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Infective Endocarditis  

Science.gov (United States)

Infective endocarditis (IE), also called bacterial endocarditis (BE), is an infection caused by bacteria that enter the bloodstream and settle in ... lining, a heart valve or a blood vessel. IE is uncommon, but people with some heart conditions ...

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Infective endocarditis.  

Science.gov (United States)

Infective endocarditis is a serious disease of the endocardium of the heart and cardiac valves, caused by a variety of infectious agents, ranging from streptococci to rickettsia. The proportion of cases associated with rheumatic valvulopathy and dental surgery has decreased in recent years, while endocarditis associated with intravenous drug abuse, prosthetic valves, degenerative valve disease, implanted cardiac devices, and iatrogenic or nosocomial infections has emerged. Endocarditis causes constitutional, cardiac and multiorgan symptoms and signs. The central nervous system can be affected in the form of meningitis, cerebritis, encephalopathy, seizures, brain abscess, ischemic embolic stroke, mycotic aneurysm, and subarachnoid or intracerebral hemorrhage. Stroke in endocarditis is an ominous prognostic sign. Treatment of endocarditis includes prolonged appropriate antimicrobial therapy and in selected cases, cardiac surgery. In ischemic stroke associated with infective endocarditis there is no indication to start antithrombotic drugs. In previously anticoagulated patients with an ischemic stroke, oral anticoagulants should be replaced by unfractionated heparin, while in intracranial hemorrhage, all anticoagulation should be interrupted. The majority of unruptured mycotic aneurysms can be treated by antibiotics, but for ruptured aneurysms, endovascular or neurosurgical therapy is indicated. PMID:24365290

Ferro, José M; Fonseca, Ana Catarina

2014-01-01

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Prophylaxis of infective endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. Infective endocarditis is defined as an infection of the endothelial surface of the heart and heart valves, above all. It is a great challenge for doctors to diagnose infective endocarditis especially in primary health care, because this is a disease in evolution, bearing in mind changes in epidemiological and clinical characteristics, which developed in the last decades. Even today this is a very severe and insidious disease, with poor prognosis and high mortality. Prevention of Infective Endocarditis. Although previous guidelines proposed a limitation to prophylaxis in patients at increased risk of adverse outcome of infective endocarditis, new guidelines recommend the principles of antibiotic prophylaxis when performing procedures at risk of infective endocarditis in patients with predisposing cardiac conditions, and limit its indication to patients at the highest risk of infective endocarditis undergoing the highest risk procedures. Conclusion. Despite the fact that previous guidelines for diagnostics and treatment of infective endocarditis were published only several years ago, the Task Force on Prevention, Diagnosis and Treatment of Infective Endocarditis of the European Society of Cardiology identify infective endocarditis as a clearly evolving disease, with changes in its microbiological profile and higher incidence of health care associated cases which has brought about a need for new recommendations to help health care providers in making clinical decisions including preventive measures and antibiotic prophylaxis. As a novelty, a group of patients at the highest risk of infective endocarditis was defined as well as the type of procedures at risk divided into four categories.

Saka? Dejan

2011-01-01

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What Is Infective Endocarditis?  

Science.gov (United States)

... conditions that put people at higher risk for IE include: • artificial (prosthetic) heart valves or heart valves ... don’t have heart disease. Infective (bacterial) endocarditis (IE) is an infection of either the heart’s inner ...

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Infective endocarditis due to brucella  

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Full Text Available One of the complications of brucellosis is infective endocarditis, which carries a high mortality rate if undiagnosed or misdiagnosed. We report a case of Brucella infective endocarditis, which was diagnosed serologically and by polymerase chain reaction. After Brucella specific treatment, patient showed dramatic improvement clinically, as evident by echocardiogram findings and other investigations.

Purwar S

2006-01-01

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Infective endocarditis due to brucella  

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One of the complications of brucellosis is infective endocarditis, which carries a high mortality rate if undiagnosed or misdiagnosed. We report a case of Brucella infective endocarditis, which was diagnosed serologically and by polymerase chain reaction. After Brucella specific treatment, patient showed dramatic improvement clinically, as evident by echocardiogram findings and other investigations.

Purwar S; Metgud S; Darshan A; Mutnal M; Nagmoti M

2006-01-01

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Endocarditis  

Science.gov (United States)

... um). The condition also is called infective endocarditis (IE). The term "endocarditis" also is used to describe ... This article only discusses endocarditis related to infection. IE occurs if bacteria, fungi, or other germs invade ...

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Candida Infective Endocarditis  

Science.gov (United States)

Purpose Candida infective endocarditis (IE) is uncommon but often fatal. Most epidemiologic data are derived from small case series or case reports. This study was conducted to explore epidemiology, treatment patterns, and outcomes of patients with Candida IE. Methods We compared 33 Candida IE cases to 2716 patients with non-fungal IE in the International Collaboration on Endocarditis - Prospective Cohort Study. Patients were enrolled and data collected from June 2000 until August 2005. Results Patients with Candida IE were more likely to have prosthetic valves (p<0.001), short term indwelling catheters (p<0.0001), and have healthcare-associated infection (p<0.001). Reasons for surgery differed between the two groups: myocardial abscess (46.7% vs. 22.2% p=0.026) and persistent positive blood cultures (33.3% vs. 9.9%, p=0.003) were more common among those with Candida IE. Mortality at discharge was higher in patients with Candida IE (30.3%) when compared to non-fungal cases (17%, p=0.046). Among Candida patients, mortality was similar in patients who received combination surgical and antifungal therapy versus antifungal therapy alone (33.3% vs. 27.8%, p=0.26). New antifungal drugs, particularly echinocandins, were used frequently. Conclusions These multi-center data suggest distinct epidemiologic features of Candida IE when compared to non-fungal cases. Indications for surgical intervention are different and mortality is increased. Newer antifungal treatment options are increasingly used. Large, multi-center studies are needed to help better define Candida IE.

Baddley, John W.; Benjamin, Daniel K.; Patel, Mukesh; Miro, Jose; Athan, Eugene; Barsic, Bruno; Bouza, Emilio; Clara, Liliana; Elliott, Tom; Kanafani, Zeina; Klein, John; Lerakis, Stamatios; Levine, Donald; Spelman, Denis; Rubinstein, Ethan; Tornos, Pilar; Morris, Arthur J.; Pappas, Paul; Fowler, Vance G.; Chu, Vivian H.; Cabell, Christopher

2009-01-01

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Candida infective endocarditis.  

Science.gov (United States)

Candida infective endocarditis (IE) is uncommon but often fatal. Most epidemiologic data are derived from small case series or case reports. This study was conducted to explore the epidemiology, treatment patterns, and outcomes of patients with Candida IE. We compared 33 Candida IE cases to 2,716 patients with non-fungal IE in the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS). Patients were enrolled and the data collected from June 2000 until August 2005. We noted that patients with Candida IE were more likely to have prosthetic valves (p < 0.001), short-term indwelling catheters (p < 0.0001), and have healthcare-associated infections (p < 0.001). The reasons for surgery differed between the two groups: myocardial abscess (46.7% vs. 22.2%, p = 0.026) and persistent positive blood cultures (33.3% vs. 9.9%, p = 0.003) were more common among those with Candida IE. Mortality at discharge was higher in patients with Candida IE (30.3%) when compared to non-fungal cases (17%, p = 0.046). Among Candida patients, mortality was similar in patients who received combination surgical and antifungal therapy versus antifungal therapy alone (33.3% vs. 27.8%, p = 0.26). New antifungal drugs, particularly echinocandins, were used frequently. These multi-center data suggest distinct epidemiologic features of Candida IE when compared to non-fungal cases. Indications for surgical intervention are different and mortality is increased. Newer antifungal treatment options are increasingly used. Large, multi-center studies are needed to help better define Candida IE. PMID:18283504

Baddley, J W; Benjamin, D K; Patel, M; Miró, J; Athan, E; Barsic, B; Bouza, E; Clara, L; Elliott, T; Kanafani, Z; Klein, J; Lerakis, S; Levine, D; Spelman, D; Rubinstein, E; Tornos, P; Morris, A J; Pappas, P; Fowler, V G; Chu, V H; Cabell, C

2008-07-01

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Prevention of Infective (Bacterial) Endocarditis: Wallet Card  

Science.gov (United States)

... risk for developing adverse outcomes from infective endocarditis (IE), also known as bacterial endocarditis (BE). The guidelines for prevention of IE shown in this card are substantially different from ...

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Infective Endocarditis in Northeastern Thailand  

Science.gov (United States)

Despite rigorous diagnostic testing, the cause of infective endocarditis was identified for just 60 (45.5%) of 132 patients admitted to hospitals in Khon Kaen, Thailand, during January 2010–July 2012. Most pathogens identified were Viridans streptococci and zoonotic bacteria species, as found in other resource-limited countries where underlying rheumatic heart disease is common.

Pachirat, Orathai; Baggett, Henry C.; Maloney, Susan A.; Lulitanond, Viraphong; Raoult, Didier; Bhengsri, Saithip; Thamthitiwat, Somsak; Paupairoj, Anucha; Kosoy, Michael; Ud-Ai, Nongrak; Sukwicha, Wichuda; Whistler, Toni; Fournier, Pierre-Edouard

2014-01-01

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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)

2002-01-01

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Infective endocarditis in northeastern Thailand.  

Science.gov (United States)

Despite rigorous diagnostic testing, the cause of infective endocarditis was identified for just 60 (45.5%) of 132 patients admitted to hospitals in Khon Kaen, Thailand, during January 2010-July 2012. Most pathogens identified were Viridans streptococci and zoonotic bacteria species, as found in other resource-limited countries where underlying rheumatic heart disease is common. PMID:24572588

Watt, George; Pachirat, Orathai; Baggett, Henry C; Maloney, Susan A; Lulitanond, Viraphong; Raoult, Didier; Bhengsri, Saithip; Thamthitiwat, Somsak; Paupairoj, Anucha; Kosoy, Michael; Ud-Ai, Nongrak; Sukwicha, Wichuda; Whistler, Toni; Fournier, Pierre-Edouard

2014-03-01

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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.

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Infective Endocarditis After Renal Transplantation  

Science.gov (United States)

Background: Infective endocarditis (IE) is a serious complication in immunosuppressive patients that has adverse effects. Objectives: The aim of this study was to define the characteristics, outcomes, and correlating factors of mortality in renal transplant recipients. Patients and Methods: Infective endocarditis was diagnosed in 22 patients from three renal transplant centers in Iran between 2000 and 2010. Modified Duke criteria were applied to confirm the diagnosis. Results: Twenty-two renal transplant patients with IE were evaluated. Blood culture results were positive in 81%. Enteroccous and group D non-enterococcal were the causative microorganisms in 31% and 25% of patients, respectively. In-hospital and 12-month mortality was 41% and the mortality rate was higher in older patients in comparison to younger patients. Overall, the rates of one-year disease-free patient and graft survival were 49% and 88%, respectively. Conclusions: Despite the availability of different and potent antibiotics, the mortality caused by IE remains considerably high. These patients are significantly prone to endovascular infections that affect the mortality and survival.

Moshkani Farahani, Maryam; Rostami, Zohreh; Einollahi, Behzad; Khosravi, Arezoo; Nemati, Eghlim; Lessan Pezeshki, Mahboob; Pourfarziani, Vahid; Joneidi, Nematollah; Hosseini, Mohammad Javad; Ghorbani, Gholam Ali

2014-01-01

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Clinical and Microbiological Characteristics of Infective Endocarditis  

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Surgical treatment of active Infective Endocarditis (IE) requires not only homodynamic repair, but also, special emphasis on the eradiation of the infection to prevent recurrence. This study was undertaken to examine the outcome of surgery for active infective endocarditis in a cohort of patients. One hundred and sixty-four consecutive patients underwent valve surgery for active IE in Madani heart centre (Tabriz, Iran) from 1996-2006. The patients with diagnosis of IE (according to Duke Crite...

Azin Alizadehasl; Rasoul Azarfarin; Farnaz Sepasi; Shamsi Ghaffari

2008-01-01

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Pseudoaneurysm formation in infective endocarditis.  

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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

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Endocarditis Caused by Rhodotorula Infection  

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Rhodotorula is an emerging opportunistic fungal pathogen that is rarely reported to cause endocarditis. We describe a case involving a patient who developed endocarditis due to Rhodotorula mucilaginosa and Staphylococcus epidermidis, proven by culture and histopathology. The case illustrates the unique diagnostic and therapeutic challenges relevant to Rhodotorula spp.

Simon, Matthew S.; Somersan, Selin; Singh, Harjot K.; Hartman, Barry; Wickes, Brian L.; Jenkins, Stephen G.; Walsh, Thomas J.

2014-01-01

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A new risk factor for infective endocarditis.  

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Body piercing has become an increasingly common practice in recent decades, especially among young people. However, it is not a completely safe procedure and may have serious complications such as infective endocarditis, which can occur in individuals with or without previous heart disease. In this paper we report a case of endocarditis after body piercing in a young woman with a pacemaker who needed surgical intervention. We also review cases of endocarditis after piercing described in the literature. Now that the recommendations of the American Heart Association for prophylaxis of infective endocarditis are more restricted, we discuss the need for inclusion of body piercings among procedures requiring prophylactic therapy in high-risk individuals. PMID:20058781

Toste, Alexandra; Ferreira, Lurdes; Oliveira, José Alberto; Feliciano, Joana; Conceição, José; Baquero, Luís; Freitas, António; Freitas, Paulo; Fragata, José; Ferreira, Rui Cruz

2009-10-01

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Double outlet right ventricle with infective endocarditis.  

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Double outlet right ventricle (DORV) is an uncommon congenital heart disease with a poor prognosis. We report a rare case of a girl with untreated DORV who survived until adolescence, but then developed infective endocarditis with florid complications and succumbed to it. Although infective endocarditis is seldom encountered in children in developed countries, a high index of suspicion is required for those with congenital heart disease. The roles of cross-sectional imaging are demonstrated, including the usefulness of magnetic resonance imaging not only in evaluating congenital heart disease, but also in detecting incidental lesions in the extracardiac structures. PMID:22941148

Lee, Chin Hwee; Teo, Lynette Li San; Hia, Cindy Ping Ping

2012-08-01

 
 
 
 
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Hairy cell leukemia masquerading as infective endocarditis.  

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Hairy cell leukemia is a chronic lymphoproliferative disorder affecting middle-aged adults, with the median age of 50-55 years. We report a case of hairy cell leukemia who presented with fever, splinter haemorrhages and moderate splenomegaly, simulating infective endocarditis. There was bicytopenia at presentation and hairy cells were seen in the peripheral blood. PMID:24426343

Ramasamy, Chandramohan; Dubashi, Biswajit; Rekha, J Sree; Basu, Debdatta; Jain, Ankit; Dutta, Tarun Kumar

2013-06-01

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Infective endocarditis: retrospective analysis at the Hospital Nacional Arzobispo Loayza between 2002 and 2007  

Directory of Open Access Journals (Sweden)

Full Text Available Objectives: To describe the clinical, epidemiologic and microbiologic characteristics of patients with infective endocarditis (IE. Methods: We perform a retrospective and analytical study. We reviewed the medical records of patients diagnosed with probable or definitive IE according to the modified Duke criteria, hospitalized at the National Hospital A. Loayza between January 2003 and December 2007. We determined the prevalence of IE and the frecuency of diagnostic criteria, clinical, echocardiographic and microbiologic characteristcs, complications, treatment and letality rate of IE. Results: We included 33 cases of IE, of which 18 (54.50% had a definitive diagnosis. The incidence calculated over five years was 0.91 cases per 1 000 hospitalizations. Mean age was 40.1±13.58 years, and 75.5% were males. The average time between symptom onset and was 9.53 weeks. Sixteen (48.48% patients had a history of heart disease, rheumatic fever was the most frequent (37.50%. Heart murmur (93.97%, fever (75.75%, and constitutional symptoms (63.60% were the most common clinical presentation. The aortic valve was the most affected by vegetations (60.60%. In 40.7% of cases a positive blood culture was found, with Streptococo viridans as the most frequently isolated microorganism (54.50%. The lethality rate was 6%. Conclusions: The profile of IE in this study is similar to recents studies in other countries, especially in South America, where rheumatic fever and Streptococo viridans remain as the underlying cardiopathy and most common microorganism, although the new trends.

Carlos Canelo

2009-08-01

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Serum C reactive protein in infective endocarditis.  

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C reactive protein (CRP) was measured serially in 29 patients with infective endocarditis. Twenty one patients were initially treated with antimicrobial drugs. In 13, serial measurement of CRP concentrations showed a progressive return to normal (less than 10 mg/l), which correlated with a satisfactory recovery. Of the remainder (eight patients), five had persistently high concentrations of CRP, indicating a failure to respond to antimicrobial treatment alone. Two of these five patients died ...

1988-01-01

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Surgery in current therapy for infective endocarditis  

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Stuart J Head1, M Mostafa Mokhles1, Ruben LJ Osnabrugge1,2, Ad JJC Bogers1, A Pieter Kappetein11Department of Cardio-Thoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands; 2Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The NetherlandsAbstract: The introduction of the Duke criteria and transesophageal echocardiography has improved early recognition of infective endocarditis but patients are still at high risk for severe morbidity or death. ...

Sj, Head; Mm, Mokhles; Rlj, Osnabrugge; Ajjc, Bogers; Ap, Kappetein

2011-01-01

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Surgery in current therapy for infective endocarditis  

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The introduction of the Duke criteria and transesophageal echocardiography has improved early recognition of infective endocarditis but patients are still at high risk for severe morbidity or death. Whether an exclusively antibiotic regimen is superior to surgical intervention is subject to ongoing debate. Current guidelines indicate when surgery is the preferred treatment, but decisions are often based on physician preferences. Surgery has shown to decrease the risk of short-term mortality i...

Head, Stuart J.; Mokhles, M. Mostafa; Osnabrugge, Ruben Lj; Bogers, Ad Jjc; Kappetein, A. Pieter

2011-01-01

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The changing face of infective endocarditis  

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Infective endocarditis (IE) is an evolving disease with a persistently high mortality and morbidity, even in the modern era of advanced diagnostic imaging, improved antimicrobial chemotherapy, and potentially curative surgery. Despite these improvements in health care, the incidence of the disease has remained unchanged over the past two decades and may even be increasing. Chronic rheumatic heart disease is now an uncommon antecedent, whereas degenerative valve disease of the elderly, mitral ...

2006-01-01

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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

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Infective endocarditis in chronic hemodialysis patients: Experience from Morocco  

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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...

2011-01-01

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Q Fever Endocarditis in HIV-Infected Patient  

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We describe a case of Q fever endocarditis in an HIV-infected patient. The case was treated successfully with valvular replacement and a combination of doxycycline and hydroxychloroquine. We review the current literature on Q fever endocarditis, with an emphasis on the co-infection of HIV and Coxiella burnetii.

Madariaga, Miguel G.; Pulvirenti, Joseph; Sekosan, Marin; Paddock, Christopher D.; Zaki, Sherif R.

2004-01-01

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Infective endocarditis caused by Granulicatella adiacens.  

Science.gov (United States)

Granulicatella adiacens, a recently nomenclatured bacterium, was considered as one of the nutritionally variant streptococci (NVS) and is a mouth commensal. It is redesignated as a streptococcus like bacterium since it differs from streptococci. We report a case of infective endocarditis (IE) caused by this fastidious and unusual bacteria in a 63-year-old man with rheumatic valvular heart disease. G. adiacens was isolated from four of his blood culture samples, which was sensitive to beta lactams, moderately sensitive to gentamicin and resistant to erythromycin and co-trimoxazole. Patient recovered completely on treatment with high dose of ampicillin and gentamicin for 28 days. PMID:23993006

Shailaja, T S; Sathiavathy, K A; Unni, Govindan

2013-01-01

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Endocarditis infecciosa por Paecilomyces variotii / Endocarditis due to infection by Paecilomyces variotii  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish La endocarditis infecciosa por hongos es una complicación cada vez más frecuente en el mundo. Presentamos un caso de endocarditis infecciosa por Paecilomyces variotii en un paciente de sexo masculino con bioprótesis mitral, que respondió satisfactoriamente al tratamiento con cirugía de reemplazo val [...] vular mitral y anfotericina B (dosis total de 3.670 mg). Hasta la fecha, sólo se han reportado seis casos similares en el mundo, con una mortalidad del 100%. Abstract in english Fungal endocarditis is a cardiac complication that has been increasing throughout the world. We present a case of infective endocarditis by Paecilomyces variotii in a male patient with a prosthetic mitral valve. Successful treatment consisted of administration of amphotericin B (total dose 3,670 mg) [...] and mitral valve replacement. Only six cases have been reported previously, with a 100% mortality rate.

Senior, Juan Manuel; Saldarriaga, Clara.

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Endocarditis infecciosa por Paecilomyces variotii Endocarditis due to infection by Paecilomyces variotii  

Directory of Open Access Journals (Sweden)

Full Text Available La endocarditis infecciosa por hongos es una complicación cada vez más frecuente en el mundo. Presentamos un caso de endocarditis infecciosa por Paecilomyces variotii en un paciente de sexo masculino con bioprótesis mitral, que respondió satisfactoriamente al tratamiento con cirugía de reemplazo valvular mitral y anfotericina B (dosis total de 3.670 mg. Hasta la fecha, sólo se han reportado seis casos similares en el mundo, con una mortalidad del 100%.Fungal endocarditis is a cardiac complication that has been increasing throughout the world. We present a case of infective endocarditis by Paecilomyces variotii in a male patient with a prosthetic mitral valve. Successful treatment consisted of administration of amphotericin B (total dose 3,670 mg and mitral valve replacement. Only six cases have been reported previously, with a 100% mortality rate.

Clara Saldarriaga

2009-06-01

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Complicaciones neurológicas de la endocarditis infecciosa: controversias / Neurological complications of infective endocarditis: controversies  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish En la endocarditis infecciosa aguda se describen complicaciones neurológicas entre 20% y 40% de los casos, lo cual representa un importante factor que predice morbimortalidad, secuelas y discapacidad. Esta entidad se caracteriza por un amplio espectro clínico debido a su compleja fisiopatología, que [...] involucra entre otros, fenómenos inflamatorios, inmunes, infecciosos y embólicos. A pesar de la notable frecuencia de las complicaciones neurológicas en la endocarditis infecciosa, dadas especialmente por enfermedad cerebrovascular y neuroinfecciones, aun existen controversias acerca de algunos aspectos diagnósticos y terapéuticos, en parte por la poca evidencia disponible, las cuales se discuten a continuación, a partir de una serie de casos atendidos en la Fundación Cardiovascular de Colombia. Abstract in english Neurological complications of acute infective endocarditis are described in 20%-40% of cases, representing an important predictive factor of morbidity, mortality, sequels and disability. Acute endocarditis is characterized by a wide clinical spectrum due to its complex physiopathology that involves [...] inflammatory, immune, infectious and embolic phenomena. Despite the remarkable frequency of neurological complications in the infective endocarditis especially by cerebrovascular disease and neuroinfections, there are still some controversies about some diagnostic and therapeutic aspects, partly because of the little evidence available. This paper describes a number of cases seen in the Fundación Cardiovascular de Colombia and discusses some aspects related with the diagnosis and treatment of the neurological complications of acute endocarditis.

Federico A, Silva; Gustavo A, Diaz; Vladimir, Rodríguez; Mario I, Bueno; Sandra, Carrillo; Nhora P, Ruiz; Jorge A, Castellanos; Iván D, Freire; Ronald G, García.

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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

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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

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Unreported neurological complications of Gemella bergeriae infective endocarditis.  

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We report the first case of native aortic and mitral valve endocarditis due to Gemella bergeriae from the Middle East in a young patient with rheumatic heart disease. Our case illustrates a fulminant course of infection with G. bergeriae endocarditis that was complicated by embolic stroke, as well as intracerebral and subarachnoid haemorrhage secondary to rupture of a mycotic aneurysm in the right middle cerebral artery. This case highlights the dire, unreported neurological complications of infective endocarditis due to a rare causative organism-G. bergeriae. PMID:24899013

Hussain, Kosar; Abubaker, Jawed; Omar Al Deesi, Zulfa; Ahmed, Raees

2014-01-01

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Prevention of the infective endocarditis during the dental procedures  

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Full Text Available Endocarditis is endovascular infective disease of intracardiac structures, which are in contact with blood. The most common cause is Staphylococcus aureus and Streptococcus viridans, which inhabit oral cavity. During dental intervention, which includes gingival trauma (risky dental intervention microorganisms that cause infective endocarditis could penetrate into circulation of the blood. The group of high risk patients consists of patients which have already had infective endocarditis, patients with prosthetic heart valves or other foreign endovascular bodies, patients with congenital heart defect, patients with acquired heart defect, prolapse of mitral valve with registered mitral regurgitation and hyphertrophic cardiomiopathy. Those groups of patients should have prevention from infective endocarditis before any risky dental intervention with bactericidal dosage of wide spectrum antibiotics at least an hour before the procedure. .

Puškar Tatjana

2005-01-01

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Intravenous thrombolysis is unsafe in stroke due to infective endocarditis.  

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Embolic stroke is the most common neurological complication of infective endocarditis and a major source of morbidity and mortality. Septic embolism is considered a contraindication to intravenous thrombolysis in patients with ischaemic stroke because of concerns over an increased risk of intracranial haemorrhage. We describe a patient with occult endocarditis who was treated with thrombolysis for acute stroke and review other cases reported in the literature. PMID:24528816

Brownlee, W J; Anderson, N E; Barber, P A

2014-02-01

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An unusual etiology of infective endocarditis: Enterobacter cloacae.  

Science.gov (United States)

Gram-negative microorganisms are rarely implicated in causing infective endocarditis (IE). Although the traditionally identified risk factor for Gram-negative endocarditis has been intravenous drug abuse, recent studies have revealed that healthcare contact and the presence of prosthetic cardiac devices are primary risk factors for IE secondary to non-HACEK Gram-negative bacteria. We present a case of Enterobacter endocarditis in a patient with no prior history of valvular heart disease, implanted endovascular device, or intravenous drug abuse. The patient was treated successfully with carbapenem monotherapy. We have reviewed 43 cases of Enterobacter endocarditis reported in the literature to date. Clinical summary and management of IE secondary to Enterobacter based on all the published cases is outlined. PMID:22327517

Moon, Juhi; Smith, Triston; Sahud, Andrew G; Bhanot, Nitin

2012-12-01

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Brain magnetic resonance findings in infective endocarditis with neurological complications  

International Nuclear Information System (INIS)

Diagnosing infective endocarditis and its complications can be difficult because of the nonspecific symptoms. We reviewed findings of intracranial abnormalities on magnetic resonance imaging (MRI) in 14 patients with neurological complications and herein discuss the overall intracranial MRI findings. We retrospectively reviewed patients with infective endocarditis from August 2004 to August 2006. Brain MRI, the causative bacteria, and abnormal neurological symptoms were reviewed for 14 patients with neurological complications. Of the 14 patients, 13 showed intracranial abnormalities on MRI. Embolization was seen in 10 patients, hemorrhage in 3, abscess formation in 3, and encephalitis in 2. Hyperintense lesions with a central hypointense area on T2-weighted and/or T2*-weighted imaging (Bull's-eye-like lesion) were seen in four patients. A combination of these intracranial abnormalities was observed in 6 patients. The MRI findings associated with infective endocarditis are wide-ranging: embolization, hemorrhage, meningitis, cerebritis, abscess, the bull's-eye-like lesion. Clinicians should consider the possibility of infective endocarditis in patients with unknown fever and neurological abnormality. Brain MRI should be promptly performed for those patients, and T2*-weighted imaging is recommended for an early diagnosis of infective endocarditis. (author)

2009-04-01

 
 
 
 
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Mycotic aneurysm of the popliteal artery due to infective endocarditis.  

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Mycotic aneurysm (MA) is an infrequent complication of infective endocarditis (IE), reported in 3 to 15% of the patients with IE. The commonest site for such aneurysm is intracranial vessels (65%) followed by abdominal and then the peripheral vessels. We describe a case of 32 year old man with recently diagnosed rheumatic heart disease and mitral regurgitation. He had infective endocarditis (IE) and developed a large mycotic popliteal artery aneurysm (MPAA) and a small profunda femoris arterial aneurysm (PFAA) while he was on antibiotic therapy. The patient was successfully treated with prolonged antibiotic therapy and embolisation of the MPAA while PFAA was managed conservatively. PMID:22479751

Rajadhyaksha, Anjali; Sonawale, Archana; Rathod, Krantikumar; Khare, Shruti; Kalal, Chetan

2011-10-01

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

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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

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Infective endocarditis 1968-1977: an Asian experience.  

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The clinical pattern of infective endocarditis as seen in 101 patients at the University Hospital in Kuala Lumpur from 1968 to 1977 is reviewed. There were 60 males and 41 females. Majority of the patients were between 10-40 years of age. The most frequent underlying heart disease was rheumatic valvular disease (69%). Endocarditis was most frequent when aortic and mitral valve disease co-existed. Other than one patient who had candida endocarditis on a Bjork Shiley valve, the other patients had congenital heart disease. Patent ductus arteriosus was the commonest congenital heart disease. Microorganisms were identified in 77 patients. Streptococcus species was the commonest, followed by streptococcus aureus. The clinical features included fever, splenomegaly, petechial haemorrhages, finger clubbing, heart failure, peripheral and pulmonary emboli and neurological lesions. On adequate antibiotic therapy the hospital mortality was 22.7%. Most of the deaths were due to major cardiac or neurological complications. PMID:7247329

Singham, K T; Anuar, M; Puthucheary, S D

1980-10-01

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Surgical management for active infective endocarditis: a single hospital 10 years experience  

International Nuclear Information System (INIS)

To examine the outcome of surgery for active infective endocarditis (IE) in a cohort of patients. One hundred sixty-four consecutive patients who underwent valve surgery for active IE (diagnosis according to Duke criteria) in Madani Heart Center, Tabriz, Iran from 1996 to 2006 were studied. The mean age of patients was 36.3+-16 years overall: 34.6+-17.5 years for native valve endocarditis and 38.6+-15.2 yrs for prosthetic valve endocarditis (p=0.169). Ninety one (55.5%) patients were men. The infected valve was native in 112 (68.7%) of patients and prosthetic in 52(31.3%). In 61 (37%) patients, no predisposing heart disease was found. The aortic valve was infected in 78 (47.6%), mitral valve in 69 (42.1%), and multiple valves in 17 (10.3%) of patients. Active culture positive endocarditis was present in 81 (49.4%) whereas 83 (50.6%) patients had culture-negative endocarditis. Staphylococcus aureus was the most common isolated microorganism. Ninety patients (54.8%) were in NYHA classes III and IV. Mechanical valves were implanted in 69 patients (42.1%) and bioprostheses in 95 (57.9%), including a homograft in 19 (11.5%). There were 16 (9%) operative deaths, but there was only 1 death in patients that underwent aortic homograft replacement. Reoperation was required in 18 (10.9%) of cases. On multivariate logistic regression analysis, Staphylococcus aureus infection (p=0.008), prosthetic valve endocarditis (p=0.01), paravalvular abscess (p=0.001) and left ventricular ejection fraction less than 40% (p=0.04) were independent predictors of in-hospital mortality. Surgery for infective endocarditis continues to be challenging and associated with high operative mortality and morbidity. Prosthetic valve endocarditis, impaired ventricular function, paravalvular abscess and Staphylococcus aureus infection adversely affect in-hospital mortality. Also we found that aortic valve replacement with an aortic homograft can be performed with acceptable in hospital mortality and provides satisfactory results. (author)

2007-01-01

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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 Neisseriaâ??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

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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  

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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

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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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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), admit [...] idos 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. Abstract in english 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. RESULT [...] S: 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; Francisco Manes, Albanesi Fº; Maurício Bastos de Freitas, Rachid; Luíz André Vieira, Fernandes; José Augusto da Silva, Messias.

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Cytokine profiles linked to fatal outcome in infective prosthetic valve endocarditis.  

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Infective endocarditis is a disease normally of bacterial cause which affects the endocardic tissue, specifically the valves (native or prosthetic). It is a serious illness and mortality rates remain high, ranging between 20% and 40%. Previous reports have evidenced the potential role of cytokines in the diagnosis of this disease, but no information is available on their relationship with outcome. We recruited 26 consecutive patients with late prosthetic valve endocarditis requiring surgical treatment according to Duke criteria. Eight cytokines were measured in plasma in the first 24 h following diagnosis by using a Bio-Rad multiplex assay. Levels of IL-6, IL-8 and interferon gamma (IFN-?) were higher in non survivors. Receiver operating characteristic curve analysis evidenced that IL-6, IL-8 and IFN-? behaved as good diagnostic tests for identifying those patients with fatal outcome (area under the curve, CI 95%, p): IL-6: [0.81 (0.61-1.00) 0.012]; IL-8 [0.76 (0.56-0.96) 0.035]; IFN-? [0.79 (0.59-0.99) 0.021]. Levels of IL-6, IL-8 and IFN-? correlated positively between them, indicating that they are produced as consequence of a simultaneous response to the infection. Our findings support the participation of IL-6, IL-8 and IFN-? in the events linked to fatal outcome in infective prosthetic valve endocarditis. PMID:24106887

Bustamante, Juan; Arévalo, Adolfo; Tamayo, Eduardo; Sarria, Cristina; Aguilar-Blanco, Eva M; Heredia, Maria; Almansa, Raquel; Rico, Lucia; Iglesias, Verónica; Bermejo-Martin, Jesús F

2014-06-01

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Infective endocarditis caused by Listeria monocytogenes forming a pseudotumor.  

