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Sample records for endocarditis bacteriana recomendadas

  1. Pautas de profilaxis antibiótica de Endocarditis Bacteriana, recomendadas por los odontólogos en España

    OpenAIRE

    Tomás Carmona, Inmaculada; Diz Dios, Pedro; Limeres Posse, Jacobo (ed.); Outumuno Rial, Mercedes; Caamaño Durán, Flor

    2004-01-01

    El propósito del presente estudio fue conocer las pautas de profilaxis antibiótica de Endocarditis Bacteriana (EB) recomendadas por los odontólogos en España. Se preguntó a través de una llamada telefónica, cuál era el régimen profiláctico que se debía administrar a un paciente de riesgo de EB antes de someterse a una exodoncia. La información se obtuvo de 400 odontólogos seleccionados aleatoriamente y distribuidos por todo el territorio español. A 200 se les preguntó ...

  2. Prevención de la Endocarditis Bacteriana :: Revisión de la Literatura

    National Research Council Canada - National Science Library

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

    2000-01-01

    .... La endocarditis bacteriana se refiere específicamente a la infección por agentes bacterianos. La mayoría de las personas que desarrollan la endocarditis han padecido una enfermedad cardíaca previa...

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

    Directory of Open Access Journals (Sweden)

    Sirio Hassem Sobrinho

    2010-04-01

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

  4. Prevención de la endocarditis bacteriana en odontología infantil

    OpenAIRE

    Boj Quesada, Juan Ramón; Molina Morales, V.; Jiménez Ruiz, Alfonso

    1994-01-01

    El presente artículo trata de la prevención de la endocarditis bacteriana en odontología infantil. Consideramos que se trata de una patología grave que no se tiene en cuenta todo lo que desearíamos.

  5. Endocarditis bacteriana por Kocuria kristinae en paciente inmunocompetente: Reporte de un caso

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    Alirio R Bastidas

    2013-09-01

    Full Text Available Las infecciones por microorganismos del género Kocuria spp. han sido descritas con mayor frecuencia en pacientes con enfermedades crónicas y estados de inmunosupresión. Comúnmente, no se ha reportado su aislamiento como causa de endocarditis en pacientes jóvenes e inmunocompetentes. Se deben diferenciar de las infecciones producidas por Staphylococcus spp. ya que su evolución clínica puede ser similar y sólo el aislamiento y tipifi cación en cultivos permite hacer el diagnóstico etiológico defi nitivo y dirigir la terapia antibiótica adecuada. Se describe el caso de un paciente joven e inmunocompetente que cursó con endocarditis bacteriana, aislándose Kocuria kristinae en hemocultivos.

  6. Endocarditis bacteriana por Kocuria kristinae en paciente inmunocompetente. Reporte de un caso

    Directory of Open Access Journals (Sweden)

    Alirio R. Bastidas, MD

    2013-09-01

    Full Text Available Las infecciones por microorganismos del género Kocuria spp. han sido descritas con mayor frecuencia en pacientes con enfermedades crónicas y estados de inmunosupresión. Comúnmente, no se ha reportado su aislamiento como causa de endocarditis en pacientes jóvenes e inmunocompetentes. Se deben diferenciar de las infecciones producidas por Staphylococcus spp. ya que su evolución clínica puede ser similar y sólo el aislamiento y tipificación en cultivos permite hacer el diagnóstico etiológico definitivo y dirigir la terapia antibiótica adecuada. Se describe el caso de un paciente joven e inmunocompetente que cursó con endocarditis bacteriana, aislándose Kocuria kristinae en hemocultivos.

  7. 103. Reparación valvular mitral en un caso de endocarditis trombótica no bacteriana

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    R. Manrique

    2012-04-01

    Conclusiones: La reparación valvular mitral es un procedimiento eficaz y seguro en la insuficiencia mitral aguda en pacientes con endocarditis trombótica no bacteriana. Permite evitar un riesgo adicional asociado al uso de prótesis mecánicas en pacientes con riesgo tromboembólico elevado.

  8. Pautas de profilaxis antibiótica de Endocarditis Bacteriana, recomendadas por los odontólogos en España

    National Research Council Canada - National Science Library

    Diz Dios, Pedro; Caamaño Durán, Flor; Tomás Carmona, Inmaculada; Limeres Posse, Jacobo; Outumuno Rial, Mercedes

    2004-01-01

    ...) among General Dental Practitioners (GDPs) in Spain. GDPs were asked over the telephone by a fictitious patient what antibiotic prophylaxis they would administer to an at risk patient for BE before a tooth extraction...

  9. Endocarditis trombótica no bacteriana bivalvular asociada a cáncer y ecocardiograma transesofágico Bivalvular non bacterial thrombotic endocarditis associated with cancer and transesophageal echocardiography

    Directory of Open Access Journals (Sweden)

    Marcelo Zylberman

    2006-06-01

    Full Text Available La endocarditis trombótica no bacteriana es la causa más frecuente de accidente cerebrovascular isquémico en pacientes con cáncer. En estos pacientes se hallaron vegetaciones valvulares hasta en el 9% de las autopsias. Sin embargo, la afección bivalvular es poco frecuente, observándose en el 9% de las endocarditis trombóticas. Se presenta una paciente con cáncer de ovario que presentó afasia e imágenes compatibles con isquemia cerebral. El ecocardiograma transtorácico fue normal. El ecocardiograma transesofágico evidenció vegetaciones en las válvulas aórtica y mitral. Se enfatiza la importancia de sospechar endocarditis trombótica no bacteriana en enfermos con cáncer y embolismo sistémico y en la escasa frecuencia de afección bivalvular.Non bacterial thrombotic endocarditis is the most frequent cause of ischemic stroke in cancer patients. Up to 9% of autopsies of cancer patients show non infectious valvular masses. However, bivalvular involvement is not frequently occurring in 9% of non bacterial thrombotic endocarditis. We report a patient with ovarian cancer who presented aphasia. The MRI was compatible with cerebral ischemia. The transthoracic echocardiogram was normal and a transesophageal echocardiogram showed vegetations in aortic and mitral valves. We emphasize the importance of suspecting non bacterial thrombotic endocarditis in patients with cancer and systemic embolism and the low frequency of bivalvular involvement.

  10. Endocarditis

    Science.gov (United States)

    ... recommends preventive antibiotics for people at risk for infectious endocarditis, such as those with: Certain birth defects of ... 26373316 . Fowler VG Jr, Scheld WM, Bayer AS. Endocarditis and ... of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015: ...

  11. Endocardite bacteriana como complicação de sepse neonatal - relato de caso Bacterial endocarditis as a complication of neonatal sepsis: a case report

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    V.L.J. Krebs

    1999-12-01

    Full Text Available Os autores relatam um paciente com 11 dias de vida, internado em Unidade de Terapia Intensiva Neonatal devido a múltiplas malformações congênitas, apresentando sepse e endocardite bacteriana. Entre os fatores de risco para endocardite foram destacados o cateterismo venoso central, hemocultura com crescimento de Staphylococcus aureus e ventilação mecânica. O diagnóstico foi realizado no 61o dia de internação devido a presença de febre persistente e aparecimento de sopro cardíaco sistólico. O ecocardiograma mostrou trombo em átrio direito, medindo 1,9 x 0,7mm sendo realizada antibioticoterapia e ressecção cirúrgica, com melhora clínica. No 125° dia de internação ocorreu óbito devido à sepse e abscesso cerebral. Na necrópsia não foram observados malformações cardíacas. Os autores concluem ser de grande importância o conhecimento das complicações potenciais das técnicas invasivas utilizadas em recém-nascidos criticamente doentes. A suspeita clínica de endocardite deve ser realizada em todos os neonatos com sepse, internados em Unidade de Terapia Intensiva Neonatal por tempo prolongadoThe authors reported on a 11 day-old child, admitted in Neonatal Intensive Care Unit for multiple congenital malformations, who had sepsis and bacterial endocarditis. Among the risk factors for endocarditis were outstanding: the central venous catheterism, hemoculture with growth of Staphylococcus aureus and mechanical ventilation. The diagnosis was made in the 61st day after admission owing to the presence of persistent fever and appearance of systolic murmur. The echocardiogram revealed a thrombus in the right atrium measuring 1.9 x 0.7mm. Antibiotic therapy and surgical resection being performed, with clinical improvement. On the 125st day after admission the patient died owing sepsis and cerebral abscess. At necropsy, heart malformations were not observed. The authors concluded to be very important the knowledge of the potential

  12. Tratamento cirúrgico do abscesso de anel valvar associado a endocardite bacteriana: resultados imediatos e tardios Surgical treatment of endocarditis with abscess in the valvular ring: immediate and long-term results

    Directory of Open Access Journals (Sweden)

    Pablo M. A Pomerantzeff

    1996-12-01

    Full Text Available No período de outubro de 1978 a dezembro de 1994, ocorreram 619 episódios de endocardite bacteriana em pacientes tratados no Instituto do Coração - HC-FMUSP. Destes, foram operados 208 pacientes e 65 apresentavam abscesso de anel. Quarenta e oito (73,8% eram do sexo masculino e 17 (26,2% do feminino. A idade variou de 6 a 61 anos (média de 38,3+/-11,9. Quarenta e seis (70,8% eram portadores de próteses (36 aórticas e 10 mitráis, 6 (9,2% apresentavam valvopatia prévia, 1 (1,5% apresentava cardiopatia congênita e 12 (18,5% não apresentavam cardiopatia. Os germes predominantes foram: Streptococcus viridans em 17 (26,2% pacientes, Enterococcus sp em 6 (7,7% e Staphylococcus aureus em 9 (13,8%. Nove pacientes apresentavam intervalo PR no eletrocardiograma maior que 0,20 mseg no pré-operatório. A indicação da operação foi devida a infecção em prótese em 46 (70,8% casos, insuficiência cardíaca em 9 (13,8%, falha no tratamento clínico em 5 (7,7%, embolia em 2 (3,1 %, infecção porfungos em 1 (1,5% e outras em 2 (3,1%. A mortalidade operatória foi de 17 (26,2% pacientes. Ocorreram 9 (13,8% óbitos tardios sendo que 5 pacientes faleceram devido a nova endocardite bacteriana. Trinta e sete (86% pacientes encontram-se em CFI (NYHA, 4 em CF II e 2 CF III no pós-operatório tardio (tempo médio de evolução de 5,3 anos. Os dados apresentados confirmam que a endocardite bacteriana associada a abscesso de anel é doença de alto risco, tem indicação cirúrgica precisa e a evolução tardia demonstra que a maior complicação é a reinfecção.Between October 1978 and December 1994, 619 cases of bacterial endocarditis were treated in the Heart Institute. Of these, 208 were submitted to surgical treatment, and 65 presented abscess in the valvular ring. Forty eight (73.8% were male, their ages varying from 6 to 61 years, with average of 38.3 +/-11.9 years. Forty six (70.8% presented a valvular prosthesis (37 aortic and 11 mitral. The

  13. HELICOBACTER PYLORI EN LA FLORA BACTERIANA ORAL

    OpenAIRE

    Moromi Nakata, Hilda; Departamento Académico Ciencias Básicas Estomatológicas. Facultad de Odontología. UNMSM.

