis. The dog had been quilled by a porcupine one month prior to presentation and had had several quills removed from the thoracic inlet and left dorsal shoulder areas. A new murmur was identified during the initial examination. Echocardiographic changes consistent with mitral valve endocarditis were identified, in addition to a linear, hyperechoic structure in the left atrium. A thoracic CT identified a possible mediastinal migrating foreign body tract. The foreign body was surgically removed and confirmed as a porcupine quill. Routine aerobic cultures of blood and pericardial samples resulted in growth of presumptive candidal organisms. PCR amplification and sequencing of samples from pericardial cultures identified the presence of a fungal organism, Lodderomyces elongisporus. The neurologic signs were attributed to a left-sided central vestibular lesion presumed secondary to an embolic event from infective endocarditis. After 3 months of antimicrobial and antifungal therapy the valvular changes had markedly improved and the clinical signs resolved. To the authors' knowledge, this is the first description of fungal endocarditis secondary to an intracardiac foreign body in a dog. PMID:25465340

Costa, Ana; Lahmers, Sunshine; Barry, Sabrina L; Stanton, James; Stern, Joshua A

2014-12-01

347

Endocarditis caused by methicillin-susceptible Staphylococcus aureus with reduced susceptibility to vancomycin: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Staphylococcus aureus is the most common cause of acute infective endocarditis. Recent reports have described heteroresistance to vancomycin associated with methicillin-resistant Staphylococcus aureus. We present the first case report in Argentina of the failure of treatment with vancomycin in endocarditis caused by methicillin-susceptible Staphylococcus aureus containing subpopulations with reduced susceptibility to vancomycin. Case presentation We report the case of a 66-year-old Hispanic man with infective endocarditis complicated by septic emboli in the lumbosacral spine and the left iliopsoas muscle. This disease was caused by methicillin-susceptible Staphylococcus aureus containing subpopulations with reduced susceptibility to vancomycin. He was initially treated with cephalothin and gentamicin but developed a rash caused by beta-lactams and interstitial nephritis. For that reason, the treatment was subsequently switched to vancomycin but he failed to respond. The infection resolved after administration of vancomycin in combination with gentamicin and rifampin. Conclusion Our case report provides important evidence for the existence of subpopulations of methicillin-susceptible Staphylococcus aureus that have reduced susceptibility to vancomycin which would account for treatment failure. Our case raises an alert about the existence of these strains and highlights the need to determine the vancomycin minimum inhibitory concentration of Staphylococcus aureus to screen for the presence of strains that have reduced vancomycin susceptibility at different infection sites.

Famiglietti Angela

2011-07-01

348

Cecocentral scotoma as the initial manifestation of subacute bacterial endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Danielle Savitsky Strauss, Samuel Baharestani, Julia Nemiroff, Kiran Amesur, David HowardNew York University Langone Medical Center, New York, NY, USAIntroduction: We report a case of a 67-year-old male who presented with a cecocentral scotoma caused by a septic embolus from subacute bacterial endocarditis (SBE.Methods: A 67-year-old man presented with sudden, painless decreased vision in the left eye. A dilated fundoscopic exam, Humphrey visual field test, transthoracic echocardiogram, abdominal computed tomography (CT, and blood cultures were all performed.Results: A dilated fundoscopic exam revealed temporal segmental optic disc pallor on the left, and Humphrey visual field testing demonstrated a dense left cecocentral scotoma. When the patient developed fever (103.9°F and palpitations, transthoracic echocardiogram revealed valvular vegetations, and contrast CT of the abdomen revealed an abscess in the dome of the liver likely due to an infectious thrombus. Blood cultures grew viridians group streptococci in three separate peripheral collections.Conclusion: This case illustrates that a sudden cecocentral scotoma may be the initial manifestation of SBE. Keywords: endocarditis, scotoma, streptococcal infections, visual fields

Danielle Savitsky Strauss

2011-03-01

349

/ Endocarditis por Bordetella holmesii en un paciente asplénico  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Se presenta el caso de una paciente de 52 años portadora de estenosis aórtica crítica, esplenectomizada, hipotiroidea, que tenía como antecedente linfoma de Hodgkin diagnosticado en 2004. En abril de 2011 ingresó al Servicio de Cardiología por insuficiencia cardíaca global y registros febriles, con [...] respuesta tórpida al tratamiento diurético-vasodilatador. El ecocardiograma transesofágico mostró imágenes ecodensas en válvulas aórtica, pulmonar y mitral compatibles con vegetaciones, por lo que el cuadro se interpretó como probable endocarditis infecciosa. En dos muestras de hemocultivos desarrolló un cocobacilo gram negativo que fue identificado como Bordetella holmesii. Se realizó tratamiento con ceftriaxona 1 g cada 12 h durante 28 días, y se observó una evolución favorable. Abstract in english The case of a 52-year-old female patient with a history of critical aortic stenosis, hypothyroidism and splenectomy as treatment for her Hodgkin's lymphoma is herein presented. In April 2011, the patient was admitted to the cardiology service due to global heart failure, fever and poor response to d [...] iuretic and vasodilator therapy. A transesophageal echocardiogram showed images compatible with vegetations in the aortic, pulmonary, and mitral valves. A diagnosis of infective endocarditis was made. Growth of gram-negative coccobacilli was observed in two blood culture sets. The microorganism was finally identified as Bordetella holmesii.The patient was treated with ceftriaxone 1 g every 12 hours for 28 days with favorable outcome.

Rolando N, Soloaga; Natalia A, Carrion; Marisa, Almuzara; Claudia, Barberis; Juan C, Pidone; Liliana I, Guelfand; Carlos, Vay.

2013-06-01

350

Cerebral vasculitis and Cardiobacterium valvarum endocarditis.  

Science.gov (United States)

We present a case of aortic and tricuspid native valve endocarditis in which Cardiobacterium valvarum was isolated from the blood culture of a 65-year-old man. Cardiobacterium valvarum is a fastidious, Gram-negative bacillus. The genus Cardiobacterium encompasses two species - Cardiobacterium valvarum and Cardiobacterium hominis. Although both species rarely feature as the aetiological agent of endocarditis, Cardiobacterium hominis has a higher incidence than Cardiobacterium valvarum. For this causative organism, we believe this is the first report of fatality prior to surgical intervention and the first clinical course to be complicated by cerebral vasculitis. Native valve endocarditis caused by Gram-negative bacilli is extremely rare and identification of isolates may require the use of reference laboratories with molecular identification techniques. PMID:22878249

Abraham, R; Irwin, R B; Kannappan, D; Isalska, B; Koroma, M; Younis, N

2012-11-01

351

Kodamaea ohmeri tricuspid valve endocarditis with right ventricular inflow obstruction in a neonate with structurally normal heart  

Directory of Open Access Journals (Sweden)

Full Text Available The yeast Kodamaea (Pichia ohmeri is a rare human pathogen with infrequent report of neonatal infection. Native valve endocarditis by Kodamaea ohmeri is extremely rare. The current case report describes a case of fatal nosocomial native valve endocarditis without any structural heart defects in a 40dayold baby. The patient was referred to our institute after having ICU stay of 18 days in another hospital for necrotizing enterocolitis and was found to have obstructive tricuspid valve mass and fungemia with Kodamaea ohmeri. In spite of the treatment, patient developed sepsis with disseminated intravascular coagulation and could not be revived.

Sundaram Ponnusamy

2011-01-01

352

Prosthetic valve endocarditis caused by Pasteurella in a penicillin allergic patient: challenges in diagnosis and treatment  

OpenAIRE

Pasteurella multocida is a rare cause of infective endocarditis with only a few cases described. This report involves a 38-year-old penicillin-allergic patient in an immunocompromised state with several co-morbidities. Two molecular microbiological techniques, 16S rRNA sequencing and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry were used to confirm the species identification as P. multocida. Previous reports in the literature are also reviewed.