Science.gov (United States)

A 73-year-old woman with breast cancer and metastasis under chemotherapy suffered from fever, pleural effusion and pericardial effusion. Despite the administration of treatment with cefozopran and prednisolone, the patient's fever relapsed. An electrocardiogram identified a new complete atrioventricular block and an echocardiogram revealed vegetation with an unusual pseudotumoral mass in the right atrium. Blood cultures grew Listeria monocytogenes. The patient was eventually diagnosed with right-sided infective endocarditis, which improved following the six-week administration of ampicillin and gentamicin. Homemade yoghurt was suspected to be the cause of infection in this case. Listeria endocarditis is rare; however, physicians should pay more attention to preventing this fatal disease in immunocompromised patients. PMID:24785898

Uehara Yonekawa, Akiko; Iwasaka, Sho; Nakamura, Hisataka; Fukata, Mitsuhiro; Kadowaki, Masako; Uchida, Yujiro; Odashiro, Keita; Shimoda, Shinji; Shimono, Nobuyuki; Akashi, Koichi

2014-01-01

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Management of neurological complications of infective endocarditis in ICU patients  

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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...

2011-01-01

51

A case of infective endocarditis after transurethral prostatic resection  

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Full Text Available We report a case of infective endocarditis (IE after transurethral prostatic resection (TUR-P. A 63-year-old man who had underwent TUR-P for benign prostatic hyperplasia. After 40 days of surgery, he developed a fever. A diagnosis of IE was established by cardiography which detected large vegetation at mitral valve. After intravenous antibiotics therapy, he underwent mitral valve replacement surgery.

Kawahara Takashi

2010-01-01

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Infective endocarditis of a rare etiology: Serratia marcescens  

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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. T...

2004-01-01

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A case of infective endocarditis after transurethral prostatic resection  

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We report a case of infective endocarditis (IE) after transurethral prostatic resection (TUR-P). A 63-year-old man who had underwent TUR-P for benign prostatic hyperplasia. After 40 days of surgery, he developed a fever. A diagnosis of IE was established by cardiography which detected large vegetation at mitral valve. After intravenous antibiotics therapy, he underwent mitral valve replacement surgery.

Kawahara Takashi; Taguchi Hiroki; Yamagishi Takuya; Udagawa Koichi; Ouchi Hideki; Misaki Hioshi

2010-01-01

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Successful Treatment of Infective Endocarditis in Four Kidney Transplant Recipients  

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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 o...

2009-01-01

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Using MALDI-TOF mass spectrometry as a rapid and accurate diagnostic tool in infective endocarditis: A case report of a patient with mitral valve infective endocarditis caused by Abiotrophia defectiva  

DEFF Research Database (Denmark)

Abstract A case of infective endocarditis caused by Abiotrophia defectiva is presented. The use of MALDI-TOF mass spectrometry as a rapid and accurate diagnostic tool in infective endocarditis is discussed.

Holler, Jon Gitz; Pedersen, Line Kynemund

2010-01-01

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Tratamiento quirúrgico de la endocarditis infecciosa / Surgical treatment of infective endocarditis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish Objetivo: describir las características epidemiológicas y los resultados del tratamiento quirúrgico temprano de los pacientes con diagnóstico de endocarditis infecciosa intervenidos en el Departamento de Cirugía Cardiovascular de la Clínica Medellín, Colombia. Métodos: estudio observacional, descrip [...] tivo, retrospectivo, de todos los pacientes con diagnóstico de endocarditis infecciosa tratados mediante cirugía en la Clínica Medellín, entre enero de 2003 y enero de 2010. Resultados: se incluyeron en total 54 pacientes, 37 (68,5%) de ellos de género masculino. La mediana de la edad fue 57,5 años (9 - 76 años). El 77,7% tenía algún factor de riesgo para desarrollar endocarditis infecciosa; entre los más destacados insuficiencia renal crónica (IRC) en hemodiálisis (18,5%) y prótesis valvulares cardiacas (18,5%). El 66,7% de los hemocultivos fue positivo. Staphylococcus aureus fue el principal germen aislado en el 40,7% del total de pacientes. El 81,4% de las válvulas comprometidas eran nativas con predominio de la válvula mitral (44,5%) y el 7,5% presentaba compromiso de dos válvulas. En el 68,5% el motivo de consulta fue falla cardiaca y 35,3% presentaron fenómenos embólicos como manifestación inicial o asociada (cerebral 16,7%, pulmonar 13%, esplénica 5,6%). En el 83,3% de los casos se realizó cirugía temprana; 66% recibieron válvulas mecánicas. La mortalidad total a tres meses fue del 13% (muerte intraoperatoria 3,7%, mortalidad a 30 días, 9%). La mediana en el tiempo de estancia hospitalaria fue de 36 días (7 a 130 días). En este estudio se reporta una mortalidad total que se encuentra en el límite inferior de lo reportado en el mundo. Una de las razones atribuibles a este hallazgo es el manejo quirúrgico temprano que se protocoliza en el servicio. Abstract in english Objective: to describe the epidemiological characteristics and the results of early surgical treatment of patients diagnosed with infectious endocarditis who underwent surgery in the Department of Cardiovascular Surgery in the Medellin Clinic, Colombia. Methods: observational, descriptive, retrospec [...] tive study of all the patients diagnosed with infective endocarditis treated by surgery in the Medellin Clinic between January 2003 and January 2010. Results: a total of 54 patients were included. 37 (68.5%) were male. Mean age was 57.5 years (9-76 years). 77.7% had a risk factor for developing infective endocarditis; among the most prominent risk factors were chronic renal failure (CRF), patients on hemodialysis (18.5%) and heart valve prostheses (18.5%). 66.7% of the blood cultures were positive. Staphylococcus aureus was the main germ isolated in 40.7% of patients. 81.4% of the involved valves were native, with mitral valve predominance (44.5%) and 7.5% had involvement of two valves. In 68.5% the reason for the consultation was heart failure and 35.3% had embolic phenomena as the initial manifestation or associated (16.7% cerebral, pulmonary 13%, spleen 5.6%). In 83.3 % of cases early surgery was performed: 66% received mechanical valves. The three-month total mortality was 13% (3.7% intraoperative death, mortality at 30 days 9%). The median length of hospital stay was 36 days (7-130 days). In this study the total mortality reported is at the lower limit of the reported in the world. One of the reasons attributed to this finding is the early surgical management that is the protocol in the service.

Alain, Eusse; Mauricio, Atehortúa; Luis, Vélez; Víctor, Bucheli; Carlos, Dallos; Gerardo, Flores; Ana M, Herrera; Sergio, Franco.

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Infective endocarditis- (a survey of the past 50 years  

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Full Text Available Autopsy incidence of infective endocarditis during the past 50 years was analysed to review the changes in the clinico-pathologic pattern if any. 185 cases were recorded in a total of 39931 autopsies giving an average incidence of 0.46%. The cases were classified into groups I, II & III depending upon whether the endocarditis super-vened on normal hearts, diseased hearts or followed surgery, re-spectively. The fifty year period could be divided into three phases on incidence. First phase (1927-41 represented pre-antibiotic era in which group I cases predominated and causative organisms in 801" o f cases were virulent cocci such as staphylococci, haemolytic streptococci and pneumococci. In the second phase (1948-66 the general incidence was reduced by 50%. Group II cases predominat-ed and the most common etiologic agent was streptococcus viridans (40%. In the third phase (1967-76 the general incidence has reached again to preantibiotic level with coagulase positive staphy-lococci, Gram negative bacilli and fungi accounting for 90% of cases. Group III contributed significantly in this phase. The changes in incidence are primarily due to fall and rise in Group I cases. Incidence of rheumatic heart disease with endocar-ditis which mainly forms Group II is declining steadily in post-antibiotic era. There is no shift in the peak age incidence which remains in the 3rd decade. Males with rheumatic heart disease are more prone to infective endocarditis than similarly affected females. There was no change in frequency of involvement of various valves or sites of embolization.

Mehta Ajita

1978-01-01

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Embolic Events And Neurological Complications In Infective Endocarditis  

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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

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

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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

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The Need for a Specific Risk Prediction System in Native Valve Infective Endocarditis Surgery  

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The need for a specific risk score system for infective endocarditis (IE) surgery has been previously claimed. In a single-center pilot study, preliminary to future multicentric development and validation, bivariate and multivariate (logistic regression) analysis of early postoperative mortality predictors in 440 native valve IE patients were performed. Mathematical procedures assigned scores to the independent predictors emerged (AUC of the ROC curve: 0.88). Overall mortality was 9.1%. Six p...

Marisa De Feo; Maurizio Cotrufo; Antonio Carozza; Santo, Luca S.; Francesco Amendolara; Salvatore Giordano; Della Ratta, Ester E.; Gianantonio Nappi; Alessandro Della Corte

2012-01-01

 
 
 
 
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Superantigen profiling of Staphylococcus aureus infective endocarditis isolates.  

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The frequency of superantigen production among Staphylococcus aureus isolates associated with endocarditis is not well defined. We tested 154 S. aureus isolates from definite infective endocarditis cases for the presence of staphylococcal enterotoxins A-E, H, and TSST-1 by PCR, enzyme-linked immunosorbent assay, and using an HLA-DR3 transgenic mouse splenocyte proliferation assay. Sixty-three isolates (50.8%) tested positive for at least 1 superantigen gene, with 21 (16.9%) testing positive for more than 2. tst (28.6%) was most common, followed by seb (27%), sea (22.2%), sed (20.6%), see (17.5%), and sec (11.1%). Of 41 methicillin-resistant S. aureus, 21 had superantigen genes, with sed being more frequently detected in this group compared to methicillin-susceptible S. aureus (P < 0.05). Superantigen genes were not associated with mortality (P = 0.81). 75% of PCR-positive isolates induced robust splenocyte proliferation. Overall, more than half of S. aureus isolates causing endocarditis carry superantigen genes, of which most are functional. PMID:24745820

Chung, Jin-Won; Karau, Melissa J; Greenwood-Quaintance, Kerryl E; Ballard, Alessandro D; Tilahun, Ashenafi; Khaleghi, Shahryar Rostamkolaei; David, Chella S; Patel, Robin; Rajagopalan, Govindarajan

2014-06-01

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Infective endocarditis complicated with left atrioventricular fistula in a 20-year-old patient. A case study  

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Intracardiac fistulas are rare complications of infective endocarditis. We report an unusual case of successful surgical repair of intracardiac fistula between the left ventricle and the left atrium in the course of infective endocarditis in a 20-year-old patient. According to this we conclude that timely diagnosis, proper antibiotic treatment, and early surgical intervention should improve the outcomes of infective endocarditis complications.

Banys?, Andrzej; Paw?owski, Witold; Jander, S?awomir; Bartczak, Karol; Maciejewski, Marek; Jaszewski, Ryszard

2011-01-01

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

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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.

Chambers, Stephen T.; Murdoch, David; Morris, Arthur; Holland, David; Pappas, Paul; Almela, Manel; Fernandez-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

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Two-step bacterial broad-range polymerase chain reaction analysis of heart valve tissue improves bacteriological diagnosis of infective endocarditis.  

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Positive heart valve (HV) culture is a major Duke's criterion for the diagnosis of infective endocarditis but is poorly sensitive. Two broad-range 16S rDNA polymerase chain reaction (PCR) methods were applied to 31 HV samples: first, a real-time method, then conventional end-point PCR was applied to HV samples on which the first PCR was negative. Five specific real-time PCR procedures were also used in order to identify Bartonella spp., Tropheryma whipplei, Chlamydophila pneumoniae, Mycoplasma pneumonia, and Coxiella burnetii. A strategy combining the 2-step broad-range PCR methods improved the sensitivity of the molecular method from 38.7% to 58%. Specific PCR identified 1 T. whipplei, which was also identified by conventional end-point PCR. These results confirm that blood culture is the gold standard for the diagnosis of infective endocarditis, shows that molecular methods applied to HV can be useful when blood culture is negative, and that 2-step broad-range PCR approach seems to be more sensitive. PMID:23318112

Boussier, Rémi; Rogez, Sylvie; François, Bruno; Denes, Eric; Ploy, Marie-Cécile; Garnier, Fabien

2013-03-01

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Prophylaxis for infective endocarditis. Who needs it? How effective is it?  

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OBJECTIVE: To review guidelines for using antibiotic prophylaxis to prevent infective endocarditis, and to present recent changes and controversies regarding these guidelines. QUALITY OF EVIDENCE: Data are from physiologic and in vitro studies, as well as studies of animal models, and from retrospective analyses of human endocarditis cases. Systematic reviews and guidelines are also examined. As no randomized clinical trials have examined prophylaxis for bacterial endocarditis, many recommend...

Press, N.; Montessori, V.

2000-01-01

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Surgical Treatment in Active Infective Endocarditis: Results of a Four-Year Experience  

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Background. Aim of present investigation was to analyze survival and recurrence rate in patients with active endocarditis referred to our centre for surgical treatment. Methods. 80 consecutive patients with active infective endocarditis (52 males, 28 females, mean age 59.2 years) were referred to our institution for surgical treatment. 78 patients underwent surgery, and 2 patients died before intervention. Results. Fifty patients had native valve endocarditis, 30 prosthetic valve involvement....

Rostagno, Carlo; Carone, Enrico; Rossi, Alessandra; Gensini, Gian Franco; Stefano, Pier Luigi

2011-01-01

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Infective endocarditis: a prospective study of 60 consecutive cases.  

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Sixty cases of infective endocarditis were studied prospectively between May, 1985 and December, 1988. There were 40 males and 20 females with a mean age of 28 years. Endocarditis was found on normal valves in 13 patients, on rheumatic valves in 30, on congenital lesions in 8, on prosthetic valves in 4 and on mitral valve prolapse in 5 cases. Positive blood cultures were detected in 35 patients (58%). In addition bone marrow culture was positive in 1 and valves removed on surgery grew causative organisms in eight. Thus the total culture positive cases were 44 (73%). The commonest infective organism was Streptococcus viridans. Uncommon organisms accounted for 10 cases (17%). Two dimensional echocardiography (2D-Echo) was done in all cases and vegetations were detected in 48 patients (80%). 2 D-Echo was helpful not only in the detection of vegetations but also in the demonstration of other complications of endocarditis like ring abscesses, ruptured chordae, ulceration of aortic root, interventricular septum abscess, and mitral xenograft obstruction. Early surgery was performed in 31 patients. In this group of patients severe heart failure was present in 21, embolization in 10, persistence of fever in 15 and large vegetations in 19. Of the 29 patients treated medically, 2 died. The mortality in the surgical group was seen in 5 (16%) with a mean follow-up of 15 months. The major reason for a large number of our patients undergoing surgery is the fact that this is a referral Center and patients were sent later or when there was a failure of medical treatment. PMID:2132422

Kiwan, Y A; Hayat, N; Vijayaraghavan, D G; Das Chugh, T; Khan, N; Mualla, F; Madi, S

1990-01-01

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

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Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish 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, posteriormente mostró signos de embolismo a distancia, hemocultivos positivos para P. aeruginosa y desarrollo de múltiples complicaciones propias de la enfermedad. La presentación clínica de la endocarditis infecciosa es inespecífica, lo cual genera diagnósticos tardíos que impiden la instauración de un tratamiento precoz y eficaz, como el reemplazo valvular, indicado en endocarditis por hongos o por gérmenes como P. aeruginosa. Este caso es fortuito por su resolución solamente con tratamiento médico combinado, con amikacina y meropenem, ya que tuvo varias complicaciones que contraindicaron el manejo quirúrgico. Abstract in english Infective endocarditis due to Pseudomonas aeruginosa is a rare clinical condition, difficult to diagnose and associated with high mortality. Herein we present a case of a 51 years old male without history of intravenous drug use or valvular disease, with past medical history of cholecystectomy in th [...] e previous month, who presented to the emergency department with fever, gastrointestinal symptoms, and subsequent signs of distant embolization, positive blood cultures for P. aeruginosa and development of multiple complications of the disease. The clinical presentation of infective endocarditis is nonspecific, leading to delayed diagnosis, and preventing early and effective treatment. Valvular replacement is indicated in fungal or P. aeruginosa endocarditis. This case is notable because of the resolution with amikacin combined with meropenem, in a patient with several complications that contraindicated surgery.

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

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

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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

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

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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.

Tran, MaryAnn P; Caldwell-McMillan, Molly; Khalife, Walid; Young, Vincent B

2008-01-01

71

Clinical criteria and the appropriate use of transthoracic echocardiography for the exclusion of infective endocarditis  

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Background: Clinical guidelines currently suggest that transthoracic echocardiography (TTE) be carried out in all patients with suspected endocarditis, but the use of TTE where there is a low probability of infective endocarditis has a poor diagnostic yield. This screening approach may no longer be appropriate.

Greaves, K.; Mou, D.; Patel, A.; Celermajer, D. S.

2003-01-01

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Kocuria kristinae endocarditis related to diabetic foot infection.  

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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

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Acute Aortic Valve Rupture From Infective Endocarditis After Transrectal Prostate Biopsy: A Call to Revise the AHA Guidelines for Prevention of Infective Endocarditis  

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We describe the case of a 63-year-old man with a known murmur who presented with a 4-month history of intermittent fever and a progressive reduction in energy level after a transrectal prostate biopsy (TRPB). He subsequently presented with acute heart failure secondary to aortic valve cusp rupture caused by endocarditis and underwent urgent aortic valve surgery. The 2008 American College of Cardiology/American Heart Association Guideline update on infective endocarditis has narrowed the use o...

Ansari, Julia; Garcha, Gurkaran Singh; Huang, Henry; Bakaeen, Faisal G.; Virani, Salim S.; Jneid, Hani

2013-01-01

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Infective endocarditis and antibiotic prophylaxis: an issue that remains controversial in Dentistry  

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Full Text Available Introduction: The issue of infective endocarditis and its antibiotic prophylaxis has passed through major changes recently.All these changes are very dynamic and therefore cause much controversy. Historically and with no scientific basis, great emphasis has been given to the concept that dental procedures are the main cause of infective endocarditis cases.Objective: The purpose of this communication is to reconsider the procedures in dental practice, analyzing the important aspects in the prescription of antibiotics and minimizing the use ofantibiotic prophylaxis for dental procedures. Conclusion:The oral health care and biofilm control should be the first steps in the prevention of infective endocarditis of odontogenic origin.

Orlando Cavezzi Junior

2010-07-01

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Infective endocarditis and phlebotomies may have killed mozart.  

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Thirty-five year-old Amadeus Mozart died in Vienna after an acute illness that lasted only 15 days but no consensus has been reached on the cause of his death. From many letters written by his farther it is almost certain that he experienced at least three episodes of acute rheumatic fever attack in his childhood, and a relapse of rheumatic fever was suggested to have killed Mozart, although death from acute rheumatic fever is very rare in adults. His last illness was characterized by high fever, massive edema, vomiting and skin rash. His last illness can be explained by infectious endocarditis and heart failure. During his last hours, he was given phlebotomy, possibly for the third time in two weeks, and soon after he became unconscious and died. As such, phlebotomy performed on a man dehydrated by high fever and vomiting may have caused systemic shock. In summary, Mozart probably died from chronic rheumatic heart disease complicated by infective endocarditis and heart failure, and repeated phlebotomy-induced hypovolemic shock. PMID:21267381

Lee, Simon Jong-Koo

2010-12-01

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Viridans and bovis group streptococci that cause infective endocarditis in two regions with contrasting epidemiology.  

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Viridans group (VGS) or bovis group streptococci (BGS) are the major causes for streptococcal infective endocarditis (IE). However, the causative isolates are not sufficiently characterized. Using multilocus sequence analysis we have examined VGS and BGS (VGS/BGS) isolates that caused IE in southern India and Germany, two distant geographic regions with a contrasting IE epidemiology. Other than in Germany, the majority of patients (68%) in Chennai, southern India had an underlying rheumatic heart disease (RHD). In accord with the high prevalence of RHD in the younger population and with the expansive age structure of India, the median age (24 years) of the VGS/BGS endocarditis patients was lower than in Germany (63 years), where RHD is rare and the age structure is contractive. Both in Germany and in southern India, the majority of cases were caused by mitis group streptococci, however, with considerable differences in the spectra of causative (sub)species. BGS endocarditis was more frequent in Germany. The spectrum of VGS/BGS that cause IE differs considerably between distant geographic regions in which different predisposing conditions prevail. Therefore, improved microbiological diagnosis in IE may facilitate determination of the optimal therapy. PMID:24220665

Naveen Kumar, Venkatesan; van der Linden, Mark; Menon, Thangam; Nitsche-Schmitz, D Patric

2014-05-01

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Management of neurological complications of infective endocarditis in ICU patients.  

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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 left-sided abnormalities of native or prosthetic valves. Occlusion of cerebral arteries, with stroke or transient ischemic attack, accounts for 40% to 50% of the central nervous system complications of IE. CT scan is the most easily feasible neuroimaging in critically unstable patients. However, magnetic resonance imaging is more sensitive and when performed should follow a standardized protocol. In patients with ischemic stroke who are already receiving oral anticoagulant therapy, this treatment should be replaced by unfractionated heparin for at least 2 weeks with a close monitoring of coagulation tests. Mounting evidence shows that, for both complicated left-sided native valve endocarditis and Staphylococcus aureus prosthetic valve endocarditis, valve replacement combined with medical therapy is associated with a better outcome than medical treatment alone. In a recent series, approximately 50% of patients underwent valve replacement during the acute phase of IE before completion of antibiotic treatment. After a neurological event, most patients have at least one indication for cardiac surgery. Recent data from literature suggest that after a stroke, surgery indicated for heart failure, uncontrolled infection, abscess, or persisting high emboli risk should not be delayed, provided that the patient is not comatose or has no severe deficit. Neurologic complications of IE contribute to a severe prognosis in ICU patients. However, patients with only silent or transient stroke had a better prognosis than patients with symptomatic events. In addition, more than neurologic event per se, a better predictor of mortality is neurologic dysfunction, which is associated with location and extension of brain damage. Patients with severe neurological impairment and those with brain hemorrhage have the worse outcome. PMID:21906336

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

2011-01-01

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Infective endocarditis detection through SPECT/CT images digital processing  

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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

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Extraskeletal osteosarcoma of the heart presenting as infective endocarditis.  

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A 7 yr old castrated male Labrador retriever (35.6 kg) was evaluated for an acute onset of vomiting of 24 hr duration. On initial examination, the patient was febrile (103.8°F) and tachycardic (150 beats/min). Thoracic radiographs revealed left atrial enlargement with mild pulmonary infiltrates. The dog's condition worsened and repeat radiographs revealed worsening pulmonary infiltrates and pleural effusion. Treatment for heart failure was initiated. An echocardiogram showed a large 3 cm × 4 cm vegetation on the atrial surface of the posterior mitral valve. The patient was euthanized due to poor clinical appearance and infective endocarditis was suspected. Necropsy revealed an osteosarcoma of the posterior mitral valve, which cultured negative. PMID:21311070

Timian, Jessica; Yoshimoto, Sean K; Bruyette, David S

2011-01-01

80

A thrombotic tendency in patients with infective endocarditis.  

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An attempt was made to evaluate a thrombotic tendency in cases of infective endocarditis (IE) from the viewpoint of the changes of platelets and coagulo-fibrinolysis. Qualitative changes of platelets by thrombi formation were detected by showing activated responses of platelets to adenosine diphosphate or collagen and by showing a high level of plasma beta-thromboglobulin which is released by platelets during aggregation. A mild hypercoagulable state without acceleration of fibrinolysis was also detected by showing low levels of plasma antithrombin III which is the most potent antithrombin in the blood and normal levels of plasma alpha 2-plasmin inhibitor in the blood. From above findings, it was concluded that a thrombotic tendency in cases of IE was clearly detected by qualitative changes of platelets by thrombi formation and by mild hypercoagulability without acceleration of fibrinolysis. PMID:6210785

Fukuda, Y; Kuroiwa, Y; Tabuchi, H; Ohshige, T; Sanada, J; Minami, Y; Takaoka, S; Kataoka, H; Furukawa, S; Miyahara, K; Nakamura, K; Hashimoto, S

1982-05-01

 
 
 
 
81

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

DEFF Research Database (Denmark)

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.

Rasmussen, Rasmus Vinther; Høst, Ulla

2011-01-01

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Are new recommendations on the prevention of infective endocarditis applicable in our environment?  

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Introduction. Over half a century ago the process of prevention of infective endocarditis in patients with predisposed cardiac diseases was started. The application of prevention has been based on the fact that infective endocarditis is preceded by bacteraemia, which can be caused by some invasive diagnostic and therapeutic procedures, and whose development can be prevented by applying antibiotics before an intervention. According to the latest guidelines of the European Society of Card...

2010-01-01

83

Endovascular Treatment of Intracerebral Mycotic Aneurysm before Surgical Treatment of Infective Endocarditis  

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Mycotic aneurysms are rarely seen in patients who have infective endocarditis, and the management of these patients remains controversial. We present the case of a patient who had infective endocarditis complicated by a mycotic aneurysm of the left middle cerebral artery. There was substantial mitral regurgitation, and Streptococcus viridans was isolated from the blood samples. Dysarthria appeared during the 4th week of the antibiotic therapy, but resolved completely 8 hours after onset. The ...

Erdogan, Hasan Basri; Erentug, Vedat; Bozbuga, Nilgun; Goksedef, Deniz; Akinci, Esat; Yakut, Cevat

2004-01-01

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Clinical Profile and Outcome of Infective Endocarditis at the Aga Khan University Hospital  

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Background: The spectrum of infective endocarditis (IE) is significantly different in developed and developing countries. The present study was conducted to study the clinical profile and outcome of infective endocarditis in Pakistan. Methods: A descriptive cross-sectional study with review of medical records for 188 patients admitted to our teaching hospital with a diagnosis of IE from January 1988 to December 2001. One hundred fifty-nine subjects fulfilled the modified Duke diagnost...

2009-01-01

85

Discrete membranous subaortic stenosis complicated by infective endocarditis: a case report.  

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Discrete membraneous subaortic stenosis is an uncommon cause of left ventricular outflow tract obstruction. Although its relationship to infective endocarditis is well defined, the expected site of vegetation is over the aortic valve. We report on a 46-year-old man who had a discrete membranous subaortic stenosis, complicated with infective endocarditis, in which the vegetation was over the subaortic membrane and the aortic valve was spared. To our knowledge, this is the first reported case of that entity. PMID:17599883

Gurel, Emre; Karaahmet, Tansu; Tanalp, Ali Cevat; Mutlu, Bulent; Basaran, Yelda

2007-01-01

86

Infective endocarditis and motivation to an oral health check-up  

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Aim: The Rhône-Alpes Union régionale des caisses d’Assurance maladie (URCAM) sent information about oral health to patients at risk of infective endocarditis (IE) and information with audit-feedback to general practitioners. Our objective was to assess the effectivenessof this action.Methods: In 2004, 5 to 70 year-old chronic patients at risk of infective endocarditis were included. We randomized 25 geographical clusters in two groups: a control and an intervention group. Several document...

2010-01-01

87

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

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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

88

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

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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

89

Are new recommendations on the prevention of infective endocarditis applicable in our environment?  

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Full Text Available Introduction. Over half a century ago the process of prevention of infective endocarditis in patients with predisposed cardiac diseases was started. The application of prevention has been based on the fact that infective endocarditis is preceded by bacteraemia, which can be caused by some invasive diagnostic and therapeutic procedures, and whose development can be prevented by applying antibiotics before an intervention. According to the latest guidelines of the European Society of Cardiology published this year, prevention is recommended only in high risk patients with previous infective endocarditis, prosthetic valves, cyanotic congenital heart diseases without surgical repair or with residual defects, palliative shunts or conduits, congenital heart diseases with complete repair with prosthetic material up to six months after the procedure (surgery or percutaneous intervention, and when the residual defect persists at the site of implantation of a prosthetic material. In addition, antibiotic prophylaxis is limited to dental procedures with the manipulation of gingival or periapical region of the teeth or perforation of the oral mucosa. Objective. The aim of this testing was to confirm whether these novelties in recommendations were applicable in our environment. Methods. Fifty-seven patients (44 men and 13 women with infective endocarditis were included in the testing. Infective endocarditis was diagnosed in 68% of patients based on two major criteria and in 32% based on one major and three minor criteria. Results. In 54.4% of patients the entry site of infection could be determined. Twenty-one percent of patients developed infection after a dental intervention, 17.5% of patients the infection occurred after a skin/soft tissue lesion, whereas urinary infection preceded infective endocarditis in 14% of patients and bowel diverticulosis was a possible cause in of 1.75% of patients. In all cases with infective endocarditis preceded by the dental intervention, antibiotic prophylaxis was not applied due to absent data of heart disease or negligence. Conclusion. In our country a high incidence of infective endocarditis following dental procedures has been observed. One of possible reasons is poor oral hygiene. Its improvement and a regular dental control, as well as the individual risk assessment of intervention and conditions under which the intervention is performed could determine risk reduction for the development of infective endocarditis.

Ivanovi? Branislava

2010-01-01

90

Genome Sequence of Staphylococcus capitis QN1, Which Causes Infective Endocarditis  

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Staphylococcus capitis is a subtype of coagulase-negative staphylococci (CoNS) which could emerge as a significant pathogen causing infective endocarditis, prosthetic valve endocarditis, and late-onset sepsis. We isolated S. capitis strain QN1 from the skin swab sample of a female. Here we prepared a genome sequence for this strain consisting of 30 contigs totaling 2,430,101 bases and a GC content of 32.76%.

Qin, Nan; Ding, Wenchao; Yao, Jian; Su, Kunkai; Wu, Lingjiao

2012-01-01

91

Infective endocarditis with Abiotrophia defectiva: the first Australian experience.  

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A 40-year old Indigenous woman with a history of mitral valve replacement was admitted to the Royal Darwin Hospital, Northern Territory, for an elective cone biopsy of the cervix. During the admission, she had recurrent fever and joint pain of the left knee. Blood was cultured, and she was treated with broad-spectrum antibiotics. Abiotrophia defectiva was identified from the culture, and a transoesophageal echocardiogram revealed endocarditis of the mitral valve prosthesis. A review of the English-language literature suggests that this is the first reported case of Abiotrophia endocarditis in Australia, and the third reported case of prosthetic-valve endocarditis caused by this species worldwide. PMID:18304019

Assche, Anthony F Van; Stephens, Dianne P

2008-03-01

92

Infective endocarditis in previously healthy children with structurally normal hearts.  

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Structural heart disease, intravascular catheters, and invasive procedures are predisposing factors for infective endocarditis (IE). Data on IE in children with structurally normal hearts and no predisposing factors are limited. We aim to characterize IE (definite or possible by Duke criteria) in such a subgroup of pediatric patients (age <18 years) who were treated at our medical center. Of 51 events of IE in 50 children, 9 (18 %) had no predisposing factors. These infections were all community-acquired and presented with fever, a newly detected heart murmur, diagnostic echocardiographic findings, and left-sided infection. Clinical course was characterized by acute onset (n = 8 of 9) with a 100 % complication rate (heart failure or embolic phenomena). Emergency cardiac surgery was performed in 7 children (Ross surgery [n = 4], mitral valve replacement [MVR; n = 2], and valve repair [n = 1]). Causative organisms were S. aureus (n = 3), S. pneumoniae (n = 2), H. parainfluenzae (n = 1), and K. kingae (n = 1). In contrast, IE in children with predisposing factors (42 of 51 [82 %]) was frequently health care-associated (30 of 42), right-sided (20 of 42, p = 0.041), and with lower rates of diagnostic echocardiographic findings (28 of 42, p = 0.041), complications (16 of 42, p < 0.001), and surgical intervention (9 of 42, p = 0.002). Causative organisms were mainly viridans streptococci (n = 9), Candida species (n = 8), coagulase-negative staphylococci (n = 6), enteric Gram-negative bacilli (n = 6), S. aureus (n = 5), and K. kingae (n = 3). Mortality was 11 % in both groups. We conclude that pediatric IE in children with and without predisposing factors differs significantly. Due to the acute and complicated course of the latter, high awareness among pediatricians and prompt diagnosis are crucial. PMID:23483241

Marom, Daphna; Ashkenazi, Shai; Samra, Zmira; Birk, Einat

2013-08-01

93

Infective endocarditis of a rare etiology: Serratia marcescens  

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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

94

Changing spectrum of clinical and laboratory profile of infective endocarditis.  

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The clinical profile of 28 consecutive patients admitted with infective endocarditis (IE) between 1987 and 1988 was studied. There were 21 males and seven females with a mean age of 24 +/- 11 years. Rheumatic heart disease (RHD) was the commonest underlying disease (68%) followed by congenital heart disease (CHD). Mitral regurgitation with aortic regurgitation were the commonest valvular lesions (47%) in those with RHD while ventricular septal defect was the commonest (43%) in those with CHD. A younger age of onset, complicated course and high mortality were seen in these six patients with acute IE. Persistently positive blood cultures during life or at autopsy were obtained in 21%. Strep viridans was the commonest isolate and was often resistant to streptomycin. 2D echocardicgram revealed vegetations in 96% of patients, the aortic valve (39%) being more commonly affected than the mitral valve (11%). ESR of more than 20 mm drop 1st hour (Wintrobe) was seen in 96%. Thrombophlebitis was a common complication of therapy and cloxacillin the commonest drug implicated. A mortality of 21% as a result of refractory congestive heart failure (CHF) (50%), uncontrolled sepsis (33%) and embolic events (17%) was seen. A rising incidence of culture negative IE, combined aortic and mitral valve disease and CHF is noted. PMID:1307530

Agarwal, R; Bahl, V K; Malaviya, A N

1992-11-01

95

Infective endocarditis - maybe yes, maybe no: Case report  

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Full Text Available Introduction. Infective endocarditis (IE is a rare disease which manifests in different ways. Case Outline. We are presenting a female patient who was suspected of IE based on the presence of fever, accelerated erythrocyte sedimentation rate, increased levels of C-reactive protein and echocardiographic findings of filamentous structures on the aortic valve which were assumed to be vegetation. Because of the well-known fact that in the pre-antibiotic era IE was almost always a fatal disease, empirical antibiotic therapy was conducted despite the absence of clear criteria for IE and it resulted in a satisfactory outcome. The course of the disease and the persistence of echocardiographic findings with a completely competent aortic valve, suggested us to consider the diagnosis of Lambl’s excrescences. There was no indication for surgical treatment in our patient; so that in the absence of pathological confirmation our diagnostic dilemma was left unresolved. Conclusion. In patients with typical clinical features of IE and filamentous structures on the cardiac valves that are completely competent, Lambl’s excrescences should be kept in mind as a possible differential diagnosis.