    2014-01-01

    No hay duda de la relación existente entre enfermedades orales con otras enfermedades sistémicas. En tal contexto, las bacterias de la flora bacteriana oral, que alcanzan alrededor de 350 especies, para la mayoría de tales bacterias no se ha demostrado un rol específico, conociéndose sí una clara relación entre los Estreptococos orales (Streptococcus sanguis, Strecoccus mutans, Streptococcus sobri nus) y Actinobacillus actinomycetencomitans, entre otros, con la endocarditis bacteriana; así co...

  14. The clinicopathological and epidemiological aspects of bacterial endocarditis in dogs: 28 cases (2003-2008 / Aspectos clínico-patológicos e epidemiológicos da endocardite bacteriana em cães: 28 casos (2003-2008

    Directory of Open Access Journals (Sweden)

    Patrícia Mendes Pereira

    2010-04-01

    Full Text Available The aim of this study was to review the clinicopathological aspects and report the data obtained from bacterial endocarditis cases in dogs. A restropective study was carried out based on files of the Veterinary Hospital and the Animal Pathology Laboratory of Universidade Estadual de Londrina (UEL from January 2003 to may 2008. During this period, 28 dogs presented bacterial endocarditis, 50% males and 50% females. Medium to large dogs were the most affected and adult animals were prevalent, with the following clinical signs: apathy, hiporexy, hyperthermia, splenomegaly, dyspnea, dehydration, dysuria and cardiac murmur, Necropsy revealed the mitral valve as the most affected cardiac structure and among the organs, the kidneys were the most affected.O presente trabalho objetivou revisar os aspectos clínico-patológicos e relatar os dados obtidos sobre a endocardite bacteriana em cães, por meio de estudo retrospectivo realizado nos arquivos do Hospital Veterinário e Laboratório de Patologia Animal da Universidade Estadual de Londrina (UEL, durante o período de janeiro de 2003 a maio de 2008. No transcorrer do período considerado, 28 cães apresentaram a doença, sendo 50% machos e 50% fêmeas. Animais de médio a grande porte foram os mais acometidos e os adultos obtiveram prevalência. Os principais sinais clínicos apresentados foram apatia, hiporexia, hipertermia, esplenomegalia, dispnéia, desidratação, disúria e sopro cardíaco. À necropsia, observou-se que a válvula mitral foi a estrutura cardíaca mais afetada, sendo o rim o órgão mais frequentemente acometido.

  15. Endocarditis - children

    Science.gov (United States)

    ... Elsevier Saunders; 2015:chap 111. Starke JR. Infective endocarditis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014: ...

  16. Infective endocarditis.

    Science.gov (United States)

    Ferro, José M; Fonseca, Ana Catarina

    2014-01-01

    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. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Endocarditis trombótica no bacteriana (Libman-Sacks

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    Antonio García-Valentín

    2006-07-01

    Full Text Available Mujer de 47 años ingresada en 2002 por ictus. Se diagnosticó masa valvular aórtica. Se intervino realizándose exéresis de trombo no bacteriano (Fig 1a, b. Durante el estudio de trombofilia fue diagnosticada de síndrome antifosfolípido primario (SAP, inciándose anticoagulación. Hasta la fecha, ha padecido múltiples accidentes cerebrovasculares, isquémicos y hemorrágicos. Está en diálisis peritoneal con probable origen en SAP. SAP es un trastorno autoinmune caracterizado por fenómenos trombóticos iterativos y alargamiento de tiempos de coagulación. La cirugía cardiaca conlleva morbimortalidad por tromboembolias, suponiendo un reto en el manejo de la circulación extracorpórea. Las complicaciones tromboembólicas son frecuentes durante el seguimiento.

  18. Meningitis bacteriana aguda

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    D. Rodrigo Blamey, Dr.

    2014-05-01

    Full Text Available La Meningitis Bacteriana Aguda (MBA de adquisición comunitaria es una enfermedad prevalente en todo el mundo; constituye siempre una emergencia médica y se asocia a una alta morbimortalidad. Su epidemiología es variable y los principales agentes en adultos son S. pneumoniae, N. meningitidis, H. influenzae y L. monocitogenes. En Chile existe un sistema de vigilancia recientemente implementado que permitirá un mejor diagnóstico epidemiológico. Las manifestaciones clínicas clásicas no siempre están presentes principalmente en adultos mayores. El diagnóstico requiere del estudio de líquido cefalorraquídeo, y las técnicas de biología molecular han significado un aporte relevante en los últimos años. El tratamiento antibiótico debe ser instaurado rápidamente para mejorar el pronóstico, mientras que la terapia coadyuvante con corticoides en adultos tiene sólo beneficios en etiología neumocócica. Se requieren mejores estrategias de prevención frente a una entidad que no ha cambiado su mortalidad a pesar del progreso de la medicina moderna.

  19. Enterococcus faecalis infective endocarditis

    DEFF Research Database (Denmark)

    Dahl, Anders; Rasmussen, Rasmus V; Bundgaard, Henning

    2013-01-01

    Because of the nephrotoxic effects of aminoglycosides, the Danish guidelines on infective endocarditis were changed in January 2007, reducing gentamicin treatment in enterococcal infective endocarditis from 4 to 6 weeks to only 2 weeks. In this pilot study, we compare outcomes in patients with En...... with Enterococcus faecalis infective endocarditis treated in the years before and after endorsement of these new recommendations....

  20. Isolated Pulmonary Valve Endocarditis

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    Mohammad Ali Hatamizadeh

    2009-06-01

    Full Text Available Infective endocarditis is one of the most severe complications of parenteral drug abuse. The outstanding clinical feature of infective endocarditis in intravenous drug abusers is the high incidence of right-sided valve infection, and the tricuspid valve is involved in 60% to 70% of the cases. We herein report a case of isolated pulmonic valve infective endocarditis with a native pulmonary valve.

  1. Shewanella putrefaciens infective endocarditis

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    Jonathan Constant

    2014-11-01

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

  2. Legionella longbeachae and Endocarditis

    OpenAIRE

    Leggieri, Nicola; Gouriet, Frédérique; Thuny, Frank; Habib, Gilbert; Raoult, Didier; Casalta, Jean-Paul

    2012-01-01

    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.

  3. [Eikenella corrodens infective endocarditis].

    Science.gov (United States)

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

    2005-07-01

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

  4. Enterococcus faecalis infective endocarditis

    DEFF Research Database (Denmark)

    Dahl, Anders; Bruun, Niels Eske

    2013-01-01

    Enterococcus faecalis infective endocarditis (IE) is a disease of increasing importance, with more patients infected, increasing frequency of health-care associated infections and increasing incidence of antimicrobial resistances. The typical clinical presentation is a subacute course with fever...

  5. Haemophilus segnis endocarditis

    DEFF Research Database (Denmark)

    Bangsborg, Jette Marie; Tvede, M; Skinhøj, P

    1988-01-01

    Haemophilus segnis is a rarely recognised commensal in the oropharynx. We wish to report the first published case of endocarditis caused by H. segnis. The patient, a 76-year-old female did not recover until after 2 courses of ampicillin given for a total of 57 days. In the second course of treatm......Haemophilus segnis is a rarely recognised commensal in the oropharynx. We wish to report the first published case of endocarditis caused by H. segnis. The patient, a 76-year-old female did not recover until after 2 courses of ampicillin given for a total of 57 days. In the second course...

  6. Gemella morbillorum Endocarditis

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    Serap Ural

    2014-01-01

    Full Text Available Infective endocarditis caused by Gemella morbillorum is a rare disease. In this report 67-year-old male patient with G. morbillorum endocarditis was presented. The patient was hospitalized as he had a fever of unknown origin and in the two of the three sets of blood cultures taken at the first day of hospitalization G. morbillorum was identified. The transthoracic echogram revealed 14 × 10 mm vegetation on the aortic noncoronary cuspis. After 4 weeks of antibiotic therapy, the case was referred to the clinic of cardiovascular surgery for valve surgery.

  7. Administração endovenosa de antibióticos e resistência bacteriana: responsabilidade da enfermagem

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    Heloisa Helena Karnas Hoefel

    2006-12-01

    Full Text Available O sucesso da terapêutica com antibióticos e o desenvolvimento da resistência bacteriana dependem de diversos fatores, sendo que os relacionados ao cuidado de enfermagem são o seu preparo e a sua administração. Objetivo: realizar uma revisão da literatura sobre falhas na administração de antibióticos analisando sua possível influência na resistência bacteriana. Delineamento: realizada uma pesquisa bibliográfica das fontes do LILACS e Medline. Métodos: realizada revisão bibliográfica sistematizada com pesquisa de artigos de 1994 a 2005 na Internet usando-se os seguintes descritores juntamente com enfermagem: resistência bacteriana, controle de antibióticos, infecções hospitalares, administração de medicamentos, erros de medicações e eventos adversos. Foram selecionados 58 artigos que apresentaram correlação com a enfermagem e/ou eram básicos na fundamentação brasileira ou internacional. Resultados: Foram descritos aspectos gerais sobre a resistência bacteriana, antibióticos e custos incluindo estratégias para prevenção da resistência e classificações de erros utilizadas internacionalmente. Conclusões: Baseado nesse conhecimento são recomendadas intervenções para implementação do cuidado de enfermagem prático e seguro.

  8. Veillonella montpellierensis Endocarditis

    Science.gov (United States)

    Rovery, Clarisse; Etienne, Anne; Foucault, Cédric; Berger, Pierre

    2005-01-01

    Veillonella spp. rarely cause infections in humans. We report a case of Veillonella endocarditis documented by isolating a slow-growing, gram-negative microbe in blood cultures. This microbe was identified as the newly recognized species Veillonella montpellierensis (100% homology) by 16S RNA gene sequence analysis. PMID:16022792

  9. Prophylaxis of endocarditis

    NARCIS (Netherlands)

    van der Meer, J. T. M.