Hala Kandil; Giovanni Satta; Rebecca Louise Gorton

2012-01-01

353

A Case of Brucella Endocarditis in Association with Subclavian Artery Thrombosis  

OpenAIRE

Brucellosis is a common zoonosis, endemic in Mediterranean countries, and caused by bacteria of Brucella genus. Brucellosis is a systemic infection and the clinical presentation varies widely from asymptomatic and mild to severe disease. Cardiovascular complications are extremely rare. We present a case of arterial thrombosis in a previously healthy young patient with Brucella endocarditis. Careful attention must be paid to any sign or symptom of thrombosis in patients affected by brucellosis...

Claudia Colomba; Lucia Siracusa; Raffaella Rubino; Marcello Trizzino; Francesco Scarlata; Claudia Imburgia; Lucina Titone

2012-01-01

354

Staphylococcal Endocarditis Presenting with a Renal Infarct in a Patient with Acute Lymphoblastic Leukemia  

OpenAIRE

We present here a patient with acute lymphoblastic leukemia (ALL) and who developed infective endocarditis during induction chemotherapy with prednisolone, L-asparaginase (Leunase®), vincristine and adriamycin. The patient did not have a history of a central venous catheter. Sharp flank pain and fever occurred on the 25th day of induction chemotherapy. In addition, a renal infarct and movable vegetations on the mitral valve were detected on the abdominal computed tomography (CT) and echocard...

Son, Meong Hi; Park, Eun Sil; Seo, Ji-hyun; Lim, Jae-young; Park, Chan-hoo; Woo, Hyang-ok; Youn, Hee-shang

2008-01-01

355

The use of a new glycopeptide antibiotic, teicoplanin, in the treatment of bacterial endocarditis.  

OpenAIRE

Teicoplanin, a new glycopeptide antibiotic, has been used to treat twelve patients with bacterial endocarditis due to Gram-positive organisms. Teicoplanin has activity against Gram-positive bacteria similar to vancomycin but therapeutic levels are maintained by a single daily dose, given as an intravenous bolus. Of six patients with native valve infections, two cases, due to viridans streptococci, were successfully treated with teicoplanin alone and two others, caused by Streptococcus faecali...

Webster, A.; Wilson, A. P.; Williams, A. H.; Treasure, T.; Gru?neberg, R. N.

1987-01-01

356

Endocardite por lactococcus garvieae: primeiro relato de caso da América Latina Endocarditis por lactococcus garvieae: primer relato de caso de América Latina Lactococcus garvieae endocarditis: first case report in Latin America  

Directory of Open Access Journals (Sweden)

Full Text Available Lactococcus garvieae, patógeno zoonótico emergente, é responsável por mastite em ruminantes e septicemia em peixes. Embora seja considerado oportunista e raramente causar infecções em humanos, sua incidência deve estar subestimada devido à dificuldade do diagnóstico. Há pouquíssimos relatos de osteomielite, abscesso hepático e peritonite, e apenas nove casos descritos na literatura mundial de endocardite. Relatamos o primeiro caso de endocardite por Lactococcus garvieae da América Latina em paciente portadora de prótese valvar metálica, com quadro de febre diária, calafrios, nodos de Osler e seis hemoculturas positivas para Lactococcus garvieae, que preenchiam os critérios de Duke para o diagnóstico de "endocardite infecciosa definitiva"Lactococcus garvieae, patógeno zoonótico emergente, es responsable por mastitis en rumiantes y septicemia en peces. Aunque sea considerado oportunista y raramente cause infecciones en humanos, su incidencia debe estar subestimada debido a la dificultad del diagnóstico. Hay poquísimos relatos de osteomielitis, absceso hepático y peritonitis, y apenas nueve casos descriptos en la literatura mundial de endocarditis. Relatamos el primer caso de endocarditis por Lactococcus garvieae de América Latina en paciente portadora de prótesis valvar metálica, con cuadro de fiebre diaria, escalofríos, nódulos de Osler y seis hemocultivos positivos para Lactococcus garvieae, que llenaban los criterios de Duke para el diagnóstico de "endocarditis infecciosa definitiva"Lactococcus garvieae, an emerging zoonotic pathogen, is responsible for mastitis in rodents and sepsis in fish. Although deemed opportunistic and hardly ever causing infections in humans, its incidence is probably underestimated due to the difficulty in diagnosis. There are very few reports of osteomyelitis, liver abscess, and peritonitis, and only nine cases of endocarditis described in worldwide literature. We describe the first case of Lactococcus garvieae endocarditis in Latin America, in a female patient with metallic prosthetic heart valve who presented with daily fever, chills, Osler nodes and six positive blood cultures for Lactococcus garvieae, which met Duke's criteria for the diagnosis of "definitive infective endocarditis"

Tatiana Franco Hirakawa

2011-11-01

357

Endocardite por lactococcus garvieae: primeiro relato de caso da América Latina / Lactococcus garvieae endocarditis: first case report in Latin America / Endocarditis por lactococcus garvieae: primer relato de caso de América Latina  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Lactococcus garvieae, patógeno zoonótico emergente, é responsável por mastite em ruminantes e septicemia em peixes. Embora seja considerado oportunista e raramente causar infecções em humanos, sua incidência deve estar subestimada devido à dificuldade do diagnóstico. Há pouquíssimos relatos de osteo [...] mielite, abscesso hepático e peritonite, e apenas nove casos descritos na literatura mundial de endocardite. Relatamos o primeiro caso de endocardite por Lactococcus garvieae da América Latina em paciente portadora de prótese valvar metálica, com quadro de febre diária, calafrios, nodos de Osler e seis hemoculturas positivas para Lactococcus garvieae, que preenchiam os critérios de Duke para o diagnóstico de "endocardite infecciosa definitiva" Abstract in spanish Lactococcus garvieae, patógeno zoonótico emergente, es responsable por mastitis en rumiantes y septicemia en peces. Aunque sea considerado oportunista y raramente cause infecciones en humanos, su incidencia debe estar subestimada debido a la dificultad del diagnóstico. Hay poquísimos relatos de oste [...] omielitis, absceso hepático y peritonitis, y apenas nueve casos descriptos en la literatura mundial de endocarditis. Relatamos el primer caso de endocarditis por Lactococcus garvieae de América Latina en paciente portadora de prótesis valvar metálica, con cuadro de fiebre diaria, escalofríos, nódulos de Osler y seis hemocultivos positivos para Lactococcus garvieae, que llenaban los criterios de Duke para el diagnóstico de "endocarditis infecciosa definitiva" Abstract in english Lactococcus garvieae, an emerging zoonotic pathogen, is responsible for mastitis in rodents and sepsis in fish. Although deemed opportunistic and hardly ever causing infections in humans, its incidence is probably underestimated due to the difficulty in diagnosis. There are very few reports of osteo [...] myelitis, liver abscess, and peritonitis, and only nine cases of endocarditis described in worldwide literature. We describe the first case of Lactococcus garvieae endocarditis in Latin America, in a female patient with metallic prosthetic heart valve who presented with daily fever, chills, Osler nodes and six positive blood cultures for Lactococcus garvieae, which met Duke's criteria for the diagnosis of "definitive infective endocarditis"

Tatiana Franco, Hirakawa; Fernando Augusto Alves da, Costa; Marcos Cairo, Vilela; Micheli, Rigon; Henry, Abensur; Maria Rita Elmor de, Araújo.

2011-11-01

358

Phylodynamic analysis of a viral infection network  

OpenAIRE

Viral infections by sexual and droplet transmission routes typically spread through a complex host-to-host contact network. Clarifying the transmission network and epidemiological parameters affecting the variations and dynamics of a specific pathogen is a major issue in the control of infectious diseases. However, conventional methods such as interview and/or classical phylogenetic analysis of viral gene sequences have inherent limitations and often fail to detect infectious clusters and tra...