Ivanovi? Branislava

2013-01-01

96

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

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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

97

Is there a role for Tc-99m HMPAO leucocyte scintigraphy in patients with infective endocarditis?  

International Nuclear Information System (INIS)

Aim: Infective endocarditis is still an important disease in developing countries. Due to the difficult diagnosis, treatment is often delayed or inappropriate. A combination of clinical findings and echocardiography are used most often, but have a low sensitivity. As Tc-99m HMPAO labelled leucocyte scintigraphy is used routinely to evaluate patients with suspected infectious processes, it was postulated that this technique may also aid in the diagnosis of acute infective endocarditis in patients with rheumatic heart disease. Materials and Methods: Six patients who presented with clinical signs and symptoms of infective endocarditis, were referred for Tc-99m HMPAO labelled leucocyte scintigraphy. The white blood cells were labelled according to standard procedures. Whole body planar imaging, and single photon emission tomography of the chest area, with imaging at 30 minutes, 3 hours and 24 hours after the administration of the labelled leucocytes, were performed on all patients. Results: All the scintigrams were negative. No abnormal concentration of leucocytes could be detected in the region of the heart. This was in spite of clinical findings indicative of active infective endocarditis. Conclusion: Vegetations mainly consist of masses of clotted blood and blood cell debris, containing the causative organisms. Leucocytes do not play a major role in the pathologic process. Although only six patients were studied, it appears that Tc-99m HMPAO leucocyte scintigraphy is of no value in the evaluation of patients with infective endocarditis. A study after the administration of radiolabelled antibiotics may be of greater value and should be considered in these patients

2002-09-01

98

Revisiting the effect of referral bias on the clinical spectrum of infective endocarditis in adults.  

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Referral bias occurs because of the clustering of patients at tertiary care centers. This may result in the distortion of observed clinical manifestations of rare diseases. This analysis evaluates the effect of referral bias on the epidemiology of infective endocarditis (IE) in the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS). This is a prospective multicenter cohort study comparing transferred and non-transferred patients with IE. Factors independently associated with transfer status were evaluated using multivariable logistic regression. A total of 2,760 patients were included in the analysis, of which 1,164 (42.2%) were transferred from other medical centers. Transferred patients more often underwent surgery for IE (odds ratio [OR]?=?2.5; 95% confidence interval [CI] 1.9-3.2). They were also more likely to have complications such as stroke (OR?=?1.5; 95% CI 1.3-1.9), heart failure (OR?=?1.4; 95% CI 1.1-1.6), and new valvular regurgitation (OR?=?1.3; 95% CI 1.1-1.6). The in-hospital mortality rates were similar in both groups. Patients with IE who require surgery and suffer complications are referred to tertiary hospitals more frequently than patients with an uncomplicated course. Hospital transfer has no obvious effect on the in-hospital mortality. Referral bias should be taken into consideration when describing the clinical spectrum of IE. PMID:20549531

Kanafani, Z A; Kanj, S S; Cabell, C H; Cecchi, E; de Oliveira Ramos, A; Lejko-Zupanc, T; Pappas, P A; Giamerellou, H; Gordon, D; Michelet, C; Muñoz, P; Pachirat, O; Peterson, G; Tan, R-S; Tattevin, P; Thomas, V; Wang, A; Wiesbauer, F; Sexton, D J

2010-10-01

99

Infective endocarditis caused by Cellulomonas spp. in an intravenous drug user: case report.  

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Cellulomonas spp. are often believed to be of low virulence. There are only a few reports of human infections. We report the first case of endocarditis caused by Cellulomonas in an intravenous drug abuser. The diagnosis of infective endocarditis (IE) in this case was definite using the Duke criteria. The course of the disease was complicated with a heart failure and possible mycotic aneurysm in the left leg. After the end of antimicrobial therapy aortic valve replacement was done because of severe heart failure. PMID:23653152

Logar, Mateja; Lejko-Zupanc, Tatjana

2013-06-01

100

How Is Endocarditis Treated?  

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... on Twitter. How Is Endocarditis Treated? Infective endocarditis (IE) is treated with antibiotics and sometimes with heart ... damaged heart valve or to help clear up IE. For example, IE caused by fungi often requires ...

 
 
 
 
101

How Is Endocarditis Diagnosed?  

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... Endocarditis Diagnosed? Your doctor will diagnose infective endocarditis (IE) based on your risk factors, your medical history ... signs and symptoms, and test results. Diagnosis of IE often is based on many factors, rather than ...

102

Diagnostic value of harmonic transthoracic echocardiography in native valve infective endocarditis: comparison with transesophageal echocardiography  

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Abstract Background Although echocardiography has been incorporated into the diagnostic algorithm of patients with suspected infective endocarditis (IE), systematic usage in clinical practice remains ill defined. To determine the diagnostic accuracy of detecting vegetations using harmonic transthoracic echocardiography (hTTE) as compared to transesophageal echocardiography (TEE) in patients with an intermediate likelihood of native valve IE. Methods Between 2004...

Jassal Davinder S; Aminbakhsh Amin; Fang Tielan; Shaikh Nasir; Embil John M; Mackenzie Gordon S; Tam James W

2007-01-01

103

Awareness of infective endocarditis prophylaxis in parents of children with congenital heart disease: A prospective survey  

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Full Text Available A prospective survey of parents of the children with congenital heart disesease was conducted to determine their awareness as regards the importance of oral hygiene and prophylaxis against infective endocarditis (IE. The results of this study demonstrated that only 8% of the parents were aware of the importance of good oro-dental hygiene and need for IE prophylaxis.

Nath Parrimala

2008-01-01

104

K2 Serotype Klebsiella pneumoniae Causing a Liver Abscess Associated with Infective Endocarditis?  

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Klebsiella pneumoniae primary liver abscess (KPLA) is an emerging disease that is associated with distant septic complications. We report the first case of KPLA associated with infective endocarditis. The K. pneumoniae strain was a hypermucoid K2 serotype carrying the rmpA virulence-associated gene.

Rivero, Andres; Gomez, Eric; Alland, David; Huang, David B.; Chiang, Tom

2010-01-01

105

Infective endocarditis and meningitis due to Scedosporium prolificans in a renal transplant recipient.  

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Scedosporium prolificans is a ubiquitous filamentous fungi that may cause disseminated diseases in neutropenic patients with hematological malignancies. We report a fatal case of renal transplant recipient who developed both infective endocarditis and meningitis due to S. prolificans during treatment with micafungin and itraconazole for chronic necrotizing aspergillosis. Breakthrough Scedosporium infection should be considered among differential diagnosis of invasive fungal diseases in patients with renal transplant recipients receiving antifungal agents. PMID:24462439

Uno, Kenji; Kasahara, Kei; Kutsuna, Satoshi; Katanami, Yuichi; Yamamoto, Yoshifumi; Maeda, Koichi; Konishi, Mitsuru; Ogawa, Taku; Yoneda, Tatsuo; Yoshida, Katsunori; Kimura, Hiroshi; Mikasa, Keiichi

2014-02-01

106

Optimal timing for cardiac surgery in infective endocarditis: is earlier better?  

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All patients with infective endocarditis should be transferred to a hospital with cardiac surgery facilities. Once the decision to operate on a patient with infective endocarditis has been made, the timing of surgery is very often a difficult decision. Literature on this topic is very scarce. The European Society of Cardiology guidelines include recommendations on the timing of surgery. Heart failure, uncontrolled infection and prevention of embolic risk are the three main indications for surgery. Most often, when the decision to operate has been made, there is no benefit and potentially harm in delaying surgery. If cardiac surgery is indicated after an ischemic stroke, it should not be delayed. Discussion should be multidisciplinary and involve at least a cardiologist, a cardiac surgeon and an infectious diseases specialist, and any other specialist as needed (for example a neurologist). PMID:24859466

Delahaye, François; Antchouey, Anne-Marie; de Gevigney, Guy

2014-07-01

107

Efficacy of Levofloxacin for Experimental Aortic-Valve Endocarditis in Rabbits Infected with Viridans Group Streptococcus or Staphylococcus aureus  

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Levofloxacin is among the more active fluoroquinolones against streptococci and staphylococci. It is effective against moderately severe infections caused by these organisms, but its efficacy in the treatment of bacteremia and serious infections such as endocarditis is not well defined. We compared the efficacy of levofloxacin to those of standard agents in the rabbit model of aortic-valve endocarditis caused by fluoroquinolone-susceptible strains including a penicillin-susceptible strain of ...

Chambers, Henry F.; Xiang, Qing; Liu; Chow, Lucian Liuxin; Hackbarth, Corinne

1999-01-01

108

Clinical, bacteriologic and echocardiographic evaluation of infective endocarditis in Ankara, Turkey.  

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This study consists of a retrospective evaluation of microbiologic, echocardiographic, and clinical characteristics of patients with infective endocarditis seen at Türkiye Yüksek Ihtisas and SSK Ihtisas Hospitals during the previous 5 years to provide a basis for comparison with other series. The study was performed retrospectively. The mean age of the patient population, which consisted of 74 cases, was considerably low (24.6+/-12.3 yr). The majority of the patients were male (male/female = 1.96). Rheumatic valvular disease was the underlying cardiac pathosis in 66% of the cases. Congestive heart failure, embolic episodes, and mortality were more frequent among those with echocardiographically demonstrable cardiac vegetations. The microbiologic profile was considerably different from that of other series. In addition, this population showed a higher rate of congestive heart failure compared to other series. The patients with infective endocarditis in this series in the previous 5 years were found to be different from series reported from western countries. PMID:11952110

Heper, Gulumser; Yorukoglu, Yavuz

2002-01-01

109

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

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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 conf...

2011-01-01

110

Epidemiology and prevention of valvular heart diseases and infective endocarditis in Africa  

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Valvular heart diseases in Africa affect mainly children and young adults and are a result of rheumatic fever. Rheumatic fever is a preventable disease, but in Africa the combination of a lack of resources, lack of infrastructure, political, social and economic instability, poverty, overcrowding, malnutrition and lack of political will contributes to the persistence of a high burden of rheumatic fever, rheumatic valvular heart diseases and infective endocarditis. Combating and eradicating rhe...

2007-01-01

111

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

1982-11-04

112

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

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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 acut...

2008-01-01

113

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  

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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.

114

Use of a Valved-Conduit for Exclusion of the Infected Portion in the Prosthetic Pulmonary Valve Endocarditis  

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A 51-year-old male was admitted to the hospital with complaints of fever and hemoptysis. After evaluation of the fever focus, he was diagnosed with pulmonary valve infective endocarditis. Thus pulmonary valve replacement and antibiotics therapy were performed and discharged. He was brought to the emergency unit presenting with a high fever (>39?) and general weakness 6 months after the initial operation. The echocardiography revealed prosthetic pulmonary valve endocarditis. Therefore, redo-...

2013-01-01

115

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

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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 receivi...

2013-01-01

116

Surgical Management of Infective Endocarditis in Patients with Non-Valvular Congenital Heart Diseases  

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Full Text Available The aim of the investigation was to develop the surgical management of infective endocarditis in patients with non-valvular congenital heart diseases. Materials and Methods. 31 patients with non-valvular congenital heart diseases complicated by infective endocartitis were operated in Nizhny Novgorod Specialized Cardiological Clinical Hospital from 1993 till 2011. The patients’ age varied from 4 months to 37 years. Among non-valvular defects there were vegetations of mural endocardium and endothelium of major arteries, infected erosions, thrombi; and most frequently they developed in patients with ventricular septal defect (19 patients, valvular and infundibular pulmonary artery stenosis (3 patients, coronaro-right-ventricular fistula (3 patients, Fallot’s tetrad (2 patients, a patent arterial duct (2 patients. In two cases infection developed in patients with the previous plasty of septal defects and was accompanied by their recanalization.Results. Four patients died in early postoperative period. The mortality rate was 12.9%. Three patients died of progressive acute heart failure, and one — of major postoperative bleeding. 19 patients managed to avoid heart valve replacement due to a timely surgery performed before gross destructive cardiac valve damage developed. In 12 patients one of cardiac valves was replaced due to a late operation and a highly active infectious process. Conclusion. Early surgery enables to improve treatment results and save the cardiac valvular apparatus. Recanalization of septal defect against the background of the developed infective endocarditis is to be considered an indication for surgical sanitation of cardiac chambers and repeated plasty of congenital heart disease. Surgical approach to different types of congenital malformations against the background of infective endocarditis is patient-centered, though the general principle is the maximum correction of turbulent blood flows contributing to endocardial damage and persistent infection, with minimal use of synthetic materials and conduits.

I.S. Chistyakov

2013-03-01

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

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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 leukocidi...

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

2008-01-01

118

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

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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

119

Use of a Valved-Conduit for Exclusion of the Infected Portion in the Prosthetic Pulmonary Valve Endocarditis  

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A 51-year-old male was admitted to the hospital with complaints of fever and hemoptysis. After evaluation of the fever focus, he was diagnosed with pulmonary valve infective endocarditis. Thus pulmonary valve replacement and antibiotics therapy were performed and discharged. He was brought to the emergency unit presenting with a high fever (>39?) and general weakness 6 months after the initial operation. The echocardiography revealed prosthetic pulmonary valve endocarditis. Therefore, redo-pulmonary valve replacement using valved conduit was performed in the Rastelli fashion because of the risk of pulmonary arterial wall injury and recurrent endocarditis from the remnant inflammatory tissue. We report here on the successful surgical treatment of prosthetic pulmonary valve endocarditis with an alternative surgical method.

Jung, Joonho; Lee, Cheol Joo; Lim, Sang-Hyun; Choi, Ho; Park, Soo-Jin

2013-01-01

120

Aerococcus urinae: severe and fatal bloodstream infections and endocarditis.  

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Aerococcus urinae is a pathogen that rarely causes severe or fatal infections. We describe four cases of severe A. urinae bloodstream infections. All patients had underlying urologic conditions. Urine cultures, however, were negative. PMID:20660216

de Jong, Margriet F C; Soetekouw, Robin; ten Kate, Reinier W; Veenendaal, Dick

2010-09-01

 
 
 
 
121

Aerococcus urinae: Severe and Fatal Bloodstream Infections and Endocarditis?  

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Aerococcus urinae is a pathogen that rarely causes severe or fatal infections. We describe four cases of severe A. urinae bloodstream infections. All patients had underlying urologic conditions. Urine cultures, however, were negative.

Jong, Margriet F. C.; Soetekouw, Robin; Ten Kate, Reinier W.; Veenendaal, Dick

2010-01-01

122

What are the differences in outcomes between right-sided active infective endocarditis with and without left-sided infection?  

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A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: in patients with isolated right-sided infective endocarditis (RSE) is the outcome of surgical management the same as in patients with or without left-sided involvement? Altogether, 419 papers were found using the reported search, six of which represented the best evidence to answer the clinical question. Two studies point towards better outcomes with isolated RSE. In one paper,...

Kamaledeen, Abderahman; Young, Christopher; Attia, Rizwan Q.

2012-01-01

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Infective endocarditis in Greece: a changing profile. Epidemiological, microbiological and therapeutic data.  

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The epidemiology, and clinical and microbiological spectrum, of infective endocarditis (IE) in Greece was analysed in a prospective 4-year study in a tertiary hospital and a heart surgery centre in Athens. In total, 101 cases of IE (71 men, 30 women, aged 54.4 +/- 17.1 years) were studied, with a follow-up period of 3 months. Seventy-seven cases were definite and 24 possible; 59 involved native valves (native valve endocarditis; NVE), 31 prosthetic valves (prosthetic valve endocarditis; PVE), of which nine were early and 22 late, and 11 permanent pacemakers (pacemaker endocarditis; PME). There was a predominant involvement of aortic (48/101) and mitral (40/101) valves. Seven patients had rheumatic valvular disease, two had mitral valve prolapse, and eight had a previous history of IE. Thirteen and six patients had undergone dental and endoscopic procedures, respectively. In 13 patients, intravenous catheters were used within the 3 months before diagnosis of IE. There were three intravenous drug users among the patients. Staphylococcus aureus was the most important pathogen, isolated in 22% of cases, followed by viridans streptococci (19%) and coagulase-negative staphylococci (16%). Enterococcus spp. were responsible for 3%, HACEK group for 2%, and fungi for 6% of cases. Viridans streptococci were the leading cause of NVE (29%), Staphylococcus epidermidis of PVE (16%), and S. aureus of PME (54.5%). Six of 22 S. aureus and ten of 16 S. epidermidis isolates were methicillin-resistant. Surgical intervention, including total pacemaker removal, was performed in 51.5% of patients. Overall mortality was 16%, but was 29% with PVE, and was significantly higher with medical than with combined surgical and medical therapy (24.5% vs. 8%). Compared with previous studies, there were changing trends in the epidemiology, microbiology, treatment and prognosis of IE in Greece. PMID:15191385

Loupa, C; Mavroidi, N; Boutsikakis, I; Paniara, O; Deligarou, O; Manoli, H; Saroglou, G

2004-06-01

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

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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.

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

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Molecular Species Identification of Streptococcus-like genera associated with Infective Endocarditis based on sequence analysis of the 16S-23S ribosomal RNA Intergenic Spacer region  

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Species identification of Gram-positive, catalase-negative, coccal shaped non-hemolytic streptococci is challenging with conventional phenotypic methods. Sequence analysis of the highly conserved 16S ribosomal Ribonucleic acid (rRNA) gene is insufficient for closely related species such as the non-hemolytic streptococci. Bacterial identification with sequence analysis of the 16S-23S Intergenic Spacer region (ITS1) has shown to be better target with the Strep16S_1471F and 6R-IGS primers. Gr...

Carkaci, Derya

2012-01-01

126

Radioimmunoimaging of subacute infective endocarditis using a technetium-99m monoclonal granulocyte-specific antibody  

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Immunoscintigraphy with a technetium-99m murine monoclonal IgG1 antibody directed against non-specific cross-reacting antigen (NCA-95) and carcinoembryonic antigen was performed with 20 patients with suspected subacute infective endocarditis (SIE) and 6 controls with suspected inflammatory/infectious disease elsewhere in the body. Immunoscintigraphy and echocardiography localised SIE in 11 of 15 patients in whom the disease could be confirmed. In 4 patients with validated SIE, the immunoscan was abnormal, and the echocardiogram was normal. In another 4 patients, the result was exactly the opposite. These findings suggest that the combination of immunoscintigraphy and echocardiography improves diagnostic efficacy in patients with suspected SIE. (orig.)

1991-01-01

127

Subaortic membrane with rupture of sinus of Valsalva presented with infective endocarditis and its thromboembolic complications.  

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Rupture of the sinus of Valsalva (RSOV) is an uncommonly encountered condition. It can present with wider manifestations ranging from an asymptomatic murmur to cardiogenic shock. The case discussed in this report also had subaortic membrane which usually presents with subvalvular aortic stenosis, left ventricular hypertrophy, myocardial ischemia and sudden death. Corrective cardiac surgery was advised, but due to financial constraints, the patient could not be operated and he died. Here, the authors report for the first time an unusual presence of both RSOV and subaortic membrane and the patient presented with thromboembolic complication resulting from infective endocarditis. PMID:22346146

Jain, Nirdesh; Gutch, Manish; Khanna, Roopali; Arora, Rahul

2012-01-01

128

Multiple Embolism in a Female Patient with Infective Endocarditis: Low Back Pain and Hematuria as the Initial Clinical Manifestations  

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Full Text Available SciELO Brazil | Language: English Abstract in english A 59-year-old female patient with mitral valve prolapse and a previous history of lumbosacral spondyloarthrosis and lumbar disk hernia had an episode of infective endocarditis due to Streptococcus viridans, which evolved with peripheral embolism to the left kidney, spleen, and left iliac artery, and [...] intraventricular cerebral hemorrhage. Her clinical manifestations were low back pain and hematuria, which were initially attributed to an osteoarticular condition. Infective endocarditis is a severe polymorphic disease with multiple clinical manifestations and it should always be included in the differential diagnosis by clinicians.

Marcelo Luiz Campos, Vieira; Mônica Luisa Rappi, Schmidt; Marcos Valério Coimbra de, Resende; Luis Sérgio Afonso de, André Júnior.

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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  

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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.

130

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

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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, posteriormente mostró signos de e...

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

2010-01-01

131

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

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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

132

"Full house" proliferative glomerulonephritis: an unreported presentation of subacute infective endocarditis.  

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A severely ill 65-year-old man presented with symptoms of shortness of breath, edema and vasculitidic purpura over his lower extremities. He had severe mitral regurgitation which had not been surgically treated. Hematologic examination demonstrated leukocytosis with profound anemia. Other blood tests revealed impaired renal function, hypoalbuminemia, hypocomplementemia and mixed-type cryoglobulinemia. Urinalysis showed proteinuria, hematuria and pyuria, typical of a nephritic sediment. Renal biopsy indicated diffuse proliferative glomerulonephritis and a "full house" deposition in immunofluorescence study (positive for C3, C4, C1q, IgG, IgA and IgM), resembling the pathologic findings in class IV lupus nephritis. Although subacute bacterial endocarditis was initially suspected owing to a history of a predisposing valvular heart disease, probable vegetation shown by cardiac sonography and a clinical picture suggestive of a chronic infection, it was thought unlikely due to the entire afebrile course and initial sterile blood cultures. However, the blood cultures repeated 2 weeks after admission grew 3 sets of viridans streptococci. Following a course of penicillin and gentamicin treatment, his renal function, anemia and abnormal urine sediments improved gradually. Diffuse proliferative glomerulonephritis is well known to occur in infective endocarditis. However, the "full house" immunostaining in immunofluorescence study has never been reported. This case adds a new entity to the differential diagnosis of "full house" immune complex-related glomerulonephritis and exemplifies the need to maintain a high index of suspicion for underlying infectious disorders when facing glomerulonephritic or vasculitic syndrome. PMID:18046678

Lee, L-C; Lam, K-K; Lee, C-T; Chen, J-B; Tsai, T-H; Huang, S-C

2007-01-01

133

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 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.

2008-01-01

134

In Vivo Activity of Evernimicin (SCH 27899) against Methicillin-Resistant Staphylococcus aureus in Experimental Infective Endocarditis  

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Currently, there exist few satisfactory alternatives to vancomycin for therapy of serious methicillin-resistant Staphylococcus aureus (MRSA) infections. We employed a rat model of aortic valve endocarditis to assess the potential efficacy of evernimicin (SCH 27899) compared with vancomycin against infection with a strain susceptible to both agents (MICs of 0.25 and 0.50 ?g/ml, respectively). Infected animals were assigned to one of three groups: controls (no treatment), evernimicin at 60 mg/...

2001-01-01

135

Infective endocarditis caused by methicillin-resistant Staphylococcus aureus in a young woman after ear piercing: a case report  

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Full Text Available Abstract Introduction Ear piercing is a common practice among Korean adolescents and young women and usually is performed by nonmedical personnel, sometimes under suboptimal hygienic conditions. Consequently, ear piercing has been associated with various infectious complications, including fatal infective endocarditis. We report a case of infective endocarditis that was caused by community-associated methicillin-resistant Staphylococcus aureus after ear piercing and that was accompanied by a noticeable facial rash. Case presentation A 29-year-old Korean woman underwent ear piercing six days before hospitalization. On admission, she had fever, erythematous maculopapular rashes on her face, signs of generalized emboli, vegetation in her mitral valve, and methicillin-resistant S. aureus bacteremia. On the basis of the blood culture results, she was treated with vancomycin in combination with gentamicin. On day six of hospitalization, a rupture of the papillary muscle of her mitral valve developed, and emergency cardiac surgery replacing her mitral valve with a prosthetic valve was performed. After eight weeks of antibiotic therapy, she was treated successfully and discharged without significant sequelae. Conclusions Numerable cases of body piercing-related infective endocarditis have been reported, and since ear piercing is commonplace nowadays, the importance of risk recognition cannot be overemphasized. In our report, a patient developed infective endocarditis that was caused by methicillin-resistant S. aureus after ear piercing and that was accompanied by an interesting feature, namely facial rash.

Kim Mijeong

2011-08-01

136

Legionella longbeachae and Endocarditis  

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We report a case of infectious endocarditis attributable to Legionella longbeachae. L. longbeachae is usually associated with lung infections. It is commonly found in composted waste wood products. L. longbeachae should be regarded as an agent of infectious endocarditis, notably in the context of gardening involving handling of potting soils.

2012-01-01

137

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

Science.gov (United States)

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 antibiotic 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. PMID:24724110

Ghaderi, F; Oshagh, M; Dehghani, R; Hasanshahi, R

2013-03-01

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Addition of Rifampin to Standard Therapy for Treatment of Native Valve Infective Endocarditis Caused by Staphylococcus aureus?  

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Staphylococcus aureus is a common cause of native valve infective endocarditis (IE). Rifampin is often added to traditional therapy for the management of serious S. aureus infections. There are no large, prospective studies documenting the safety and efficacy of adjunctive therapy with rifampin for treatment of native valve S. aureus IE. We reviewed all cases of definite native valve S. aureus IE confirmed by modified Duke criteria in a large urban hospital between 1 January 2004 and 31 Decem...

Riedel, David J.; Weekes, Elizabeth; Forrest, Graeme N.

2008-01-01

139

Perivalvular Abscess of Tricuspid Valve: A Rare Complication of Infective Endocarditis  

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Full Text Available Infective endocarditis is a serious complication of intravenous (IV drug abuse, with a reported mortality of 5 to 10%. A 21-year-old man, who was an intravenous drug abuser, presented with fever and dyspnea. Transthoracic echocardiography showed a highly mobile, large vegetation on the anterior leaflet of the tricuspid valve. Despite antibiotic therapy for ten days, the patient remained febrile. Transesophageal echocardiography revealed severe aortic regurgitation and an echo-lucent space between the tricuspid and aortic valves. Color Doppler demonstrated a flow within the echo-lucent space and a connection between that and the left ventricle, suggesting a perivalvular abscess of the tricuspid valve opening in the left ventricle. The patient was transferred to the operating room, where he unfortunately expired.

Khallil Zarrabie

2010-05-01

140

[High risk infective endocarditis embolism during pregnancy: Medical or surgical management?].  

Science.gov (United States)

A 22-year-old pregnant woman was seen at 14 weeks of pregnancy for infective endocarditis with a vegetation of 15mm 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 persistence 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. PMID:23896064

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

2013-01-01

 
 
 
 
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A Case of Primary Infective Endocarditis Caused by Community-Associated Methicillin-Resistant Staphylococcus aureus in a Healthy Individual and Colonization in the Family  

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Primary community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) endocarditis has rarely been reported in healthy individuals without risk factors, such as skin and soft tissue infections, and intravenous drug abuse. We describe a case of infective endocarditis by CA-MRSA (ST72-PVL negative-SCCmec IVA) in previously healthy individuals with no underlying medical condition and CA-MRSA colonization in the family.

Lee, Seo Young; Kim, Jin Yong; Kim, Jin Hee; Kim, Sue-yun; Park, Chulmin; Park, Yoon Soo; Seo, Yiel-hae; Cho, Yong Kyun

2009-01-01

142

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

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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

143

Factores asociados a aumento de la sensibilidad del ecocardiograma transtorácico en el diagnóstico de la endocarditis infecciosa / Associated factors to increased sensivity in the transthoracic echocardiogram for the diagnosis of infective endocarditis  

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Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish Introducción y objetivos: Actualmente se considera que los hallazgos ecocardiográficos son un componente esencial en el diagnóstico de la endocarditis infecciosa. La ecocardiografía transesofágica es más sensible que el estudio transtorácico para el diagnóstico de la endocarditis infecciosa y sus co [...] mplicaciones. El objetivo del presente trabajo fue analizar qué factores estaban asociados a una mayor sensibilidad del ecocardiograma transtorácico en el diagnóstico de endocarditis infecciosa. La presencia de dichos factores en un paciente con ecocardiograma transtorácico normal haría poco necesaria la realización de un estudio transesofágico y orientaría al clínico a buscar localidades infecciosas alternativas en localizaciones diferentes al corazón. Métodos: 127 pacientes consecutivos ingresados en el hospital con el diagnóstico de endocarditis infecciosa fueron evaluados, analizándose variables clínicas, microbiológicas, factores de riesgo, datos evolutivos, complicaciones y ventana acústica del ecocardiograma transtorácico. Resultados: En el análisis univariado, la existencia de ventana acústica adecuada, la presencia de un soplo, valvulopatía degenerativa y hemocultivos positivos se asociaban de forma estadísticamente significativa a una mayor incidencia de ecocardiograma transtorácico positivo.Sin embargo, en el análisis multivariado sólo la presencia de soplo (RR 2.724; IC95% 1.071-6.926; p 0.035) y la existencia de una ventana acústica adecuada (RR 5.538; IC95% 2.75- 11.15; p Abstract in english Introduction and objectives: Echocardiography is considered a basic tool in the diagnosis and management of infective endocarditis. Transesophageal echocardiography is more sensitive than transthoracic echocardiography. Our aim was to describe which factors are related to the ability of transthoraci [...] c echocardiography to establish the diagnosis of infective endocarditis.The presence of this factors in a patient with a normal transthoracic echocardiography would make unnecessary to perform a transesophageal echocardiography and would suggest to seek for other diagnostic possibilities. Methods:127 consecutive patients admitted to our hospital with the diagnosis of infective endocarditis and a complete transthoracic echocardiography and transesophageal echocardiography comprised our study group. Predisposing factors and clinical, echocardiographic and microbiological variables were studied. Results: The presence of a cardiac murmur, the presence of an optimal acoustic window, degenerative valvular disease as the predisposing factor for infective endocarditis and positive blood cultures were related to the ability of transthoracic echocardiography to diagnose the existence of signs of infective endocarditis on its own. Nevertheless,only the presence of a cardiac murmur (RR 2.724; 95% CI 1.071-6.926; p 0,035) and the presence of an optimal acoustic window (RR 5.538; 95%IC 2.75-11.15; p

Hernando, Lorenzo; Zamorano, José Luis; Pérez de Isla, Leopoldo; Almería, Carlos; Rodrigo, José Luis; Aubele, Ada Lia; Mataix, Luis; Herrera, Dionisio; Macaya, Carlos.

144

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

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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.

145

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

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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

146

Community-associated methicillin-resistant Staphylococcus aureus infective endocarditis in a tennis player: an emerging pathogen in infectious disease  

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In the 2000s, the Center for Disease Control and Prevention has defined community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) disease which is a disease of healthcare unrelated patients. We report here on a 39-year-old female patient who was admitted to our institution without any medical history. She was a tennis player and had been suffering from ankle pain for a month. She was diagnosed with infective endocarditis according to modified Duke criteria. Blood cultures we...

Basaran, O.; Basaran, Nf; Kaskari, D.; Sozen, H.

2013-01-01

147

Successful recovery of infective endocarditis-induced rapidly progressive glomerulonephritis by steroid therapy combined with antibiotics: a case report  

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Full Text Available Abstract Background The mortality rate among patients with infective endocarditis, especially associated with the presence of complications or coexisting conditions such as renal failure and the use of combined medical and surgical therapy remains still high. Prolonged parenteral administration of a bactericidal antimicrobial agent or combination of agents is usually recommended, however, the optimal therapy for infective endocarditis associated with renal injury is not adequately defined. Case presentation Patient was a 24-years old man who presented to our hospital with fever, fatigue, and rapidly progressive glomerulonephritis. He had a history of ventricular septum defect (VSD. A renal biopsy specimen revealed crescentic glomerulonephritis and echocardiogram revealed VSD with vegetation on the tricuspid valve. Specimens of blood demonstrated Propionibacterium Acnes. The intensive antibiotic therapy with penicillin G was started without clinical improvement of renal function or resolution of fever over the next 7 days. After the short-term treatment of low dose of corticosteroid combined with continuous antibiotics, high fever and renal insufficiency were dramatically improved. Conclusion Although renal function in our case worsened despite therapy with antibiotics, a short-term and low dose of corticosteroid therapy with antibiotics was able to recover renal function and the patient finally underwent tricuspid valve-plasty and VSD closure. We suggest that the patients with rapidly progressive glomerulonephritis associated with infective endocarditis might be treated with a short-term and low dose of corticosteroid successfully.

Kikkawa Ryuichi

2004-12-01

148

Prosthetic Valve Endocarditis Caused by Bartonella quintana  

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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

149

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

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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 7.5â?? 26.5), and with twice daily gentamicin, 20.4% (95% confidence interval 12.0â??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

150

Outcome of aortic homograft implantation in 24 cases of severe infective endocarditis.  