    2002-01-01

    For a long time it has been known that bacteraemias caused by medical or dental procedures may cause endocarditis in patients with specific types of congenital or acquired heart disease. In the 1940s it was thought that the administration of antibiotics before such procedures would prevent

  10. Candida infective endocarditis

    NARCIS (Netherlands)

    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.; DraGordon, David; Devi, Uma; Spelman, Denis; van der Meer, Jan T. M.; Kauffman, Carol; Bradley, Suzanne; Armstrong, William; Giannitsioti, Efthymia; Giamarellou, Helen; Lerakis, Stamatios; del Rio, Ana; Moreno, Asuncio; Mestres, Carlos A.; Pare, Carlos; Garcia de la Maria, Cristina; de Lazzario, Elisa; Marco, Francesc; Gatell, Jose M.; Miro, Jose M.; Almela, Manel; Azqueta, Manuel; Jimenez-Exposito, Maria Jesus; de Benito, Natividad; Perez, Noel; Almirante, Benito; Fernandez-Hidalgo, Nuria; de Vera, Pablo Rodriguez; Tornos, Pilar; Falco, Vicente; Claramonte, Xavier; Armero, Yolanda; Sidani, Nisreen; Kanj-Sharara, Souha; Kanafani, Zeina; Raglio, Annibale; Goglio, Antonio; Gnecchi, Fabrizio; Suter, Fredy; Valsecchi, Grazia; Rizzi, Marco; Ravasio, Veronica; Hoen, Bruno; Chirouze, Catherine; Leroy, Joel; Plesiat, Patrick; Bernard, Yvette; Casey, Anna; Lambert, Peter; Watkin, Richard; Elliot, Tom; Patel, Mukesh; Dismukes, William; Pan, Angelo; Caros, Giampiero; Tribouilloy, Amel Brahim Mathiron Christophe; Goissen, Thomas; Delahaye, Armelle; Delahaye, Francois; Vandenesch, Francois; Vizzotti, Carla; Nacinovich, Francisco M.; Marin, Marcelo; Trivi, Marcelo; Lombardero, Martin; Cortes, Claudia; Casabe, Jose Horacio; Altclas, Javier; Kogan, Silvia; Clara, Liliana; Sanchez, Marisa; Commerford, Anita; Hansa, Cass; Deetlefs, Eduan; Ntsekhe, Mpiko; Commerford, Patrick; Wray, Dannah; Steed, Lisa L.; Cantey, Robert; Morris, Arthur; Holland, David; Murdoch, David; Graham, Katherine; Read, Kerry; Raymond, Nigel; Bridgman, Paul; Troughton, Richard; Lang, Selwyn; Chambers, Stephen; Kotsanas, Despina; Korman, Tony M.; Peterson, Gail; Purcell, Jon; Southern, Paul M.; Shah, Manisha; Bedimo, Roger; Reddy, Arjun; Levine, Donald; Dhar, Gaurav; Hanlon-Feeney, Alanna; Hannan, Margaret; Kelly, Sinead; Wang, Andrew; Cabell, Christopher; Woods, Christopher; Sexton, Daniel J.; Benjamin, Danny; Corey, G. Ralph; McDonald, Jay R.; Federspiel, Jeff; Engemann, John J.; Barth Reller, L.; Drew, Laura; Caram, L. B.; Stryjewski, Martin; Morpeth, Susan; Lalani, Tahaniyat; Fowler, Vance; Chu, Vivian; Mazaheri, Bahram; Neuerburg, Carl; Naber, Christoph; Athan, Eugene; Henry, Margaret; Harris, Owen; Alestig, Eric; Olaison, Lars; Wikstrom, Lotta; Snygg-Martin, Ulrika; Francis, Johnson; Venugopal, K.; Nair, Lathi; Thomas, Vinod; Chaiworramukkun, Jaruwan; Pachirat, Orathai; Chetchotisakd, Ploenchan; Suwanich, Tewan; Kamarulzaman, Adeeba; Tamin, Syahidah Syed; Premru, Manica Muella; Logar, Mateja; Lejko-Zupanc, Tatjana; Orezzi, Christina; Klein, John; Bouza, Emilio; Moreno, Mar; Rodriguez-Creixems, Marta; Marin, Mercedes; Fernandez, Miguel; Munoz, Patricia; Fernandez, Rocio; Ramallo, Victor; Raoult, Didier; Thuny, Franck; Habib, Gilbert; Casalta, Jean-Paul; Fournier, Pierre-Edouard; Chipigina, Natalia; Kirill, Ozerecky; Vinogradova, Tatiana; Kulichenko, Vadim P.; Butkevich, O. M.; Lion, Christine; Selton-Suty, Christine; Alla, Francois; Coyard, Helene; Doco-Lecompte, Thanh; Larussi, Diana; Durante-Mangoni, Emanuele; Francoise Tripodi, Marie; Utili, Riccardo; Sampath Kumar, A.; Sharma, Gautam; Dickerman, Stuart A.; Street, Alan; Eisen, Damon Peter; McBryde, Emma Sue; Grigg, Leeanne; Abrutyn, Elias; Michelet, Christian; Tattevin, Pierre; Yves Donnio, Pierre; Fortes, Claudio Querido; Edathodu, Jameela; Al-Hegelan, Mashael; Font, Bernat; Raimon Guma, Joan; Cereceda, M.; Oyonarte, Miguel J.; Mella, Rodrigo Montagna; Garcia, Patricia; Braun Jones, Sandra; Isabel de Oliveira Ramos, Auristela; Ley Woon, Lok; Lum, Luh-Nah; Tan, Ru-San; Rees, David; Kornecny, Pam; Lawrence, Richard; Dever, Robyn; Post, Jeffey; Jones, Phillip; Ryan, Suzzane; Harkness, John; Fenely, Michael; Rubinstein, Ethan; Strahilewitz, Jacob; Ionac, Adina; Mornos, Cristian; Dragulescu, Stefan; Forno, Davide; Cecchi, Enrico; de Rosa, Francesco; Imazio, Massimo; Trinchero, Rita; Wiesbauer, Franz; Gattringer, Rainer; Deans, Greg; Andrasevic, Arjana Tambic; Barsic, Bruno; Klinar, Igor; Vincelj, Josip; Bukovski, Suzana; Krajinovic, Vladimir

    2008-01-01

    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

  11. Endocarditis in adults with bacterial meningitis

    NARCIS (Netherlands)

    Lucas, Marjolein J.; Brouwer, Matthijs C.; van der Ende, Arie; van de Beek, Diederik

    2013-01-01

    Endocarditis may precede or complicate bacterial meningitis, but the incidence and impact of endocarditis in bacterial meningitis are unknown. We assessed the incidence and clinical characteristics of patients with meningitis and endocarditis from a nationwide cohort study of adults with

  12. Klebsiella oxytoca Endocarditis With Complete Heart Block

    Directory of Open Access Journals (Sweden)

    Saad Ullah MD

    2016-08-01

    Full Text Available Gram-negative bacterial endocarditis causes 5% of all bacterial endocarditis. Among gram-negative bacteria, Klebsiella species are rare causes of native valve endocarditis. Klebsiella oxytoca is an extremely rare subspecies that can infrequently cause endocarditis and is associated with poor outcome. We report a case of Klebsiella oxytoca endocarditis in an elderly man who initially presented with stroke but later developed sepsis and heart block secondary to endocarditis.

  13. ENDOCARDITIS WITH AN UNCOMMON GERM

    Directory of Open Access Journals (Sweden)

    M. Gharouni

    2006-07-01

    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.

  14. Reparación valvular mitral en un caso de endocarditis de Libman-Sacks

    Directory of Open Access Journals (Sweden)

    Eduardo Bernabeu

    2012-07-01

    Full Text Available La endocarditis de Libman-Sacks es una forma de endocarditis no bacteriana asociada a los pacientes con lupus eritematoso sistémico (LES. Aunque con frecuencia cursa de forma asintomática, en ocasiones es causa de insuficiencia cardíaca grave. Presentamos un caso de reparación valvular mitral en una paciente aquejada de esta infrecuente entidad, que debutó clínicamente con un edema agudo de pulmón secundario a insuficiencia mitral masiva. La reparación valvular mitral puede ser un procedimiento eficaz y seguro, que permite evitar el riesgo adicional asociado al uso de prótesis valvulares en estos pacientes con riesgo trombótico elevado.

  15. Peritonite bacteriana espontânea

    Directory of Open Access Journals (Sweden)

    Strauss Edna

    2003-01-01

    Full Text Available A peritonite bacteriana espontânea ocorre em 30% dos cirróticos com ascite e, neste grupo, apresenta altas taxas de morbidade e mortalidade. Os fatores predisponentes incluem a diminuição da defesa imunológica encontrada no homem nas fases avançadas da cirrose, o supercrescimento da flora intestinal e a translocação bacteriana da luz dos intestinos aos linfonodos mesentéricos. As manifestações clínicas variam de graves a leves ou ausentes, sendo sempre necessária a análise do líquido ascítico. O diagnóstico de peritonite bacteriana espontânea se faz pela contagem de neutrófilos > 250/mm³ no líquido ascítico associado ou não ao crescimento de bactéria na cultura. As enterobactérias predominam como causa da infecção, sendo a Echerichia coli a bactéria mais freqüentemente isolada. O diagnóstico precoce e o tratamento adequado provocaram a queda das taxas de mortalidade nas duas últimas décadas. O uso endovenoso de cefalosporinas de terceira geração mostra-se eficaz em 70% a 95% dos casos. A recorrência de peritonite bacteriana espontânea é comum e pode ser prevenida com norfloxacina oral, de uso contínuo. O surgimento de resistência bacteriana tem estimulado a procura de novas opções para a profilaxia da peritonite bacteriana espontânea; os probióticos constituem nova abordagem promissora, mas que necessita melhor avaliação. Recomenda-se a profilaxia primária de curta duração aos cirróticos com ascite que apresentem episódio de hemorragia digestiva alta.

  16. Endocarditis de Libman-Sacks

    Directory of Open Access Journals (Sweden)

    Carolina Saldarriaga

    2015-05-01

    Se reporta el caso de un paciente de género masculino, de 63 años, quien manifestó signos y síntomas compatibles con endocarditis infecciosa, y cuyos diferentes estudios demostraron una endocarditis de Libman-Sacks que respondió de forma favorable al tratamiento inmunosupresor.