TeiichiroShiino

2012-01-01

359

Endocarditis por Trichoderma longibrachiatum en paciente con nutrición parenteral domiciliaria / Endocarditis caused by Trichoderma longibrachiatum and parenteral nutrition  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish La modalidad domiciliaria de la nutrición parenteral (NPD) mejora la calidad de vida de los pacientes, pero tiene complicaciones como infecciones asociadas a catéter (IAC) y complicaciones mecánicas. Presentamos el caso de un paciente con NPD por intestino corto que desarrolla una endocarditis sobre [...] catéter con matices especiales: asentar sobre un catéter abandonado en aurícula derecha y tratarse de una infección con participación de un microorganismo no descrito hasta el momento en esta patología, Trichoderma longibrachiatum. El catéter se extrajo mediante cirugía convencional. En la pieza quirúrgica se aislaron Staphylococcus epidermidis, Ochrobactrum anthropi y Trichoderma longibrachiatum. Combinando el tratamiento antibiótico y la eliminación del foco infeccioso se consiguió la recuperación completa. Ochrobactrum anthropi y Trichoderma longibrachiatum son microorganismos poco habituales, pero que cada vez adquieren mayor relevancia. Aunque no existe acuerdo en el manejo de los catéteres intravasculares "abandonados", es recomendable el seguimiento y eliminarlos en caso de complicación. Abstract in english Home parenteral nutrition (HPN) improves the quality of life of the patients although it has complications. Catheter-related infections and mechanical complications are the most frequent ones. We report the case of endocarditis over catheter in a man suffering from short bowel and receiving HPN. The [...] special features of the case are firstly the catheter was a remaining fragment on the right atrial and secondly the infection was caused by Trichoderma longibrachiatum, an isolated fact regarding this pathology so far. Conventional surgery was applied to take the catheter out. Staphylococcus epidermidis, Ochrobactrum anthropi and Trichoderma longibrachiatum were isolated from the surgical specimen. The extraction of the infected catheter along with antibiotic therapy led to the complete recovery of the subject. Ochrobactrum anthropi and Trichoderma longibrachiatum are unusual microorganisms but they are acquiring more relevance. Although there is no agreement about intravascular retained catheter management, the most recommended approach consists on monitoring them and removing the device in case of complications.

Laura I., Rodríguez Peralta; M.ª Reyes, Mañas Vera; Manuel J., García Delgado; Antonio J., Pérez De la Cruz.

2013-06-01

360

Scintigraphic detection of acute experimental endocarditis with the technetium-99m labelled glycoprotein IIb/IIIa receptor antagonist DMP444  

Energy Technology Data Exchange (ETDEWEB)

Bacterial endocarditis is an important clinical problem that may result in persistent bacteraemia and irreversible cardiac damage. Since endocarditis is characterized by aggregation of activated platelets, fibrin and bacteria, we studied DMP444, a technetium-99m labelled high-affinity antagonist of the GP IIb/IIIa receptor that is expressed on activated platelets. In seven Beagle dogs (11-15 kg), the left ventricle was catheterized via the right carotid artery. One hour later, 5 x 10{sup 7} colony forming units of Staphylococcus aureus were injected intracardially. Half an hour later, the catheter was removed. Two extra dogs underwent a complete sham procedure. One day after the intervention, five infected and the two non-infected dogs were injected with 37 MBq/kg {sup 99m}Tc-DMP444 and two infected dogs with 37 MBq/kg {sup 99m}Tc-IgG (used as a non-specific control agent) and imaged up to 4 h after injection. Samples were obtained for tissue counting, microbiology and histology. From 1 to 2 h post injection onward, there was clear focal accumulation of DMP444 in the aortic valve region when endocarditis was present, and this accumulation increased with time. The non-infected and the {sup 99m}Tc-IgG injected dogs showed only persisting blood pool activity without any focal abnormality. At 4 h post injection, the in vivo valve-to-blood pool ratios were 1.87{+-}0.18 in endocarditis, 1.01{+-}0.05 in non-infected controls and 1.09{+-}0.02 in {sup 99m}Tc-IgG injected dogs (P<0.05). It is concluded that targeting activated platelets with the {sup 99m}Tc-labelled GP IIb/IIIa antagonist DMP444 allows a final diagnosis of experimental bacterial endocarditis within 4 h owing to high, specific and fast in vivo uptake. (orig.)

Oyen, W.J.G.; Boerman, O.C.; Corstens, F.H.M. [Department of Nuclear Medicine, University Hospital Nijmegen, Nijmegen (Netherlands); Brouwers, F.M. [Department of Nuclear Medicine, University Hospital Nijmegen, Nijmegen (Netherlands); Department of Internal Medicine, University Hospital Nijmegen, Nijmegen (Netherlands); Barrett, J.A. [DuPont Pharmaceutical Company, Radiopharmaceutical Division, North Billerica, MA (United States); Verheugt, F.W.A. [Department of Cardiology, University Hospital Nijmegen, Nijmegen (Netherlands); Ruiter, D.J. [Department of Pathology, University Hospital Nijmegen, Nijmegen (Netherlands); Meer, J.W.M. van der [Department of Internal Medicine, University Hospital Nijmegen, Nijmegen (Netherlands)

2000-04-01

361

Scintigraphic detection of acute experimental endocarditis with the technetium-99m labelled glycoprotein IIb/IIIa receptor antagonist DMP444  

International Nuclear Information System (INIS)

Bacterial endocarditis is an important clinical problem that may result in persistent bacteraemia and irreversible cardiac damage. Since endocarditis is characterized by aggregation of activated platelets, fibrin and bacteria, we studied DMP444, a technetium-99m labelled high-affinity antagonist of the GP IIb/IIIa receptor that is expressed on activated platelets. In seven Beagle dogs (11-15 kg), the left ventricle was catheterized via the right carotid artery. One hour later, 5 x 107 colony forming units of Staphylococcus aureus were injected intracardially. Half an hour later, the catheter was removed. Two extra dogs underwent a complete sham procedure. One day after the intervention, five infected and the two non-infected dogs were injected with 37 MBq/kg 99mTc-DMP444 and two infected dogs with 37 MBq/kg 99mTc-IgG (used as a non-specific control agent) and imaged up to 4 h after injection. Samples were obtained for tissue counting, microbiology and histology. From 1 to 2 h post injection onward, there was clear focal accumulation of DMP444 in the aortic valve region when endocarditis was present, and this accumulation increased with time. The non-infected and the 99mTc-IgG injected dogs showed only persisting blood pool activity without any focal abnormality. At 4 h post injection, the in vivo valve-to-blood pool ratios were 1.87±0.18 in endocarditis, 1.01±0.05 in non-infected controls and 1.09±0.02 in 99mTctrols and 1.09±0.02 in 99mTc-IgG injected dogs (P99mTc-labelled GP IIb/IIIa antagonist DMP444 allows a final diagnosis of experimental bacterial endocarditis within 4 h owing to high, specific and fast in vivo uptake. (orig.)