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The objective of the study was to evaluate the results of treatment of severe aortic endocarditis with an aortic homograft (an aortic valve and root from a donor) in combination with antibiotic therapy. 24 patients with either aortic prosthetic valve endocarditis (n=16) or severe aortic native valve endocarditis (n=8) with destruction of 1 or more cusps, paravalvular abscess formation and/or cardiac fistulas caused by aggressive bacteria, underwent surgery in 1997-2006. Staphylococcal species were the most common pathogens followed by streptococci. Intravenous antibiotic therapy was started before surgery and continued for at least 4-6 weeks. Three patients with prosthetic valve endocarditis died within the first 24 h after surgery from heart failure. Two of these patients required an additional implantation of a mitral valve prosthesis. Five patients died from non-cardiac causes within 1-7 y of surgery. Within the follow-up period no patients had relapse of endocarditis, and only 1 episode of recurrent endocarditis in an intravenous drug abuser was registered. In conclusion, an aortic homograft in combination with intravenous antibiotics is an excellent option for treatment of severe aortic endocarditis. PMID:17852908

Foghsgaard, Signe; Bruun, Niels; Kjaergard, Henrik

2008-01-01

151

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  

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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

152

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  

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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.

153

ENDOCARDITIS WITH AN UNCOMMON GERM  

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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

154

Comparison of clinical features of left-sided infective endocarditis involving previously normal versus previously abnormal valves.  

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Native valve infective endocarditis (IE) in patients with normal valves has increased in the last decades. Whether patients with normal valves present a similar prognosis to those with pathologic valves is unresolved. Our aim is to describe epidemiologic and clinical differences between patients with left-sided IE and normal valves and those with native pathologic valves. We analyzed 945 consecutive episodes of IE, 435 of which involved left-sided nonprosthetic IE. They were classified into 2 groups: episodes in normal valves (normal group, n = 173) and episodes in pathologic valves (abnormal group, n = 262). Patients in the normal group were younger, Staphylococcus aureus and Streptococcus bovis were more frequently isolated, and vegetations were more frequently found. Heart failure, septic shock, and the need for surgery or death were more common. Multivariate analysis identified the following as factors independently associated with normal valve IE: age <65 years, S bovis, S aureus, heart failure, and vegetation detection. Factors independently associated with in-hospital events included S aureus, periannular complications, heart failure, and septic shock development. In conclusion, compared with patients with abnormal valve IE, patients with IE on normal valves were younger, had a more virulent microbiological profile, developed heart failure and septic shock more frequently, needed more surgical procedures, and had worse prognosis. PMID:24878130

Olmos, Carmen; Vilacosta, Isidre; Fernández, Cristina; Sarriá, Cristina; López, Javier; Del Trigo, María; Ferrera, Carlos; Vivas, David; Maroto, Luis; Hernández, Miguel; Rodríguez, Enrique; San Román, José Alberto

2014-07-15

155

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

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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

156

Diagnostic value of harmonic transthoracic echocardiography in native valve infective endocarditis: comparison with transesophageal echocardiography  

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Full Text Available Abstract Background Although echocardiography has been incorporated into the diagnostic algorithm of patients with suspected infective endocarditis (IE, systematic usage in clinical practice remains ill defined. To determine the diagnostic accuracy of detecting vegetations using harmonic transthoracic echocardiography (hTTE as compared to transesophageal echocardiography (TEE in patients with an intermediate likelihood of native valve IE. Methods Between 2004 and 2005, 36 consecutive inpatients with an intermediate likelihood of disease were prospectively evaluated by hTTE and TEE. Results Of 36 patients (21 males with a mean age of 57 ± 15 years, range 32 to 86 years, 19 patients had definite IE by TEE. The sensitivity for the detection of vegetations by hTTE was 84%, specificity of 88%, positive predictive value (PPV of 89% and negative predictive value (NPV of 82%. The association between hTTE and TTE interpretation for the presence and absence of vegetations were high (kappa = 0.90 and 0.85 respectively. Conclusion In patients with an intermediate likelihood of native valve IE, TTE with harmonic imaging provides diagnostic quality images in the majority of cases, has excellent concordance with TEE and should be recommended as the first line test.

Embil John M

2007-05-01

157

Non-nosocomial healthcare-associated infective endocarditis in Taiwan: an underrecognized disease with poor outcome  

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Full Text Available Abstract Background Non-nosocomial healthcare-associated infective endocarditis (NNHCA-IE is a new category of IE of increasing importance. This study described the clinical and microbiological characteristics and outcome of NNHCA-IE in Taiwan. Methods A retrospective study was conducted of all patients with IE admitted to the Kaohsiung Veterans General Hospital in Kaohsiung, Taiwan over a five-year period from July 2004 to July 2009. The clinical and microbiological features of NNHCA-IE were compared to those of community-acquired and nosocomial IE. Predictors for in-hospital death were determined. Results Two-hundred episodes of confirmed IE occurred during the study period. These included 148 (74% community-acquired, 30 (15% non-nosocomial healthcare-associated, and 22 (11% nosocomial healthcare-associated IE. Staphylococcus aureus was the most frequent pathogen. Patients with NNHCA-IE compared to community-acquired IE, were older (median age, 67 vs. 44, years, p p p p p = 0.002. The overall in-hospital mortality rate for all patients with IE was 25%. Shock was the strongest risk factor for in-hospital death (odds ratio 7.8, 95% confidence interval 2.4-25.2, p Conclusions NNHCA-IE is underrecognized and carries a high mortality rate. Early recognition is crucial to provide optimal management and improve outcome.

Sy Cheng-Len

2011-08-01

158

Infective Endocarditis in the U.S., 1998–2009: A Nationwide Study  

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Background: Previous studies based on local case series estimated the annual incidence of endocarditis in the U.S. at about 4 per 100,000 population. Small-scale studies elsewhere have reported similar incidence rates. However, no nationally-representative population-based studies have verified these estimates. Methods and findings: Using the 1998–2009 Nationwide Inpatient Sample, which provides diagnoses from about 8 million U.S. hospitalizations annually, we examined endocarditis hospital...

2013-01-01

159

Significado de la fiebre persistente o recurrente durante el tratamiento de la endocarditis infecciosa / Clinical significance of persistent or recurrent fever during the treatment of infective endocarditis  

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Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Se evaluaron 81 pacientes con endocarditis infecciosa con el objeto de establecer la significación clínica de la presencia de fiebre persistente (FP) y/o fiebre recurrente (FR) durante el tratamiento. Un total de 46 pacientes (56.8%) (Grupo 1) tuvieron FP y/o FR durante el tratamiento: 35 FP y 16 FR [...] , que se compararon con 35 sin FP/FR (Grupo 2). No hubo diferencias en la edad, sexo, permanencia hospitalaria, origen nosocomial, demora diagnóstica y comorbilidad asociada. El compromiso aórtico (47.8 vs 34.2%) y tricuspídeo (21.7 vs 11.4%) y la infección por Staphylococcus aureus (55.5 vs 28%) fueron más frecuentes en el Grupo 1, aunque no significativamente. El S. aureus meticilino resistente (SAMR) (22.2 vs 4%), las complicaciones (95.6 vs 65.7%), la disfunción renal (58.6 vs 31.4%), el embolismo mayor (60.8 vs 34%), los fenómenos microvasculares (43.4 vs 17.1%) y la cirugía valvular (34.7 vs 11.4%) ocurrieron significativamente en el Grupo 1 (p Abstract in english Patients with infective endocarditis (IE) were studied to assess incidence, clinical features and mortality in a population with either persistent (PF) or recurrent fever (RF) during treatment. A sample of 81 patients was evaluated. Of these, 46 patients (56.8%) had fever during treatment: 35 had PF [...] and 16 had RF (Group 1). This group was compared with 35 patients with IE without fever (Group 2). Age, sex, in-hospital days, nosocomial acquisition, delay in diagnosis, and co-morbidities were similar among each group. The aortic and tricuspid valve compromise, and Staphylococcus aureus as etiologic agent were more frequent in Group 1 (although not significantly). However, the development of complications (95.6 vs. 65.7%), renal dysfunction (58.6 vs. 31.4%), major vessel embolization (60.8 vs. 34%), microvascular phenomena (43.4 vs. 17.1%), infections with MRSA (22.2 vs. 4%) and valvular surgery (34.7 vs. 11.4%) were significantly higher in Group 1(p

José, Carena; Guillermo, Marucci; Susana, Salomón.

160

Pneumococcal endocarditis of subacute evolution  

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Full Text Available With the development of penicillin, Streptococcus pneumoniae has become an uncommon cause of bacterial endocarditis in adults. Subacute manifestation of pneumococcal endocarditis has been reported a few times in the literature, but most reports define the disease as acute, severe, and having a high mortality rate. We report the case of a 58-year-old male with subacute bacterial endocarditis due to Streptococcus pneumoniae. We stress the low frequency of this agent as a cause of endocarditis and the atypical evolution of this case. The pathophysiology, clinical manifestations and evolution, and the therapeutical options for this type of infection are also discussed.

Laercio Uemura

2001-04-01

 
 
 
 
161

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

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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: 17â??27%) were diagnosed with definite IE. In patients with native heart valves the prevalence was 19% (95% CI: 14â??25%) compared with 38% (95% CI: 20â??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

162

Molecular Detection of Coxiella burnetii in the Sera of Patients with Q Fever Endocarditis or Vascular Infection  

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In the absence of a specific diagnosis based on serology, chronic Q fever is inevitably fatal. However, diagnosis is often delayed because the test is not widely available. To shorten the diagnostic delay, we adapted a nested-PCR assay with serum as a template and the LightCycler as a thermal cycler, termed LCN-PCR. We retrospectively and prospectively applied this method to samples from 48 patients diagnosed with Q fever endocarditis or vascular infection and to samples from 100 controls wit...

Fenollar, F.; Fournier, P. E.; Raoult, D.

2004-01-01

163

Enterococcal endocarditis in the beginning of the 21st century: analysis from the International Collaboration on Endocarditis-Prospective Cohort Study.  

Science.gov (United States)

Enterococci are reportedly the third most common group of endocarditis-causing pathogens but data on enterococcal infective endocarditis (IE) are limited. The aim of this study was to analyse the characteristics and prognostic factors of enterococcal IE within the International Collaboration on Endocarditis. In this multicentre, prospective observational cohort study of 4974 adults with definite IE recorded from June 2000 to September 2006, 500 patients had enterococcal IE. Their characteristics were described and compared with those of oral and group D streptococcal IE. Prognostic factors for enterococcal IE were analysed using multivariable Cox regression models. The patients' mean age was 65 years and 361/500 were male. Twenty-three per cent (117/500) of cases were healthcare related. Enterococcal IE were more frequent than oral and group D streptococcal IE in North America. The 1-year mortality rate was 28.9% (144/500). E. faecalis accounted for 90% (453/500) of enterococcal IE. Resistance to vancomycin was observed in 12 strains, eight of which were observed in North America, where they accounted for 10% (8/79) of enterococcal strains, and was more frequent in E. faecium than in E. faecalis (3/16 vs. 7/364 , p 0.01). Variables significantly associated with 1-year mortality were heart failure (HR 2.4, 95% CI 1.7--3.5, p <0.0001), stroke (HR 1.9, 95% CI 1.3--2.8, p 0.001) and age (HR 1.02 per 1-year increment, 95% CI 1.01--1.04, p 0.002). Surgery was not associated with better outcome. Enterococci are an important cause of IE, with a high mortality rate. Healthcare association and vancomycin resistance are common in particular in North America. PMID:23517406

Chirouze, C; Athan, E; Alla, F; Chu, V H; Ralph Corey, G; Selton-Suty, C; Erpelding, M-L; Miro, J M; Olaison, L; Hoen, B

2013-12-01

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Infective endocarditis caused by multidrug-resistant Streptococcus mitis in a combined immunocompromised patient: an autopsy case report.  

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An autopsy case of infective endocarditis caused by multidrug-resistant Streptococcus mitis was described in a patient with a combination of factors that compromised immune status, including autoimmune hemolytic anemia, post-splenectomy state, prolonged steroid treatment, and IgA deficiency. The isolated S. mitis strain from blood culture was broadly resistant to penicillin, cephalosporins, carbapenem, macrolides, and fluoroquinolone. Recurrent episodes of bacterial infections and therapeutic use of several antibiotics may underlie the development of multidrug resistance for S. mitis. Because clinically isolated S. mitis strains from chronically immunocompromised patients have become resistant to a wide spectrum of antibiotics, appropriate antibiotic regimens should be selected when treating invasive S. mitis infections in these compromised patients. PMID:22965841

Matsui, Natsuko; Ito, Makoto; Kuramae, Hitoshi; Inukai, Tomomi; Sakai, Akiyoshi; Okugawa, Masaru

2013-04-01

165

Streptococcus sanguis secretes CD14-binding proteins that stimulate cytokine synthesis: a clue to the pathogenesis of infective (bacterial) endocarditis?  

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Streptococcus sanguis is the major causative organism of infective (bacterial) endocarditis but, surprisingly, almost nothing is known about how it induces endocardial inflammation. In earlier studies we have shown that many bacteria secrete potent cytokine-inducing or -inhibiting proteins. We have therefore isolated the material secreted by S. sanguis grown on blood agar or in broth culture and have tested its ability to induce human peripheral blood monocytes to synthesize pro-inflammatory cytokines. The activation of monocytes by the secreted components of S. sanguis was almost totally blocked by heat and trypsin treatment but not by the lipopolysaccharide-inactivating antibiotic, polymyxin B, suggesting that activity is due to secreted proteins. The activity of the secreted material was significantly reduced by anti-CD14 monoclonal antibodies suggesting that the active protein (or proteins) was binding to the CD14/Toll-like receptor (TLR)4 complex. Fractionation of the secreted proteins by high performance liquid chromatography (HPLC) identified two proteins as being responsible for the majority of the cytokine induction: a manganese-dependent superoxide dismutase and a 190 kDa protein, which could not be sequenced, but which was neither CshA nor the PI/II proteins. These proteins, or the receptors to which they bind, may be therapeutic targets and may allow the development of adjunctive therapies to prevent endocardial damage during the often prolonged treatment of infective endocarditis with antibiotics. In addition, blocking of CD14 may have some therapeutic benefit. PMID:11855941

Banks, Julia; Poole, Stephen; Nair, Sean P; Lewthwaite, Jo; Tabona, Peter; McNab, Rod; Wilson, Michael; Paul, Angela; Henderson, Brian

2002-03-01

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

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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

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The use of ceftaroline fosamil in methicillin-resistant Staphylococcus aureus endocarditis and deep-seated MRSA infections: a retrospective case series of 10 patients.  

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There are many limitations to the current antibiotics used for the treatment of severe methicillin-resistant Staphylococcus aureus (MRSA) infections. Ceftaroline is a new fifth-generation cephalosporin approved for the treatment of skin and soft tissue infections caused by MRSA and community-acquired pneumonia. We propose that ceftaroline can also be used successfully in more severe MRSA infections, including endocarditis. We conducted a retrospective chart review in a university-affiliated Department of Veterans Affairs hospital in San Diego, California (USA) of ten inpatients treated with ceftaroline for severe MRSA infection, including five cases of probable endocarditis (including two endocardial pacemaker infections), one case of pyomyositis with possible endocarditis, two cases of pneumonia (including one case of empyema), two cases of septic arthritis (including one case of prosthetic joint infection), and two cases of osteomyelitis. Seven of the 10 patients achieved microbiological cure. Six of the 10 patients achieved clinical cure. Seven patients were discharged from the hospital. Three patients were placed on comfort care and expired in the hospital; one achieved microbiological cure before death, and two remained bacteremic at time of death. In most patients, ceftaroline was effective for treatment of MRSA bacteremia and other severe MRSA infections. Adverse effects seen included rash, eosinophilia, pruritus, and Clostridium difficile infection. Ceftaroline can be a safe and effective drug for treatment of severe MRSA infections, and further comparative studies are warranted. PMID:22797874

Lin, Jennifer C; Aung, Gregory; Thomas, Amy; Jahng, Maximillian; Johns, Scott; Fierer, Joshua

2013-02-01

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

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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

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

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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

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Characteristics of infective endocarditis in a developing country-clinical profile and outcome in 192 Indian patients, 1992-2001.  

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Total 198 episodes of Duke "definite" infective endocarditis (IE) in 192 patients observed over last 10 years were studied [141 males and 51 females, mean age 27.6+/-12.7 years (range 4-68 years)]. Majorities of patients (76.5%) were below 40 years of age. Rheumatic heart disease (RHD) was the commonest underlying heart disease (present in 46.9% patients). Probable source of infection could be identified in only 16.6% episodes. None of our patient was intravenous drug abuser. Fever (90.0%), anemia (81.0%), clubbing (58.1%), splenomegaly (60.6%), changing/new murmur (22.7%) were the common clinical findings. Vegetations were present in 89.9% episodes. Blood cultures were positive in 134 (67.7%) episodes (streptococci in 23.2%, staphylococci in 19.7%, gram negative in 13.6%, enterococci in 8.1%, polymicrobial and fungal in 1.5% episodes each). Complications were cardiovascular [congestive heart failure (CHF) in 41.9%, atrioventricular block in 1.5%, cardiac temponade and acute myocardial infarction in 0.5% each), neurological in 16.6%, renal in 13.1% and embolisms in total 21.7% episodes. Total 182 (91.9%) episodes in 176 patients were managed completely [(medical in 140 (76.9%) and surgical in 42 (23.1%) episodes] while patients in remaining 16 (8.1%) episodes left against medical advises before completion of therapy. Total 21% patients (37 out of 176 completely treated patients) died during therapy (cause of deaths; CHF in 11, septicemia in 10, cerebral embolism in 7, post cardiac surgery in 5, ruptured cerebral mycotic aneurysm in 2, ventricular tachycardia in 2 patients). On stepwise logistic regression analysis; cardiac abscess and CHF were independent predictors of cardiac surgery. Similarly, CHF, renal failure and prosthetic valve dysfunction were independent predictors of mortality. To conclude, spectrum of IE in our country is different from the west, but quite similar as reported from developed countries about 40 years ago. IE in our country occurs in relatively younger population with RHD as the commonest underlying heart disease. Streptococci are still the commonest responsible microorganisms. Morbidity and mortality are still high. Early cardiac surgery, whenever indicated, helps in improving outcome of these patients. PMID:15686775

Garg, Naveen; Kandpal, Bhuwanesh; Garg, Nitish; Tewari, Satendra; Kapoor, Aditya; Goel, Praveen; Sinha, Nakul

2005-02-15

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Predictores de mortalidad intrahospitalaria de la endocarditis infecciosa en la República Argentina: resultados del EIRA-II / Predictors of In-hospital Mortality due to Infective Endocarditis in the Argentine Republic: Results of EIRA II Study  

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Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Objetivo Determinar la mortalidad hospitalaria y los marcadores clínicos relacionados con la mortalidad de la endocarditis infecciosa (EI) en la República Argentina. Métodos Registro prospectivo, multicéntrico (82 centros de 16 provincias de la Argentina) de EI definidas o posibles según los criteri [...] os Duke, entre junio de 2001 y noviembre de 2002. Resultados Se evaluaron 470 episodios de EI en 452 pacientes (edad media: 58,1 ± 17,6 años; sexo masculino 69,7%; EI definida 83% y posible 17%). Bacteriología: Staphylococcus 38% (S. aureus 30%, Staphylococcus coagulasa negativo 8%), Streptococcus 39,4% (S. viridans 36,8%), Enterococcus 10,8%, HACEK 6,6%, hemocultivos negativos 17,7%. Existía cardiopatía subyacente en el 66,4% y EI de válvula protésica en el 19,2%. Se indicó tratamiento quirúrgico en el 33,3% de los pacientes. La mortalidad fue del 24,3%. En el análisis de regresión logística fueron predictores independientes de mortalidad: edad > 65 años (OR 2,1; IC 95%, 1,1- 3,96; p = 0,024); insuficiencia cardíaca en la evolución (OR 5,9; IC 95%, 3,1-10,9; p Abstract in english Work objective To determine the in-hospital mortality rate and the predictors of mortality of infective endocarditis (IE) in Argentina. Research Design and Methods Prospective, multicentric survey carried out in 82 hospitals all over the country (16 provinces). Patients were enrolled according to Du [...] ke criteria (definite or possible IE) during an 18-month period (June 2001-November 2002). Results Four hundred and seventy episodes in 452 patients were included (mean age 58.1±17.6 years, 69.7% male, 83% definite and 17% possible IE). Blood cultures were negative in 17.7%. The most frequent causative microorganisms were: Staphylococcus 38% (S. aureus 30%, S. coagulase-negative 8%), Streptococcus 39.4% (S. viridans 26.8%), Enterococcus 10,8%, S. coagulase-negative 8%, HACEK group 6,6% and S. bovis 5,5%. Underlying heart disease was present in 66.4% and prosthetic-valve IE was diagnosed in 19.2%. Surgical treatment was indicated in 33.3% and in-hospital mortality was 24.3%. In a logistic regression analysis the following variables were independent predictors of increased mortality: age > 65 years (OR 2.1; 95% CI 1.1-3.96; p = 0.024); heart failure (OR 5.9; 95% CI 3.1-10.9; p

Juan C., Modenesi; Ernesto R., Ferreirós; Sandra, Swieskowski; Francisco M., Nacinovich; Claudia, Cortés; Hernán, Cohen Arazi; Lucía, Kazelián; Sergio, Varini; Mario, Ciruzzi; José Horacio, Casabé.

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

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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,...

2012-01-01

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Prosthetic Mitral Valve Endocarditis Due to Ochrobactrum anthropi: Case Report  

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We describe a case of infective endocarditis in a prosthetic mitral valve due to Ochrobactrum anthropi. Although O. anthropi is an emerging pathogen in immunocompromised patients, infections with the bacterium have very rarely been documented in healthy hosts, and endocarditis is rare. To our knowledge, only two cases of O. anthropi endocarditis have been reported in the medical literature.

2004-01-01

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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)

2006-07-01

175

Efficacy of cardiac surgery in endocarditis  

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Full Text Available 2 factors changed the clinical course of infective endocarditis dramatically: 1 The discovery and evolution of techniques for identifying and treating its microbiologic causes and 2 Valvular surgery. We retrospectively evaluated 43 (33.5% patients (8 female, 35 male from 4 to 65 years old of 128 patients with infective endocarditis who underwent surgical intervention. Indication for surgery were: Refractory congestive heart failure 14 (32.5%, prosthetic valves 10 (23.2%, large vegetation 6 (13.9%, recurrent endocarditis 4 (9.3%, ring abscess 4 (9.3%, brucella endocarditis 2 (4.6%, staph aureus endocarditis 3 (6.9% and recurrent emboli 2 (4.6%. 30 to 50% of patients with infective endocarditis are operated during the active phase of the disease, this percentage is higher in case of aortic valve endocarditis, prosthetic valve endocarditis, some microorganisms such as staph aureus, gram negative bacilli, fungus and brucella. We suggest that internists refer patients for surgical intervention with infective endocarditis as early as possible in the active stage of infection.

Moradmand S

2000-06-01

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

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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 1â??:â??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

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Pasteurella multocida endocarditis.  

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Pasteurella multocida is a Gram-negative rod that forms part of the natural oral flora of cats and dogs. It is usually associated with skin and soft tissue infections, as a result of bites and scratches. Although invasive and serious infections by P. multocida are rare, there are limited reports of pneumonia and sepsis. Infective endocarditis (IE) is extremely rare. The case is reported of an 82-year-old male who presented with a productive cough, fever, and shortness of breath, and who was initially diagnosed with pneumonia. Further work-up revealed P. multocida bacteremia and an aortic valve lesion consistent with endocarditis. The patient was treated with antibiotics, and showed significant clinical recovery on follow up. PMID:22645864

Khan, Muhammad F; Movahed, Mohammad Reza; Jung, Jiyeon

2012-03-01

178

Synergistic Activity of Ceftobiprole and Vancomycin in a Rat Model of Infective Endocarditis Caused by Methicillin-Resistant and Glycopeptide-Intermediate Staphylococcus aureus  

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The therapeutic activity of ceftobiprole medocaril, the prodrug of ceftobiprole, was compared to that of vancomycin, daptomycin, and the combination of a subtherapeutic dose of ceftobiprole and vancomycin in a rat model of infective endocarditis due to methicillin-resistant Staphylococcus aureus (MRSA) (ATCC 43300) or glycopeptide-intermediate Staphylococcus aureus (GISA) (NRS4 and HIP 5836) strains. The minimum bactericidal concentrations of ceftobiprole, vancomycin, and daptomycin at bacterial cell densities similar to those encountered in the cardiac vegetation in the rat endocarditis model were 2, >64, and 8 ?g/ml, respectively, for MRSA ATCC 43300 and 4, >64, and 8 ?g/ml, respectively, for the GISA strain. Ceftobiprole medocaril administered in doses of 100 mg/kg of body weight given intravenously (i.v.) twice a day (BID) every 8 h (q8h) (equivalent to a human therapeutic dose of ceftobiprole [500 mg given three times a day [TID]) was the most effective monotherapy, eradicating nearly 5 log10 CFU/g MRSA or 6 log10 CFU/g GISA organisms from the cardiac vegetation and had the highest incidence of sterile vegetation compared to the other monotherapies in the endocarditis model. In in vitro time-kill studies, synergistic effects were observed with ceftobiprole and vancomycin on MRSA and GISA strains, and in vivo synergy was noted with combinations of subtherapeutic doses of these agents for the same strains. Additionally, sterile vegetations were achieved in 33 and 60%, respectively, of the animals infected with MRSA ATCC 43300 or GISA NRS4 receiving ceftobiprole-vancomycin combination therapy. In summary, ceftobiprole was efficacious both as monotherapy and in combination with vancomycin in treating MRSA and GISA infections in a rat infective endocarditis model and warrants further evaluation.

Abbanat, Darren; Shang, Wenchi; He, Wenping; Amsler, Karen; Hastings, James; Queenan, Anne Marie; Melton, John L.; Barron, Alfred M.; Flamm, Robert K.; Lynch, A. Simon

2012-01-01

179

Synergistic activity of ceftobiprole and vancomycin in a rat model of infective endocarditis caused by methicillin-resistant and glycopeptide-intermediate Staphylococcus aureus.  

Science.gov (United States)

The therapeutic activity of ceftobiprole medocaril, the prodrug of ceftobiprole, was compared to that of vancomycin, daptomycin, and the combination of a subtherapeutic dose of ceftobiprole and vancomycin in a rat model of infective endocarditis due to methicillin-resistant Staphylococcus aureus (MRSA) (ATCC 43300) or glycopeptide-intermediate Staphylococcus aureus (GISA) (NRS4 and HIP 5836) strains. The minimum bactericidal concentrations of ceftobiprole, vancomycin, and daptomycin at bacterial cell densities similar to those encountered in the cardiac vegetation in the rat endocarditis model were 2, >64, and 8 ?g/ml, respectively, for MRSA ATCC 43300 and 4, >64, and 8 ?g/ml, respectively, for the GISA strain. Ceftobiprole medocaril administered in doses of 100 mg/kg of body weight given intravenously (i.v.) twice a day (BID) every 8 h (q8h) (equivalent to a human therapeutic dose of ceftobiprole [500 mg given three times a day [TID]) was the most effective monotherapy, eradicating nearly 5 log(10) CFU/g MRSA or 6 log(10) CFU/g GISA organisms from the cardiac vegetation and had the highest incidence of sterile vegetation compared to the other monotherapies in the endocarditis model. In in vitro time-kill studies, synergistic effects were observed with ceftobiprole and vancomycin on MRSA and GISA strains, and in vivo synergy was noted with combinations of subtherapeutic doses of these agents for the same strains. Additionally, sterile vegetations were achieved in 33 and 60%, respectively, of the animals infected with MRSA ATCC 43300 or GISA NRS4 receiving ceftobiprole-vancomycin combination therapy. In summary, ceftobiprole was efficacious both as monotherapy and in combination with vancomycin in treating MRSA and GISA infections in a rat infective endocarditis model and warrants further evaluation. PMID:22232278

Fernandez, Jeffrey; Abbanat, Darren; Shang, Wenchi; He, Wenping; Amsler, Karen; Hastings, James; Queenan, Anne Marie; Melton, John L; Barron, Alfred M; Flamm, Robert K; Lynch, A Simon

2012-03-01

180

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

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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 ...

2012-01-01

 
 
 
 
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Endocarditis infecciosa: características clínicas, complicaciones y mortalidad en 506 pacientes y factores pronósticos de sobrevida a 10 años (1998-2008). Estudio cooperativo nacional en endocarditis infecciosa en Chile (ECNEI-2) / Clinical characteristics, complications and mortality in 506 patients with infective endocarditis and determinants of survival rate at 10 years  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english Background: Rates ofmorbidity and mortality in Infective Endocarditis (IE) remain high and prognosis in this disease is still difficult and uncertain. Aim: To study IE in Chile in its active phase during inpatient hospital stay and long term survival rates. Material and Methods: Observational prospe [...] ctive national cohort study of 506 consecutive patients included between June 1,1998 and July 31, 2008, from 37 Chilean hospitals (secondary and tertiary centers) nationwide. Results: The main findings were the presence of Rheumatic valve disease in 22.1 % of patients, a history of intravenous drug abuse (IVDA) only in 0.7%, the presence of Staphylo-coccus aureus in 29.2% of blood cultures, negative blood cultures in 33.2%, heart failure in 51.7% and native valve involvement in 86% ofpatients. Echocardiographic diagnosis was achieved in 94% of patients. Hospital mortality was 26.1% and its prognostics factors were persisting infection (Odds ratio (OR) 6.43, Confidence Interval (CI) 1.45-28.33%), failure of medical treatment and no surgical intervention (OR 48.8; CI 6.67-349.9). Five and 10 years survival rates were 75.6 and 48.6%, respectively. The significant prognostic factors for long term mortality, determined by multivariate analysis were the presence of diabetes, Staphylococcus aureus infection, sepsis, heart failure, renal failure and lack of surgical treatment during the IE episode. Conclusions: The microbiologic diagnosis of IE must be urgently improved in Chile. Mortality rates are still high (26.1%) partly because of a high incidence of negative blood cultures and the need for more surgical valve interventions during in-hospital period. Long term prognostic factors for mortality should be identified early to improve outcome.

Miguel, Oyonarte; Rodrigo, Montagna; Sandra, Braun; Pamela, Rojo; José L, Jara; Mauricio, Cereceda; Marcelo, Morales; Carolina, Nazal; Faustino, Alonso.

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Endocarditis infecciosa: características clínicas, complicaciones y mortalidad en 506 pacientes y factores pronósticos de sobrevida a 10 años (1998-2008. Estudio cooperativo nacional en endocarditis infecciosa en Chile (ECNEI-2 Clinical characteristics, complications and mortality in 506 patients with infective endocarditis and determinants of survival rate at 10 years  

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Full Text Available Background: Rates ofmorbidity and mortality in Infective Endocarditis (IE remain high and prognosis in this disease is still difficult and uncertain. Aim: To study IE in Chile in its active phase during inpatient hospital stay and long term survival rates. Material and Methods: Observational prospective national cohort study of 506 consecutive patients included between June 1,1998 and July 31, 2008, from 37 Chilean hospitals (secondary and tertiary centers nationwide. Results: The main findings were the presence of Rheumatic valve disease in 22.1 % of patients, a history of intravenous drug abuse (IVDA only in 0.7%, the presence of Staphylo-coccus aureus in 29.2% of blood cultures, negative blood cultures in 33.2%, heart failure in 51.7% and native valve involvement in 86% ofpatients. Echocardiographic diagnosis was achieved in 94% of patients. Hospital mortality was 26.1% and its prognostics factors were persisting infection (Odds ratio (OR 6.43, Confidence Interval (CI 1.45-28.33%, failure of medical treatment and no surgical intervention (OR 48.8; CI 6.67-349.9. Five and 10 years survival rates were 75.6 and 48.6%, respectively. The significant prognostic factors for long term mortality, determined by multivariate analysis were the presence of diabetes, Staphylococcus aureus infection, sepsis, heart failure, renal failure and lack of surgical treatment during the IE episode. Conclusions: The microbiologic diagnosis of IE must be urgently improved in Chile. Mortality rates are still high (26.1% partly because of a high incidence of negative blood cultures and the need for more surgical valve interventions during in-hospital period. Long term prognostic factors for mortality should be identified early to improve outcome.

Miguel Oyonarte

2012-12-01

183

Prosthetic valve endocarditis due to coagulase-negative staphylococci: findings from the International Collaboration on Endocarditis Merged Database.  