  17. ENDOCARDITIS IN SYSTEMIC LUPUS ERYTHEMATOSUS

    Directory of Open Access Journals (Sweden)

    AMEL Harzallah

    2017-04-01

    Full Text Available Endocarditis is one of the most prevalent forms of cardiac involvement in patients with lupus, as it is considered as one a life-threatening complication. Libman-Sacks endocarditis is common. Infective endocarditis can also cause complications within immunocompromised patients. The aim of this study is to determine particularities of endocarditis in patients with lupus and to look for distinguishing features between infectious or immunological origin. A retrospective study was conducted on patients with lupus presenting endocarditis. Lupus was diagnosed according to the American college of rheumatology criteria. The diagnosis of endocarditis was made based on the modified Duke criteria. The present case report studies seven cases of endocarditis. Six of these patients are women and the other one is a man. They are aged meanly of 29.4 years (extremes: 20-36. Fever was present in all the cases with a new cardiac murmur in six cases and a modification of its intensity in one case. Biologic inflammatory syndrome was present in six cases. Cardiac ultrasound performed in six cases made the diagnosis of endocarditis which involved the left heart valves in five cases and the right heart valves in one case. Valvular insufficiency was identified in six patients. The valve involvement was mitral in two cases, mitro-aortic in two others, aortic in the fifth one and tricuspid in the sixth one. Endocarditis was infectious in 4 cases, thanks to positive blood culture. The germs identified were gram negative bacilli in two cases, anaerobic organism in one case and gram positive cocci in one case. Candida albicans was isolated in one case. Libman-Sacks endocarditis was objectified in three cases. A combination of Libman-Sacks endocarditis with infectious endocarditis was diagnosed in one case. The treatment consisted of antibiotics in four cases with surgery in two cases. The outcome was favorable in five cases and fatal in the two others. Endocarditis in lupus

  18. Higiene intima femenina y vaginosis bacteriana. Encuesta epidemiologica latinoamericana 2008

    National Research Council Canada - National Science Library

    Cuevas, Aura; Celis, Cuauhtemoc; Herron, Santiago; Hernandez, Imelda; Paredes, Osiris; Paradas, Alejandro

    2010-01-01

    .... Se aplico una encuesta que contenia informacion sociodemografica, informacion sobre actividad sexual e higiene intima y se hizo el diagnostico presuntivo de vaginosis bacteriana basado en criterios...

  19. Osteomyelitis complicating Streptococcus milleri endocarditis.

    Science.gov (United States)

    Barham, N. J.; Flint, E. J.; Mifsud, R. P.

    1990-01-01

    A patient with osteomyelitis of the spine complicating bacterial endocarditis due to Streptococcus milleri is discussed. To our knowledge, this is the first time this organism has been associated with this complication. Images Figure 1 PMID:2385559

  20. Aerococcus viridans Native Valve Endocarditis

    Directory of Open Access Journals (Sweden)

    Wenwan Zhou

    2013-01-01

    Full Text Available Aerococcus viridans is an infrequent human pathogen and few cases of infective endocarditis have been reported. A case involving a 69-year-old man with colon cancer and hemicolectomy 14 years previously, without recurrence, is reported. A diagnosis of native mitral valve endocarditis was established on the basis of clinical presentation, characteristic echocardiographic findings and pathological specimen examination after urgent valve replacement. A viridans endocarditis appears to be particularly virulent, requiring a surgical approach in four of 10 cases reported and death in one of nine. Given the aggressive nature of A viridans endocarditis and the variable time to diagnosis (a few days to seven months, prompt recognition of symptoms and echocardiography, in addition to blood cultures, should be performed when symptoms persist.

  1. Pacemaker Lead Endocarditis Due to Trichosporon Species.

    Science.gov (United States)

    Rath, Pratap Chandra; Purohit, Bharat Vijay; Agrawal, Binod; Reddy, Krupal; Nutankavala, Lavanya; Narreddy, Suneetha; Reddy, Mallikkarjun; Abu Salim, Md

    2015-04-01

    Pacemaker-related fungal endocarditis is an uncommon and unexpected complication. It is associated with high mortality rates. Due to nonspecific clinical symptoms, negative blood culture and delays in obtaining appropriate imaging studies; late diagnosis is common with fungal endocarditis. Hereby we are reporting a rare case of pacemaker lead endocarditis due to Trichosporon species. In literature we did not find any case of pacemaker-related endocarditis due to Trichosporon species.

  2. [INFECTIOUS ENDOCARDITIS IN PREGNANT WOMEN].

    Science.gov (United States)

    Mravyan, S R; Shuginin, I O; Pronina, V P; Budykina, T S; Mikhailova, I S; Popov, V V; Khorikova, E N; Stepanova, E A

    2015-01-01

    A case of primary infectious endocarditis with the lesion of mitral valve in a pregnant woman is reported The diseases was caused by meticillin-resistant Staphylococcus aureus. Special attention is given to inefficiency of beta-lactame antibiotics against this infection and beneficial effect of daptomycin therapy. This observation confirms literature data about high frequency of thromboembolic complications of S aureus-induced infectious endocarditis due to the production of various coagulases and von Willebrand factor-binding protein by these microorganisms. An increase of coagulation caused by S. aureus is mediated through activation of prothrombin, factor XIII, and fibrin-binding fibronectin. It requires prescription of direct thrombin inhibitor pradax that proved to yield good results in the treatment of our patient. It is concluded that infectious endocarditis in pregnant women is characterized by an atypical clinical picture due to impaired immunity associated with rapid progression of the process after delivery, high frequency of thromboembolic and DIC syndromes.

  3. Listeria Endocarditis: A Diagnostic Challenge

    Directory of Open Access Journals (Sweden)

    Wilhelmina J. A. R. M. Valckx MD

    2017-04-01

    Full Text Available A 74-year-old hemodialysis patient with a history of an atrial septum defect closure, coronary bypass surgery, and a St. Jude aortic prosthetic valve was diagnosed with pneumonia and volume overload. Blood cultures were positive for Listeria monocytogenes, and amoxicillin was given for 2 weeks. Immediately after discontinuation of amoxicillin, fever relapsed. Transthoracic and transesophageal echocardiography showed no sign of endocarditis. Given the fever relapse and 3 positive minor Duke criteria, an 18F-FDG PET-CT scan (18F-fluorodeoxyglucose-positron emission tomography-computed tomography scan was performed. This scan showed activity at the aortic root, proximal ascending aorta, and inferior wall of the heart, making Listeria monocytogenes endocarditis a likely explanation. Amoxicillin was given for 6 weeks with good clinical result. Diagnosing a life-threatening Listeria monocytogenes endocarditis can be challenging and an 18F-FDG PET-CT scan can be helpful.

  4. [Infectious endocarditis in drug addicts].

    Science.gov (United States)

    Gasanov, A B

    2006-01-01

    Clinicomorphological features of infectious endocarditis (IE) were studied on autopsy material from chronic drug addicts. Of special interest were morphological changes in the lymphoid organs. The experience of the author and literature data suggest that IE in drug addicts is a manifestation of secondary immunodeficiency syndrome on the background of chronic narcotic intoxication.

  5. Cardiac imaging in infectious endocarditis.

    Science.gov (United States)

    Bruun, Niels Eske; Habib, Gilbert; Thuny, Franck; Sogaard, Peter

    2014-03-01

    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.

  6. Infectious endocarditis: diagnosis and treatment.

    Science.gov (United States)

    Pierce, Deborah; Calkins, Bethany C; Thornton, Kristen

    2012-05-15

    Infectious endocarditis results from bacterial or fungal infection of the endocardial surface of the heart and is associated with significant morbidity and mortality. Risk factors include the presence of a prosthetic heart valve, structural or congenital heart disease, intravenous drug use, and a recent history of invasive procedures. Endocarditis should be suspected in patients with unexplained fevers, night sweats, or signs of systemic illness. Diagnosis is made using the Duke criteria, which include clinical, laboratory, and echocardiographic findings. Antibiotic treatment of infectious endocarditis depends on whether the involved valve is native or prosthetic, as well as the causative microorganism and its antibiotic susceptibilities. Common blood culture isolates include Staphylococcus aureus, viridans Streptococcus, enterococci, and coagulase-negative staphylococci. Valvular structural and functional integrity may be adversely affected in infectious endocarditis, and surgical consultation is warranted in patients with aggressive or persistent infections, emboli, and valvular compromise or rupture. After completion of antibiotic therapy, patients should be educated about the importance of daily dental hygiene, regular visits to the dentist, and the need for antibiotic prophylaxis before certain procedures.

  7. Laboratory diagnosis of infective endocarditis

    OpenAIRE

    Auckenthaler, R. W.

    2017-01-01

    The diagnosis of infective endocarditis is based on positive blood cultures. Modern microbiological techniques can isolate the aetiological agent in 90-95% of cases. The rapidity of detection has been improved by inoculation of 10 ml of blood, adequate dilution and media and systematic subcultures. Lysis-centrifugation has yreatly improved the detection of fungi in blood

  8. Propionibacterium endocarditis: a case series from the International Collaboration on Endocarditis Merged Database and Prospective Cohort Study

    NARCIS (Netherlands)

    Lalani, Tahaniyat; Person, Anna K.; Hedayati, Susan S.; Moore, Laura; Murdoch, David R.; Hoen, Bruno; Peterson, Gail; Shahbaz, Hasan; Raoult, Didier; Miro, Jose M.; Olaison, Lars; Snygg-Martino, Ulrika; Suter, Fredy; Spelman, Dennis; Eykyn, Susannah; Strahilevitz, Jacob; van der Meer, Jan T.; Verhagen, Dominique; Baloch, Khaula; Abrutyn, Elias; Cabell, Christopher H.

    2007-01-01

    Propionibacterium species are occasionally associated with serious systemic infections such as infective endocarditis. In this study, we examined the clinical features, complications and outcome of 15 patients with Propionibacterium endocarditis using the International Collaboration on Endocarditis

  9. Molecular imaging in Libman-Sacks endocarditis

    DEFF Research Database (Denmark)

    Dahl, Anders; Schaadt, Bente K; Santoni-Rugiu, Eric

    2015-01-01

    cardiothoracic surgery and pathologic examinations showed characteristic morphology of Libman-Sacks vegetations. All microbiological examinations including blood cultures, microscopy, culture and 16s PCR of the valve were negative and the diagnosis of Libman-Sacks endocarditis was convincing. It is difficult...... to distinguish Libman-Sacks endocarditis from culture-negative infective endocarditis (IE). Molecular imaging techniques are being used increasingly in cases of suspected IE but no studies have previously reported the use in patients with Libman-Sacks endocarditis. In the present case, (18)F-FDG-PET-CT clearly...

  10. Efficacy of cardiac surgery in endocarditis

    Directory of Open Access Journals (Sweden)

    Moradmand S

    2000-06-01

    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.

  11. Partial oral treatment of endocarditis

    DEFF Research Database (Denmark)

    Iversen, Kasper; Høst, Nis; Bruun, Niels Eske

    2013-01-01

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

  12. Cardiac imaging in infectious endocarditis

    DEFF Research Database (Denmark)

    Bruun, Niels Eske; Habib, Gilbert; Thuny, Franck

    2014-01-01

    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...... infectious foci. A flowchart for the use of imaging in both left-sided and right-sided endocarditis is suggested....

  13. Endocarditis due to Chryseobacterium meningosepticum

    Directory of Open Access Journals (Sweden)

    Bomb K

    2007-01-01

    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.