362

Predictive Factors for Metastatic Infection in Patients With Bacteremia Caused by Methicillin-Sensitive Staphylococcus aureus  

Science.gov (United States)

Abstract: Background: Metastatic infections such as infective endocarditis and psoas abscess are serious complications of Staphylococcus aureus bacteremia because failure to identify these infections may result in bacteremia relapse or poor prognosis. In the present study, we determined the predictive factors for metastatic infection due to methicillin-sensitive S. aureus bacteremia. Methods: A retrospective cohort study was conducted among patients with methicillin-sensitive S. aureus bacteremia at the Jikei University Hospital between January 2008 and December 2012. Factors analyzed included the underlying disease, initial antimicrobial treatment and primary site of infection. Results: During the 5-year study period, 73 patients met the inclusion criteria and were assessed. The most common primary site of bacteremia was catheter-related bloodstream infection (25/73 [34.2%]). Metastatic infection occurred in 14 of 73 patients (19.2%) (infective endocarditis [3], septic pulmonary abscess [3], spondylitis [4], psoas abscess [4], epidural abscess [3] and septic arthritis [1]). Six patients had multiple metastatic infections. Multivariate analysis revealed that the predictive factors associated with the development of metastatic infection were a delay in appropriate antimicrobial treatment of >48 hours, persistent fever for >72 hours after starting antibiotic treatment and lowest C-reactive protein levels of >3 mg/dL during 2 weeks after the onset of bacteremia. Conclusions: This study demonstrated that additional diagnostic tests should be conducted to identify metastatic infection, particularly in patients with delayed antimicrobial treatment, persistent fever and persistently high C-reactive protein levels. PMID:25250988

Sato, Fumiya; Hosaka, Yumiko; Hoshina, Tokio; Tamura, Kumi; Nakaharai, Kazuhiko; Kato, Tetsuro; Nakazawa, Yasushi; Yoshida, Masaki; Hori, Seiji

2015-01-01

363

Teicoplanin-induced neutropenic sepsis mimicking endocarditis.  

Science.gov (United States)

Teicoplanin is a less toxic replacement for vancomycin in most situations where resistant organisms are encountered, and is therefore the drug of choice. As a commonly used drug in cardiac surgery, we treated a case of presumptive endocarditis with teicoplanin that caused neutropenic sepsis, unmasked on withdrawal of treatment. PMID:22879557

Booth, Karen; Parissis, Haralambos

2012-08-01

364

[A case report of Cardiobacterium hominis endocarditis].  

Science.gov (United States)

We here report a case of endocarditis due to Cardiobacterium hominis in a 53-year-old patient, who presented with large vegetations on the mitral valve. Good cooperation between clinicians and microbiologists and an efficient automated blood culture system were the decisive factors in establishing the diagnosis. Early and appropriate treatment prevented the septic embolisms often observed in this pathology. PMID:12147451

Lesimple, B; Dujardin, J J; Joly, P; Hendricx, S; Fievet, P

2002-01-01

365

Phylodynamic analysis of a viral infection network.  

Science.gov (United States)

Viral infections by sexual and droplet transmission routes typically spread through a complex host-to-host contact network. Clarifying the transmission network and epidemiological parameters affecting the variations and dynamics of a specific pathogen is a major issue in the control of infectious diseases. However, conventional methods such as interview and/or classical phylogenetic analysis of viral gene sequences have inherent limitations and often fail to detect infectious clusters and transmission connections. Recent improvements in computational environments now permit the analysis of large datasets. In addition, novel analytical methods have been developed that serve to infer the evolutionary dynamics of virus genetic diversity using sample date information and sequence data. This type of framework, termed "phylodynamics," helps connect some of the missing links on viral transmission networks, which are often hard to detect by conventional methods of epidemiology. With sufficient number of sequences available, one can use this new inference method to estimate theoretical epidemiological parameters such as temporal distributions of the primary infection, fluctuation of the pathogen population size, basic reproductive number, and the mean time span of disease infectiousness. Transmission networks estimated by this framework often have the properties of a scale-free network, which are characteristic of infectious and social communication processes. Network analysis based on phylodynamics has alluded to various suggestions concerning the infection dynamics associated with a given community and/or risk behavior. In this review, I will summarize the current methods available for identifying the transmission network using phylogeny, and present an argument on the possibilities of applying the scale-free properties to these existing frameworks. PMID:22993510

Shiino, Teiichiro

2012-01-01

366

Phylodynamic analysis of a viral infection network  

Directory of Open Access Journals (Sweden)

Full Text Available Viral infections by sexual and droplet transmission routes typically spread through a complex host-to-host contact network. Clarifying the transmission network and epidemiological parameters affecting the variations and dynamics of a specific pathogen is a major issue in the control of infectious diseases. However, conventional methods such as interview and/or classical phylogenetic analysis of viral gene sequences have inherent limitations and often fail to detect infectious clusters and transmission connections. Recent improvements in computational environments now permit the analysis of large datasets. In addition, novel analytical methods have been developed that serve to infer the evolutionary dynamics of virus genetic diversity using sample date information and sequence data. This type of framework, termed “phylodynamics”, helps connect some of the missing links on viral transmission networks, which are often hard to detect by conventional methods of epidemiology. With sufficient number of sequences available, one can use this new inference method to estimate theoretical epidemiological parameters such as temporal distributions of the primary infection, fluctuation of the pathogen population size, basic reproductive number, and the mean time span of disease infectiousness. Transmission networks estimated by this framework often have the properties of a scale-free network, which are characteristic of infectious and social communication processes. Network analysis based on phylodynamics has alluded to various suggestions concerning the infection dynamics associated with a given community and/or risk behavior. In this review, I will summarize the current methods available for identifying the transmission network using phylogeny, and present an argument on the possibilities of applying the scale-free properties to these existing frameworks.

TeiichiroShiino

2012-07-01

367

QT Prolongation Complicated with Torsades de Pointes in Prosthetic Mitral Valve Endocarditis: A Case Report.  

Science.gov (United States)

We present the case of a 49-year-old male patient with prosthetic mitral valve endocarditis associated with QT prolongation and torsades de pointes. He was asymptomatic until the end of January 2012, when he was admitted to our hospital emergency unit because of syncope, fever, and suspicion of endocarditis. Cardiologic evaluation was requested and the transthoracic (TTE) and transesophageal (TEE) echocardiograms revealed vegetations on the prosthetic mitral valve. All cultures were positive for methicillin-sensitive Staphylococcus aureus. The corrected QT (QTc) interval was markedly prolonged upon admission (QTc 540 ms). He experienced torsades de pointes (TdP) several times and he was recovered after bystander cardiopulmonary resuscitation. The clinical course and the long QTc interval with deep inverted T wave were completely normalized 4 weeks after. He continued on triple antibiotic therapy for 45 days with a good revolution. The clinical features and the possible mechanisms of QT prolongation (inflammation, infection) of this patient are discussed. PMID:23093971

Tounsi, A; Abid, L; Akrout, M; Hentati, M; Kammoun, S

2012-01-01

368

[Surgical treatment of septic endocarditis in drug addicts].  

Science.gov (United States)

The clinical picture of endocarditis in addicts is characterized by mainly right-sided localization of the process in the heart, poor auscultatory picture of the heart, pleuro-pulmonary manifestations against the background of a feverish course of the disease. The leading role in diagnosis of infectious endocarditis in addicts should be given to echocardiography. A description of three cases of surgical treatment of infectious endocarditis in addicts is presented. PMID:2169101

Shevchenko, Iu L; Shikhverdiev, N N; Zhuravlev, V P; Gridasov, V F; Matveev, S A; Khubulava, G G; Tsvetkova, T V

1990-03-01

369

Rare Association of Henoch-Schönlein Purpura with Recurrent Endocarditis  

OpenAIRE

We report a rare association of Henoch-Schönlein Purpura with recurrent endocarditis in a 36 year old male patient presenting with rash and renal failure. Bacterial endocarditis can be complicated by renal failure of various etiologies. Biopsy may distinguish these and guide therapy as seen in this case. Here, timely diagnosis of Henoch-Schönlein Purpura in the setting of recurrent methacillin sensitive staphylococcus endocarditis, led to steroid therapy and renal recovery. This is a rare r...