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Infective endocarditis due to coagulase-negative staphylococci is increasingly recognized as a difficult-to-treat disease associated with poor outcome. The aim of this report is to describe the characteristics and outcome of patients with prosthetic valve endocarditis (PVE) due to coagulase-negative staphylococci versus those of patients with PVE due to Staphylococcus aureus and viridans streptococci. Patients were identified through the International Collaboration on Endocarditis Merged Database. A total of 54 cases of coagulase-negative staphylococci PVE, 58 cases of S. aureus PVE, and 63 cases of viridans-streptococci-related PVE were available for analysis. There was no difference between the three groups with respect to the type of valve involved or the rate of embolization. However, heart failure was encountered more frequently with coagulase-negative staphylococci (54%) than with either S. aureus (33%; p=0.03) or viridans streptococci (32%; p=0.02). In addition, valvular abscesses complicated 39% of infections due to coagulase-negative staphylococci compared with 22% of those due to S. aureus (p=0.06) and 6% of those due to viridans streptococci (p<0.001). Mortality was highest in patients with S. aureus and coagulase-negative staphylococcal endocarditis (47 and 36%, respectively; p=0.22) and was considerably lower in patients with viridans streptococcal endocarditis (p=0.002 compared to patients with coagulase-negative staphylococcal endocarditis). The results of this analysis demonstrate the aggressive nature of coagulase-negative staphylococcal PVE and the substantially greater morbidity and mortality associated with this infection compared to PVE caused by other pathogens. PMID:16767483

Lalani, T; Kanafani, Z A; Chu, V H; Moore, L; Corey, G R; Pappas, P; Woods, C W; Cabell, C H; Hoen, B; Selton-Suty, C; Doco-Lecompte, T; Chirouze, C; Raoult, D; Miro, J M; Mestres, C A; Olaison, L; Eykyn, S; Abrutyn, E; Fowler, V G

2006-06-01

184

Molecular Identification of Gemella Species from Three Patients with Endocarditis  

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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

185

Staphylococcus capitis endocarditis: two cases and review of the literature  

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Coagulase negative staphylococci are the principal cause of prosthetic valve endocarditis but are a rare cause of native valve infections. However, the incidence of native valve endocarditis is increasing. Staphylococcus capitis is a coagulase negative staphylococcus with the capacity to cause endocarditis on native heart valves. Two cases of native valve endocarditis caused by S capitis are presented; both in patients with aortic valve disease. The patients were cured with prolonged intraven...

Sandoe, J.; Kerr, K.; Reynolds, G.; Jain, S.

1999-01-01

186

Unusual case of Aeromonas hydrophila endocarditis.  

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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

187

Polymicrobial Endocarditis in Intravenous Heroin and Fentanyl Abuse  

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Infective endocarditis is a life threatening condition with a high mortality rate. Intravenous Drug Abusers (IVDA) are more likely to acquire endocarditis. Most of the cases of infective endocarditis are caused by a single pathogen; cases of polymicrobial endocarditis are rare and they are associated with a reported mortality rate of more than 30%. Only 21 cases of N. sicca endocarditis have been described in the literature since 1918, and only 15 reported cases of endocarditis which involved Actinomyces species have been reported since 1939. We are reporting a case of a 49-year-old male with intravenous heroin and fentanyl abuse, who presented with infective endocarditis caused by Neisseria sicca/subflava(N. sicca), Actinomyces, Streptococcus mitis, and Haemophilus parainfluenzae, complicated by septic emboli to the lungs and skin, ARDS , splenic infarct and immunocomplex mediated proliferative glomerulonephritis.

Mehrzad, Raman; Sublette, Marcus; Barza, Michael

2013-01-01

188

Polymicrobial endocarditis in intravenous heroin and fentanyl abuse.  

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Infective endocarditis is a life threatening condition with a high mortality rate. Intravenous Drug Abusers (IVDA) are more likely to acquire endocarditis. Most of the cases of infective endocarditis are caused by a single pathogen; cases of polymicrobial endocarditis are rare and they are associated with a reported mortality rate of more than 30%. Only 21 cases of N. sicca endocarditis have been described in the literature since 1918, and only 15 reported cases of endocarditis which involved Actinomyces species have been reported since 1939. We are reporting a case of a 49-year-old male with intravenous heroin and fentanyl abuse, who presented with infective endocarditis caused by Neisseria sicca/subflava(N. sicca), Actinomyces, Streptococcus mitis, and Haemophilus parainfluenzae, complicated by septic emboli to the lungs and skin, ARDS , splenic infarct and immunocomplex mediated proliferative glomerulonephritis. PMID:24551699

Mehrzad, Raman; Sublette, Marcus; Barza, Michael

2013-12-01

189

C-reactive protein, Rheumatoid factor and circulatory immune complex as markers for monitoring treatment of infective endocarditis  

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Objectives: To evaluate the diagnostic usefulness of serum C-reactive protein (CRP), rheumatoid factor (RF) and circulatory immune complex (CIC) determinations in monitoring the outcome of infective endocarditis (IE). Methodology: In this prospective analytic descriptive study CRP, RF and CIC were measured on admission and 4 weeks after initiation of standard antibiotic regimen in 30 hospitalized patients with IE in an educational hospital between 2006 and 2007 in Ahvaz a city south west Iran . Duke criteria were used for diagnosis of IE. CRP and RF were examined using quantitative neflometry (Binding site kit, UK) and CIC was detected by semi quantitative immune diffusion (Baharafshan SIRD kit, Iran). Data were evaluated using statistical analyses in SPSS (version 12, USA) software for windows. Results: The fall in serum C-reactive protein or RF was significant (P=0.05). Only two of the 30 patients, who had elevated CRP, RF and CIC week four failed to response and one needed cardiac surgery. Conclusions: The C-reactive protein proved to be a good tool for monitoring the treatment of IE. Also RF proved useful in the assessment of patients with IE, but the value of CIC was negligible. (author)

2010-01-01

190

Possible Usefulness of Gadolinium-Enhanced Brain MRI for Evaluating Risk of Perioperative Hemorrhage: A Case of Infective Endocarditis  

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A 59-year-old woman visited a local hospital for fever and was diagnosed as having infective endocarditis (IE) on the basis of blood cultures and transthoracic echocardiography. Based on clinical episodes of subarachnoid hemorrhage after admission, it was judged that she was not a good candidate for urgent open heart surgery, and it was decided to treat her with conservative medical therapy for the acute phase. We explored the optimum timing for surgery by employing gadolinium (Gd) contrast medium-enhanced magnetic resonance imaging (MRI) T2* weighted image (black dots) due to her high risk of perioperative cerebral hemorrhage. After the disappearance of the contrast media enhancement effect around the black dots, open heart surgery was performed successfully on the 103rd hospitalization day. The patient was discharged 22 days after the surgery with no clinical complications. This case suggests that disappearance of the contrast media enhancement effect around the black dots may be a useful marker for optimal timing of surgery to minimize the risk of perioperative cerebral hemorrhage in patients with IE. Learning Objective. The MRI T2* weighted images including those with Gd contrast medium enhancement effect may be useful for evaluating the risk of perioperative intracranial hemorrhage in IE.

Koeda, Chikahiko; Tashiro, Atsushi; Takahashi, Tomohiro; Niiyama, Masanobu; Sakamoto, Ryohei; Kimura, Takumi; Morino, Yoshihiro; Terui, Katsutoshi; Tanaka, Ryoichi; Yoshioka, Kunihiro; Kin, Hajime; Okabayashi, Hitoshi; Nakamura, Motoyuki

2014-01-01

191

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

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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

192

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

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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

193

Erysipelothrix rhusiopathiae endocarditis and presumed osteomyelitis  

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Erysipelothrix rhusiopathiae is known to cause infections in humans following exposure to decaying organic matter or animals colonized with the organism, such as swine and fish. Invasive infections with this organism are unusual and are manifested primarily as infective endocarditis. The present report is believed to be the first to report a case of E rhusiopathiae endocarditis and presumptive osteomyelitis. E rhusiopathiae appears to have intrinsic resistance to vancomycin. Because vancomyci...

Romney, Marc; Cheung, Stephen; Montessori, Valentina

2001-01-01

194

Valve Replacement for Acute Left Heart Endocarditis  

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Between January 1982 and June 1993, 66 patients (48 men and 18 women of mean (range) age 50 (21-77) years) underwent valve replacement for acute infective endocarditis. There were 45 aortic valve and 17 mitral valve infections. Four patients had bivalvular involvement. Fifty-three patients suffered from native valve endocarditis, with underlying valvular lesions documented for 31 patients. Staphylococci and Streptococci spp. were responsible for 68% of infection, and 20% of blood and valve cu...

Detry, Olivier; Defraigne, Jean-olivier; Limet, Raymond

1995-01-01

195

Maternal understanding of infective endocarditis after hospitalization: assessing the knowledge of mothers of children with congenital heart disease and the practical implications.  

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This study aimed to examine the knowledge of mothers of children with congenital heart disease as well as the association of cardiological factors and maternal characteristics with maternal understanding. Mothers of 135 children (?2 years old) were interviewed to assess maternal knowledge of infective endocarditis (IE) using the Hannover Inventory of Parental Knowledge of Congenital Heart Disease. Two subscales, endocarditis and risk factors, were used. Cardiological data as well as maternal characteristics were collected. Two-thirds of the mothers achieved only low scores, answering 0-20 % of the questions correctly (endocarditis = 64.4 %; risk factors = 71.1 %). Mothers with higher education recalled the correct definition of IE (P = 0.001) and the importance of dental hygiene (P = 0.004) more often. Mothers with only one child were more likely to know the most typical symptom (P = 0.007). The severity of the heart disease and the requirement of endocarditis prophylaxis did not influence maternal understanding. Yet, mothers assessing the heart disease as severe showed better knowledge (typical symptom P = 0.021; importance of dental hygiene P = 0.007). If mothers learned the diagnosis before their child's birth, they remembered relevant information more often. Mothers receiving information by the medical staff and from the Internet showed better knowledge (definition P = 0.014; importance of dental hygiene P = 0.001). Due to low levels of knowledge, more efforts must be put into the education of mothers. Educational programs should take maternal characteristics into account, providing written material and thereby keeping the instruction of lower-educated persons in mind. Furthermore, education should be focused on mothers of children requiring IE prophylaxis. PMID:23982219

Knöchelmann, Anja; Geyer, Siegfried; Grosser, Urte

2014-02-01

196

Endocarditis del marcapasos / Pacemaker endocarditis  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish La endocarditis del marcapasos es una complicación poco frecuente pero grave. La forma más frecuente de presentación es como síndrome febril y/o bacteriemia por gérmenes gram positivos. Dos elementos claves para el diagnóstico son los hemocultivos y el ecocardiograma. Se realiza un análisis retrospe [...] ctivo de los pacientes con endocarditis del marcapasos ingresados en el Servicio de Medicina Interna de nuestro hospital entre 1989-2003. Se incluyeron 6 pacientes. En este estudio la manipulación repetida del sistema y la diabetes mellitus fueron los factores de riesgo más frecuentes. Los microorganismos más frecuentemente implicados fueron los Staphylococcus spp. A pesar de la menor sensibilidad del ecocardiograma transtorácico, en manos expertas puede mejorar su rendimiento, en esta serie se sitúa en el 66%. Se realizó extracción mediante cirugía extracorpórea e implantación de un nuevo sistema en la misma intervención en todos, sin ningún caso de recidiva y con una mortalidad del 17%. Abstract in english Pacemaker endocarditis is a rare but serious complication of permanent transvenous pacing. The most common presentation is fever syndrom or gram positive bacteremia. For the diagnostic it is important to performed blood cultures and an echocardiography. A retrospective study included the cases of pa [...] cemaker endocarditis diagnosed in the Internal Medicine Department of our Hospital between 1989-2003. Six patients were included. Repeated manipulation of the system and diabetes were the most frequent risk factors. The most frequently detected causative microorganisms were Staphylococci. In spite of the low sensitivity of the transthoracic echocardiography in expert hands it can improve, in this series it places in 66 %. Surgical treatment with cardiopulmonar bypass and implantation of a new system was performed in the same intervention in all patients. None relapsed and the overall mortality was 17%.

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

197

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

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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

198

Leonurus cardiaca L. herb - a derived extract and an ursolic acid as the factors affecting the adhesion capacity of Staphylococcus aureus in the context of infective endocarditis.  

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The objective was an assessment of the impact of Leonurus cardiaca L. extract (LCE) and ursolic acid (UA) on the adhesive properties of Staphylococus aureus NCTC 8325 strain, expressing virulence factors important in the pathogenesis of infective endocarditis. The adhesion and biofilm formation of bacteria cultured in the presence of subinhibitory concentrations of LCE or UA on the abiotic surface or covered with fibrinogen, fibronectin or collagen, were evaluated. Inhibitory effects of LCE and UA on staphylococcal adherence to both types of surface were demonstrated. This, in the case of UA, resulted in a significant reduction of biofilm formation. PMID:24918490

Micota, Bart?omiej; Sadowska, Beata; Pods?dek, Anna; Redzynia, Ma?gorzata; Ró?alska, Barbara

2014-01-01

199

Retrospective Studies on Pediatric Infective Endocarditis over 40 Years in a Mid-West Area of China.  

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Objective: We have evaluated 106 pediatric cases of infective endocarditis (IE) to elucidate clinical manifestations and pathogenic microorganism profiling of IE in China. Methods: Clinical features, complications, pathogenic microorganisms, diagnosis and treatment of pediatric IE were reviewed in two groups of patients with IE from the different periods of time (group A, 34 cases obtained in the period from 2000 to 2011 and group B, 72 cases obtained in the period from 1964 to 1999). Results: A total of 106 pediatric patients with a definite diagnosis of IE based on the modified Duke criteria were enrolled and evaluated in this study. By comparing two groups of patients from different time periods, we found that the incidence of rheumatic heart disease was significantly reduced (from 19.4 to 5.9%), whereas congenital heart disease-associated IE had a tendency to increase (from 55.6 to 79.4%). Staphylococcus aureus was detected as the most common pathogenic microorganism, and its involvement tended to increase (from 32.0 to 58.5%), whereas the percentage of infections caused by Streptococcus viridans (8.0%) had not changed. It was interesting to note that the rate of vegetations detected was increased from 50.0 to 67.6% and the incidence of right-sided IE was also increased (from 35.0 to 60.9%). The most common valves involved in recent cases were tricuspid valves (increase from 30.0 to 47.8%), while mitral valve infection was reduced (from 60.0 to 39.1%). Penicillin was still the most commonly used antibiotic for the treatment of IE; the combination of penicillin plus cephalosporin has been recommended more and more recently. Conclusions: Comparing pediatric IE patients during the past 40 years, we found that the role of rheumatic heart disease as a predisposing factor is diminishing. Pediatric IE is still predominantly caused by staphylococci. The most commonly involved valves are tricuspid valves instead of mitral valves. Gram-positive bacteria showed an increased resistance to penicillin when used alone, and the use of combination treatment with antibiotics is increasing in the area. © 2014 S. Karger AG, Basel. PMID:24662733

Wang, Wenshu; Sun, Huichao; Lv, Tiewei; Tian, Jie

2014-01-01

200

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

 
 
 
 
201

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

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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

202

Chronic Q Fever-Related Dual-Pathogen Endocarditis: Case Series of Three Patients?  

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Following Coxiella burnetii infection, there is a 1 to 5% risk of chronic Q fever. Endocarditis, mycotic aneurysm, and vascular prosthesis infection are common manifestations. We present three patients with endocarditis by C. burnetii concomitant with another bacterial pathogen. Chronic Q fever should therefore be considered in all endocarditis patients in regions where Q fever is endemic.

Kampschreur, Linda M.; Oosterheert, Jan Jelrik; Vries Feyens, Cornelia A.; Delsing, Corine E.; Hermans, Mirjam H. A.; Sluisveld, Ingrid L. L.; Lestrade, Peter J.; Renders, Nicole H. M.; Elsman, Peter; Wever, Peter C.

2011-01-01

203

A case of Mycobacterium goodii prosthetic valve endocarditis in a non-immunocompromised patient: use of 16S rDNA analysis for rapid diagnosis  

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Full Text Available Abstract Background Mycobacterium goodii is a rare cause of significant infection. M. goodii has mainly been associated with lymphadenitis, cellulitis, osteomyelitis, and wound infection. Case presentation A case of a 76-year-old Caucasian female is presented. The patient developed a prosthetic valve endocarditis caused by M. goodii. She had also suffered from severe neurological symptoms related to a septic emboli that could be demonstrated as an ischemic lesion found on CT of the brain. Transesophageal echocardiography verified a large vegetation attached to the prosthetic valve. Commonly used blood culture bottles showed growth of the bacteria after 3?days. Conclusions Although M. goodii is rarely involved in these kinds of severe infections, rapidly growing mycobacteria should be recognized during conventional bacterial investigations and identified by molecular tools such as analysis of 16S rDNA. Species identification of nontuberculous mycobacteria is demanding and is preferably done in collaboration with a mycobacterial laboratory. An early diagnosis provides the opportunity for adequate treatment. In the present case, prolonged antimicrobial treatment and surgery with replacement of the prosthetic valve was successful.

Jönsson Göran

2012-11-01

204

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

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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...

Sola Claudia; Lamberghini Ricardo O; Ciarlantini Marcos; Egea Ana L; Gonzalez Patricia; Diaz Elda G; Huerta Vanina; Gonzalez Jose; Corso Alejandra; Vilaro Mario; Petiti Juan P; Torres Alicia; Vindel Ana; Bocco Jose L

2011-01-01

205

Endocarditis due to Chryseobacterium meningosepticum  

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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

206

Fungal endocarditis after cardiac valve replacement  

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Full Text Available Fungal endocarditis developed in 15 cases out of 205 in whom cardiac valves were replaced during the years 1969-75. Bacterial and fungal infections co-existed in 3 cases. Pure bacterial endo-carditis was seen only in one case during this period. Fungal endo-carditis was not observed following any other type of open or closed heart surgery. Clinicopathologic features of these cases are briefly described. Paucity of clinical signs and symptoms make early diagnosis difficult. The diagnosis of fungal infection was essentially histological. It was corroborated by culture in 3 cases. In 6 cases candida was responsible while in others either Aspergillus or Penicillium was responsible. In 11 out of 15 cases, endocarditis supervened in the early post-operative period stressing the need for vigilance.

Kinare Suman

1978-01-01

207

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

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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

208

Case of Indolent Endocarditis Due to Pseudomonas stutzeri with Genetic Evidence of Relapse after 4 Years?  

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Pseudomonas stutzeri, a gram-negative bacterium, is a common inhabitant of soil and water. We report an unusual case of a relapse of infective endocarditis due to P. stutzeri 4 years after the initial episode. The identity of the strains was proven by genomic analysis.

2009-01-01

209

Plasmid pattern analysis of Staphylococcal epidermidis isolates from patients with prosthetic valve endocarditis.  

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The electrophoretic pattern formed by individual bacterial plasmid DNA molecules of differing molecular size was evaluated as an epidemiological marker among isolates of Staphylococcus epidermidis from patients with prosthetic valve endocarditis (PVE). Purified covalently closed circular plasmid DNA was obtained from selected isolates, and 79% of the plasmids were found to be less than 10 megadaltons in size; only these small plasmids were sought in subsequent screening gels. Crude cell lysat...

Archer, G. L.; Vishniavsky, N.; Stiver, H. G.

1982-01-01

210

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  

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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.

211

Hampered by historical paradigms - echinocandins and the treatment of Candida endocarditis.  

Science.gov (United States)

Infective endocarditis due to Candida sp. has a high mortality rate. Traditionally, management involves early surgery and prolonged amphotericin ± flucytosine. We report a case of Candida parapsilosis bileaflet mitral valve endocarditis cured with anidulafungin and fluconazole, and review the role of echinocandins in the management of Candida endocarditis. PMID:24251958

Gardiner, B J; Slavin, M A; Korman, T M; Stuart, R L

2014-05-01

212

Endocarditis Prophylaxis in Cardiac Patients: Knowledge among General Dental Practitioners in Tabriz  

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Background and aims. Dental procedures injuring oral tissues may induce bacterial release to blood stream that can cause infective endocarditis in susceptible patients. The aim of this study was to determine the level of knowledge of general dental practitioners (GDPs in Tabriz, Northwest of Iran, regarding endocarditis prophylaxis in cardiac patients receiving dental treatments.

Materials and methods. This was a cross-sectional, descriptive, analytical study that included 150 GDPs. All practitioners were given a self-administered questionnaire which consisted of three parts assessing their knowledge of cardiac diseases requiring prophylaxis, dental procedures requiring prophylaxis, and antibiotic regimen for endocarditis prophylaxis. Statistical analysis of data was carried out using independent t-test, one-way ANOVA and chi-square test.

Results. The level of knowledge among GDPs in three areas of cardiac diseases requiring prophylaxis, dental procedures requiring prophylaxis, and antibiotic regimen for endocarditis prophylaxis were 63.7%, 66.8% and 47.7%, respectively. Their overall level of knowledge regarding endocarditis prophylaxis was 59%. Association of the level of knowledge with age and practice period was statistically significant (P < 0.05. However, the level of knowledge was not significantly associated with gender or university of graduation in either of three areas evaluated (P > 0.05.

Conclusion. According to our results, the knowledge of endocarditis prophylaxis among GDPs in Tabriz was in a moderate level. Regarding the importance of endocarditis prophylaxis in susceptible patients, it should be more emphasized in the curriculum of dental schools and continuing dental education programs.

Ardeshir Lafzi

2008-04-01

213

Prosthetic valve endocarditis caused by Acinetobacter calcoaceticus subsp. lwoffi.  

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Acinetobacter spp. are uncommon etiologic agents of prosthetic valve endocarditis. Two patients with Acinetobacter calcoaceticus subsp. lwoffi prosthetic valve endocarditis are described. The patients were successfully treated with antibiotics (cefotaxime sodium and gentamicin sulfate); thus, we suggest medical treatment rather than early valve replacement in this particular type of infection.

Weinberger, I.; Davidson, E.; Rotenberg, Z.; Fuchs, J.; Agmon, J.

1987-01-01

214

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  

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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

215

Endocarditis infecciosa: análisis de 261 casos y resultados del tratamiento con un enfoque multidisciplinario Infective endocarditis: short and long term results in 261 cases managed by a multidiciplinary approach  

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Full Text Available Background: Early diagnosis, an effective treatment and prompt recognition of complications are essential to improve the prognosis of infective endocarditis (IE Aim: To report the results of a multidisciplinary approach to diagnosis and management of patients with IE at the Universidad Católica de Chile Hospital. Patients and methods: The clinical history, diagnosis, treatment and outcome of 261 episodes (Duke criteria of IE admitted between January 1980 and January 1999 were analyzed. These included 185 episodes of native, 73 of prosthetic valve and 3 of nonvalvular IE. Results: Sixty nine percent of patients were men and the mean age was 49 ± 16 years. Seventy five percent had a definite diagnosis of IE (Duke. S. viridans, staphylococci and enterococci together constituted 85% of the isolated bacterial strains. Twenty seven had culture-negative IE, related to a high incidence of antibiotic therapy prior to diagnosis. Transesophageal echocardiography was performed in 102 cases and it detected vegetations in 91% of aortic and 96% of mitral IE, rupture or prosthesis dehiscence in 67% of aortic and 52% of mitral IE and abscesses in 51% of aortic and 15% of mitral IE. Fifty one percent developed heart failure and 34% had embolic events. S. aureus IE was associated to a higher incidence of embolic events, complications which contraindicated surgery and increased mortality rate (27%. Of all patients, 40% were treated exclusively with antibiotics, 52% were operated on and 8% had surgical indication but were nonoperable because of serious complications. The overall mortality was 16.3%: 13% in the medical, 9% in the surgical and 81% in the non-operable groups. The type of treatment and mortality rates did not differ between IE of native valves and prosthetic valves. Long term follow up showed survival rates of 73% at 5 years and 66% at 10 years. Conclusion: A multidisciplinary approach may be very helpful to improve the prognosis of IE. (Rev Méd Chile 2000; 128: 708-20.

Sandra Braun J

2000-07-01

216

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

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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

217

Streptococcus dysgalactiae endocarditis presenting as acute endophthalmitis  

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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

218

Chronic Q fever endocarditis.  

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Eight patients with chronic Q fever endocarditis were treated with tetracycline for up to 40 months. In addition, five of these patients received co-trimoxazole. Six patients had prosthetic valves. Two patients who had Q fever endocarditis on their native valves required valve replacement because of haemodynamic difficulties: in only one did the Q fever endocarditis contribute to the haemodynamic difficulty. One patient died. It is suggested that medical treatment is continued until clinicall...

Varma, M. P.; Adgey, A. A.; Connolly, J. H.

1980-01-01

219

Infective Endocarditis in a Dog and the Phylogenetic Relationship of the Associated “Bartonella rochalimae” Strain with Isolates from Dogs, Gray Foxes, and a Human?  

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The first case of canine endocarditis caused by “Bartonella rochalimae” is reported. By PCR-restriction fragment length polymorphism, sequence, and phylogenetic analyses, Bartonella isolates from a dog with endocarditis, 22 gray foxes, and three dogs, described as B. clarridgeiae like, were confirmed to belong to the new species “B. rochalimae,” suggesting canids as the natural reservoir.

2009-01-01

220

A study of infectious endocarditis in Ribeirão Preto, SP - Brazil. Analysis of cases occurring between 1992 and 1997  

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Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: To analyze the epidemiology, diagnosis, clinical aspects causes and evolution of infectious endocarditis. METHODS: The patients analyzed were treated at the University Hospital of the Faculdade de Medicina of Ribeirão Preto-USP and had a diagnosis of infectious endocarditis defined by Duk [...] e's criteria, which classifies infectious endocarditis as native, prosthetic valve or that occurring in intravenous drug users. RESULTS: One hundred and eighty episodes of infectious endocarditis in 168 patients were observed. Echocardiograms in 132 (73.3%) provided a diagnosis of infectious endocarditis in 111 (84%) patients; mitral valves were affected in 55 (30.5%), tricuspid valves in 30 (16.6%) and the aortic valve in 28 (15.5%) patients. Hemocultures were performed in 148 (93.8%) episodes of IE. The most commonly isolated infectious organisms were Staphylococcus aureus in 46 (27.2%) patients and Streptococcus viridans in 27 (15.9%). Complications occurred in 116 (64.4%) patients and 73 (40.5%) of the patients died. CONCLUSION: The general profile of the observed infectious endocarditis was similar to that reported in studies performed in other countries and included users of intravenous drugs. The high degree of mortality observed is not compatible with progress in diagnosis and treatment of infectious endocarditis and is probably due to the absence of diagnostic suspicion. The high frequency of fatal cases of septicemia (45.1% of deaths) in the patients studied indicates that unnoticed cases of infectious endocarditis had only been diagnosed at necropsy.

Everaldo, Ruiz Jr; Tarciso, Schirmbeck; Luiz Tadeu Moraes, Figueiredo.

 
 
 
 
221

Uncommon acquired Gerbode defect following extensive bicuspid aortic valve endocarditis  

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Gerbode defect is a rare type of left ventricle to right atrium shunt. It is usually congenital in origin, but acquired cases are also described, mainly following infective endocarditis, valve replacement, trauma or acute myocardial infarction. We report a case of a 50-year-old man who suffered an extensive and complex infective endocarditis involving a bicuspid aortic valve, the mitral-aortic intervalvular fibrosa and the anterior leaflet of the mitral valve. After dual valve replacement and...

Dores, He?lder; Abecasis, Joa?o; Ribeiras, Regina; Neves, Jose? Pedro; Mendes, Miguel

2012-01-01

222

Spondylodiscitis and endocarditis caused by S. vestibularis  

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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.

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

223

Spondylodiscitis and endocarditis caused by S. vestibularis  

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Full Text Available 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 agent 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

2010-08-01

224

Acute vertebral osteomyelitis complicating Streptococcus sanguis endocarditis.  

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The first well documented case of acute pyogenic vertebral osteomyelitis presenting as the initial manifestation of Streptococcus sanguis endocarditis is reported. The importance of suspecting vertebral osteomyelitis in the presence of disc infection and the diagnostic value of imaging procedures are underlined.

Demers, C.; Tremblay, M.; Lacourcie?re, Y.

1988-01-01

225

Aortic valve streptococcus group B endocarditis post-extracorporeal shock wave lithotripsy  

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BACKGROUND Sub-acute left-sided bacterial endocarditis is a serious condition that may present with variable clinical manifestations. Its symptoms include both sterile and infected emboli, and various immunological phenomena. CASE REPORT This report presents a 55 year old man with frequency and dysuria after a lithotripsy and several admissions with urosepsis. Due to the suspicion of infective endocarditis echocardiography was done which confirmed streptococcus group B endocarditis. CONCLUSION Streptococci group B is one of the rare causes of infective endocarditis, but it was observed after various producers such as lithotripsy.

Meidani, Mohsen; Taghavi, Mahboobeh; Abdar Esfahani, Morteza

2013-01-01

226

An Unusual Case of Early Onset Persistent Escherichia coli Septicemia Associated with Endocarditis  

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Escherichia coli infection is very common cause of early onset septicemia especially in very low-birth-weight newborns, but E. coli endocarditis has not been described in newborns. E. coli endocarditis, even in the adult population, is a rare and not well-characterized disease and is associated with high mortality. We report a very unusual presentation of persistent E. coli infection associated with endocarditis.

Gupta, Sachin K.; Nanda, Vishakha; Malviya, Prashant; Jacobs, Norman; Naheed, Z.; Joseph, Tessy

2013-01-01

227

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

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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

228

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

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

229

Streptococcus endocarditis after tongue piercing.  

Science.gov (United States)

While body piercing has been practiced for many centuries, the popularity of this body art has increased vastly in recent years. It is estimated that up to 51% of college-age individuals in the United States have ear piercing or other forms of piercing or tattoo. Although perceived as a relatively safe practice, medical complications, mostly resulting from bleeding and infections, occur in 17% of all cases after piercing. The case is reported of a patient with native mitral valve endocarditis after tongue piercing, resulting in acute mitral valve insufficiency that required valve replacement. PMID:17578056

Kloppenburg, Geoffrey; Maessen, Jos G

2007-05-01

230

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  

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Full Text Available 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 embolism requiring TPA thrombolysis which was instantly successful. A review of literature of pacemaker endocarditis and tricuspid thrombosis along with the relevant management strategies is presented. We believe this case report is unusual on account of non operative management of right atrial lead perforation following an unsuccessful attempt at percutaneous removal of right sided infected pacemaker leads and the incidental discovery of the perforated lead 13 years later at sternotomy, presentation of pacemaker endocarditis with a massive load of vegetations along the entire pacemaker lead tract in superior vena cava, right atrial endocardium, tricuspid valve and right ventricular endocardium, leading to a functional and structural SVC obstruction, requirement of an unusually large dose of warfarin postoperatively occasioned, in all probability, by antibiotic drug interactions, presentation of tricuspid prosthetic valve thrombosis uniquely as vasovagal syncope and isolated hypoxia and near instantaneous resolution of tricuspid prosthetic valve thrombosis with Alteplase thrombolysis.

Javangula Kalyana

2009-02-01

231

Platelet-streptococcal interactions in endocarditis.  

Science.gov (United States)

Infective endocarditis is characterized by the formation of septic masses of platelets on the surfaces of heart valves and is most commonly caused by viridans streptococci. Streptococcal virulence in endocarditis involves factors that promote infectivity and pathogenicity. Adhesins and exopolysaccharide (glycocalyx) contribute to infectivity. Although many factors may contribute to pathogenicity, the platelet aggregation-associated protein (PAAP) of Streptococcus sanguis contributes directly to the development of experimental endocarditis. PAAP is synthesized as a rhamnose-rich glycoprotein of 115 kDa and contains a collagen-like platelet-interactive domain, pro-gly-glu-gln-gly-pro-lys. Expressed on the cell wall of platelet aggregation-inducing strains (Agg+) of S. sanguis, PAAP apparently interacts with a signal-transducing receptor complex on platelets, which includes a novel 175-kDa alpha 2-integrin-associated protein and a 65-kDa collagen-binding component. From available data, the role of PAAP in the pathogenesis of experimental endocarditis may be explained by a proposed mechanistic model. On injured heart valves, PAAP first enhances platelet accumulation into a fibrin-enmeshed thrombus (vegetation), within which S. sanguis colonizes. Colonizing bacteria must resist platelet microbicidal protein (PMPR). The aggregation of platelets on the heart valve may be potentiated by an ectoATPase expressed on the surface of the S. sanguis and platelet alpha-adrenoreceptors that respond to endogenous catecholamines. The expression of PAAP may be modified during infection. Collagen is exposed on damaged heart valves; fever (heat shock) occurs during endocarditis. In response to heat shock or collagen in vitro, PAAP expression is altered. After colonization, streptococcal exotoxin(s) may cause fever. Proteases and other enzymes from streptococci and host sources may directly destroy the heart valves. When PAAP is unexpressed or neutralized with specific antibodies, experimental endocarditis runs a milder course and vegetations are smaller. The data suggest strongly, therefore, that the role of PAAP may overlap the colonization function of putative adhesins such as FimA or SsaB. Finally, PAAP also contributes to the development of the characteristic septic mural thrombus (vegetation) of infective endocarditis and the signs of valvular pathology. PMID:8909879

Herzberg, M C

1996-01-01

232

The first reported case of Bartonella endocarditis in Thailand  

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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

233

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

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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

234

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

235

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

236

Streptococcus viridans osteomyelitis and endocarditis following dental treatment: a case report  

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Vertebral osteomyelitis is an uncommon complication of infective endocarditis with the organism Streptococcus viridans being a rare cause of the condition. This case highlights an unusual presentation of Streptococcus viridans associated with infective endocarditis and pyogenic osteomyelitis in a patient following a dental procedure.

Choudhury, Maitrayee; Patel, Brijesh R.; Patel, Minal; Bashir, Tariq

2009-01-01

237

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

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Full Text Available 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 course of intravenous antimicrobial therapy. A brief analysis of the patient's clinical course and review of the literature is presented.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 dos 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.

Marc Zac Handler

2011-06-01

238

Permanent pacemaker-associated actinomycetemcomitans endocarditis: A case report.  

Science.gov (United States)

Aggregatibacter actinomycetemcomitans is a Gram-negative bacillus, member of the HACEK group of bacteria, and it is a very rare cause of endocarditis. It is also an extremely rare cause of device-associated infection of the heart. We describe the case of a 25 year-old man who presented with pacemaker-associated endocarditis due to Aggregatibacter actinomycetemcomitans and also discuss the implications and treatment of this organism. PMID:24432293

Li, Zhenhong; Madeo, Jennifer; Ahmed, Shadab; Vidal, Alex; Makaryus, Amgad; Mejia, Jose; Yasmin, Tabassum

2013-09-01

239

Dextranase enhances antibiotic efficacy in experimental viridans streptococcal endocarditis.  