  14. Resistencia bacteriana a los antibióticos

    OpenAIRE

    Crispín Pérez, Victor

    2014-01-01

    El descubrimiento de la antibiosis "in vitro" y el desarrollo de los antibióticos generó la ilusión del control de las enfermedades infecciosas bacterianas. Sin embargo, tan pronto como estas moléculas maravillosas fuero introducidas en la clínica, casi de inmediato surgieron las cepas bacterianas con resistencia adquirida, como se ha comprobado en las colecciones de cepas aisladas en las décadas del 50 del siglo pasado. Las moléculas de antibióticos inhiben o matan a las cepas sensibles, inh...

  15. Antibióticos vs. resistencia bacteriana

    Directory of Open Access Journals (Sweden)

    Elso Manuel Cruz Cruz

    2015-02-01

    Full Text Available La resistencia bacteriana a los antibióticos es un problema de salud mundial que se encuentra en constante evolución. De manera frecuente se reportan nuevos mecanismos de resistencia bacteriana a los antibióticos, tanto en bacterias gram negativas como en gram positivas. La presencia de resistencia en una bacteria causante de infección disminuye las posibilidades de obtener la curación clínica y la erradicación bacteriológica e incrementa los costos del tratamiento, la morbilidad y la mortalidad; por lo que es importante seleccionar el tratamiento adecuado. Uno de los aspectos que más preocupa a los médicos en el diagnóstico y tratamiento de una infección es la llamada resistencia adquirida, la cual ocurre en una bacteria inicialmente sensible a los antibióticos, por cambios, mutaciones o la adquisición de genes de resistencia durante el fenómeno de transferencia genética lateral, proceso por medio del cual un organismo transfiere material genético a otra célula que no es descendiente. La resistencia bacteriana adquirida a los antibióticos puede ser de distintos tipos, dependiendo de la presión selectiva, las mutaciones o la transferencia de genes de resistencia. Las definiciones de resistencia se clasifican según el número y clase de antibióticos afectados. La multirresistencia (Multiple Drug Resistance, MDR se define como la ausencia de sensibilidad a, por lo menos, un fármaco en tres o más de las categorías de antibióticos; la resistencia extrema (Extensively Drug-Resistant, XDR se refiere a la ausencia de sensibilidad a, por lo menos, un agente en todas las categorías de antimicrobianos, excepto en dos de ellas o menos, y la resistencia a todos los antimicrobianos se define como resistencia a todas las categorías de antibióticos. (1 Los mecanismos de resistencia dependen del tipo de bacteria que los desarrollen. Las bacterias gram positivas que producen con más frecuencias infecciones en humanos y que por

  16. [Letal endocarditis due to Corynebacterium pseudodiphtheriticum].

    Science.gov (United States)

    Pérez-Parra, Santiago; Peña, Alejandro; Blanca, Enrique; García, Federico

    2016-04-01

    We present a case report of a infective endocarditis by Corynebacterium pseudodiphtheriticum in a young patient eight years old with bicuspid aortic valve that led to a severe neurological embolism and death. Corynebacterium pseudodiphtheriticum is part of the nasopharyngeal and skin flora. However, there are cases reported of endocarditis usually associated with immunocompromised patients that mostly presented a poor clinical outcome.

  17. Endocarditis in Greenland with special reference to endocarditis caused by Streptococcus pneumoniae

    DEFF Research Database (Denmark)

    Madsen, Rasmus Gaarde; Ladefoged, Karin; Kjaergaard, Jens Jørgen

    2009-01-01

    OBJECTIVES: The aim of this retrospective study was to determine the incidence and outcome of infectious endocarditis in Greenland with an emphasis on pneumococcal endocarditis. STUDY DESIGN: Retrospective, non-interventional study. METHODS: Review of files and medical history of all patients...... with infectious endocarditis from the Patient Registry in Greenland in the 11-year period 1995-2005. RESULTS: There were 25 cases of endocarditis, giving an incidence rate of 4.0/100,000 per year. Twenty-four percent of these cases were caused by Streptoccous pneumonia, which is significantly more frequent than...... in studies on Caucasian populations, where pneumococcal infection was seen in 1-3% of endocarditis cases. The overall mortality rate was 12%. Pneumococcal endocarditis (PE) had the clinical characteristics of fulminant disease with frequent heart failure, complications and need for surgery. Among cases...

  18. Endocarditis infecciosa activa: 152 casos Active infective endocarditis: 152 cases

    Directory of Open Access Journals (Sweden)

    Lucía R. Kazelian

    2012-04-01

    Full Text Available La endocarditis infecciosa es una enfermedad de baja incidencia que en las últimas décadas mostró modificaciones respecto de su presentación, posibilidad diagnóstica y tratamiento. A pesar de estos avances, la mortalidad hospitalaria sigue siendo muy elevada. Nuestro objetivo fue analizar las características de los pacientes con endocarditis infecciosa activa y su relación con la mortalidad hospitalaria a lo largo de 16 años. Se realizó un registro prospectivo entre 1994 y 2010 de pacientes ingresados con endocarditis. Se analizaron características clínicas, evolución y tratamiento y se registraron los eventos intrahospitalarios. Ingresaron 152 pacientes, 64.5% varones, edad 45 ± 16 años, las causas más frecuentes de cardiopatía de base fueron: congénita 32 (21% y reumática 20 (13.2%. Los motivos de internación fueron síndrome febril 116 (76.3% e insuficiencia cardíaca 61 (40.1%. Se identificó el agente infeccioso en 106 (69.7% de los casos, el más frecuente fue Streptococcus viridans. El ecocardiograma mostró vegetaciones en 123 (80.9% de los pacientes y 88 (57.8% presentaron complicaciones durante su internación, siendo la más frecuente la insuficiencia cardíaca. Se indicó tratamiento quirúrgico en 96 (63.1% de los casos, fundamentalmente por insuficiencia cardíaca en 66. La mortalidad hospitalaria global fue 46 (30.2%. El desarrollo de complicaciones en la internación, la indicación de cirugía y la presencia de insuficiencia cardíaca refractaria al tratamiento fueron predictores independientes de mortalidad hospitalaria, mientras que la presencia de vegetaciones resultó un predictor independiente de mejor supervivencia. La identificación temprana de estos predictores descriptos podría ayudar a mejorar los resultados.Active infective endocarditis (IE is a disease of low incidence that has showed changes in presentation, diagnosis and treatment options during the past decades. Despite these advances

  19. Proteus endocarditis in an intravenous drug user.

    Science.gov (United States)

    Goel, Rohan; Sekar, Baskar; Payne, Mark N

    2015-11-26

    Infective endocarditis (IE) is a life-threatening condition with adverse consequences and increased mortality, despite improvements in treatment options. Diagnosed patients usually require a prolonged course of antibiotics, with up to 40-50% requiring surgery during initial hospital admission. We report a case of a 42-year-old intravenous drug user who presented feeling generally unwell, with lethargy, rigours, confusion and a painful swollen right leg. He was subsequently diagnosed with Proteus mirabilis endocarditis (fulfilling modified Duke criteria for possible IE) and deep vein thrombosis (DVT). He was successfully treated with single antibiotic therapy without needing surgical intervention or requiring anticoagulation for his DVT. Proteus endocarditis is extremely uncommon, with a limited number of case reports available in the literature. This case illustrates how blood cultures are invaluable in the diagnosis of IE, especially that due to unusual microorganisms. Our case also highlights how single antibiotic therapy can be effective in treating Proteus endocarditis. 2015 BMJ Publishing Group Ltd.

  20. Erysipelothrix Rhusiopathiae Endocarditis and Presumed Osteomyelitis

    Directory of Open Access Journals (Sweden)

    Marc Romney

    2001-01-01

    Full Text Available 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 vancomycin is often used empirically for the treatment of endocarditis, rapid differentiation of E rhusiopathiae> from other Gram-positive organisms is critical. In patients with endocarditis caused by a Gram-positive bacillus and epidemiological risk factors for E rhusiopathiae exposure, empirical treatment with vancomycin should be reconsidered.

  1. INFECTIVE ENDOCARDITIS IN INTRAVENOUS DRUGS ABUSED PATIENT

    Directory of Open Access Journals (Sweden)

    E. Y. Ponomareva

    2011-01-01

    Full Text Available Three-year observation of acute tricuspid infective endocarditis in intravenous drug abused patient: diagnosis, clinical features, visceral lesions, the possibility of cardiac surgery and conservative treatment, outcome.

  2. INFECTIVE ENDOCARDITIS IN INTRAVENOUS DRUGS ABUSED PATIENT

    Directory of Open Access Journals (Sweden)

    E. Y. Ponomareva

    2014-07-01

    Full Text Available Three-year observation of acute tricuspid infective endocarditis in intravenous drug abused patient: diagnosis, clinical features, visceral lesions, the possibility of cardiac surgery and conservative treatment, outcome.

  3. Prevention of Infective (Bacterial) Endocarditis: Wallet Card

    Science.gov (United States)

    ... AHA guideline. Members of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the American Heart Association’s Rheumatic Fever, Endocarditis, ...

  4. Endocarditis infecciosa activa: 152 casos

    Directory of Open Access Journals (Sweden)

    Lucía R. Kazelian

    2012-04-01

    Full Text Available La endocarditis infecciosa es una enfermedad de baja incidencia que en las últimas décadas mostró modificaciones respecto de su presentación, posibilidad diagnóstica y tratamiento. A pesar de estos avances, la mortalidad hospitalaria sigue siendo muy elevada. Nuestro objetivo fue analizar las características de los pacientes con endocarditis infecciosa activa y su relación con la mortalidad hospitalaria a lo largo de 16 años. Se realizó un registro prospectivo entre 1994 y 2010 de pacientes ingresados con endocarditis. Se analizaron características clínicas, evolución y tratamiento y se registraron los eventos intrahospitalarios. Ingresaron 152 pacientes, 64.5% varones, edad 45 ± 16 años, las causas más frecuentes de cardiopatía de base fueron: congénita 32 (21% y reumática 20 (13.2%. Los motivos de internación fueron síndrome febril 116 (76.3% e insuficiencia cardíaca 61 (40.1%. Se identificó el agente infeccioso en 106 (69.7% de los casos, el más frecuente fue Streptococcus viridans. El ecocardiograma mostró vegetaciones en 123 (80.9% de los pacientes y 88 (57.8% presentaron complicaciones durante su internación, siendo la más frecuente la insuficiencia cardíaca. Se indicó tratamiento quirúrgico en 96 (63.1% de los casos, fundamentalmente por insuficiencia cardíaca en 66. La mortalidad hospitalaria global fue 46 (30.2%. El desarrollo de complicaciones en la internación, la indicación de cirugía y la presencia de insuficiencia cardíaca refractaria al tratamiento fueron predictores independientes de mortalidad hospitalaria, mientras que la presencia de vegetaciones resultó un predictor independiente de mejor supervivencia. La identificación temprana de estos predictores descriptos podría ayudar a mejorar los resultados.