Berquist, Jilaine Bolek; Bartels, Christie Michels

2011-01-01

370

Endocarditis infecciosa, experiencia de diez años en un centro de referencia nacional / Infectious endocarditis, 10 years of experience in a national reference center  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Objetivo: estudiar las características clínicas, epidemiológicas y microbiológicas, así como el tratamiento médico quirúrgico de los pacientes ingresados con el diagnóstico de endocarditis infecciosa, con el propósito de profundizar en su estudio y contribuir a un mejor tratamiento a estos pacientes [...] . Métodos: se estudiaron 24 pacientes procedentes de todo el país, egresados con el diagnóstico de endocarditis infecciosa. Los datos fueron recogidos de las historias clínicas procedentes del archivo del Hospital "William Soler", y de la base de datos del servicio de cirugía del cardiocentro. Se determinó la frecuencia de las diferentes manifestaciones de la endocarditis infecciosa según: grupos etarios, factores de riesgo, y los datos clínicos, de laboratorio y microbiológicos más frecuentes. Además, se determinó la toma valvular predominante, la etiología y su respuesta a los antibióticos. Resultados: el grupo de edad más afectado fue entre 5 y 18 años; la cardiopatía previa fue el factor de riesgo predominante; los síntomas y signos más frecuentes fueron la fiebre, la anorexia y la pérdida de peso. La insuficiencia cardiaca y el embolismo pulmonar fueron complicaciones frecuentes. La mayoría de los pacientes tuvo una eritrosedimentación acelerada, y la cuarta parte de los casos presentaron hemocultivos negativos. Las válvulas aórtica y mitral resultaron las más afectadas, y el curso clínico que predominó fue el subagudo. En casi la mitad de los pacientes la infección tuvo un origen nosocomial. Los antimicrobianos más utilizados fueron la amikacina, la vancomicina y la ceftriaxona. Conclusiones: la endocarditis infecciosa es poco frecuente en nuestra institución, ocurre más a menudo en relación con las cardiopatías congénitas. Los hechos clínicos más constantes fueron la fiebre y el antecedente de cardiopatía previa. Abstract in english Objective: to study the clinical, epidemiological and microbiological characteristics as well as the surgical medical treatment of patients admitted diagnosed with infectious endocarditis to deepen in its study and to contribute to a better treatment for these patients. Methods: twenty four patients [...] from whole country, discharged with the diagnosis of infectious endocarditis. Data were collect from the medical records of the "William Soler" Children Hospital files and from the database of surgery service of heart center. The frequency of different manifestations of infectious endocarditis was determined according to: age groups, risk factors and the more frequent clinical, laboratory and microbiologic data. Also, the predominant valvular take, the etiology and the response to antibiotics were determined. Results: the more involved age group was between 5 and 18 years; the previous heart disease was the more predominant factor; the more frequent symptoms and signs were: fever, anorexia and weight loss. The heart failure and the pulmonary embolism were frequent complications. Most of patients had an accelerated erythrosedimentation and the fourth of cases had negative blood cultures. The aortic and mitral valves were the more involved and the predominant clinical course was the subacute. In almost the half of patients the infection had a nosocomial origin. The more used antimicrobial agents were amikacin, vancomycin and ceftriaxone. Conclusions: the infectious endocarditis is uncommon in our institution occurs more often in relation to congenital heart diseases. The more constant clinical facts were fever and a history of previous heart disease.

Elsa, Fleitas Ruisánchez; Andrés, Savío Benavides; Jorge, Ponce Bittar; Carlos, García Guevara; Xiomara, Calzadilla Mesa.

2011-12-01

371

Endocarditis infecciosa, experiencia de diez años en un centro de referencia nacional Infectious endocarditis, 10 years of experience in a national reference center  

Directory of Open Access Journals (Sweden)

Full Text Available Objetivo: estudiar las características clínicas, epidemiológicas y microbiológicas, así como el tratamiento médico quirúrgico de los pacientes ingresados con el diagnóstico de endocarditis infecciosa, con el propósito de profundizar en su estudio y contribuir a un mejor tratamiento a estos pacientes. Métodos: se estudiaron 24 pacientes procedentes de todo el país, egresados con el diagnóstico de endocarditis infecciosa. Los datos fueron recogidos de las historias clínicas procedentes del archivo del Hospital "William Soler", y de la base de datos del servicio de cirugía del cardiocentro. Se determinó la frecuencia de las diferentes manifestaciones de la endocarditis infecciosa según: grupos etarios, factores de riesgo, y los datos clínicos, de laboratorio y microbiológicos más frecuentes. Además, se determinó la toma valvular predominante, la etiología y su respuesta a los antibióticos. Resultados: el grupo de edad más afectado fue entre 5 y 18 años; la cardiopatía previa fue el factor de riesgo predominante; los síntomas y signos más frecuentes fueron la fiebre, la anorexia y la pérdida de peso. La insuficiencia cardiaca y el embolismo pulmonar fueron complicaciones frecuentes. La mayoría de los pacientes tuvo una eritrosedimentación acelerada, y la cuarta parte de los casos presentaron hemocultivos negativos. Las válvulas aórtica y mitral resultaron las más afectadas, y el curso clínico que predominó fue el subagudo. En casi la mitad de los pacientes la infección tuvo un origen nosocomial. Los antimicrobianos más utilizados fueron la amikacina, la vancomicina y la ceftriaxona. Conclusiones: la endocarditis infecciosa es poco frecuente en nuestra institución, ocurre más a menudo en relación con las cardiopatías congénitas. Los hechos clínicos más constantes fueron la fiebre y el antecedente de cardiopatía previa.Objective: to study the clinical, epidemiological and microbiological characteristics as well as the surgical medical treatment of patients admitted diagnosed with infectious endocarditis to deepen in its study and to contribute to a better treatment for these patients. Methods: twenty four patients from whole country, discharged with the diagnosis of infectious endocarditis. Data were collect from the medical records of the "William Soler" Children Hospital files and from the database of surgery service of heart center. The frequency of different manifestations of infectious endocarditis was determined according to: age groups, risk factors and the more frequent clinical, laboratory and microbiologic data. Also, the predominant valvular take, the etiology and the response to antibiotics were determined. Results: the more involved age group was between 5 and 18 years; the previous heart disease was the more predominant factor; the more frequent symptoms and signs were: fever, anorexia and weight loss. The heart failure and the pulmonary embolism were frequent complications. Most of patients had an accelerated erythrosedimentation and the fourth of cases had negative blood cultures. The aortic and mitral valves were the more involved and the predominant clinical course was the subacute. In almost the half of patients the infection had a nosocomial origin. The more used antimicrobial agents were amikacin, vancomycin and ceftriaxone. Conclusions: the infectious endocarditis is uncommon in our institution occurs more often in relation to congenital heart diseases. The more constant clinical facts were fever and a history of previous heart disease.

Elsa Fleitas Ruisánchez

2011-12-01

372

Gentamicin-resistant enterococci and endocarditis.  

OpenAIRE

We report a case of endocarditis associated with a highly gentamicin-resistant enterococcus that failed to respond to conventional antibiotic combination therapy. Clinical resolution was achieved following cardiac surgery and antimicrobial treatment dictated by in vitro testing of the patient's organism. Laboratories should test blood culture isolates of enterococci for high level gentamicin resistance. Management of such cases requires individual assessment and extensive laboratory investiga...

Holliman, R.; Smyth, E.

1989-01-01

373

Bacillus licheniformis prosthetic aortic valve endocarditis.  

OpenAIRE

A 73-year old man developed an acute prosthetic aortic valve dehiscence for which emergent operation was undertaken. The intraoperative evidence of an aortic annular disruption and of a subannular abscess led to the hypothesis that an endocarditis process was involved. The aortic valve was replaced with a stentless porcine bioprosthesis. Cultures taken intraoperatively from the aortic area had a pure growth of aerobic, spore-forming, gram-positive bacilli identified as Bacillus licheniformis....

Santini, F.; Borghetti, V.; Amalfitano, G.; Mazzucco, A.

1995-01-01

374

A pediatric case of cardiobacterium hominis endocarditis.  