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In endocarditis, exopolysaccharide production by viridans streptococci has been associated with delayed antimicrobial efficacy in cardiac vegetations. We compared the efficacies of temafloxacin alone and in combination with dextranase, an enzyme capable of hydrolyzing 20 to 90% of the bacterial glycocalyx, in a rabbit model of endocarditis. In in vivo experiments, rabbits were infected intravenously with 10(8) Streptococcus sanguis organisms and were treated 6 days later with temafloxacin (50...

Mghir, A. S.; Cremieux, A. C.; Jambou, R.; Muffat-joly, M.; Pocidalo, J. J.; Carbon, C.

1994-01-01

240

Long-term outcome of infective endocarditis: A study on patients surviving over one year after the initial episode treated in a Finnish teaching hospital during 25 years  

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Full Text Available Abstract Background Only a few previous studies have focused on the long-term prognosis of the patients with infective endocarditis (IE. Our purpose was to delineate factors potentially associated with the long-term outcome of IE, recurrences of IE and requirement for late valve surgery. Methods A total of 326 episodes of IE in 303 patients were treated during 1980–2004 in the Turku University Hospital. We evaluated the long-term outcome and requirement for late valve surgery for 243 of these episodes in 226 patients who survived longer than 1 year after the initial admission. Factors associated with recurrences were analysed both for the 1-year survivors and for all 303 patients. Results The mean (SD follow-up time for the 1-year survivors was 11.5 (7.3 years (range 25 days to 25.5 years. The overall survival was 95%, 82%, 66%, 51% and 45% at 2, 5, 10, 15 and 20 years. In age and sex adjusted multivariate analyses, significant predictors for long-term overall mortality were heart failure within 3 months of admission (HR 1.97, 95% CI 1.27 to 3.06; p = 0.003 and collagen disease (HR 2.54, 95% CI 1.25 to 5.19; p = 0.010 or alcohol abuse (HR 2.39, 95% CI 1.30 to 4.40; p = 0.005 as underlying conditions, while early surgery was significantly associated with lower overall mortality rates (HR 0.31, 95% CI 0.17 to 0.58; p Conclusion Heart failure during the index episode of IE was the complication, which significantly predicted a poor long-term outcome. Patients who underwent surgery during the initial hospitalisation for IE faired significantly better than those who did not.

Engblom Erik

2008-04-01

 
 
 
 
241

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

242

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..

243

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

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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

244

Group B streptococcus endocarditis associated with multiple pulmonary septic emboli  

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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

245

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

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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 inv...

Tran MaryAnn P; Caldwell-McMillan Molly; Khalife Walid; Young Vincent B

2008-01-01

246

The challenge of staphylococcal pacemaker endocarditis in a patient with transposition of the great arteries endocarditis in congenital heart disease  

International Nuclear Information System (INIS)

Staphylococcus aureus is a leading cause of septicaemia and infective endocarditis. The overall incidence of staphylococcal bacteraemia is increasing, contributing to 16% of all hospital-acquired bacteraemias. The use of cardiac pacemakers has revolutionized the management of rhythm disturbances, yet this has also resulted in a group of patients at risk of pacemaker lead endocarditis and seeding in the range of 1% to 7%. We describe a 26-year-old man with transposition of the great arteries who had a pacemaker implanted and presented with S. aureus septicaemia 2 years postpacemaker implantation and went on to develop pacemaker lead endocarditis. This report illustrates the risk of endocarditis in the population with congenital heart disease and an intracardiac device

2003-01-01

247

Successful treatment of Candida parapsilosis and Pseudomonas aeruginosa infection using medical and surgical management in an injecting drug user with mitral and aortic valve endocarditis: a case report  

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Abstract Introduction Polymicrobial endocarditis is a well-recognized problem in intravenous drug users and it accounts for 1 to 3% of endocarditis cases overall and up to 9% in other series. The most common combinations of organisms include Staphylococcus aureus and Streptococcus pneumoniae followed by Staphylococcus aureus and Pseudomonas aeruginosa. Candida parapsilosis endocarditis carries a mortality rate of 45%, and each infe...

Daas Hanady; Abuhmaid Fadi; Zervos Marcus

2009-01-01

248

Presumed Endocarditis Caused by BRO ?-Lactamase-Producing Moraxella lacunata in an Infant with Fallot's Tetrad  

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A case of presumed endocarditis caused by Moraxella lacunata in a 15-month-old male infant with Fallot's tetrad is described. This infection may have occurred as the result of transmission of this organism between the father and his son. This is the first report of BRO ?-lactamase-producing M. lacunata causing presumed endocarditis.

2003-01-01

249

Engyodontium album endocarditis.  

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This is the first reported case of native valve endocarditis caused by Engyodontium album. This fungus, rarely seen as a human pathogen, is separated from Tritirachium species by its lack of pigmentation and from Beauveria species by the presence of conidiogenous cells in whorls.

Augustinsky, J.; Kammeyer, P.; Husain, A.; Dehoog, G. S.; Libertin, C. R.

1990-01-01

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

Role of sigmaB in the expression of Staphylococcus aureus cell wall adhesins ClfA and FnbA and contribution to infectivity in a rat model of experimental endocarditis.  

Science.gov (United States)

Isogenic Staphylococcus aureus strains with different capacities to produce sigma(B) activity were analyzed for their ability to attach to fibrinogen- or fibronectin-coated surfaces or platelet-fibrin clots and to cause endocarditis in rats. In comparison to the sigma(B)-deficient strain, BB255, which harbors an rsbU mutation, both rsbU-complemented and sigma(B)-overproducing derivatives exhibited at least five times greater attachment to fibrinogen- and fibronectin-coated surfaces and showed increased adherence to platelet-fibrin clots. No differences in adherence were seen between BB255 and a DeltarsbUVWsigB isogen. Northern blotting analyses revealed that transcription of clfA, encoding fibrinogen-binding protein clumping factor A, and fnbA, encoding fibronectin-binding protein A, were positively influenced by sigma(B). Sigma(B) overproduction resulted in a statistically significant increase in positive spleen cultures and enhanced bacterial densities in both the aortic vegetations and spleens at 16 h postinoculation. In contrast, at 72 h postinoculation, tissues infected with the sigma(B) overproducer had lower bacterial densities than did those infected with BB255. These results suggest that although sigma(B) appears to increase the adhesion of S. aureus to various host cell-matrix proteins in vitro, it has limited effect on pathogenesis in the rat endocarditis model. Sigma(B) appears to have a transient enhancing effect on bacterial density in the early stages of infection that is lost during progression. PMID:15664942

Entenza, Jose-Manuel; Moreillon, Philippe; Senn, Maria Magdalena; Kormanec, Jan; Dunman, Paul M; Berger-Bächi, Brigitte; Projan, Steven; Bischoff, Markus

2005-02-01

252

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.

253

Infectious endocarditis caused by Rhodococcus equi.  

Science.gov (United States)

Rhodococcus equi is an unusual cause of infection. Furthermore, this infection also tends to be typically described in immunocompromised patients. This report describes a 25-year-old previously healthy man with infectious endocarditis that was found to have been caused by R equi complicated by a subarachnoid hemorrhage, subdural hematoma, and a superior mesenteric artery aneurysm. The patient was successfully treated with antibiotic therapy, followed by a resection of the superior mesenteric artery aneurysm and a repair of the mitral valve. PMID:20172165

Matsushita, Hiroshi; Hanayama, Naoji; Hobo, Kyoko; Kuba, Kiyomi; Takazawa, Arifumi

2010-03-01

254

Piperacillin, tazobactam, and gentamicin alone or combined in an endocarditis model of infection by a TEM-3-producing strain of Klebsiella pneumoniae or its susceptible variant.  

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The efficacy of tazobactam, a beta-lactamase inhibitor, in combination with piperacillin, was studied in vitro and in rabbit experimental endocarditis due to a Klebsiella pneumoniae strain (KpR) producing an extended-spectrum beta-lactamase, TEM-3, or its nonproducing variant (KpS). In vitro, piperacillin was active against KpS (MIC = 4 micrograms/ml, MBC = 8 micrograms/ml with 10(7)-CFU/ml inoculum) but not against KpR (MIC = MBC = 256 micrograms/ml). Tazobactam (1 microgram/ml) restored the...

Mentec, H.; Vallois, J. M.; Bure, A.; Saleh-mghir, A.; Jehl, F.; Carbon, C.

1992-01-01

255

Contribution of Lipoproteins and Lipoprotein Processing to Endocarditis Virulence in Streptococcus sanguinis? §  

Science.gov (United States)

Streptococcus sanguinis is an important cause of infective endocarditis. Previous studies have identified lipoproteins as virulence determinants in other streptococcal species. Using a bioinformatic approach, we identified 52 putative lipoprotein genes in S. sanguinis strain SK36 as well as genes encoding the lipoprotein-processing enzymes prolipoprotein diacylglyceryl transferase (lgt) and signal peptidase II (lspA). We employed a directed signature-tagged mutagenesis approach to systematically disrupt these genes and screen each mutant for the loss of virulence in an animal model of endocarditis. All mutants were viable. In competitive index assays, mutation of a putative phosphate transporter reduced in vivo competitiveness by 14-fold but also reduced in vitro viability by more than 20-fold. Mutations in lgt, lspA, or an uncharacterized lipoprotein gene reduced competitiveness by two- to threefold in the animal model and in broth culture. Mutation of ssaB, encoding a putative metal transporter, produced a similar effect in culture but reduced in vivo competiveness by >1,000-fold. [3H]palmitate labeling and Western blot analysis confirmed that the lgt mutant failed to acylate lipoproteins, that the lspA mutant had a general defect in lipoprotein cleavage, and that SsaB was processed differently in both mutants. These results indicate that the loss of a single lipoprotein, SsaB, dramatically reduces endocarditis virulence, whereas the loss of most other lipoproteins or of normal lipoprotein processing has no more than a minor effect on virulence.

Das, Sankar; Kanamoto, Taisei; Ge, Xiuchun; Xu, Ping; Unoki, Takeshi; Munro, Cindy L.; Kitten, Todd

2009-01-01

256

Contribution of lipoproteins and lipoprotein processing to endocarditis virulence in Streptococcus sanguinis.  

Science.gov (United States)

Streptococcus sanguinis is an important cause of infective endocarditis. Previous studies have identified lipoproteins as virulence determinants in other streptococcal species. Using a bioinformatic approach, we identified 52 putative lipoprotein genes in S. sanguinis strain SK36 as well as genes encoding the lipoprotein-processing enzymes prolipoprotein diacylglyceryl transferase (lgt) and signal peptidase II (lspA). We employed a directed signature-tagged mutagenesis approach to systematically disrupt these genes and screen each mutant for the loss of virulence in an animal model of endocarditis. All mutants were viable. In competitive index assays, mutation of a putative phosphate transporter reduced in vivo competitiveness by 14-fold but also reduced in vitro viability by more than 20-fold. Mutations in lgt, lspA, or an uncharacterized lipoprotein gene reduced competitiveness by two- to threefold in the animal model and in broth culture. Mutation of ssaB, encoding a putative metal transporter, produced a similar effect in culture but reduced in vivo competiveness by >1,000-fold. [(3)H]palmitate labeling and Western blot analysis confirmed that the lgt mutant failed to acylate lipoproteins, that the lspA mutant had a general defect in lipoprotein cleavage, and that SsaB was processed differently in both mutants. These results indicate that the loss of a single lipoprotein, SsaB, dramatically reduces endocarditis virulence, whereas the loss of most other lipoproteins or of normal lipoprotein processing has no more than a minor effect on virulence. PMID:19395487

Das, Sankar; Kanamoto, Taisei; Ge, Xiuchun; Xu, Ping; Unoki, Takeshi; Munro, Cindy L; Kitten, Todd

2009-07-01

257

Left ventricular rupture after embolic myocardial infarction due to mitral valve endocarditis.  

Science.gov (United States)

We report a very rare case of a 43-year-old patient with fatal left ventricular subepicardial aneurysm rupture complicating embolic myocardial infarction due to mitral valve infective endocarditis. PMID:24447262

Caspar, Thibault; Delabranche, Xavier; Mazzucotelli, Jean-Philippe; Samet, Hafida; Morel, Olivier; Ohlmann, Patrick

2014-04-01

258

Technical aspects of mitral valve replacement with an allograft for acute bacterial endocarditis.  

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Mitral valve replacement with a mitral valve allograft is receiving a resurgence of interest. We discuss the technical aspects of this procedure as it applies to cases of acute bacterial endocarditis infecting the mitral valve.

Conklin, L. D.; Reardon, M. J.

1999-01-01

259

Salmonella species group B causing endocarditis of the prosthetic mitral valve.  

Science.gov (United States)

The Salmonella species is an extremely rare cause of infective endocarditis. This case report is for Salmonella spp. group B proven by positive multiple blood cultures, and positive intraoperative culture from the vegetation of the mitral valve prosthesis. PMID:19668894

Al-Sherbeeni, Nisreen M

2009-08-01

260

Bacterial Endocarditis. Effect of Dimethyl Sulfoxide in X-Irradiated and Nonirradiated Rats.  

Science.gov (United States)

Bacterial endocarditis and associated renal lesions were induced in rats given two exposures to 400 roentgens, followed by one or two intravenous injections of a broth culture of Streptococcus mitis. Cultures of the same organism induced a similiar infect...

B. Highman P. D. Altland A. R. Hanks N. W. Rantanen

1969-01-01

 
 
 
 
261

Osteomyelitis and possible endocarditis secondary to Lactococcus garvieae: a first case report  

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Although osteomyelitis is commonly caused by staphylococcal infection, the first case of a lumbar osteomyelitis secondary to Lactococcus garvieae is reported. The case was complicated by possible endocarditis of an aortic valve prosthesis.???Keywords: Lactococcus garvieae; osteomyelitis

James, P.; Hardman, S.; Patterson, D.

2000-01-01

262

Induction of Experimental Endocarditis by Continuous Low-Grade Bacteremia Mimicking Spontaneous Bacteremia in Humans ?  

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Transient high-grade bacteremia following invasive procedures carries a risk of infective endocarditis (IE). This is supported by experimental endocarditis. On the other hand, case-control studies showed that IE could be caused by cumulative exposure to low-grade bacteremia occurring during daily activities. However, no experimental demonstration of this latter possibility exists. This study investigated the infectivity in animals of continuous low-grade bacteremia compared to that of brief h...

Veloso, T. R.; Amiguet, M.; Rousson, V.; Giddey, M.; Vouillamoz, J.; Moreillon, P.; Entenza, J. M.

2011-01-01

263

Successful Surgical Treatment of Mitral Valve Endocarditis Caused by Staphylococcus Lugdunensis ????? ??? ????? ????? ???? ????? ?????? ????? ?????? ????? ?? ???????? ??????? ????????? ( ????????? )  

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Staphylococcus lugdunensis, a very virulent coagulase negative species, has been recently recognized, and rarely reported in few cases, as a cause of endocarditis. This infection, in contrast to the ordinary staphylococcus epidermidis, is frequently lethal and carries a very high risk of devastating embolic complications. In this paper, it was reported that aggressive infection in a child presenting with mitral valve endocarditis, major left cerebral infarction, bulbar palsy and incontinence,...

Khaled Al-Ebrahim

2007-01-01

264

Mixed biofilms of Staphylococcus epidermidis and Candida parapsilosis as an insight in polymicrobial endocarditis  

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Infective endocarditis is a serious clinical issue, often related to the prolonged use of intravenous catheters that can eventually become infected. Although polymicrobial endocarditis (PE) involving Staphylococcus epidermidis and Candida species is uncommon, it is generally associated with patients’ high mortality due to the presence of Candida spp.. Additionally, investigation on the phenomenon of microbial competition in PE is still scarce. Thus, the main goal of this work is...

Sousa, Cla?udia; Henriques, Mariana; Oliveira, R.

2010-01-01

265

Primary purulent pericarditis and secondary endocarditis: a case report.  

Science.gov (United States)

Purulent pericarditis is a rare diagnosis to be made. It is exceedingly rare as a primary infection. We describe the case of an 18-month-old boy who presented with primary purulent pericarditis and developed a secondary endocarditis. Current literature on the subject is reviewed and discussed. PMID:24480459

Bielefeld, Kyle; O'Connor, Matthew J; Collins, Ronnie T

2014-06-01

266

[The current course and treatment of infectious endocarditis].  

Science.gov (United States)

Clinical study of 172 patients treated in the Burdenko Military Hospital for subacute infectious endocarditis in 1980-1996 compared with 192 cases in 1950-1979. Contemporary course of the disease is attended by a few symptoms, primordiality and single-valve affection. On the grounds of antibiotics sensitivity of the most prevalent infection agents discovered in 1996, the article develops some schemes of antibacterial therapy for Streptococcus, Enterococcus and staphylococcal etiology of disease. Rational antibiotic therapy together with surgery measures reduced lethality to 14.3% for Streptococcus endocarditis, to 16.7%--for Enterococcus and to 34.4%--for Staphylococcus. PMID:9817016

Tiurin, V P; Akimkin, V G; Tikhonov, Iu G

1998-09-01

267

A prospective multicenter study of Staphylococcus aureus bacteremia: incidence of endocarditis, risk factors for mortality, and clinical impact of methicillin resistance.  

Science.gov (United States)

Our objectives were to determine the incidence of endocarditis in patients whose Staphylococcus aureus bacteremia was community-acquired, related to hemodialysis, or hospital-acquired; to assess clinical factors that would reliably distinguished between S. aureus bacteremia and S. aureus endocarditis; to assess the emergence of methicillin-resistant S. aureus (MRSA) as a cause of endocarditis; and to examine risk factors for mortality in patients with S. aureus endocarditis. We conducted a prospective observational study in 6 university teaching hospitals; we evaluated 505 consecutive patients with Staphylococcus aureus bacteremia. Thirteen percent of patients with S. aureus bacteremia were found to have endocarditis, including 21% with community-acquired S. aureus bacteremia, 5% with hospital-acquired bacteremia, and 12% on hemodialysis. Infection was due to MRSA in 31%. Factors predictive of endocarditis included underlying valvular heart disease, history of prior endocarditis, intravenous drug use, community acquisition of bacteremia, and an unrecognized source. Twelve patients with bacteremia had a prosthetic valve; 17% developed endocarditis. Unexpectedly, nonwhite race proved to be an independent risk factor for endocarditis by both univariate and multivariate analyses. Persistent bacteremia (positive blood cultures at day 3 of appropriate therapy) was identified as an independent risk factor for both endocarditis and mortality, a unique observation not reported in other prospective studies of S. aureus bacteremia. Patients with endocarditis due to MRSA were significantly more likely to have complicating renal insufficiency and to experience persistent bacteremia than those with endocarditis due to MSSA. The 30-day mortality was 31% among patients with endocarditis compared to 21% in patients who had bacteremia without endocarditis (p = 0.055). Risk factors for death due to endocarditis included severity of illness at onset of bacteremia (as measured by Apache III and Pitt bacteremia score), MRSA infection, and presence of atrioventricular block on electrocardiogram. Patients with S. aureus bacteremia who have community acquisition of infection, underlying valvular heart disease, intravenous drug use, unknown portal of entry, history of prior endocarditis, and possibly, nonwhite race should undergo echocardiography to screen for the presence of endocarditis. We recommend that blood cultures be repeated 3 days following initiation of antistaphylococcal antibiotic therapy in all patients with S. aureus bacteremia. Positive blood cultures at 3 days may prove to be a useful marker in promoting more aggressive management, including more potent antibiotic therapy and surgical resection of the valve in endocarditis cases. MRSA as the infecting organism should be added to the list of risk factors for consideration of valvular resection in cases of endocarditis. PMID:14530781

Chang, Feng-Yee; MacDonald, Brent B; Peacock, James E; Musher, Daniel M; Triplett, Patricia; Mylotte, Joseph M; O'Donnell, Alice; Wagener, Marilyn M; Yu, Victor L

2003-09-01

268

Prosthetic valve endocarditis. A survey.  

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Fifty eight patients (aged 8-59 years, mean 27) treated for prosthetic valve endocarditis from January 1966 to January 1985 were studied retrospectively by review of case notes. There were 12 cases of early and 46 cases of late prosthetic valve endocarditis. These developed in 28 patients with an isolated aortic valve, in 26 with an isolated mitral valve, and in four with both aortic and mitral prosthetic valves. Streptococci were the most commonly isolated microorganisms, followed by staphyl...

Ben Ismail, M.; Hannachi, N.; Abid, F.; Kaabar, Z.; Rouge?, J. F.

1987-01-01

269

Bacterial endocarditis complicating body art.  

Science.gov (United States)

Increasing numbers of patients are living with congenital heart disease at a time when body art is growing in popularity. We present a case of subacute bacterial endocarditis following repeated tattooing in a patient with known valvular heart disease. This case highlights the importance of education of patients with structural heart disease to the potential risks of such procedures, particularly at a time when endocarditis prophylaxis protocols are being revised. PMID:18180055

Tse, Donald; Khan, Sadia; Clarke, Sarah

2009-03-20

270

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.

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; Casabe, Jose; Chipigina, Natalia; Eisen, Damon P; Spelman, Denis; Delahaye, Francois; Peterson, Gail; Olaison, Lars; Wang, Andrew

2013-01-01

271

Conservative surgery of the mitral valve in bacterial endocarditis.  

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Surgical repair of the mitral valve was undertaken in two young female patients during the active phase of bacterial endocarditis to eradicate persistent infection. Operation resulted in rapid resolution of infection with good haemodynamic results in both patients. A mitral valve prosthesis has the disadvantage for children of needing replacement because of growth, and for young women of leading to problems in pregnancy because of the need for lifelong anticoagulant treatment. Thus repair rat...

Gammage, M. D.; Littler, W. A.; Abrams, L. D.

1984-01-01

272

Staphylococcus lugdunensis endocarditis--the hidden peril of coagulase-negative staphylococcus in blood cultures.  

Science.gov (United States)

Reported here is a successfully treated case of native mitral valve endocarditis caused by Staphylococcus lugdunensis and a review of 47 similar cases reported in the English literature. In the literature review, perineal skin flora appeared to be the source of the organism in patients with endocarditis. Staphylococcus lugdunensis is generally susceptible in vitro to beta-lactam agents. If speciation is not performed, these bacteria might be mistaken for Staphylococcus epidermidis, a relatively avirulent bacterium that is a common contaminant of cultures. Prompt speciation can lead to earlier recognition of endocarditis and possibly enable earlier surgical intervention with improved outcome for this high-mortality infection. Multiple positive blood cultures yielding coagulase-negative staphylococci should be identified to the species level; endocarditis or another intravascular source of infection should be sought. PMID:12845551

Seenivasan, M H; Yu, V L

2003-08-01

273

Linezolid in Prophylaxis against Experimental Aortic Valve Endocarditis Due to Streptococcus oralis or Enterococcus faecalis  

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There are no experimental studies regarding the prophylactic efficacy of linezolid against infective endocarditis. Nonbacterial thrombotic endocarditis of the aortic valve was induced in rabbits by the insertion of a polyethylene catheter. Twenty-four hours later, animals were randomly assigned to a control group, and groups receiving either ampicillin (two doses of 40 mg/kg of body weight each, given intravenously, 2 h apart) or linezolid (a single per os dose of 75 mg/kg). The first dose of...

2006-01-01

274

Isolation of Bartonella washoensis from a Dog with Mitral Valve Endocarditis  

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We report the first documented case of Bartonella washoensis bacteremia in a dog with mitral valve endocarditis. B. washoensis was isolated in 1995 from a human patient with cardiac disease. The main reservoir species appears to be ground squirrels (Spermophilus beecheyi) in the western United States. Based on echocardiographic findings, a diagnosis of infective vegetative valvular mitral endocarditis was made in a spayed 12-year-old female Doberman pinscher. A year prior to presentation, the...

Chomel, Bruno B.; Wey, Aaron C.; Kasten, Rickie W.

2003-01-01

275

Endocarditis Prophylaxis in Cardiac Patients: Knowledge among General Dental Practitioners in Tabriz  

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Background and aims. Dental procedures injuring oral tissues may induce bacterial release to blood stream that can cause infective endocarditis in susceptible patients. The aim of this study was to determine the level of knowledge of general dental practitioners (GDPs) in Tabriz, Northwest of Iran, regarding endocarditis prophylaxis in cardiac patients receiving dental treatments.

2008-01-01

276

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.

277

Right-sided endocarditis due to Staphylococcus lugdunensis: First reported case  

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Staphylococcus lugdunensis is a coagulase-negative organism first identified in 1988. It is often incorrectly identified as Staphylococcus aureus, and has been isolated as the etiological agent in over 20 cases of left-sided endocarditis. This report describes the first documented case of right-sided endocarditis caused by S lugdunensis. This experience suggests that S lugdunensis can infect native valves in the absence of any predisposing risk factors such as injection drug use.

Cooper, Cl; Choudhri, Sh; Hoeschen, Rj

1998-01-01

278

Pacemaker endocarditis: an important clinical entity  

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Pacemaker endocarditis remains a rare but potentially life threatening complication of pacemaker implantation. This case illustrates a rare cause of pacemaker endocarditis, Serratia marcescens, the management difficulties that can be faced with such organisms, and the potential indolent nature of pacemaker lead associated endocarditis. A review of the current data for pacemaker endocarditis management suggests that treatment with antimicrobials alone is unlikely to be curative and explantatio...

Silva, Kalpa; Fife, Amanda; Murgatroyd, Francis; Gall, Nicholas

2009-01-01

279

Whole genome analysis of a livestock-associated methicillin-resistant Staphylococcus aureus ST398 isolate from a case of human endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Recently, a new livestock-associated methicillin-resistant Staphylococcus aureus (MRSA Sequence Type 398 (ST398 isolate has emerged worldwide. Although there have been reports of invasive disease in humans, MRSA ST398 colonization is much more common in livestock and demonstrates especially high prevalence rates in pigs and calves. The aim of this study was to compare the genome sequence of an ST398 MRSA isolate with other S. aureus genomes in order to identify genetic traits that may explain the success of this particular lineage. Therefore, we determined the whole genome sequence of S0385, an MRSA ST398 isolate from a human case of endocarditis. Results The entire genome sequence of S0385 demonstrated considerable accessory genome content differences relative to other S. aureus genomes. Several mobile genetic elements that confer antibiotic resistance were identified, including a novel composite of an type V (5C2&5 Staphylococcal Chromosome Cassette mec (SCCmec with distinct joining (J regions. The presence of multiple integrative conjugative elements combined with the absence of a type I restriction and modification system on one of the two ?Sa islands, could enhance horizontal gene transfer in this strain. The ST398 MRSA isolate carries a unique pathogenicity island which encodes homologues of two excreted virulence factors; staphylococcal complement inhibitor (SCIN and von Willebrand factor-binding protein (vWbp. However, several virulence factors such as enterotoxins and phage encoded toxins, including Panton-Valentine leukocidin (PVL, were not identified in this isolate. Conclusions Until now MRSA ST398 isolates did not cause frequent invasive disease in humans, which may be due to the absence of several common virulence factors. However, the proposed enhanced ability of these isolates to acquire mobile elements may lead to the rapid acquisition of determinants which contribute to virulence in human infections.

van Strijp Jos AG

2010-06-01

280

[Microbial spectrum and microbiological diagnosis of infectious endocarditis].  

Science.gov (United States)

Still streptococci play the most important role as causatives of infective endocarditis. As change in composition of patient groups has taken place gradually pathogens like Staphylococcus epidermidis, enterococci, gram-negative rods and Candida species become more and more important now. Providing high-level accuracy if applied according to current rules blood culture is yet the basis for endocarditis caused by popular bacterial pathogens. If infection due to Candida species is suspected additional measuring of antibody response may be helpful in supporting the tentative diagnosis. Rare pathogens like Rickettsiae and Mycoplasma sp. must be considered for differential diagnosis, as infections caused by these organisms are to be identified by serological methods in first line. PMID:1855807

Schubert, S; Ullmann, U

1991-04-01

 
 
 
 
281

Candida endocarditis associated with cardiac rhythm management devices: review with current treatment guidelines.  

Science.gov (United States)

Coincident with an increased use of cardiac rhythm management devices (CRMD) has been an increase in the number of pacemaker and cardioverter-defibrillator infections. CRMD endocarditis accounts for about 10% of all device-related infections, and cardiac infection caused by Candida sp. is a rare event. To date, only sporadic reports of this unusual and life-threatening event have been reported. By describing a case of CRMD-related Candida endocarditis and conducting a literature review, we provide a detailed characterisation of this unusual clinical entity with an emphasis on diagnosis, management and treatment. A case of CRMD-related Candida endocarditis is presented and a computer search for confirmed cases of CRMD-Candida endocarditis was conducted. Current recommendations for management and treatment were documented. From 1969 to 2009, 15 patients with CRMD-Candida endocarditis (12 pacemaker and three implanted cardioverter-defibrillator) were documented. All were males, non-albicans Candida sp. were frequently recovered, a major fungal embolus occurred in 27% of patients and two of 10 patients who received defined antifungal therapy and device explantation expired. CRMD Candida endocarditis is a rare and serious clinical event; isolates can include Candida albicans and other Candida sp., and treatment involves both targeted antifungal therapy and device removal. PMID:21672037

Halawa, Ahmad; Henry, Philip D; Sarubbi, Felix A

2011-07-01

282

Successful surgical treatment with mitral valve replacement and coronary embolectomy in a patient with active infective endocarditis complicated by multiple septic embolisms involving cerebral arteries and the right coronary artery.  

Science.gov (United States)

The proper management of a patient with active infective endocarditis (IE) remains to be determined, especially when his or her condition is complicated with intracranial mycotic aneurysm. Here we present a 46-year-old company employee hospitalized with a subarachnoid hemorrhage caused by a ruptured mycotic aneurysm. Cardiac echography showed a verruca on the posterior mitral cusp and leaflet destruction, resulting in severe valvular regurgitation (determined pathogen was ?-streptococcus). High-dose antibiotic infusion and restriction of physical activity to prevent heart failure were combined with emergency craniotomy drainage and coiling of the necks of two cerebral mycotic aneurysms. After 2 months of conservative therapy for IE, he suddenly collapsed with hypotension and bradycardia because of embolic occlusion of the proximal right coronary artery (RCA). An emergent operation was carried out to remove the emboli in the RCA and to replace the mitral valve with a mechanical prosthesis. The postoperative course was uneventful. Although disturbances of spatial recognition and manual dexterity remained, he was able to walk and talk. After postoperative sufficient-duration antibiotic therapy, which lasted 20 days, he was transferred to a rehabilitation center. PMID:20859727

Yamasaki, Manabu; Watanabe, Sunao; Abe, Kohei; Uenishi, Michiko; Kawazoe, Kohei

2010-09-01

283

Triple valve endocarditis by mycobacterium tuberculosis. A case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Granulomas caused by Mycobacterium Tuberculosis have been observed at autopsy in the heart, pre-dominantly in the myocardium and endocardium, but rarely involving the coronary vessels and valvular structures. Mycobacterium tuberculosis valvular endocarditis is extremely rare, with most reports coming from autopsy series. Case presentation We report the case of a 17 year old immunocompetent girl who presented with history of fever, malaise, foot gangrene and a left sided hemiparesis. On investigation she was found to have infective endocarditis involving the aortic, mitral and tricuspid valves. She had developed a right middle cerebral artery stroke. She underwent dual valve replacement and tricuspid repair. The vegetations showed granulomatous inflammation but blood cultures and other biological specimen cultures were negative for any organisms. She was started on antituberculous treatment and anticoagulation. Conclusion This is the first reported case of triple valve endocarditis by Mycobacterium Tuberculosis in an immunocompetent host. Especially important is the fact that the right heart is involved which has been historically described in the setting of intravenous drug abuse. This implies that Tuberculosis should be considered in cases of culture negative endocarditis in endemic areas like Pakistan even in immunocompetent hosts.

Shaikh Quratulain

2012-09-01

284

Diagnosis of endocarditis caused by Mycobacterium abscessus  

Directory of Open Access Journals (Sweden)

Full Text Available We report a fatal case of native valve endocarditis due to Mycobacterium abscessus in a hemodialysis patient. The diagnosis was based on culture isolation of acid-fast bacilli from peripheral blood and a permanent catheter tip, and their identification as M abscessus by a reverse hybridization-based assay and direct DNA sequencing of the 16S-23S internal transcribed spacer region. Rapid diagnosis and combination therapy are essential to minimize mortality due to this pathogen. Although combination therapy was started with clarithromycin and tigecycline, the patient refused to take clarithromycin due to severe abdominal pain. The patient became afebrile after therapy with tigecycline alone although bacteremia persisted. He was discharged against medical advice and readmitted three months later for persistent fever. His blood cultures again yielded M abscessus and a transesophageal echocardiogram showed two mobile vegetations. The patient was noncompliant with therapy and died due to cardiac arrest and multiorgan failure. This report shows that M abscessus should also be considered in the differential diagnosis of infective endocarditis in hemodialysis patients.

Al-Benwan Khalifa

2010-01-01

285

Effect of nitrogen mustard on natural history of right-sided streptococcal endocarditis in rabbits: role for cellular host defenses.  

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Cellular host defenses are considered to be ineffective in bacterial endocarditis; the microorganisms in infected vegetations are protected from phagocytic cells by dense layers of fibrin. To test this hypothesis, nitrogen mustard-induced agranulocytosis and leukopenia were produced in rabbits with right-sided streptococcal endocarditis. The spontaneous sterilization of tricuspid infection observed in the control animals was not present in the granulocytopenic, leukopenic animals. Since the b...