  5. Brucella Endocarditis Caused By Brucella Melitensis

    Directory of Open Access Journals (Sweden)

    Suzan Saçar

    2008-01-01

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

  6. Infective endocarditis and cancer in the elderly

    Science.gov (United States)

    García-Albéniz, Xabier; Hsu, John; Lipsitch, Marc; Logan, Roger W.; Hernández-Díaz, Sonia; Hernán, Miguel A

    2017-01-01

    Background Little is known about the magnitude of the association between infective endocarditis and cancer, and about the natural history of cancer patients with concomitant diagnosis of infective endocarditis. Methods We used the SEER-Medicare linked database to identify individuals aged 65 years or more diagnosed with colorectal, lung, breast, or prostate cancer, and without any cancer diagnosis (5% random Medicare sample from SEER areas) between 1992–2009. We identified infective endocarditis from the ICD-9 diagnosis of each admission recorded in the Medpar file and its incidence rate 90 days around cancer diagnosis. We also estimated the overall survival and CRC-specific survival after a concomitant diagnosis of infective endocarditis. Results The peri-diagnostic incidence of infective endocarditis was 19.8 cases per 100,000 person-months for CRC, 5.7 cases per 100,000 person-months for lung cancer, 1.9 cases per 100,000 person-months for breast cancer, 4.1 cases per 100,000 person-months for prostate cancer and 2.4 cases per 100,000 person-months for individuals without cancer. Two-year overall survival was 46.4% (95% CI 39.5, 54.5%) for stage I–III CRC patients with concomitant endocarditis and 73.1% (95% CI 72.9, 73.3%) for those without it. Conclusion In this elderly population, the incidence of infective endocarditis around CRC diagnosis was substantially higher than around the diagnosis of lung, breast and prostate cancers. A concomitant diagnosis of infective endocarditis in patients with CRC diagnosis is associated with shorter survival. PMID:26683995

  7. Infective endocarditis following percutaneous pulmonary valve replacement

    DEFF Research Database (Denmark)

    Cheung, Gary; Vejlstrup, Niels; Ihlemann, Nikolaj

    2013-01-01

    Infective endocarditis (IE) following percutaneous pulmonary valve replacement (PPVR) with the Melody valve is rarely reported. Furthermore, there are challenges in this diagnosis; especially echocardiographic evidence of vegetation within the prosthesis may be difficult.......Infective endocarditis (IE) following percutaneous pulmonary valve replacement (PPVR) with the Melody valve is rarely reported. Furthermore, there are challenges in this diagnosis; especially echocardiographic evidence of vegetation within the prosthesis may be difficult....

  8. Streptococcus sanguis endocarditis associated with colonic carcinoma.

    Science.gov (United States)

    Nijjer, Sukhjinder; Dubrey, Simon William

    2010-01-01

    Infective endocarditis caused by Streptococcus bovis is known to be associated with colorectal malignancy. Other less common streptococci, specifically Streptococcus sanguis, can be similarly associated with gastrointestinal carcinoma. We present a case of disseminated colorectal carcinoma occurring after a confirmed S sanguis endocarditis, that required mitral valve surgery. There may be a need for gastrointestinal surveillance in patients presenting with bacteraemia caused by less common streptococci.

  9. Bartonella Endocarditis and Pauci-Immune Glomerulonephritis

    Science.gov (United States)

    Raybould, Jillian E.; Raybould, Alison L.; Morales, Megan K.; Zaheer, Misbah; Lipkowitz, Michael S.; Timpone, Joseph G.; Kumar, Princy N.

    2016-01-01

    Abstract Among culture-negative endocarditis in the United States, Bartonella species are the most common cause, with Bartonella henselae and Bartonella quintana comprising the majority of cases. Kidney manifestations, particularly glomerulonephritis, are common sequelae of infectious endocarditis, with nearly half of all Bartonella patients demonstrating renal involvement. Although a pauci-immune pattern is a frequent finding in infectious endocarditis–associated glomerulonephritis, it is rarely reported in Bartonella endocarditis. Anti–neutrophil cytoplasmic antibody (ANCA) positivity can be seen with many pathogens causing endocarditis and has been previously reported with Bartonella species. In addition, ANCA-associated vasculitis can also present with renal and cardiac involvement, including noninfectious valvular vegetations and pauci-immune glomerulonephritis. Given the overlap in their clinical presentation, it is difficult to differentiate between Bartonella endocarditis and ANCA-associated vasculitis but imperative to do so to guide management decisions. We present a case of ANCA-positive Bartonella endocarditis with associated pauci-immune glomerulonephritis that was successfully treated with medical management alone. PMID:27885316

  10. Endocarditis

    Science.gov (United States)

    ... that infections in your mouth from poor oral hygiene might increase the risk of germs entering your bloodstream. In addition to brushing and flossing, regular dental exams are an important part of maintaining good oral health. By Mayo Clinic Staff . Mayo Clinic Footer Legal Conditions and Terms Any ...

  11. Endocarditis

    Science.gov (United States)

    ... bloodstream through: Everyday oral activities. Activities such as brushing your teeth, or other activities that could cause your gums ... of germs entering your bloodstream. In addition to brushing and flossing, regular dental exams are an important part of maintaining good ...

  12. Treatment of endocarditis due to Proteus species: a literature review.

    Science.gov (United States)

    Kalra, Ankur; Cooley, Christine; Tsigrelis, Constantine

    2011-04-01

    Endocarditis due to Proteus species is very rare. We report a case of endocarditis due to Proteus mirabilis that was successfully treated with ampicillin and gentamicin, and review the treatment regimens of previously published cases of Proteus endocarditis. Copyright © 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  13. Abiotrophia spp. and Staphylococcus epidermidis Endocarditis Treated with Daptomycin

    Directory of Open Access Journals (Sweden)

    E. Bishburg

    2008-01-01

    Full Text Available Endocarditis due to Abiotrophia spp. occurs in about 5% of endocarditis cases. Most of the cases respond to a combination of penicillin and gentamicin, or vancomycin. We describe a case of Staphylococcus epidermidis (CONS and Abiotrophia spp. endocarditis that failed vancomycin treatment, but responded to daptomycin and rifampin.

  14. [Clinical and morphological aspects of infectious endocarditis].

    Science.gov (United States)

    Fedorova, T A; Tazina, S Ia; Kakturskiĭ, L V; Kanareĭtseva, T D; Burtsev, V I; Rusanov, N I; Semenenko, N A

    2014-01-01

    Comparative analysis of anamnestic, clinical, laboratory and instrumental data involved 106 patients with infectious endocarditis treated in S.P. Botkin City Clinical Hospital in 2000-2011 and 92 ones admitted in 1985-1977. The results give evidence of ongoing pathomorphosis of infectious endocarditis as is apparent from the growing number of male patients, increased frequency of primary cases and previous invasive or intravascular manipulations, thromboembolic complications including pulmonary thromboembolism, right heart chamber endocarditis. Over half of the patients are socially unadapted C-peptide level is of diagnostic value for the assessment of inflammation activity, precursors of natriuretic peptide can be used to detect preclinical and clinical stages of cardiac failure related to infectious endocarditis. There is correlation between severity of inflammation and myocardial dysfunction. Early surgical intervention in the absence of effect of combined antibacterial therapy improves prognosis. Morphological studies of inflammation-related changes in myocardium, destruction of cardiomyocytes, dystrophic processes, and fibrosis play an important role in the development of cardiac insufficiency and prognosis of infectious endocarditis.

  15. [Subcutaneous teicoplanin for children with infectious endocarditis].

    Science.gov (United States)

    Carpentier, E; Roméo, B; El Samad, Y; Geslin-Lichtenberger, L; Maingourd, Y; Tourneux, P

    2013-07-01

    Infectious endocarditis in children requires prolonged antibiotic therapy. In adults, antibiotics administrated subcutaneously such as teicoplanin are an alternative to intravenous treatment. We report the use of subcutaneous teicoplanin, after an initial antibiotic treatment administrated intravenously, for 2 children treated for infectious endocarditis following an initial cardiac surgery. Serum concentrations of teicoplanin were within the target range after the adaptation in the teicoplanin subcutaneous dosages. The treatment was effective for both cases. No specific side effects related to the treatment were reported. Subcutaneous administration could be used for prolonged antibiotic therapy for the treatment of infectious endocarditis in children, after an initial intravenous treatment. Variability of the bioavailability of antibiotics administrated subcutaneously requires regular testing. Prospective, randomized trials comparing intravenous and subcutaneous administration of teicoplanin should be conducted to assess the efficacy and safety of this treatment. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  16. Streptococcus dysgalactiae endocarditis presenting as acute endophthalmitis

    Directory of Open Access Journals (Sweden)

    Angelina Su-Min Yong

    2012-02-01

    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.

  17. "Streptococcus milleri" endocarditis caused by Streptococcus anginosus.

    Science.gov (United States)

    Woo, Patrick C Y; Tse, Herman; Chan, Kai-ming; Lau, Susanna K P; Fung, Ami M Y; Yip, Kam-tong; Tam, Dorothy M W; Ng, Kenneth H L; Que, Tak-lun; Yuen, Kwok-yung

    2004-02-01

    Unlike other viridans streptococci, members of the "Streptococcus milleri group" are often associated with abscess formation, but are only rare causes of infective endocarditis. Although it has been shown that almost all S. intermedius isolates and most S. constellatus isolates, but only 19% of S. anginosus isolates, were associated with abscess formation, no report has addressed the relative importance of the 3 species of the "S. milleri group" in infective endocarditis. During a 5-year period (April 1997 through March 2002), 6 cases of "S. milleri" endocarditis (out of 377 cases of infective endocarditis), that fulfil the Duke's criteria for the diagnosis of infective endocarditis, were encountered. All 6 "S. milleri" isolates were identified as S. anginosus by 16S ribosomal RNA (rRNA) gene sequencing. Three patients had underlying chronic rheumatic heart disease and 1 was an IV drug abuser. Five had monomicrobial bacteremia, and 1 had polymicrobial (S. anginosus, S. mitis, Granulicatella adiacens, and Slackia exigua) bacteremia. Two patients died. None of the 6 isolates were identified by the Vitek system (GPI) or the API system (20 STREP) at >95% confidence. All 6 isolates were sensitive to penicillin G (MIC 0.008-0.064 microg/mL), cefalothin, erythromycin, clindamycin, and vancomycin. Accurate identification to the species level, by 16S rRNA gene sequencing, in cases of bacteremia caused by members of the "S. milleri group", would have direct implication on the underlying disease process, hence guiding diagnosis and treatment. Infective endocarditis should be actively looked for in cases of monomicrobial S. anginosus bacteremia, especially if the organism is recovered in multiple blood cultures.