Science.gov (United States)

Gram negative endocarditis is relatively rare in pediatrics but when they occur they are most frequently caused by one of the HACEK (Haemophilus species, Actinobacillus actinomycetemcomitans, C. hominis, Eikenella corrodens and Kingella kingae) group of microorganisms. Within the HACEK group of microorganisms there have been approximately 100 cases of Cardiobacterium hominis endocarditis reported in the literature, but only 2 previous cases of endocarditis and one case of pericarditis have been reported in children. In this report, we present a case of a 12-year-old boy with a right ventricle to pulmonary artery conduit for Tetralogy of Fallot with pulmonary atresia who presented at an annual cardiology examination with a 3 week history of fatigue and was found to have a vegetation on routine echocardiogram. Subsequent blood cultures grew Cardiobacterium hominis and the patient was treated successfully with 6 weeks of appropriate antibiotic therapy. We present this case and a review of the literature of the HACEK group of microorganisms in pediatrics. PMID:24470958

Suresh, Priyanka; Blackwood, R Alexander

2013-01-22

375

A pediatric case of Cardiobacterium hominis endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Gram negative endocarditis is relatively rare in pediatrics but when they occur they are most frequently caused by one of the HACEK (Haemophilus species, Actinobacillus actinomycetemcomitans, C. hominis, Eikenella corrodens and Kingella kingae group of microorganisms. Within the HACEK group of microorganisms there have been approximately 100 cases of Cardiobacterium hominis endocarditis reported in the literature, but only 2 previous cases of endocarditis and one case of pericarditis have been reported in children. In this report, we present a case of a 12-year-old boy with a right ventricle to pulmonary artery conduit for Tetralogy of Fallot with pulmonary atresia who presented at an annual cardiology examination with a 3 week history of fatigue and was found to have a vegetation on routine echocardiogram. Subsequent blood cultures grew Cardiobacterium hominis and the patient was treated successfully with 6 weeks of appropriate antibiotic therapy. We present this case and a review of the literature of the HACEK group of microorganisms in pediatrics.

Priyanka Suresh

2013-01-01

376

Endocarditis infecciosa en la Unidad de Medicina Intensiva / Infectious endocarditis in the intensive care unit  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Conocer las características, evolución y pronóstico de los pacientes con endocarditis infecciosa que requieren tratamiento en la Unidad de Medicina Intensiva. Diseño: Estudio observacional de cohortes prospectivo en pacientes ingresados por endocarditis infecciosa. Ámbito: Hospital Univers [...] itario Nuestra Señora de Candelaria, centro con 824 camas y población asignada de 493.145 personas. Pacientes: Todos los pacientes diagnosticados de endocarditis siguiendo los criterios de Duke entre el 1 de enero de 2005 y el 31 de julio de 2011. Variables de interés: Variables demográficas, clínicas, scores de gravedad, hallazgos microbiológicos y ecocardiográficos, mortalidad intrahospitalaria y complicaciones. Resultados: De 102 pacientes diagnosticados de endocarditis, 38 (37%) ingresaron en Medicina Intensiva. Comparándolos con los que no lo hicieron, sufrieron con más frecuencia afectación mitral (OR= 7,13; IC del 95%, 2,12-24; p= 0,002) y embolia cerebral (OR= 3,89; IC del 95%, 1,06-14,3; p= 0,041). La mortalidad fue mayor (42,1 vs 18,8%, p= 0,011), así como la proporción de cirugías urgentes (45,8 vs 5,9%, p Abstract in english Objective: To study the characteristics, evolution and prognosis of patients with infectious endocarditis requiring treatment in the Intensive Care Unit. Design: A prospective, observational cohort study of patients admitted due to infectious endocarditis. Setting: Nuestra Señora de Candelaria Unive [...] rsity Hospital, a third - level center with a recruitment population of 493,145. Patients: All patients consecutively diagnosed with infectious endocarditis in our center according to the Duke criteria, between 1 January 2005 and 31 July 2011. Study variables: Demographic data, clinical severity scores, microbiological and echocardiographic data, hospital mortality and complications. Results: Out of 102 patients diagnosed with endocarditis, 38 (37%) were admitted to Intensive Care. Compared with those patients not admitted to the ICU, these subjects suffered more frequent mitral valve alterations (OR= 7.13; 95%CI: 2.12-24; p= 0.002) and cerebral embolism (OR= 3.89; 95%CI: 1.06-14.3; p= 0.041). In turn, mortality was greater (42.1% vs 18.8%, p= 0.011), as was the proportion of emergency surgeries (45.8% vs 5.9%, p

S., Miranda-Montero; M., Rodríguez-Esteban; L., Álvarez-Acosta; S., Lubillo-Montenegro; H., Pérez-Hernández; R., Llorens-León.

2012-10-01

377

Bacterial endocarditis due to eikenella corrodens: A case report  

Directory of Open Access Journals (Sweden)

Full Text Available Of all the causes of bacterial endocarditis, HACEK group consisting of Haemophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella Kingae are rare causative agents. We report a case of bacterial endocarditis by E. corrodens, which is one of the members of the HACEK group.

Mahapatra A

2003-01-01

378

Bacterial endocarditis due to Eikenella corrodens: a case report.  

Science.gov (United States)

Of all the causes of bacterial endocarditis, HACEK group consisting of Haemophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella Kingae are rare causative agents. We report a case of bacterial endocarditis by E. corrodens, which is one of the members of the HACEK group. PMID:17643001

Mahapatra, A; Mishra, S; Pattnaik, D; Patnaik, K

2003-01-01

379

Endocarditis de válvula protésica por Salmonella no tifoidea / Prosthetic Valve Endocarditis due to Non-Typhoid Salmonella  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Existen varios factores predisponentes para el desarrollo de endocarditis infecciosa; entre ellos se destacan el antecedente de haber padecido endocarditis infecciosa y el recambio valvular con válvula protésica. La endocarditis infecciosa de válvula protésica producida por Salmonella es una entidad [...] de muy baja incidencia. En esta presentación se describe el caso de una paciente con antecedente de doble recambio valvular, mitral y aórtico, que ingresó con un cuadro de sepsis grave. Se llegó al diagnóstico etiológico de endocarditis infecciosa por Salmonella enteritidis a través de hemocultivos. La paciente tuvo una evolución fulminante y falleció antes de las 24 horas. Abstract in english There are several predisposing factors for the development of infectious endocarditis, among them, the history of infectious endocarditis and prosthetic valve replacement. Infectious endocarditis in prosthetic valve caused by Salmonella is an unusual entity. We report the case of a female patient wi [...] th a history of double-valve mitral and aortic replacement, who was admitted due to severe sepsis. The etiological diagnosis of infectious endocarditis by Salmonella enteritidis was reached through blood cultures. The clinical course was fulminant and she died within the first 24 hours.

Marta E., Cardús; Romina E., Trossero; Jorge, Curotto Grasiosi; Antonio, Abdala; María J., Torres.

2013-02-01

380

Q Fever Endocarditis in Romania: The First Cases Confirmed by Direct Sequencing  

Directory of Open Access Journals (Sweden)

Full Text Available Infective endocarditis (IE is a serious, life-threatening disease with highly variable clinical signs, making its diagnostic a real challenge. A diagnosis is readily made if blood cultures are positive, but in 2.5 to 31% of all infective endocarditis cases, routine blood cultures are negative. In such situations, alternative diagnostic approaches are necessary. Coxiella burnetii and Bartonella spp. are the etiological agents of blood culture-negative endocarditis (BCNE most frequently identified by serology. The purpose of this study is to investigate the usefulness of molecular assays, as complementary methods to the conventional serologic methods for the rapid confirmatory diagnostic of Q fever endocarditis in patients with BCNE. Currently, detection of C. burnetii by culture or an antiphase I IgG antibody titers >800 represents a major Duke criterion for defining IE, while a titers of >800 for IgG antibodies to either B. henselae or B. quintana is used for the diagnosis of endocarditis due to Bartonella spp. We used indirect immunofluorescence assays for the detection of IgG titers for C. burnetii, B. henselae and B. quintana in 57 serum samples from patients with clinical suspicion of IE. Thirty three samples originated from BCNE patients, whereas 24 were tested before obtaining the blood cultures results, which finally were positive. The results of serologic testing showed that nine out of 33 BCNE cases exhibited antiphase I C. burnetii IgG antibody titer >800, whereas none has IgG for B. henselae or B. quintana. Subsequently, we used nested-PCR assay for the amplification of C. burnetii DNA in the nine positive serum samples, and we obtained positive PCR results for all analyzed cases. Afterwards we used the DNA sequencing of amplicons for the repetitive element associated to htpAB gene to confirm the results of nested-PCR. The results of sequencing allowed us to confirm that C. burnetii is the causative microorganism responsible for BCNE. In conclusion, the nested PCR amplification followed by direct sequencing is a reliable and accurate method when applied to serum samples, and it may be used as an additional test to the serological methods for the confirmatory diagnosis of BCNE cases determined by C. burnetii.