Yersin, B. R.; Glauser, M. P.; Freedman, L. R.

1982-01-01

286

Uncommon acquired Gerbode defect following extensive bicuspid aortic valve endocarditis  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Gerbode defect is a rare type of left ventricle to right atrium shunt. It is usually congenital in origin, but acquired cases are also described, mainly following infective endocarditis, valve replacement, trauma or acute myocardial infarction. We report a case of a 50-year-old man who suffered an extensive and complex infective endocarditis involving a bicuspid aortic valve, the mitral-aortic intervalvular fibrosa and the anterior leaflet of the mitral valve. After dual valve replacement and annular reconstruction, a shunt between the left ventricle and the right atrium - Gerbode defect, and a severe leak of the mitral prosthesis were detected. Reintervention was performed with successful shunt closure with an autologous pericardial patch and paravalvular leak correction. No major complications occurred denying the immediate post-surgery period and the follow-up at the first year was uneventful.

Dores Hélder

2012-02-01

287

Beta-hemolytic streptococcus group a endocarditis: a rare clinical presentation  

International Nuclear Information System (INIS)

A case report of an elderly gentleman is reported herein, who presented with one week history of fever, drowsiness and left lower limb weakness. Examination revealed left lower limb weakness with power of grade 3/5. His workup showed evidence of infection and multiple cerebral infarcts on the right side. Blood culture grew Streptococcus pyogens. Echocardiogram showed two vegetations on the aortic valve. Fever was the main presenting feature in this case but it was the presentation of patient with multiple cerebral infarcts that lead to the diagnosis of infective endocarditis. The organism causing Infective Endocarditis (IE) in this patient was a rare one. (author)

2008-01-01

288

Tricuspid endocarditis in hyper-IgE syndrome  

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Hyper-IgE syndrome is a congenitally acquired primary immune deficiency condition. We report a case of possible hyper-IgE syndrome who presented with multiple cold skin abscesses and chest infection due to Staphylococcus aureus and hyper-IgE findings. Patient also had tricuspid valve acute bacterial endocarditis with purulent pericarditis which is very rare. This case is presented to highlight that early diagnosis and treatment in such cases decreases the mortality and morbidity in pha...

Mittal A; Gupta S; Jagdish

2010-01-01

289

Role of Monocytes and Bacteria in Staphylococcus epidermidis Endocarditis  

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The endocardial vegetation which is formed in the course of bacterial endocarditis (BE) contains tissue factor (TF)-dependent procoagulant activity. Earlier studies showed that monocytes are the main source of TF in the vegetations. The TF activity (TFA) of vegetations isolated from Streptococcus sanguis-infected rabbits depended on the numbers of bacteria as well as monocytes in the vegetation. In this study, we investigated whether for Staphylococcus epidermidis, a frequent pathogen in BE, ...

1998-01-01

290

Streptobacillus moniliformis endocarditis: case report and review of literature.  

Science.gov (United States)

Rat bite fever is a rare infection and sometimes results in complications. This case report describes native mitral valve endocarditis in a 44-year-old male patient caused by Streptobacillus moniliformis. The diagnosis was confirmed by transesophageal echocardiography and blood cultures (BACTEC). The patient was treated with IV crystalline penicillin (6 weeks) and gentamicin (2 weeks). The fundamental importance of a high index of suspicion, interpreting investigations and appropriateness of therapy are highlighted. PMID:23993005

Madhubashini, M; George, Susan; Chandrasekaran, Sujatha

2013-01-01

291

Cardiac imaging in infectious endocarditis  

DEFF Research Database (Denmark)

Infectious endocarditis remains both a diagnostic and a treatment challenge. A positive outcome depends on a rapid diagnosis, accurate risk stratification, and a thorough follow-up. Imaging plays a key role in each of these steps and echocardiography remains the cornerstone of the methods in use. The technique of both transthoracic echocardiography and transoesophageal echocardiography has been markedly improved across the last decades and most recently three-dimensional real-time echocardiography has been introduced in the management of endocarditis patients. Echocardiography depicts structural changes and abnormalities in the heart, but it does not uncover the underlying pathophysiological processes at the cellular or molecular level. This problem is addressed with introduction of new molecular imaging methods as (18)F-fluorodesoxyglucose ((18)F-FDG) PET-CT and single photon emission computed tomography fused with conventional CT (SPECT/CT). Of these methods, (18)F-FDG PET-CT carries the best promise for a future role in endocarditis. But there are distinct limitations with both SPECT/CT and (18)F-FDG PET-CT which should not be neglected. MRI and spiral CT are methods primarily used in the search for extra cardial infectious foci. A flowchart for the use of imaging in both left-sided and right-sided endocarditis is suggested.

Bruun, Niels Eske; Habib, Gilbert

2014-01-01

292

Prosthetic valve endocarditis caused by Pseudomonas luteola  

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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.

Casalta Jean-Paul; Fournier Pierre-Edouard; Habib Gilbert; Riberi Alberto; Raoult Didier

2005-01-01

293

Staphylococcal endocarditis as the first manifestation of heritable protein S deficiency in childhood.  

Science.gov (United States)

A 12-year-old Japanese girl developed infective endocarditis and central nervous system disease. The previously healthy girl showed altered consciousness and abnormal behaviors along with the classical signs of septic emboli. Staphylococcus aureus was isolated from peripheral blood, but not, the pleocytotic cerebrospinal fluid. Diagnostic imaging studies revealed a vegetative structure in the morphologically normal heart, and multiple thromboembolisms in the brain and spleen. Low plasma activity of protein S (12%) and thrombophilic family history allowed the genetic study, demonstrating that she carried a heterozygous mutation of PROS1 (exon 13; 1689C > T, p.R474C). Surgical intervention of the thrombotic fibrous organization and subsequent anticoagulant therapy successfully managed the disease. There are no reports of infective endocarditis in childhood occurring as the first presentation of heritable thrombophilia. Protein S deficiency might be a risk factor for the development or exacerbation of infective endocarditis in children having no pre-existing heart disease. PMID:24462440

Hoshina, Takayuki; Nakashima, Yasutaka; Sato, Daisuke; Nanishi, Etsuro; Nishio, Hisanori; Nagata, Hazumu; Yamamura, Kenichiro; Doi, Takehiko; Shiokawa, Yuichi; Koga, Yui; Kang, Dongchon; Ohga, Shouichi; Hara, Toshiro

2014-02-01

294

Linezolid in Prophylaxis against Experimental Aortic Valve Endocarditis Due to Streptococcus oralis or Enterococcus faecalis  

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There are no experimental studies regarding the prophylactic efficacy of linezolid against infective endocarditis. Nonbacterial thrombotic endocarditis of the aortic valve was induced in rabbits by the insertion of a polyethylene catheter. Twenty-four hours later, animals were randomly assigned to a control group, and groups receiving either ampicillin (two doses of 40 mg/kg of body weight each, given intravenously, 2 h apart) or linezolid (a single per os dose of 75 mg/kg). The first dose of ampicillin and the single dose of linezolid were administered 0.5 and 1 h, respectively, prior to the intravenous inoculation of ?107 CFU of Streptococcus oralis or Enterococcus faecalis. Linezolid peak levels in rabbit serum were similar to the peak serum levels in humans following a 600-mg oral dose of linezolid. Linezolid prevented endocarditis in 87% of S. oralis-challenged rabbits (P < 0.001 versus controls; P = 0.026 versus ampicillin). In rabbits challenged with E. faecalis, linezolid prevented endocarditis in 73% (P = 0.003 versus controls; P = 0.049 versus ampicillin). Ampicillin prevented endocarditis due to S. oralis or due to E. faecalis in 47% (P = 0.005 versus controls) and in 30% (P = not significant versus controls) of the challenged animals, respectively. In conclusion, linezolid was effective as prophylaxis against endocarditis caused by a strain of S. oralis and to a lesser degree against that caused by a strain of E. faecalis. Its prophylactic efficacy was superior to that of ampicillin.

Athanassopoulos, George; Pefanis, Angelos; Sakka, Vissaria; Iliopoulos, Dimitrios; Perrea, Despina; Giamarellou, Helen

2006-01-01

295

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

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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

296

Systemic inflammatory response and local cytokine expression in porcine models of endocarditis.  

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The knowledge of systemic inflammation and local cytokine expression in porcine endocarditis models is limited, though it could provide valuable information about the pathogenesis and comparability to human endocarditis. Analyses of bacteriology and hematology were performed on blood samples from pigs with non-bacterial thrombotic endocarditis (NBTE, n = 11), Staphylococcus aureus infective endocarditis (IE, n = 2), animals with S. aureus sepsis without endocarditis (n = 2) and controls (n = 2). Furthermore, immunohistochemistry was used to examine the local expression of IL-1? and IL-8. Bacterial blood cultures were continuously positive in IE pigs from inoculation to euthanasia, and negative in all other pigs at all times. The total white blood cell counts and total neutrophil counts were massively elevated in pigs with IE. Local IL-1? and IL-8 expression in IE pigs were moderate to high, and high, respectively. In addition, slight local expression of IL-1? and IL-8 was present in some NBTE pigs. In the IE model, both the systemic inflammatory response and the high local expression of IL-8 were comparable to the human disease. Furthermore, the results indicate IL-1? and IL-8 as important contributors in the endocarditis pathogenesis. PMID:23879680

Christiansen, Johanna G; Jensen, Henrik E; Jensen, Louise K; Koch, Janne; Aalbaek, Bent; Nielsen, Ole L; Leifsson, Páll S

2014-04-01

297

 Native Valve Endocarditis Caused by Coagulase Negative Staphylococci; an Appeal to Start Outpatient Antimicrobial Therapy: An Unusual Case Report  

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Full Text Available  Coagulase negative staphylococci (CNS were a rare cause of native valve endocarditis. However, they are emerging as an important cause of native valve endocarditis (NVE in both community and healthcare settings. We describe a 64 yrs. old male who developed mitral valve endocarditis caused by coagulase negative staphylococci. There were no predisposing conditions or underlying cardiac disease that could have been the risk factor for the development of native valve infection. The patient had good recovery after six weeks of treatment with anti-staphylococcal antibiotics.

Seif Al-Abri

2011-07-01

298

Clonal structure of Streptococcus sanguinis strains isolated from endocarditis cases and the oral cavity.  

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A collection of Streptococcus sanguinis strains from patients with endocarditis (n = 21) and from the oral cavity (n = 34) was subjected to a multi-locus sequence typing analysis using seven housekeeping genes, carbamoyl-phosphate synthetase (carB), Co/Zn/Cd efflux system component (czcD), d-alanyl-d-alanine ligase (ddl), DNA polymerase III (dnaX), glucose-6-phosphate dehydrogenase (gdh), DNA-directed RNA polymerase, beta subunit (rpoB) and superoxide dismutase (sodA). The scheme was expanded by the inclusion of two the putative virulence genes, bacitracin-resistance protein (bacA) and saliva-binding protein (ssaB), to increase strain discrimination. Extensive intra-species recombination was apparent in all genes but inter-species recombination was also apparent with strains apparently harbouring gdh and ddl from unidentified sources and one isolate harboured a sodA allele apparently derived from Streptococcus oralis. The recombination/mutation ratio for the concatenated housekeeping gene sequences was 1.67 (95% confidence limits 1.25-2.72) and for the two virulence genes the r/m ratio was 3.99 (95% confidence limits 1.61-8.72); recombination was the major driver for genetic variation. All isolates were distinct and the endocarditis strains did not form distinct sub-clusters when the data were analysed using ClonalFrame. These data support the widely held opinion that infecting S. sanguinis strains are opportunistic human pathogens. PMID:21896156

Do, T; Gilbert, S C; Klein, J; Warren, S; Wade, W G; Beighton, D

2011-10-01

299

Candida tropicalis causing Prosthetic Valve Endocarditis  

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Full Text Available The incidence of endocarditis produced by the so-called "opportunists" as a complication of prosthetic valve surgery is progressively increasing in frequency and gradually transforming the clinical picture habitually associated with this disease. Candida endocarditis is an unusual but severe complication caused by Candida albicans or other fungal species. This case and a review of the literature indicate that Candida endocarditis treated with amphotericin B and prosthetic valve replacement may recur months after treatment, and that late recurrent Candida endocarditis, which is difficult to diagnose and treat, may be best prevented by lifelong antifungal suppressive therapy.

Nagaraja P

2005-01-01

300

Streptococcus Constellatus Community Acquired Pneumonia with Subsequent Isolated Pulmonic Valve Endocarditis and Abscess Formation in a Structurally Normal Heart  

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Pulmonic valve infective endocarditis in isolation is a rare clinical entity. The formation of an abscess in the right ventricular outflow tract as a consequence of vegetations affecting the pulmonic valve in a structurally normal heart is extremely rare and has not been reported. We report a case of isolated pulmonic valve endocarditis complicated by a regional abscess formed within the right ventricular outflow tract caused by Streptococcus Constellatus (S. Constellatus), a member of the Streptococcus Milleri group in a young male whose risk factor was alcohol abuse and he was treated medically, a comprehensive literature review on the subject is also reported. Our case is the first reported in literature with infective endocarditis caused by S. Constellatus affecting the pulmonic valve, and the first with pulmonic valve endocarditis and perivalvular abscess formation in a structurally normal heart.

Hutchison, Stuart James

2014-01-01

 
 
 
 
301

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

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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.

302

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

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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

303

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

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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

304

Endocarditis infecciosa y complicaciones neurológicas  

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Las complicaciones neurológicas (CN) son frecuentes en la endocarditis infecciosa (EI) y ensombrecen el pronóstico. Nuestro objetivo ha sido analizar los grupos con (EICN) y sin ellas (EISCN) para determinar los factores relacionados con las CN y prevenirlas. Se observó que la EICN es un grupo menos comórbido, con localización predominantemente en cavidades izquierdas y tendencia a la afectación por Staphylococcus aureus. No se observó relación con un retraso diagnóstico de EI ni con...

2013-01-01

305

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

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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 phlegmon-like 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. PMID:22975166

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

2012-01-01

306

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

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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

307

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.

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

308

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

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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

309

Brucella endocarditis on double valvular prosthesis.  

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The case is reported of a 48-year-old man suffering from Brucella endocarditis on a double prosthesis. The successful medical and surgical treatment is described. So far as the authors know, this is the first report of Brucella endocarditis from a heart valve prosthesis.

Lezaun, R.; Teruel, J.; Mai?tre, M. J.; Artaza, M.

1980-01-01

310

Antibiotic prophylaxis for bacterial endocarditis: A study of knowledge of guidelines among dentists participated in the 47th international congress of dentistry  

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Full Text Available "nBackground and Aim: Infective endocarditis is a rare disease resulted in mortality and morbidity in 10-80% of patients. The purpose of present study was to investigate the knowledge of guidelines on antibiotic prophylaxis for bacterial endocarditis in a group of Iranian dentists. "nMaterials and Methods: This was a descriptive study in which the population under study was 205 who were participated in the 47th international congress of dentistry (Tehran-Spring 2007 and they were chosen by census sampling methods. Nameless questionnaires were designed and were given to the dentists to complete. The t-test, ?² and spearman with the SPSS 13.5 program were used in the data analysis. P<0.05 was considered as the level of significance. "nResults: Regarding to the prescribing of prophylactic antibiotic for patients with prosthetic cardiac valves, 94.6% of all answers were correct. Also, the most common procedures in which the prophylaxis antibiotic was distinguished to be necessary were periodontal surgery, scaling, dental extraction and using subgingival cord, respectively. More than half of the dentists (65.8% had chosen amoxicillin as a prophylactic antibiotic. Mean knowledge score was 38.77±12.4. "nConclusion: Results of the present study showed that the knowledge of dentists about prescribing antibiotics for prevention of bacterial endocarditis is relatively low. It was also found that the level of knowledge decreases by passing time from graduation.

Hashemipour M.

2008-12-01

311

Pacemaker Lead Endocarditis Due to Multidrug-Resistant Corynebacterium striatum Detected with Sonication of the Device ?  

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Corynebacterium striatum is a commensal of human skin and has been recently recognized as an emerging pathogen. A case of nosocomial pacemaker lead endocarditis due to a multidrug-resistant C. striatum strain is described, highlighting the role of sonication as a diagnostic tool in cardiac device infections.

2010-01-01

312

Successful surgical intervention in an unusual case of Aspergillus endocarditis with acute myeloid leukemia.  

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Endocarditis due to Aspergillus infection is a rare complication in patients with hematological malignancies. Here, we present a case of aspergillus endocarditis in a patient with acute myeloid leukemia (AML) successfully treated with antifungal therapy and surgical treatment. The patient was a 51 years old male, a known case of AML who was admitted to our medical center for evacuating his valvular vegetations and repairing his atrial septal defect. He underwent an open heart surgery to relinquish his thromboses and also received an antifungal regimen. The patient tolerated the procedure well and eight months after his surgery, the patient remains asymptomatic. Successful treatment of this severe case of aspergillus endocarditis justifies a multidisciplinary method to be as a safe and effective approach to manage these patients. PMID:23945898

Ansari Aval, Zahra; Mirhosseini, Seyed Mohsen; Fakhri, Mohammad; Mozaffary, Amirhossein; Adimi Naghan, Parisa; Behzadnia, Neda; Ahmadi, Zargham-Hossein

2013-01-01

313

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

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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

314

Tricuspid endocarditis in hyper-IgE syndrome  

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Full Text Available Hyper-IgE syndrome is a congenitally acquired primary immune deficiency condition. We report a case of possible hyper-IgE syndrome who presented with multiple cold skin abscesses and chest infection due to Staphylococcus aureus and hyper-IgE findings. Patient also had tricuspid valve acute bacterial endocarditis with purulent pericarditis which is very rare. This case is presented to highlight that early diagnosis and treatment in such cases decreases the mortality and morbidity in phagocytic disorders.

Gupta S

2010-01-01

315

Endocarditis lenta-patient survived septic shock: a case report  

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Full Text Available Infective endocarditis is defi ned as an infection of the endocardial surface of the heart. Its intracardiac effects include severe valvular insuffi ciency, which may lead to intractable congestive heart failure and myocardialabscesses. This disease still carries a poor prognosis and a high mortality.A severe case of infective endocarditis with its complications is presented. A man with aortic prosthetic valve due to earlier aortic stenosis and corrected aortal coarctation and implanted pacemaker presentedwith prolonged unexplained fever, malaise, sweating, weight loss (15 kg/4 months and lumbar pain. He was treated with broad-spectrum antibiotics prior IE diagnosis was considered. Echocardiogram showedaortic vegetations and possible periaortal abscess formation. Nonspecifi c infl ammation parameters were high positive. Cultures were constantly negative. His condition had deteriorated suddenly, and he had presentedwith worsening of cutaneous vasculitis, subacute glomerulonephritis and subsequent acute respiratory distress syndrome and septic shock. This patient survived with residual bilateral necrosis of the feet andtoxic peroneal paresis. At the end transthoracic echocardiogram showed enlarged heart chambers, LV mild dilated and concentric hypertrophy with ejection fraction about 40%, degenerative postinfl ammatory mitralvalve changes, mild mitral regurgitation and tricuspid regurgitation, postinfl ammatory aortic root fi brosis and moderate aortic valve stenosis (AVPG max 50,9 mmHg, AVPG mean 24 mmHg with no pericardial effusion. Initial suspicion of Q fever was defi nitely excluded by serological testing showing nonspecifi c IgM positivity,probably rheumatoid factor related.

Amra Maci? Džankovi?

2012-09-01

316

Prosthetic valve endocarditis caused by Scedosporium apiospermum.  

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Scedosporium apiospermum, the asexual state of Pseudallescheria boydii, is increasingly recognized as an opportunistic pathogen. We report a case of prosthetic valve endocarditis caused by this organism that developed in a patient following cardiac surgery. PMID:16327126

Verghese, S; Padmaja, P; Chellamma, M T; Leelavathy, S; Nayar, P

2005-10-01

317

Prosthetic valve endocarditis caused by scedosporium apiospermum  

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Full Text Available Scedosporium apiospermum , the asexual state of Pseudallescheria boydii , is increasingly recognized as an opportunistic pathogen. We report a case of prosthetic valve endocarditis caused by this organism that developed in a patient following cardiac surgery.

Verghese S

2005-01-01

318

Infectious endocarditis and chylothorax in a cat.  

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A 6 yr old domestic longhair cat was evaluated for progressive weight loss, weakness, and dyspnea. Results of a physical examination and electrocardiogram were suggestive of cardiac disease. Thoracic radiographs revealed pleural effusion, which thoracocentesis revealed was consistent with chyle. An echocardiogram was performed, and aortic valve endocarditis with secondary aortic insufficiency was presumptively diagnosed. The cat was treated with broad-spectrum oral antibiotics and palliative cardiac medications. Two days after discharge, the cat's dyspnea returned, and it died suddenly. Histopathology and culture confirmed Pseudomonas bacterial endocarditis of the aortic valve. Bacterial endocarditis in the cat has rarely been reported in the literature. This case described heart failure and chylothorax resulting from bacterial endocarditis. PMID:22058358

Dixon-Jimenez, Amy; Margiocco, Marco L

2011-01-01

319

Prognostic factors in left-sided endocarditis: results from the andalusian multicenter cohort  

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Full Text Available Abstract Background Despite medical advances, mortality in infective endocarditis (IE is still very high. Previous studies on prognosis in IE have observed conflicting results. The aim of this study was to identify predictors of in-hospital mortality in a large multicenter cohort of left-sided IE. Methods An observational multicenter study was conducted from January 1984 to December 2006 in seven hospitals in Andalusia, Spain. Seven hundred and five left-side IE patients were included. The main outcome measure was in-hospital mortality. Several prognostic factors were analysed by univariate tests and then by multilogistic regression model. Results The overall mortality was 29.5% (25.5% from 1984 to 1995 and 31.9% from 1996 to 2006; Odds Ratio 1.25; 95% Confidence Interval: 0.97-1.60; p = 0.07. In univariate analysis, age, comorbidity, especially chronic liver disease, prosthetic valve, virulent microorganism such as Staphylococcus aureus, Streptococcus agalactiae and fungi, and complications (septic shock, severe heart failure, renal insufficiency, neurologic manifestations and perivalvular extension were related with higher mortality. Independent factors for mortality in multivariate analysis were: Charlson comorbidity score (OR: 1.2; 95% CI: 1.1-1.3, prosthetic endocarditis (OR: 1.9; CI: 1.2-3.1, Staphylococcus aureus aetiology (OR: 2.1; CI: 1.3-3.5, severe heart failure (OR: 5.4; CI: 3.3-8.8, neurologic manifestations (OR: 1.9; CI: 1.2-2.9, septic shock (OR: 4.2; CI: 2.3-7.7, perivalvular extension (OR: 2.4; CI: 1.3-4.5 and acute renal failure (OR: 1.69; CI: 1.0-2.6. Conversely, Streptococcus viridans group etiology (OR: 0.4; CI: 0.2-0.7 and surgical treatment (OR: 0.5; CI: 0.3-0.8 were protective factors. Conclusions Several characteristics of left-sided endocarditis enable selection of a patient group at higher risk of mortality. This group may benefit from more specialised attention in referral centers and should help to identify those patients who might benefit from more aggressive diagnostic and/or therapeutic procedures.

de la Torre-Lima Javier

2010-01-01

320

Scopulariopsis endocarditis associated with Duran ring valvuloplasty.  

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Fungal endocarditis is rare and is usually caused by Aspergillus and Candida species. We present a patient with endocarditis caused by Scopulariopsis brevicaulis. The patient had a history of mitral valve disease and, 1 year earlier, had undergone valvuloplasty with the placement of a prosthetic Duran ring in the mitral valve position. S. brevicaulis was cultured from samples of a large vegetation on the mitral valve apparatus. The mitral valve was replaced with a St. Jude mechanical prosthes...

Gentry, L. O.; Nasser, M. M.; Kielhofner, M.

1995-01-01

 
 
 
 
321

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

Sen Yew, Haur; 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

322

Ampicillin (parenteral): prevention of infective endocarditis.  

Science.gov (United States)

This Hospital Pharmacy feature is extracted from Off-Label Drug Facts, a publication available from Wolters Kluwer Health. Off-Label Drug Facts is a practitioner-oriented resource for information about specific drug uses that are unapproved by the US Food and Drug Administration. This new guide to the literature enables the health care professional or clinician to quickly identify published studies on off-label uses and determine if a specific use is rational in a patient care scenario. References direct the reader to the full literature for more comprehensive information before patient care decisions are made. Direct questions or comments regarding Off-Label Drug Uses to jgeneral@kumc.edu. PMID:24421506

Generali, Joyce A; Cada, Dennis J

2013-06-01

323

Takayasu Arteritis Initially Mimicking Infective Endocarditis  

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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 sten...

Aytekin Alcelik; Sevim Karacay; Ismail Necati Hakyemez; Busra Akin; Serkan Ozturk; Haluk Savli

2011-01-01

324

A New Risk Factor for Infective Endocarditis  

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A implantação de piercings corporais tem sido uma prática cada vez mais comum nas últimas décadas, sobretudo entre os mais jovens. No entanto, não se trata de um procedimento inócuo, podendo apresentar complicações tão graves como a endocardite infecciosa, que pode surgir em indivíduos com ou sem cardiopatia de base. Neste artigo relatamos o caso de uma endocardite pós piercing numa jovem com pacemaker definitivo, tendo havido necessidade de intervenção cirúrgica. Fazemos igual...

2009-01-01

325

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

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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

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

327

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.

328

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

329

First report of endocarditis by Gluconobacter spp. in a patient with a history of intravenous-drug abuse.  

Science.gov (United States)

Gluconobacter belongs to the acetic acid bacteria (AAB), which are microorganisms commonly found in the environment and used in the food industry. These bacteria have increasingly been reported as organisms that can potentially infect humans. We report a case of Gluconobacter spp. bloodstream infection associated with endocardial lesions in a 25 year-old female intravenous drug abuser. To the best of our knowledge, this is the first case of Gluconobacter spp. endocarditis reported in the literature. For the first time we report that a multiresistant strain belonging to the genus Gluconobacter can cause endocarditis, giving evidence to the fact that this microorganism should be considered a new opportunistic human pathogen. PMID:22634600

Bassetti, M; Pecori, D; Sartor, A; Londero, A; Villa, G; Cadeo, B; Brillo, F; Bongiorno, D; Campanile, F; Stefani, S

2013-03-01

330

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

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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

331

Virulence factors and antibiotic susceptibility in enterococci isolated from oral mucosal and deep infections  

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This study evaluates the presence of virulence factors and antibiotic susceptibility among enterococcal isolates from oral mucosal and deep infections. Forty-three enterococcal strains from oral mucosal lesions and 18 from deep infections were isolated from 830 samples that were sent during 2 years to Oral Microbiology, University of Gothenburg, for analysis. The 61 strains were identified by 16S rDNA, and characterized by the presence of the virulence genes efa A (endocarditis gene), gel E (...

Gunnar Dahlén; Susanne Blomqvist; Hl, Annica Almst X. E.; Anette Carlén

2012-01-01

332

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

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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 ...

Sundaram Ponnusamy; Bijulal Sasidharan; Tharakan Jaganmohan; Antony Molly

2011-01-01

333

{sup 18}F-FDG PET/CT diagnosis of unexpected extracardiac septic embolisms in patients with suspected cardiac endocarditis  

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Acute infective endocarditis is a potentially life-threatening disease. Its outcome strongly depends on systemic embolization and extracardiac infections. When present, these conditions usually lead to a more aggressive therapeutic approach. However, the diagnosis of peripheral septic embolism is very challenging. {sup 18}F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT has proven to be accurate for the detection of inflammatory diseases and occult infections. The aim of this study was to assess the added value of {sup 18}F-FDG PET/CT in the detection of extracardiac embolisms in the evaluation of patients with suspected valvular endocarditis (VE). Seventy-one patients with suspected infective endocarditis, enrolled between June 2010 and December 2012, underwent {sup 18}F-FDG PET/CT with the standard procedure on a dedicated PET/CT scanner. Extracardiac findings were subsequently evaluated with other imaging procedures. Of the 71 patients with suspicion of infective endocarditis, we found unexpected extracardiac findings in 17 patients (24 %) without any clinical suspicion. Extracardiac findings were subsequently evaluated with other imaging procedures. PET/CT detected unexpected extra sites of infection in 24 % of cases, leading to changes in therapeutic management in a very relevant percentage of patients. These findings may have important therapeutic implications. (orig.)

Bonfiglioli, Rachele; Nanni, Cristina; Morigi, Joshua James; Ambrosini, Valentina; Fanti, Stefano [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Nuclear Medicine, Bologna (Italy); Graziosi, Maddalena; Rapezzi, Claudio [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Cardiology, Bologna (Italy); Trapani, Filippo; Bartoletti, Michele; Tumietto, Fabio; Viale, Pier Luigi [Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Infective Diseases, Bologna (Italy); Ferretti, Alice; Rubello, Domenico [Azienda Ospedaliera S. Maria della Misericordia, Nuclear Medicine, Radiology, Neuroradiology, Medical Physics, Rovigo (Italy)

2013-08-15

334

Enterococcal endocarditis after extracorporeal shock wave lithotripsy for nephrolithiasis.  

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We report a case of enterococcal endocarditis following extracorporeal shock wave lithotripsy (ESWL) for ureteral stone. Although endocarditis following ESWL is very rare, transient bacteraemia occurs during ESWL. This case is a reminder that enterococcal endocarditis may follow innovative genitourinary procedures without appropriate prophylaxis.

1996-01-01

335

First case of Fusobacterium necrophorum endocarditis to have presented after the 2nd decade of life.  

Science.gov (United States)

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. We describe the case of a previously healthy 34-year-old man who emergently presented with flu-like symptoms and dyspnea on exertion. He had recently undergone a dental procedure. Empiric antibiotic therapy was initiated. Blood cultures were positive for metronidazole-resistant F. necrophorum. A transesophageal echocardiogram revealed 2 mobile vegetations on the mitral valve. Despite the antibiotic therapy, the patient's respiratory status worsened and, after 3 weeks, he died. On the basis of the organism's pathophysiology and the patient's recent dental procedure, the oral cavity was the likely source of the bacteremia. Our patient's case underscores the importance of recognizing Fusobacterium bacteremia as a possible cause of endocarditis. To our knowledge, this is the first reported case of monomicrobial F. necrophorum endocarditis to have presented in a patient after the 2nd decade of life. In addition, it is apparently only the 4th report of F. necrophorum mitral valve endocarditis with case results derived from modern culture techniques. PMID:24082377

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

2013-01-01

336

Cecocentral scotoma as the initial manifestation of subacute bacterial endocarditis  

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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

337

Rothia dentocariosa endocarditis and aortic root abscess.  

Science.gov (United States)

We report a case of endocarditis and associated paravalvular abscess due to Rothia dentocariosa which did not respond to antibiotic therapy. Nine case reports describing endocarditis caused by this organism, formerly thought to be non-pathogenic, have been recorded in the literature. The isolates were extremely sensitive to penicillin, and eight patients responded to this agent which, in most cases, was used in combination with an aminoglycoside. Surgery is recommended for an associated abscess, as the outcome in the two recorded cases has been fatal. PMID:9892536

Ferraz, V; McCarthy, K; Smith, D; Koornhof, H J

1998-11-01

338

First Case of Streptococcus oligofermentans Endocarditis Determined Based on sodA Gene Sequences after Amplification Directly from Valvular Samples?  

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We report the first case of infection due to Streptococcus oligofermentans, which is a recently described oral Streptococcus species. It was responsible for the endocarditis and left forearm abscess of a 43-year-old woman. Identification was made using molecular techniques performed directly from valvular and surgical samples.

2009-01-01

339

Evaluation of noninvasive methods for the diagnosis of fungal endocarditis.  

Science.gov (United States)

Fungal endocarditis (FE) is an uncommon disease with a high risk of morbidity and mortality. Here, we evaluated the different methods for diagnosing this infection. Cardiac valve, vegetation, and embolic materials obtained during surgery were examined for fungal infections by direct smear and culture. At least two blood samples were inoculated at the bedside into BACTEC medium. Galactomannan, mannan Ag enzyme-linked immunosorbent assay, and real-time polymerase chain reaction (PCR) assay were performed with serum samples. Of 25 patients with suspected infective endocarditis (IE), 8 were found to have proven FE according to the direct culture results. The etiologic agents were Aspergillus niger (three cases), A. flavus (two cases), A. fumigatus (one case), and Candida albicans (two cases). Blood culture was positive in only 1 case. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of the results from the galactomannan test were 83.3%, 84.2%, 62.5%, 94.1%, 5.3, and 0.2; these same values, obtained from real-time PCR, were 87.5%, 94.4%, 87.5%, 94.4%, 15.6, and 0.14, respectively. Because mannan antigen was positive in samples from only one patient, we opted not to calculate the sensitivity. However, the specificity value in 23 cases without IE caused by Candida spp. was 100%. Based on our results, both the galactomannan test and real-time PCR can serve as reliable, noninvasive tests for the diagnosis of FE, compared with culture, which is considered to be the gold standard. PMID:24915853

Badiee, Parisa; Amirghofran, Ahmad Ali; Ghazi Nour, Mohammad

2014-07-01

340

Daptomycin-nonsusceptible, vancomycin-intermediate, methicillin-resistant Staphylococcus aureus endocarditis  

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Due to the emergence of Staphylococcus aureus with reduced vancomycin susceptibility, newer antibiotics, including daptomycin, have been used to treat methicillin-resistant S aureus infections. Daptomycin is a cyclic lipopeptide that is approved to treat S aureus bacteremia and right-sided endocarditis, and reports of S aureus with reduced susceptibility to daptomycin are infrequent. To our knowledge, the present report describes the first Canadian case of daptomycin-nonsusceptible, vancomyci...