  18. A misinterpreted case of aorta prosthesis endocarditis

    DEFF Research Database (Denmark)

    Lerche, Christian Johann; Haugan, Ketil Jørgen; Reimers, Jesper Irving

    2013-01-01

    A 17-year-old male with a history of newly implanted mechanical valve at the aortic position, presented with fever, rigors, and painful cutaneous abscesses on his lower extremities and was suspected for infective endocarditis. Transthoracic echocardiography (TTE) showed a vegetation-like structur...... following the movement of the mechanical heart valve (MHV), which eventually proved to be a product of degassing microbubbles (MB).......A 17-year-old male with a history of newly implanted mechanical valve at the aortic position, presented with fever, rigors, and painful cutaneous abscesses on his lower extremities and was suspected for infective endocarditis. Transthoracic echocardiography (TTE) showed a vegetation-like structure...

  19. Cytokine Signature in Infective Endocarditis

    Science.gov (United States)

    Araújo, Izabella Rodrigues; Ferrari, Teresa Cristina Abreu; Teixeira-Carvalho, Andréa; Campi-Azevedo, Ana Carolina; Rodrigues, Luan Vieira; Guimarães Júnior, Milton Henriques; Barros, Thais Lins Souza; Gelape, Cláudio Léo; Sousa, Giovane Rodrigo; Nunes, Maria Carmo Pereira

    2015-01-01

    Infective endocarditis (IE) is a severe disease with high mortality rate. Cytokines participate in its pathogenesis and may contribute to early diagnosis improving the outcome. This study aimed to evaluate the cytokine profile in IE. Serum concentrations of interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12 and tumor necrosis factor (TNF)-α were measured by cytometric bead array (CBA) at diagnosis in 81 IE patients, and compared with 34 healthy subjects and 30 patients with non-IE infections, matched to the IE patients by age and gender. Mean age of the IE patients was 47±17 years (range, 15–80 years), and 40 (50%) were male. The IE patients had significantly higher serum concentrations of IL-1β, IL-6, IL-8, IL-10 and TNF-α as compared to the healthy individuals. The median levels of IL-1β, TNF-α and IL-12 were higher in the IE than in the non-IE infections group. TNF-α and IL-12 levels were higher in staphylococcal IE than in the non-staphylococcal IE subgroup. There was a higher proportion of both low IL-10 producers and high producers of IL-1β, TNF-α and IL-12 in the staphylococcal IE than in the non-staphylococcal IE subgroup. This study reinforces a relationship between the expression of proinflammatory cytokines, especially IL-1β, IL-12 and TNF-α, and the pathogenesis of IE. A lower production of IL-10 and impairment in cytokine network may reflect the severity of IE and may be useful for risk stratification. PMID:26225421

  20. Spondylodiscitis and endocarditis caused by S. vestibularis

    Directory of Open Access Journals (Sweden)

    Muge Aydin Tufan

    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.

  1. [Infectious endocarditis in the intensive care unit].

    Science.gov (United States)

    Miranda-Montero, S; Rodríguez-Esteban, M; Alvarez-Acosta, L; Lubillo-Montenegro, S; Pérez-Hernández, H; Llorens-León, R

    2012-10-01

    To study the characteristics, evolution and prognosis of patients with infectious endocarditis requiring treatment in the Intensive Care Unit. A prospective, observational cohort study of patients admitted due to infectious endocarditis. Nuestra Señora de Candelaria University Hospital, a third - level center with a recruitment population of 493,145. All patients consecutively diagnosed with infectious endocarditis in our center according to the Duke criteria, between 1 January 2005 and 31 July 2011. Demographic data, clinical severity scores, microbiological and echocardiographic data, hospital mortality and complications. 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%, pendocarditis require admission to the Intensive Care Unit, presenting a much poorer prognosis. Staphylococcus aureus infection, heart failure, cerebral embolism and SAPS II scores are independent predictors of hospital mortality. Copyright © 2011 Elsevier España, S.L. y SEMICYUC. All rights reserved.

  2. Serological diagnosis of experimental Enterococcus faecalis endocarditis

    DEFF Research Database (Denmark)

    Kjerulf, A; Espersen, F; Gutschik, E

    1998-01-01

    A modified rat model of endocarditis with catheterization for 2 days was established in female Lewis rats using different inocula of Enterococcus faecalis (strain no. EF 19) in order to measure IgG antibodies in serum during the course of infection. Increasing the inocula intravenously resulted...

  3. Blood Culture-Negative Endocarditis, Morocco.

    Science.gov (United States)

    Boudebouch, Najma; Sarih, M'hammed; Chakib, Abdelfattah; Fadili, Salma; Boumzebra, Drissi; Zouizra, Zahira; Mahadji, Badie Azamane; Amarouch, Hamid; Raoult, Didier; Fournier, Pierre-Edouard

    2017-11-01

    We investigated the microorganisms causing blood culture-negative endocarditis (BCNE) in Morocco. We tested 19 patients with BCNE by serologic methods, molecular methods, or both and identified Bartonella quintana, Staphylococcus aureus, Streptococcus equi, and Streptococcus oralis in 4 patients. These results highlight the role of these zoonotic agents in BCNE in Morocco.

  4. Return to the workforce following infective endocarditis

    DEFF Research Database (Denmark)

    Butt, Jawad H.; Kragholm, Kristian; Dalager-Pedersen, Michael

    2018-01-01

    BACKGROUND: The ability to return to work after infective endocarditis (IE) holds important socioeconomic consequences for both patients and society, yet data on this issue are sparse. We examined return to the workforce and associated factors in IE patients of working age. METHODS: Using Danish ...

  5. Bartonella henselae endocarditis in Laos - 'the unsought will go undetected'.

    Directory of Open Access Journals (Sweden)

    Sayaphet Rattanavong

    2014-12-01

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

  6. Bartonella henselae endocarditis in Laos - 'the unsought will go undetected'.

    Science.gov (United States)

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

    2014-12-01

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

  7. Achromobacter species endocarditis: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Catherine Derber

    2011-01-01

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

  8. Tecnicas de fermentacion y aplicaciones de la celulosa bacteriana: una revision

    National Research Council Canada - National Science Library

    Carreno Pineda, Luz Dary; Caicedo Mesa, Luis Alfonso; Martinez Riascos, Carlos Arturo

    2012-01-01

    La celulosa bacteriana es un polimero obtenido por fermentacion con microrganismos de los generos Acetobacter, Rhizobium, Agrobacterium y Sarcina, de las cuales la especie mas eficiente es la Acetobacter Xylinum...

  9. Subacute bacterial endocarditis (SBE due to Streptococcus gordonii

    Directory of Open Access Journals (Sweden)

    Raffaella Battista

    2009-12-01

    Full Text Available Endocarditis is an inflammatory state of the endothelium that promotes thrombus formation and tissue damage on the surface of heart valves. Recent studies have reported endocarditis mortality rates ranging from 12% to 46% (2008. The Streptococcus gordonii is a normal inhabitant of the human oral cavity. It is a component of the microbial communities responsible of plaque formation, associated with dental caries and also regarded as the main causative agent in the development of subacute bacterial endocarditis (SBE.

  10. Las enfermedades periodontales como infecciones bacterianas Periodontal diseases as bacterial infection

    OpenAIRE

    A. Bascones Martínez; E. Figuero Ruiz

    2005-01-01

    Las infecciones periodontales son un conjunto de enfermedades localizadas en las encías y estructuras de soporte del diente. Están producidas por ciertas bacterias provenientes de la placa bacteriana. Estas bacterias son esenciales para el inicio de la enfermedad, pero existen factores predisponentes del hospedador y microbianos que influyen en la patogénesis de la enfermedad. La microbiota bacteriana periodontopatógena es necesaria pero no suficiente para que exista enfermedad, siendo necesa...

  11. Polymicrobial infective endocarditis caused by Neisseria sicca and Haemophilus parainfluenzae

    Directory of Open Access Journals (Sweden)

    Nikoloz Koshkelashvili

    2016-01-01

    Full Text Available Infective endocarditis is a common clinical problem in industrialized countries. Risk factors include abnormal cardiac valves, a history of endocarditis, intracardiac devices, prosthetic valves and intravenous drug use. We report a case of polymicrobial infective endocarditis in a 33 year-old female with a history chronic heroin use caused by Neisseria sicca and Haemophilus parainfluenzae. We believe the patient was exposed to these microbes by cleansing her skin with saliva prior to injection. Pairing a detailed history with the consideration of atypical agents is crucial in the proper diagnosis and management of endocarditis in patients with high-risk injection behaviors.

  12. Infectious endocarditis caused by Escherichia coli

    DEFF Research Database (Denmark)

    Lauridsen, Trine Kiilerich; Arpi, Magnus; Fritz-Hansen, Thomas

    2011-01-01

    -spectrum intravenous antibiotics. Transthoracic and transoesophageal echocardiography revealed a severe mitral endocarditis. E. coli DNA was identified from the mitral valve and the vegetation, and no other pathogen was found. The case was further complicated by spondylodiscitis and bilateral endophthalmitis. Extra-intestinal...... pathogenic E. coli (ExPEC) are able to colonize tissue outside the gastrointestinal tract and contain a variety of virulence factors that may enable the pathogens to invade and induce infections in the cardiac endothelia. In these cases echocardiography as the imaging technology is of paramount importance......Although Escherichia coli is among the most common causes of Gram-negative bacteraemia, infectious endocarditis (IE) due to this pathogen is rare. A 67-y-old male without a previous medical history presented with a new mitral regurgitation murmur and persisting E. coli bacteraemia in spite of broad...

  13. Infectious endocarditis caused by Escherichia coli.

    Science.gov (United States)

    Lauridsen, Trine Kiilerich; Arpi, Magnus; Fritz-Hansen, Thomas; Frimodt-Møller, Niels; Bruun, Niels Eske

    2011-07-01

    Although Escherichia coli is among the most common causes of Gram-negative bacteraemia, infectious endocarditis (IE) due to this pathogen is rare. A 67-y-old male without a previous medical history presented with a new mitral regurgitation murmur and persisting E. coli bacteraemia in spite of broad-spectrum intravenous antibiotics. Transthoracic and transoesophageal echocardiography revealed a severe mitral endocarditis. E. coli DNA was identified from the mitral valve and the vegetation, and no other pathogen was found. The case was further complicated by spondylodiscitis and bilateral endophthalmitis. Extra-intestinal pathogenic E. coli (ExPEC) are able to colonize tissue outside the gastrointestinal tract and contain a variety of virulence factors that may enable the pathogens to invade and induce infections in the cardiac endothelia. In these cases echocardiography as the imaging technology is of paramount importance for the correct diagnosis and treatment.