Monica Straut

2011-12-01

381

Q fever endocarditis in Romania: the first cases confirmed by direct sequencing.  

Science.gov (United States)

Infective endocarditis (IE) is a serious, life-threatening disease with highly variable clinical signs, making its diagnostic a real challenge. A diagnosis is readily made if blood cultures are positive, but in 2.5 to 31% of all infective endocarditis cases, routine blood cultures are negative. In such situations, alternative diagnostic approaches are necessary. Coxiella burnetii and Bartonella spp. are the etiological agents of blood culture-negative endocarditis (BCNE) most frequently identified by serology. The purpose of this study is to investigate the usefulness of molecular assays, as complementary methods to the conventional serologic methods for the rapid confirmatory diagnostic of Q fever endocarditis in patients with BCNE. Currently, detection of C. burnetii by culture or an antiphase I IgG antibody titers >800 represents a major Duke criterion for defining IE, while a titers of >800 for IgG antibodies to either B. henselae or B. quintana is used for the diagnosis of endocarditis due to Bartonella spp. We used indirect immunofluorescence assays for the detection of IgG titers for C. burnetii, B. henselae and B. quintana in 57 serum samples from patients with clinical suspicion of IE. Thirty three samples originated from BCNE patients, whereas 24 were tested before obtaining the blood cultures results, which finally were positive. The results of serologic testing showed that nine out of 33 BCNE cases exhibited antiphase I C. burnetii IgG antibody titer >800, whereas none has IgG for B. henselae or B. quintana. Subsequently, we used nested-PCR assay for the amplification of C. burnetii DNA in the nine positive serum samples, and we obtained positive PCR results for all analyzed cases. Afterwards we used the DNA sequencing of amplicons for the repetitive element associated to htpAB gene to confirm the results of nested-PCR. The results of sequencing allowed us to confirm that C. burnetii is the causative microorganism responsible for BCNE. In conclusion, the nested PCR amplification followed by direct sequencing is a reliable and accurate method when applied to serum samples, and it may be used as an additional test to the serological methods for the confirmatory diagnosis of BCNE cases determined by C. burnetii. PMID:22272146

Cotar, Ani Ioana; Badescu, Daniela; Oprea, Mihaela; Dinu, Sorin; Banu, Otilia; Dobreanu, Dan; Dobreanu, Minodora; Ionac, Adina; Flonta, Mirela; Straut, Monica

2011-01-01

382

Teicoplanin pharmacokinetics in intravenous drug abusers being treated for bacterial endocarditis.  

OpenAIRE

The pharmacokinetics of teicoplanin were determined after multiple 30-min intravenous infusions of 10 to 15 mg/kg every 12 to 24 h in 11 intravenous drug abuse (IVDA) patients being treated for bacterial endocarditis. Multiple serum samples were obtained over 7 to 14 days. Twenty-four-hour urine collections were obtained on days 1 and 5. Serum concentration-time data were analyzed by using multiple-dose pharmacokinetic analysis (NONLIN84). Results were compared with pharmacokinetic parameters...

Rybak, M. J.; Lerner, S. A.; Levine, D. P.; Albrecht, L. M.; Mcneil, P. L.; Thompson, G. A.; Kenny, M. T.; Yuh, L.

1991-01-01

383

Pseudoaneurysm of mitro-aortic intervalvular fibrosa during the course of mitral valve endocarditis with aorto-left ventricle outflow tract fistula.  

Science.gov (United States)

The mitro-aortic intervalvular fibrosa (MAIVF) connects the anterior mitral leaflet to the posterior portion of the aortic annulus. The pseudoaneurysm of MAIVF is one of the uncommon but catastrophic complications of native or prosthetic aortic valve endocarditis or chest trauma. We report a case of infective endocarditis of mitral valve complicated by development of pseudoaneurysm of MAIVF, and fistulous formation causing massive shunt flow from the ascending aorta above the non-coronary cusp to the left ventricle outflow tract. PMID:23960696

Fazlinezhad, A; Fatehi, H; Tabaee, S; Alavi, M; Hoseini, L; Yousefzadeh, H

2012-07-01

384

Optimisation of the prevention and treatment of bacterial endocarditis.  

Science.gov (United States)

This paper reviews currently established guidelines for the prevention and treatment of bacterial endocarditis. Endocarditis remains a life-threatening disease with substantial morbidity and mortality. Primary prevention of endocarditis, whenever possible, is therefore very important. In an individual with endocarditis, rapid diagnosis and effective treatment are essential to good patient outcome. The guidelines discussed here are largely based on those issued by the American Heart Association. While most cases of endocarditis are not attributable to an invasive procedure, certain procedures are associated with bacteraemia by organisms commonly associated with endocarditis, and antibacterial prophylaxis is recommended before such procedures. Patient cardiac conditions are stratified into high, moderate and negligible risk categories based on potential outcome if endocarditis develops. For oral, dental, respiratory tract, and oesophageal procedures (most often associated with viridans streptococci) the standard antibacterial regimen is oral amoxicillin. For gastrointestinal and genitourinary procedures (most often associated with enterococci), parenteral antibacterials are most often recommended. For high-risk patients, intramuscular or intravenous ampicillin and gentamicin (or vancomycin and gentamicin in penicillin-allergic individuals) is recommended. For moderate risk patients, an option of oral amoxicillin or parenteral ampicillin is offered. Treatment of bacterial endocarditis is guided by identification of the causative micro-organism. Approximately 80% of cases of endocarditis are due to the gram-positive cocci: streptococci and staphylococci. Other gram-positive organisms include enterococci (predominantly Enterococcusfaecalis and E. faecium) and the HACEK group of organisms (Haemophilus parainfluenzae, H. aphrophilus, Actinobacillus [Haemophilus] actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae). In general, for uncomplicated cases of endocarditis due to penicillin-susceptible viridans streptococci or Streptococcus bovis 4 weeks of benzylpenicillin (or ceftriaxone) is the preferred regimen for most patients aged >65 years. A 2-week course of treatment can be used when gentamicin is added, in patients at low risk for adverse events caused by gentamicin therapy. When endocarditis is caused by strains of viridans streptococci or S. bovis relatively resistant to penicillin, or by enterococci, both benzylpenicillin and gentamicin are recommended. For staphylococcal endocarditis on native heart valves, nafcillin or oxacillin with or without gentamicin is the preferred regimen. In prosthetic valve staphylococcal endocarditis, nafcillin (or oxacillin) with rifampicin and gentamicin is recommended. For all of the above situations, vancomycin is recommended for the patient allergic to penicillin (or methicillin). Finally, consideration of out-of-hospital therapy in selected patients is discussed. PMID:11419916

Taubert, K A; Dajani, A S

2001-01-01

385

Redo cardiac surgery for active prosthetic valve endocarditis associated with hereditary hemorrhagic telangiectasia: report of a case.  