2012-01-01

 
 
 
 
341

The Pitfalls of Transthoracic Echocardiography: A Case of Eustachian Valve Endocarditis  

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A case of infective endocarditis involving the vestigial eustachian valve is presented and the available English medical literature is reviewed. Only 5 prior cases have been reported: 4 of those required transesophageal echocardiography for diagnosis, and the other was found at autopsy. This clinical entity is routinely missed on transthoracic echocardiography. Injection drug use is a common predisposing factor, and Staphylococcus aureus is the most commonly identified organism.

Bowers, Jamelle; Krimsky, William; Gradon, Jeremy D.

2001-01-01

342

Complication of nasal piercing by Staphylococcus aureus endocarditis: a case report and a review of literature  

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Body piercing, a growing trend especially in young people, is often complicated by severe infections. We present a case of acute bacterial endocarditis by Staphylococcus aureus complicated by multiple cerebral, kidney, spleen embolisms in a young girl, with no known previous cardiac abnormalities, following the piercing of nasal septum. This case highlights the importance of education of patients with and without structural heart disease to the potential dangerous and even life threatening in...

Giuliana, Battagin; Loredana, Sarmati; Pasquale, Sordillo; Giovanna, Picchi; Giorgio, Calisti; Laura, Ceccarelli; Pellegrino, Antonio; Paolo, Nardi; Luigi, Chiariello; Massimo, Andreoni

2010-01-01

343

Tissue factor is a major stimulus for vegetation formation in enterococcal endocarditis in rabbits.  

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We examined the possible mechanisms of local initiation of coagulation in vegetation formation in enterococcal endocarditis by using a rabbit model. Contact activation and tissue factor expression by freshly excised aortic valves were assessed using assays developed for use with cultured cells. Bacteria alone lacked procoagulant activity and contact activation of plasma by excised valves did not occur. 4-d infected but not control valves expressed significant tissue factor activity (231 +/- 1...

Drake, T. A.; Rodgers, G. M.; Sande, M. A.

1984-01-01

344

Contribution of Lipoproteins and Lipoprotein Processing to Endocarditis Virulence in Streptococcus sanguinis? §  

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Streptococcus sanguinis is an important cause of infective endocarditis. Previous studies have identified lipoproteins as virulence determinants in other streptococcal species. Using a bioinformatic approach, we identified 52 putative lipoprotein genes in S. sanguinis strain SK36 as well as genes encoding the lipoprotein-processing enzymes prolipoprotein diacylglyceryl transferase (lgt) and signal peptidase II (lspA). We employed a directed signature-tagged mutagenesis approach to systematica...

Das, Sankar; Kanamoto, Taisei; Ge, Xiuchun; Xu, Ping; Unoki, Takeshi; Munro, Cindy L.; Kitten, Todd

2009-01-01

345

Prognostic factors in left-sided endocarditis: results from the andalusian multicenter cohort  

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Abstract Background Despite medical advances, mortality in infective endocarditis (IE) is still very high. Previous studies on prognosis in IE have observed conflicting results. The aim of this study was to identify predictors of in-hospital mortality in a large multicenter cohort of left-sided IE. Methods An observational multicenter study was conducted from January 1984 to December 2006 in seven hospitals in Andalusia, Spain. Seven hundred and five left-side I...

Gálvez-Acebal Juan; Rodríguez-Baño Jesús; Martínez-Marcos Francisco J; Reguera Jose M; Plata Antonio; Ruiz Josefa; Marquez Manuel; Lomas Jose M; de la Torre-Lima Javier; Hidalgo-Tenorio Carmen; de Alarcón Arístides

2010-01-01

346

Ecto-5?-Nucleotidase: A Candidate Virulence Factor in Streptococcus sanguinis Experimental Endocarditis  

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Streptococcus sanguinis is the most common cause of infective endocarditis (IE). Since the molecular basis of virulence of this oral commensal bacterium remains unclear, we searched the genome of S. sanguinis for previously unidentified virulence factors. We identified a cell surface ecto-5?-nucleotidase (Nt5e), as a candidate virulence factor. By colorimetric phosphate assay, we showed that S. sanguinis Nt5e can hydrolyze extracellular adenosine triphosphate to generate adenosine. Moreover...

2012-01-01

347

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

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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 lite...

Giovanni Satta; Rebecca Louise Gorton; Hala Kandil

2012-01-01

348

Staphylococcus Lugdunensis Native Tricuspid Valve Endocarditis: a Case Report and Review of Literature  

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Coagulase negative staphylococci are skin commensals and are generally disregarded as contaminants in clinical specimens. Repeated isolation of coagulase negative staphylococci in blood cultures should warrant a species identification to recognize unusually virulent organisms that demand aggressive treatment, such as Staphylococcus lugdunensis. Staphylococcus lugdunensis is known to cause a wide variety of infections, including a predominant left-sided endocarditis. We report a rare case of n...

Patil, Ritesh; Patil, Trupti; Hussain, K. M. Anwar

2011-01-01

349

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

Directory of Open Access Journals (Sweden)

Full Text Available 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

2012-04-01

350

Endocarditis por Coxiella burnetii: fiebre Q / Coxiella burnetii endocarditis: Q fever  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish La fiebre Q es una zoonosis causada por Coxiella burnetii; más frecuente en Europa pero reportada en otros continentes, puede cursar en forma aguda o crónica. La endocarditis es una forma de presentación crónica con curso insidioso y se asocia frecuentemente a fenómenos embólicos, representa 1% de t [...] odos los casos de endocarditis en el mundo. El diagnóstico se realiza por la sospecha clínica, cultivos negativos para patógenos convencionales y la confirmación serológica. Este artículo describe el caso clínico de un paciente con endocarditis causada por Coxiella burnetii y se revisa la literatura. (Acta Med Colomb 2012: 37: 31-33). Abstract in english Q fever is a zoonosis caused by Coxiella burnetii. Q fever may present as subacute or chronic endocarditis, has a high incidence of embolic phenomena and is often fatal, representing 1% of all cases of endocarditis worldwide. Q fever most commonly presents an insidious course. The diagnosis is made [...] by clinical suspicion after serial blood cultures for conventional pathogens are negative and by serological confirmation. This article describes the clinical case of a patient with endocarditis caused Coxiella burnetii and updated review of the literature. (Acta Med Colomb 2012: 37: 31-33).

Betancur, Carlos Alberto; Múnera, Ana G.

351

Endocarditis por Coxiella burnetii: fiebre Q Coxiella burnetii endocarditis: Q fever  

Directory of Open Access Journals (Sweden)

Full Text Available La fiebre Q es una zoonosis causada por Coxiella burnetii; más frecuente en Europa pero reportada en otros continentes, puede cursar en forma aguda o crónica. La endocarditis es una forma de presentación crónica con curso insidioso y se asocia frecuentemente a fenómenos embólicos, representa 1% de todos los casos de endocarditis en el mundo. El diagnóstico se realiza por la sospecha clínica, cultivos negativos para patógenos convencionales y la confirmación serológica. Este artículo describe el caso clínico de un paciente con endocarditis causada por Coxiella burnetii y se revisa la literatura. (Acta Med Colomb 2012: 37: 31-33.Q fever is a zoonosis caused by Coxiella burnetii. Q fever may present as subacute or chronic endocarditis, has a high incidence of embolic phenomena and is often fatal, representing 1% of all cases of endocarditis worldwide. Q fever most commonly presents an insidious course. The diagnosis is made by clinical suspicion after serial blood cultures for conventional pathogens are negative and by serological confirmation. This article describes the clinical case of a patient with endocarditis caused Coxiella burnetii and updated review of the literature. (Acta Med Colomb 2012: 37: 31-33.

Carlos Alberto Betancur

2012-01-01

352

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

353

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"

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

354

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.

355

[ Bacterial endocarditis of the pulmonary valve damaged by thoracic radiotherapy (in Hodgkin's disease)].  

Science.gov (United States)

It is well known that radiation therapy to the anterior mediastinum may induce lesions of all cardiac structures. The pericardium is most frequently involved, but atrioventricular conduction disorders, cardiomyopathy, coronary stenosis may also be produced. Aortic, mitral and tricuspid lesions have been described. However, clinical evidence of pulmonic valve involvement has not been reported. Only at necropsy has fibrotic thickening of the pulmonic cusps occasionally been found. We report a case of infective endocarditis of the pulmonic valve in a 53-year-old patient who had undergone thoracic radiation therapy for Hodgkin's disease 31 years previously. Four years prior to the endocarditis he had also been submitted to myocardial revascularisation for critical lesions of the left main and right coronary ostia, and to aortic valve replacement because of stenosis and insufficiency. At that time, the pulmonic valve was fibrotic on echo examination. It is noteworthy that, of all the cardiac valves, the infective process involved only the pulmonic one, which is seldom the target of an infection. To our knowledge this is the first case of bacterial endocarditis of a heart valve that had been previously damaged by radiation therapy. PMID:1790826

Conte, M R; Orzan, F; Figliomeni, M C; Mangiardi, L; Brusca, A

1991-09-01

356

Aortic valvular endocarditis in a dog  

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A 4-year-old German Shepherd was evaluated for progressive depression, lethargy, anorexia, and dyspnea. Despite treatment with diuretics and antibiotics, the dog died. Based on clinical, radiographic, and pathologic findings, the diagnosis was heart failure resulting from aortic valvular endocarditis.

Brown, Valerie A.

2004-01-01

357

Aortic valve endocarditis by Capnocytophaga haemolytica.  

Science.gov (United States)

We report a case of a 51-year-old patient with suspected prosthetic valve endocarditis. Capnocytophaga haemolytica was isolated in blood cultures and the repeated echocardiograms showed growth of vegetations and disruption of the proximal prosthetic valve suture line with progressive aortic regurgitation. The patient underwent a root debridement and replacement with a stentless bioprosthesis. PMID:17720421

Gutierrez-Martin, Maria A; Araji, Omar A; Barquero, Jose M; Velázquez, Carlos; García-Borbolla, Mariano; Gallego, Pastora; Infantes, Carlos A

2007-09-01

358

[Aortopulmonary infectious endocarditis with fatal evolution: a case report].  

Science.gov (United States)

We report the case of an aortic and pulmonary infective endocarditis in a 25-year-old patient originating from Guinea Conakry. The patient did not have any particular cardiovascular antecedent. He is allowed in a table of total heart failure and fever. The transthoracic echocardiography found vegetations on the level of sigmoid aortic and pulmonary ones. A probabilistic bi-antibiotherapy was instituted while waiting for the results of hemocultures. The patient was apyretic after one week, with regression of inflammatory biological syndrome. However, he was deceased after 20 days in a table of heart failure. The necropsy found vegetations on the level of sigmoid aortic and pulmonary ones, which were perforated, a right lung oedema and a cardiac liver. PMID:20709313

Ndiaye, M B; Diao, M; Pessinaba, S; Kane, Ad; Mbaye, A; Bodian, M; Dia, M M; Yaméogo, N V; Sarr, M; Kane, A; Ba, S A

2012-04-01

359

Fungal endocarditis: evidence in the world literature, 1965-1995.  

Science.gov (United States)

We analyzed 270 cases of fungal endocarditis (FE) that occurred over 30 years. Vascular lines, non-cardiac surgery, immunocompromise and injection drug abuse are increasing risk factors. Delayed or mistaken diagnosis (82% of patients), long duration of symptoms before hospitalization (mean +/- standard deviation, 32+/-39 days) and extracardiac manifestations were characteristic. From 1988 onwards, 72% of patients were diagnosed preoperatively, compared with 43% before 1988 (P=.0001). The fungi most commonly isolated were Candida albicans (24% of patients), non-albicans species of Candida (24%), Apergillus species (24%), and Histoplasma species (6%); recently-emerged fungi accounted for 25% of cases. The mortality rate was 72%. Survival rates were better among patients who received combined surgical-antifungal treatment, were infected with Candida, and had univalvular involvement. Improvement in the survival rate (from or =4 years while on prophylactic antifungal therapy. PMID:11118386

Ellis, M E; Al-Abdely, H; Sandridge, A; Greer, W; Ventura, W

2001-01-01

360

Rapid reversion of Loeffler's endocarditis by imatinib in early stage clonal hypereosinophilic syndrome.  

Science.gov (United States)

Endomyocardial fibrosis (Loeffler's endocarditis) is the main cause of poor outcome in Hyper Eosinophilic Syndrome (HES) and Eosinophilic Leukemia (EL). Reversion of the cardiac damage has been seldom reported, and thrombi can superimpose on infiltrated walls, originating oembolic complications. The tyrosine kynase inhibitor imatinib has been recently employed in patients affected by HES or EL, with impressive results. We have treated with imatinib a young patient affected by Loeffler's endocarditis during EL. Loeffler's endocarditis was studied by transthoracic Doppler echocardiography with and without the contrast agent SonoVue. Cytogenetics, FISH and molecular analysis showed the presence of the FIP1L1/PDGFRA fusion gene, recently detected in a majority of HES patients. Standard echocardiography revealed a large infiltration of the apical region, with apparently pedunculate corpora floating in the LV chamber; after SonoVue injection, a thick endo-myocardial infiltration involving papillary muscles and tendinous chords appeared, which simulated mobile thrombi at standard echography. Treatment with low dose imatinib caused rapid regression of both eosinophilic proliferation and endomyocardiopathy. The fusion gene FIP1L1-PDGFRA was found significantly decreased after a few months of treatment. Using a contrast echocardiographic approach, we demonstrated the non-thrombotic origin of the "in plus" image in our patient and its rapid resolution following imatinib treatment. Imatinib is an excellent candidate for first line treatment of Loeffler's endocarditis, especially when the FIP1L1/PDGFA fusion gene is detected. PMID:15621768

Rotoli, Bruno; Catalano, Lucio; Galderisi, Maurizio; Luciano, Luigia; Pollio, Giuditta; Guerriero, Anna; D'Errico, Arcangelo; Mecucci, Cristina; La Starza, Roberta; Frigeri, Ferdinando; Di Francia, Raffaele; Pinto, Antonio

2004-12-01

 
 
 
 
361

Severe mitral stenosis as the first manifestation of systemic lupus erythematosus in a 20-year-old woman: the value of magnetic resonance imaging in the diagnosis of Libman-Sacks endocarditis.  

Science.gov (United States)

We report a case of severe mitral stenosis caused by Libman-Sacks endocarditis, as an initial manifestation of systemic lupus erythematosus (SLE) in a 20-year-old woman. Cardiac magnetic resonance imaging (MRI) demonstrated a thickening of the mitral valve with basal endocardial thickening exhibiting defect on first-pass perfusion short-axis acquisition and delayed enhancement in keeping with extensive fibrous endocarditis. The patient underwent successful mechanical mitral valve replacement. This case illustrates that MRI is useful in diagnosing this recognised but uncommon cardiac complication of SLE and excluding differential diagnosis such as valve tumour and infective endocarditis with perivalvular abscesses. PMID:24715438

Gouya, Hervé; Cabanes, Laure; Mouthon, Luc; Pavie, Alain; Legmann, Paul; Vignaux, Olivier

2014-06-01

362

Rare Association of Henoch-Schönlein Purpura with Recurrent Endocarditis  

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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

363

Technique to treat extensive abscesses in double valve replacement for prosthetic valve endocarditis.  

Science.gov (United States)

A 52-year-old man, who underwent double valve replacement for native valve infectious endocarditis, developed prosthetic valve endocarditis (PVE) at nine months after the initial operation. Operative findings revealed a wide aortic annular abscess, which extended through the intervalvular fibrous body to the mitral annulus. The infected mitral valve was excised through the atrial septum. After complete debridement of the abscess, a xenopericardial patch was sutured on to the abscessed area in the partially destroyed intervalvular fibrous body. Using this procedure, the affected annuli were reinforced and the abscessed area was isolated from the blood flow, reducing the probability of recurrent endocarditis. For valve implantation, 'anchoring' sutures were threaded externally through the aortic root, taking into consideration the fragility of the reconstructed annulus. The patient recovered with intensive administration of antibiotics and showed no sign of recurrent infection. The reinforcement of the intervalvular fibrous body and the use of 'anchoring' sutures may represent good alternatives for the surgical treatment of PVE. PMID:24224423

Nonaka, Michihito; Iwakura, Atsushi; Yamanaka, Kazuo

2013-07-01

364

In Vivo Activities of Evernimicin (SCH 27899) against Vancomycin-Susceptible and Vancomycin-Resistant Enterococci in Experimental Endocarditis  

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To assess the potential efficacy of evernimicin (SCH 27899) against serious enterococcal infections, we used a rat model of aortic valve endocarditis established with either a vancomycin-susceptible Enterococcus faecalis or a vancomycin-resistant Enterococcus faecium strain. Animals infected with either one of the test strains were assigned to receive no treatment (controls) or 5-day therapy with one of the following regimens: evernimicin 60-mg/kg of body weight intravenous (i.v.) bolus once ...

Souli, Maria; Thauvin-eliopoulos, Claudie; Eliopoulos, George M.

2000-01-01

365

Efficacy of oxacillin and ampicillin-sulbactam combination in experimental endocarditis caused by beta-lactamase-hyperproducing Staphylococcus aureus.  

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Optimal therapy of infections caused by borderline oxacillin-susceptible, beta-lactamase-hyperproducing Staphylococcus aureus has not been established. We used a rat model of aortic valve endocarditis to examine efficacies of antibiotic regimens against a borderline oxacillin-susceptible strain as compared with a fully susceptible S. aureus strain. Animals were treated with oxacillin alone or in combination with sulbactam or with ampicillin-sulbactam combinations at two dose levels. Infection...

1990-01-01

366

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.

Tounsi, A.; Abid, L.; Akrout, M.; Hentati, M.; Kammoun, S.

2012-01-01

367

In vivo detection of Staphylococcus aureus endocarditis by targeting pathogen-specific prothrombin activation.  

Science.gov (United States)

Coagulase-positive Staphylococcus aureus (S. aureus) is the major causal pathogen of acute endocarditis, a rapidly progressing, destructive infection of the heart valves. Bacterial colonization occurs at sites of endothelial damage, where, together with fibrin and platelets, the bacteria initiate the formation of abnormal growths known as vegetations. Here we report that an engineered analog of prothrombin could be used to detect S. aureus in endocarditic vegetations via noninvasive fluorescence or positron emission tomography (PET) imaging. These prothrombin derivatives bound staphylocoagulase and intercalated into growing bacterial vegetations. We also present evidence for bacterial quorum sensing in the regulation of staphylocoagulase expression by S. aureus. Staphylocoagulase expression was limited to the growing edge of mature vegetations, where it was exposed to the host and co-localized with the imaging probe. When endocarditis was induced with an S. aureus strain with genetic deletion of coagulases, survival of mice improved, highlighting the role of staphylocoagulase as a virulence factor. PMID:21857652

Panizzi, Peter; Nahrendorf, Matthias; Figueiredo, Jose-Luiz; Panizzi, Jennifer; Marinelli, Brett; Iwamoto, Yoshiko; Keliher, Edmund; Maddur, Ashoka A; Waterman, Peter; Kroh, Heather K; Leuschner, Florian; Aikawa, Elena; Swirski, Filip K; Pittet, Mikael J; Hackeng, Tilman M; Fuentes-Prior, Pablo; Schneewind, Olaf; Bock, Paul E; Weissleder, Ralph

2011-09-01

368

Surgery for fulminant prosthetic valve endocarditis after transapical transcatheter aortic valve-in-valve implantation.  

Science.gov (United States)

We report the clinical course of a patient with a history of transapical aortic "valve-in-valve" transcatheter aortic valve implantation (TAVI), actually suffering from prosthetic valve endocarditis. The patient now underwent cardiac surgery as a salvage procedure. The procedure itself was uneventful, but the patient died several days postoperative due to persisting sepsis. The present case raises the question, how to deal with high-risk patients, once considered unsuitable for cardiac surgery in presence of prosthetic valve infection? Up to now, there exists only insufficient knowledge about incidence, clinical course, and effectiveness of treatment strategies for prosthetic valve endocarditis after TAVI. A review of the available literature is given. PMID:23344757

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

2014-02-01

369

Fatal rupture of aortic root abscess following native aortic valve enterococcal endocarditis.  

Science.gov (United States)

We describe the case of a 66-year-old male, who was referred to our cardiology department with suspected endocarditis, following an enterococcal bacteremia. Transesophageal echocardiography showed vegetations on a native trileaflet aortic valve. Having been prescribed intravenous amoxicillin and gentamicin, to which he initially responded, the patient became increasingly breathless during the third week of treatment. Although lung fields were clear and there were no changes to a pre-existing heart murmur on physical examination, transthoracic echocardiography and Doppler color flow imaging revealed that an aortic root abscess had ruptured and formed a left-to-right shunt. The patient was transferred to a specialist cardiac center, but was unsuitable for major surgery and died a week later. We discuss this rare and devastating complication of infective endocarditis. PMID:24863073

Razii, Nima; Izzat, Lena M

2014-01-01

370

Staphylococcus aureus endocarditis presenting as meningitis and mimicking meningococcal sepsis.  

Science.gov (United States)

A case of Staphylococcus aureus meningitis (SAM) secondary to endocarditis is presented. The presence of a petechial rash affecting the lower limbs led to an initial presumptive diagnosis of meningococcal meningitis. There were no stigmata of endocarditis at presentation, though these subsequently developed. Underlying endocarditis should be diligently sought in any patient presenting with spontaneous SAM, even if typical stigmata are initially absent. In view of the association with skin lesions and neurological complications, S. aureus endocarditis may mimic the classical presentation of meningococcal sepsis. PMID:10563077

Kelly, J; Barnass, S

1999-06-01

371

Endocarditis infecciosa, experiencia de diez años en un centro de referencia nacional / Infectious endocarditis, 10 years of experience in a national reference center  

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.

372

Endocardite por Streptococcus gallolyticus em portadora de lúpus eritematoso sistêmico: avaliação pelo ecocardiograma tridimensional / Streptococcus gallolyticus infective endocarditis in a patient with systemic lupus erythematosus: a three-dimensional echocardiography evaluation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Mulher de 42 anos foi encaminhada ao hospital com história de febre e queda do estado geral há 30 dias. À admissão, apresentava taquicardia e sopro sistólico na região apical. Os exames de laboratório mostraram leucocitose com 13.100/mL, hemoglobina 8,4g/dL e anticorpos positivos para lúpus eritemat [...] oso sistêmico (anti-Ro/SSA, anti-La/SSB, anticardiolipina e anticorpo antinuclear); hemocultura foi positiva para Streptococcus gallolyticus. Foi realizado um ecocardiograma transesofágico tridimensional, que mostrou múltiplas vegetações na valva mitral, com perfuração do folheto e refluxo importante, além de grande vegetação aórtica com perfuração valvar e refluxo importante adicionalmente. Pequena vegetação foi identificada na valva tricúspide, com um refluxo significativo. O emprego da ecocardiografia transesofágica tridimensional proporcionou o diagnóstico de complicações decorrentes de endocardite infecciosa. Abstract in english A 42 year-old woman was referred to our hospital with a history of fever and poor general status for the last 30 days. She presented tachycardia and a systolic apical murmur. Laboratory tests revealed leukocytosis of 13,100/mL, hemoglobin of 8.4g/dL and positive systemic lupus erythematosus antibodi [...] es (anti-Ro/SSA, anti-La/SSB, anticardiolipin, and antinuclear antibodies); blood culture was positive for Streptococcus gallolyticus. Three-dimensional transesophageal echocardiography was performed and revealed multiple mitral valve vegetations, with leaflet perforation and important mitral regurgitation, as well as large aortic vegetation, with cusp perforation and severe regurgitation. Additionally, a small vegetation was observed on the tricuspid valve, which presented moderate regurgitation. Threedimensional transesophageal echocardiography provides appropriate visualization of complications resulting from infectious endocarditis.

Rudyney Eduardo Uchôa de, Azevedo; Ana Clara Tude, Rodrigues; Lucas Arraes de, França; Maria Luciana Zacarias Hannouche da, Trindade; Marcelo Luiz Campos, Vieira; Claudio Henrique, Fischer; Samira Saady, Morhy.

373

Failure of clinical features of low probability endocarditis. The early echo remains essential  

DEFF Research Database (Denmark)

Abstract Objective. To investigate if earlier reported retrospectively derived criteria for predicting absence of infective endocarditis (IE) on transthoracic echocardiography could be prospectively confirmed or improved with transoesophageal echocardiography (TOE). Design. Prospective analysis of the relationship between predefined clinical IE features and findings on TOE in 708 IE suspected patients. Results. The previously reported criteria were rejected as 1/10 of our confirmed IE patients fulfilled criteria for predicting absence of IE. However, our study generated another model of low probability of IE: This disease was absent in 99.4% of patients with negative blood cultures and absence of vascular phenomena and predisposing cardiac conditions. Such patients accounted for 25% of our population of patients suspected of IE. Conclusions. The utility of earlier reported clinical criteria for predicting absence of IE proved insufficient. Instead the study generated new simpler criteria of low probability ofIE. However, these included negative blood cultures, but echocardiography must not be postponed while awaiting the results of blood cultures. Therefore the proposed new criteria only apply to patients with documented negative blood cultures when the suspicion of IE arises, in our study only 10% of the population. Accordingly, the study documented the essential role of early echocardiography in suspected IE.

Knudsen, Jane B; Fuursted, Kurt

2011-01-01

374

Bacillus licheniformis prosthetic aortic valve endocarditis.  

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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

375

Haemophilus aphrophilus Endocarditis after Tongue Piercing  

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Piercing invades subcutaneous areas and has a high potential for infectious complications. The number of case reports of endocarditis associated with piercing is increasing. We studied a 25-year-old man with a pierced tongue, who arrived at Memorial Health University Medical Center with fever, chills, rigors, and shortness of breath of 6 days duration and had an aortic valvuloplasty for correction of congenital aortic stenosis.

Akhondi, Hossein; Rahimi, Ali R.

2002-01-01

376

Cerebral embolism from libman–sacks endocarditis  

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Libman–Sacks endocarditis consists of aseptic valvular abnormalities, associated with systemic lupus erythematosus and antiphospholipid syndrome. Embolic ischaemic stroke is a possible clinical presentation. The authors present the case of a woman in her fourth decade who developed central facial palsy after several transient ischaemic attacks with visual loss. Cerebral imaging revealed multiple small ischaemic lesions in the right hemisphere. The transoesophagic echocardiogram showed mitra...

Malvar, Beatriz; Almeida, Filipa Mendonc?a; Rebocho, Luisa; Moniz, Jose Carlos; Azevedo, Francisco

2011-01-01

377

Prosthetic valve endocarditis caused by Candida lusitaniae, an uncommon pathogen: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Candida lusitaniae was originally described as a human pathogen in 1979 and typically affects immunocompromised patients. Case presentation We describe a case of prosthetic valve endocarditis with Candida lusitaniae in an immunocompetent 62-year-old woman following aortic valve replacement. In vitro testing demonstrated that our isolate was sensitive to amphotericin B, caspofungin and fluconazole. Conclusion The infection was lethal despite aggressive medical and surgical management and sterilization of blood cultures. The outcome of our case illustrates the need to recognize Candida lusitaniae fungemia as a life-threatening infection in a patient with a prosthetic aortic valve.

Michel Ross G

2009-05-01

378

[Infectious endocarditis in intensive care patients].  

Science.gov (United States)

Infectious endocarditis is a rare disease with high mortality. Epidemiological changes in recent years, the emergence of new risk factors, and the increasing use of intravasal prosthetic materials has led to changes in not only the clinical appearance of this disease but also in its diagnosis and treatment. Early diagnosis of infectious endocarditis is crucial. However, the often unspecific symptoms and the changes in its epidemiologic profile pose a challenge for the treating physician. This is especially true since the incidence of hospital-acquired, "nosocomial" cases of infectious endocarditis is increasing and often affects severely ill patients in intensive care units (ICU). There are diagnostic and therapeutic algorithms to guide the physician from an early diagnosis to an adequate treatment of the disease. In some critically ill patients, only surgery in combination with antimicrobial treatment may lead to complete eradication of the infectious disease. This review aims to subsume the guidelines, paying special attention to aspects that are important for intensive care and emergency doctors. PMID:22349477

Dietz, S; Lemm, H; Raaz, U; Werdan, K; Buerke, M

2012-02-01

379

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.

380

Isolated pulmonary valve endocarditis in a normal heart.  

Science.gov (United States)

Isolated pulmonary valve endocarditis is a very rare entity, usually associated with intravenous drug abuse. We describe a case of isolated pulmonary valve endocarditis in a diabetic patient with no apparent precipitating factors besides a lesion on the right hallux. The clinical course was favorable and he was discharged home after a six-week course of antibiotic therapy. PMID:22857915

Moreira, Davide; Correia, Emanuel; Rodrigues, Bruno; Santos, Luís; Capelo, Joana; Abreu, Luís; Nunes, Luís; Oliveira-Santos, Jorge

2012-09-01

 
 
 
 
381

Unexpected sequel of chronic Q-fever endocarditis.  

Science.gov (United States)

We report a patient with chronic Q-fever endocarditis who was treated with Bentall procedure on two occasions due to persistent endocarditis. A chronic pseudoaneurysm of the aortic root was discovered incidentally by cardiac magnetic resonance and computed tomography eight years post-operatively. Due to chronicity of the pseudoaneurysm and great risk of re-intervention, conservative management was recommended. PMID:23628330

Moustafa, Sherif; Patton, David J; Ross, David B; Balon, Yvonne; Alvarez, Nanette

2013-12-01

382

Pseudomonas Aeruginosa Endocarditis in Acute Myeloid Leukemia: A Rare Complication  

Science.gov (United States)

Infectious endocarditis is a rarely encountered complication among leukemia patient during induction therapy. We describe a young patient who developed prolonged high fever after aggressive chemotherapy for Acute Myeloid Leukemia. Pseudomonas Aeruginosa endocarditis was found to be the etiology for the febrile state. Our purpose is to emphasize the need for an early diagnosis of this rare, albeit treatable complication.

J, Barshay; A, Nemets; A, Ducach; G, Lugassy

2008-01-01

383

Bordetella holmesii endocarditis: case report and review of literature.  

Science.gov (United States)

The second case of Bordetella holmesii endocarditis in a pediatric patient is presented. This patient had a prosthetic mitral valve and asplenia. He was successfully treated with 6 weeks of intravenous meropenem. We review all 9 other reported cases of endocarditis and summarize treatment and outcome. Five were immunocompromised and 6 had predisposing cardiac conditions. PMID:24463808

Couturier, Amy P; Dahl, Karen

2014-06-01

384

Culture of a prosthetic valve excised for streptococcal endocarditis positive for Aspergillus fumigatus 20 years after previous A fumigatus endocarditis.  

Science.gov (United States)

Culture of a mitral valve prosthesis excised for streptococcal endocarditis yielded Aspergillus fumigatus. The patient had undergone valve replacement 20 years earlier for A fumigatus endocarditis. Data suggest that quiescent A fumigatus may have survived in a biofilm on the surface of the prosthesis. An antifungal therapy was initiated for 6 months. PMID:21619957

Escande, William; Fayad, Georges; Modine, Thomas; Verbrugge, Eric; Koussa, Mohamad; Senneville, Eric; Leroy, Olivier

2011-06-01

385

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

386

Clindamycin therapy of experimental Staphylococcus aureus endocarditis.  

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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) ...

1982-01-01

387

Cloning of an Enterococcus faecalis endocarditis antigen: homology with adhesins from some oral streptococci.  

Science.gov (United States)

Serum from a patient with Enterococcus faecalis endocarditis was used to identify the gene efaA cloned in Lambda ZapII in Escherichia coli. Nucleotide sequence analysis revealed a 924-bp open reading frame encoding a protein with a predicted molecular weight of 34,768. The amino acid sequence of EfaA shows 55 to 60% homology to a group of streptococcal proteins, FimA from Streptococcus parasanguis, SsaB from Streptococcus sanguis, ScaA from Streptococcus gordonii, and PsaA from Streptococcus pneumoniae. Members of this group have been shown to be adhesins, and we hypothesize that EfaA may function as an adhesin in endocarditis. PMID:7822045

Lowe, A M; Lambert, P A; Smith, A W

1995-02-01

388

Acute Bivalvular Left-Sided Methicillin-Resistant Staphylococcus Aureus Endocarditis with Cardiac, Cerebral, Renal and Septic Complications  

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Infective endocarditis (IE) is now rare in developed countries, but its prevalence is higher in elderly patients with prosthetic valves, diabetes, renal impairment, or heart failure. An increase in health-care associated IE (HCAIE) has been observed due to invasive maneuvers (30% of cases). Methicillin-resistant Staphylococcus aureus (MRSA) and Enterococcus are the most common agents in HCAIE, causing high mortality and morbidity. We review complications of IE and i...

Po?voas, D.; Figueiredo, M.; Murinello, A.; Dama?sio, H.; Ramos, A.; Rodrigues, N.; Sousa, J.; Carvalho, F.; Peres, H.; Gomes, P.

2011-01-01

389

Enhancement of experimental bacteremia and endocarditis caused by dysgonic fermenter (DF-2) bacterium after treatment with methylprednisolone and after splenectomy.  

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The dysgonic fermenter-2 bacterium is a newly recognized fastidious gram-negative bacillus that causes bacteremia and sometimes endocarditis in immunocompromised persons after they are bitten by dogs. To develop