Science.gov (United States)

Hereditary hemorrhagic telangiectasia (HHT) is caused by an autosomal dominant gene and characterized by multiple arteriovenous malformations in several organs, leading to bleeding or shunting. These patients often suffer severe infections and heart failure, which should be managed in the perioperative period, when open heart surgery is indicated. We report a case of successful aortic root replacement for active prosthetic valve endocarditis and ventricular septal perforation in a patient with HHT, who had severe heart failure. PMID:24643265

Nakamura, Yuki; Shikata, Fumiaki; Ryugo, Masahiro; Okamura, Toru; Yasugi, Takumi; Izutani, Hironori

2014-12-01

386

Lysostaphin Treatment of Experimental Aortic Valve Endocarditis Caused by a Staphylococcus aureus Isolate with Reduced Susceptibility to Vancomycin  

OpenAIRE

The rabbit model of endocarditis was used to test the effectiveness of vancomycin and two different lysostaphin dosing regimens for the treatment of infections caused by a Staphylococcus aureus strain with reduced susceptibility to vancomycin (glycopeptide-intermediate susceptible S. aureus [GISA]). Vancomycin was ineffective, with no evidence of sterilization of aortic valve vegetations. However, rates of sterilization of aortic valve vegetations were significantly better for animals treated...

Patron, Roberto L.; Climo, Michael W.; Goldstein, Beth P.; Archer, Gordon L.

1999-01-01

387

Misidentification of toxigenic Corynebacterium diphtheriae as a Corynebacterium species with low virulence in a child with endocarditis.  

OpenAIRE

A 6-year-old boy presented to a university hospital in Malaysia with infective endocarditis complicating cyanotic congenital heart disease. Blood cultures showed a gram-positive, aerobic, coryneform-like bacillus identified by the hospital laboratory as Corynebacterium xerosis, but a reference laboratory identified the organism as a toxigenic strain of Corynebacterium diphtheriae. The two laboratories concurred on all biochemical test results except for sucrose fermentation.

Pennie, R. A.; Malik, A. S.; Wilcox, L.

1996-01-01

388

Pefloxacin therapy for experimental endocarditis caused by methicillin-susceptible or methicillin-resistant strains of Staphylococcus aureus.  

OpenAIRE

The therapeutic efficacy of pefloxacin in experimental endocarditis caused by methicillin-susceptible or methicillin-resistant Staphylococcus aureus was evaluated. In rabbits infected with a methicillin-susceptible strain, 4 days of pefloxacin therapy significantly reduced both the number of bacteria per gram of vegetation and the mortality rate compared with untreated controls, and pefloxacin was equivalent to cephalothin. Pefloxacin was also as effective as vancomycin in reducing vegetation...

Sullam, P. M.; Ta?uber, M. G.; Hackbarth, C. J.; Chambers, H. F.; Scott, K. G.; Sande, M. A.

1985-01-01

389

Clindamycin therapy of experimental Staphylococcus aureus endocarditis.  

OpenAIRE

The efficacy of clindamycin in the treatment of experimental endocarditis in rabbits was compared with that of nafcillin. Both drugs were administered intramuscularly three times daily for 5 days, clindamycin at doses of 6.25, 12.5, 25, or 50 mg/kg and nafcillin at a dose of 200 mg/kg. The minimum inhibitory and bactericidal concentrations (0.125 microgram/ml) of clindamycin for the test strain of Staphylococcus aureus were very similar to the corresponding concentrations (0.25 microgram/ml) ...

Scheld, W. M.; Johnson, M. L.; Gerhardt, E. B.; Sande, M. A.

1982-01-01

390

Endocardite infecciosa: uma suspeita sempre presente / Infectious endocarditis: an ever-present suspicion  

Scientific Electronic Library Online (English)

Full Text Available SciELO Portugal | Language: Portuguese Abstract in portuguese Introdução: O diagnóstico de endocardite infecciosa requer um elevado grau de suspeição para ser estabelecido atempadamente. O médico de família, conhecendo os fatores de risco de cada doente, está numa posição privilegiada para a suspeita clínica de endocardite, podendo desempenhar um papel fulcral [...] no diagnóstico desta patologia. Descrição do Caso: Manuel, utente de 59 anos acompanhado na nossa consulta desde 2007, tem como antecedentes pessoais 3 episódios prévios de endocardite infecciosa, dois dos quais associados a prótese valvular colocada na sequência do primeiro episódio. Foi acompanhado na nossa consulta por um quadro de síndrome febril indeterminado, associado a parâmetros inflamatórios elevados, com dois ecocardiogramas negativos realizados a nível hospitalar. Por se tratar de um utente de risco elevado para recorrência de endocardite infecciosa, a médica de família nunca abandonou esta hipótese diagnóstica. Perante o quadro, pediu hemoculturas em ambulatório, que foram positivas para Enterococos faecalis. O doente foi novamente enviado ao hospital, desta vez realizando um ecocardiograma que revelou vegetação, tendo-se estabelecido o diagnóstico definitivo de endocardite infecciosa 20 dias após o início do quadro clínico. Foi internado e cumpriu antibioterapia. Contudo, no início do segundo mês de internamento, teve um episódio de AVC hemorrágico, tendo como consequências hemiparesia direita e disartria a longo prazo. Comentário: Apesar de se tratar de uma doença rara, a endocardite infecciosa associada a próteses valvulares está associada a elevada morbimortalidade. A forma de apresentação é variável, estando o médico dependente de um elevado grau de suspeição para conseguir estabelecer o diagnóstico atempadamente, minimizando as sequelas a longo prazo. Os critérios de Duke facilitam o estabelecimento adequado do diagnóstico; no entanto a sensibilidade destes critérios diminui em doentes com próteses valvulares. Trata-se de um quadro subagudo de endocardite, necessitando de 20 dias para se estabelecer o diagnóstico final, após o resultado de hemoculturas positivas. Foi a persistência da suspeita diagnóstica que permitiu o diagnóstico atempado. Abstract in english Introduction: An elevated level of suspicion is required to make a timely diagnosis of infective endocarditis. The family physician with knowledge of the risk factors of each patient is in a privileged position to diagnose this disease. Case Description: A 59 year-old male patient with a history of [...] 3 previous episodes of infective endocarditis has been treated in our practice since 2007. Two episodes were associated with a prosthetic valve (a consequence of the first episode). He was seen recently for an episode of fever of unknown origin associated with high serum levels of markers of inflammation. Two echocardiograms performed in hospital were non-diagnostic. The family physician retained a suspicion of infective endocarditis in this high-risk patient. Ambulatory blood cultures were positive for Enterococcus faecalis. The patient was again sent to the hospital and the echocardiogram now revealed a cardiac vegetation, confirming the diagnosis of infective endocarditis, 20 days after the initial onset of symptoms. At the beginning of the second month of his stay at the hospital, the patient suffered a hemorrhagic stroke, leaving him with dysarthria and a right hemiparesis. Discussion: Although infective endocarditis is a rare disease, it has high morbidity and mortality when associated with prosthetic heart valves. The presentation of the disease is variable, so the physician needs a high level of suspicion to make a prompt diagnosis and prevent long-term consequences. The Duke criteria may help with diagnosis. However, the sensitivity of the criteria is reduced in patients with prosthetic valves. This is a sub-acute case of endocarditis, in which the diagnosis was made with positive blood cultures

Ana Santos, Ferreira.

2013-01-01

391

Hepatitis C virus infection : molecular analysis of transmission and immunity  

OpenAIRE

HEPATITIS C VIRUS INFECTION: MOLECULAR ANALYSIS OF TRANSMISSION AND IMMUNITY by Tobias Allander Hepatitis C virus (HCV) is an important cause for chronic liver disease worldwide. Infection by HCV may resolve spontaneously, but in the majority of cases a chronic infection is established, that may result in liver cirrhosis and hepatocellular cancer. HCV is parenterally transmitted, but up to 50% of patients lack a history of known parenteral exposure. The present stu...

Allander, Tobias

1997-01-01