  14. Infectious endocarditis caused by Escherichia coli

    DEFF Research Database (Denmark)

    Lauridsen, Trine Kiilerich; Arpi, Magnus; Fritz-Hansen, Thomas

    2011-01-01

    Although Escherichia coli is among the most common causes of Gram-negative bacteraemia, infectious endocarditis (IE) due to this pathogen is rare. A 67-y-old male without a previous medical history presented with a new mitral regurgitation murmur and persisting E. coli bacteraemia in spite of broad......-spectrum intravenous antibiotics. Transthoracic and transoesophageal echocardiography revealed a severe mitral endocarditis. E. coli DNA was identified from the mitral valve and the vegetation, and no other pathogen was found. The case was further complicated by spondylodiscitis and bilateral endophthalmitis. Extra......-intestinal pathogenic E. coli (ExPEC) are able to colonize tissue outside the gastrointestinal tract and contain a variety of virulence factors that may enable the pathogens to invade and induce infections in the cardiac endothelia. In these cases echocardiography as the imaging technology is of paramount importance...

  15. Infective endocarditis following transcatheter aortic valve replacement-

    DEFF Research Database (Denmark)

    Loh, Poay Huan; Bundgaard, Henning; S�ndergaard, Lars

    2013-01-01

    Transcatheter aortic valve replacement (TAVR) can improve the symptoms and prognosis of patients with severe aortic stenosis who, due to a high expected operative risk, would not have otherwise been treated surgically. If these patients develop prosthetic valve endocarditis, their presentations m...... treated medically, discuss the challenges in the diagnosis and management of such patients, and review available literature on the incidence and outcome of the condition. © 2012 Wiley Periodicals, Inc....

  16. Takayasu Arteritis Initially Mimicking Infective Endocarditis

    Directory of Open Access Journals (Sweden)

    Aytekin Alcelik

    2011-09-01

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

  17. Molecular Methods for Diagnosis of Infective Endocarditis

    OpenAIRE

    Moter, Annette; Musci, Michele; Schmiedel, Dinah

    2002-01-01

    Infective endocarditis (IE) is a life-threatening disease associated with high mortality. Conventional microbiologic diagnosis is based mainly on culture-dependent methods that often fail because of previous antibiotic therapy or the involvement of fastidious or slowly growing microorganisms. In recent years, molecular techniques entered the field of routine diagnostics. Amplification-based methods proved useful for detection of microorganisms in heart valve tissue. More recently, they were a...

  18. Native valve Escherichia coli endocarditis following urosepsis

    Directory of Open Access Journals (Sweden)

    D Rangarajan

    2013-01-01

    Full Text Available Gram-negative organisms are a rare cause of infective endocarditis. Escherichia coli, the most common cause of urinary tract infection and gram-negative septicemia involves endocardium rarely. In this case report, we describe infection of native mitral valve by E. coli following septicemia of urinary tract origin in a diabetic male; subsequently, he required prosthetic tissue valve replacement indicated by persistent sepsis and congestive cardiac failure.

  19. Native valve Escherichia coli endocarditis following urosepsis

    OpenAIRE

    Rangarajan, D.; Ramakrishnan, S.; Patro, K. C.; Devaraj, S.; Krishnamurthy, V.; Kothari, Y.; Satyaki, N.

    2013-01-01

    Gram-negative organisms are a rare cause of infective endocarditis. Escherichia coli, the most common cause of urinary tract infection and gram-negative septicemia involves endocardium rarely. In this case report, we describe infection of native mitral valve by E. coli following septicemia of urinary tract origin in a diabetic male; subsequently, he required prosthetic tissue valve replacement indicated by persistent sepsis and congestive cardiac failure.

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

    Directory of Open Access Journals (Sweden)

    Federico A Silva

    2011-07-01

    Full Text Available 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.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.

  1. Tricuspid valve endocarditis caused by Eikenella corrodens

    Directory of Open Access Journals (Sweden)

    Martin Tretjak

    2015-06-01

    Full Text Available AbstractBackground. Infectious endocarditis of the tricuspid valve is rare in non-intravenous drug users and patients without central venous devices. The most frequent causative agents are staphylococci, rarely other bacteria.Methods. We describe a case of a 57-year-old patient without history of drug abuse that was admitted to our hospital because of fever with chills, dry cough, loss of appetite and wasting lasting for a few months. He had a venous ulcer on the right foot and interdigital inflammation on both feet. Eikenella corrodens was isolated from blood cultures. Transthoracic echocardiography showed a large vegetation on the anterior leaflet of tricuspid valve. CT scan oh the thorax showed probable septic emboli. The patient was treated conservatively with prolonged double antibiotic regimen. During the treatment there were no further complications.Conclusions. In our patients a rare form of tricuspid valve endocarditis was confirmed, caused by Eikenella corrodens. The possibility of infectious endocarditis should always be considered in patients with prolonged fever, especially when a possible causative agent is isolated from blood cultures.

  2. [Analysis of 112 cases of infectious endocarditis].

    Science.gov (United States)

    He, Shengping; Chen, Yahua; Zhang, Zhen; Wang, Zhenkang; Wang, Wujun

    2013-02-01

    To analyze the clinical manifestations, epidemiological features, pathogens, treatment and outcomes of 112 patients with infectious endocarditis. The clinical data were reviewed for all the patients with the diagnosis of infectious endocarditis in Nanfang Hospital over the period from 2002 to 2012. The average age of disease onset was 46∓17.1 years among these cases. Seventy patients (62.5%) had underlying cardiac conditions, including, in the order of frequency, rheumatic heart disease, congenital cardiovascular anomalies, and senile valve degeneration. Clinically the patients presented with fever, anemia, congestive heart failure, and embolism events, etc. Echocardiography found endocardial neoplasms in 105 cases, and the mitral valve was often involved. Blood culture yielded positive results in 61 cases, and the most common causative bacteria were Streptococcus (20.5%), Staphylococcus (19.6%) and Enterococcus (5.4%). Surgical intervention was performed in 78 cases. Ninety-one patients were cured or improved after comprehensive treatment, and 10 discontinued treatment for financial reasons; 11 died of cardiac failure (8 cases), pulmonary embolism (2 cases) and central nervous system events (1 case). Infectious endocarditis shows a significant change in the clinical profiles and its mortality remains high despite improved diagnostic and therapeutic procedures.

  3. [Infectious endocarditis in intensive care patients].

    Science.gov (United States)

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

    2012-02-01

    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.

  4. Valvular Heart Disease in Adults: Infective Endocarditis.

    Science.gov (United States)

    Khan, Zubair A; Hollenberg, Steven M

    2017-06-01

    A variety of microorganisms can cause infective endocarditis (IE) in patients with native valves. Staphylococci and streptococci are most common in community-acquired IE; staphylococci are most common in nosocomial IE. Microbiology of prosthetic valve endocarditis (PVE) depends on timing. Early-onset PVE (ie, 60 days or fewer postsurgery) typically is nosocomial, with Staphylococcus aureus infection being most common. Intermediate-onset PVE (ie, 60 to 365 days postsurgery) typically involves a mix of nosocomial and non-nosocomial organisms. PVE that develops more than 1 year after surgery has microbiology similar to that of native valve endocarditis. Fever is the most common symptom; others include dyspnea, pleuritic pain, anorexia, and myalgias. The Modified Duke Criteria is the standard for diagnosis, with blood cultures being the most important test. If patients are in stable condition, three sets of blood cultures should be obtained more than 6 hours apart and from separate sites before starting antibiotics. Echocardiography aids in diagnosis and can identify conditions best managed with surgery. For empiric therapy for native valve IE, most patients should receive vancomycin. For PVE, vancomycin and gentamicin should be prescribed, plus cefepime or an antipseudomonal carbapenem. Treatment typically continues for 6 weeks after blood culture results are negative. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  5. Bacterial endocarditis due to eikenella corrodens: A case report

    Directory of Open Access Journals (Sweden)

    Mahapatra A

    2003-01-01

    Full Text Available Of all the causes of bacterial endocarditis, HACEK group consisting of Haemophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella Kingae are rare causative agents. We report a case of bacterial endocarditis by E. corrodens, which is one of the members of the HACEK group.

  6. [Aspergillus fumigatus endocarditis in a patient with a biventricular pacemaker].

    Science.gov (United States)

    Cuesta, José M; Fariñas, María C; Rodilla, Irene G; Salesa, Ricardo; de Berrazueta, José R

    2005-05-01

    Aspergillus fumigatus endocarditis is one of the rarest and severest complications in cardiological patients. We describe a patient with an intracardial pacemaker who was diagnosed as having Aspergillus fumigatus endocarditis. Postmortem examination showed a large, Aspergillus-infected thrombus encased in the right ventricle, pulmonary trunk and main pulmonary branches.

  7. Enterococcal endocarditis - a case treated with teicoplanin and ...

    African Journals Online (AJOL)

    Enterococcal endocarditis - a case treated with teicoplanin and amoxycillin. P L Botha, M C Struwig, W de Vries, J Hough, L J Chalkley. Abstract. The study aimed to determine the antibacterial therapy effective in the cure of endocarditis caused by Enterococcus faecalis resistant to clinically achievable levels of vancomycin.

  8. Infective endocarditis in Ethiopian children: A hospital based review ...

    African Journals Online (AJOL)

    Introduction: infective endocarditis is an infection of the endocardial lining of the heart mainly associated with congenital and rheumatic heart disease. Although it is a rare disease in children, it is associated with high morbidity and mortality; death due to infective endocarditis has been reported to be as high as 26% in ...

  9. [Sylvian and mesenteric arteries aneurysm revealing infective endocarditis].

    Science.gov (United States)

    Ghalem, Amine; Laachach, Houssam; Fliti, Alaa; Elyandouzi, Abdelmalek; Elkasimi, Abdelwahab; Ismaili, Nabila; El Ouafi, Noha

    2016-01-01

    Infective endocarditis is an emergency condition usually diagnosed in the context of an infectious syndrome associated with heart murmur. It can lead to life-threatening complications. We report the case of a patient with endocarditis presenting as neuro-abdominal manifestations associated with sylvian and mesenteric arteries mycotic aneurysm. Evolution was favorable under medical-surgical treatment.

  10. Infectious endocarditis with five localisations--case reports.

    Science.gov (United States)

    Luca, Alina-Costina; Iordache, C

    2014-01-01

    Infectious endocarditis is defined as an infection of the endocardial surface area of the heart which can include one or more cardiac valves, mural endocardium or a septal defect. We present the case of a patient, aged 8, hospitalized in Hemato-Oncology Department with pontine glioma, who was also diagnosed with infectious endocarditis in five locations.

  11. Native Pulmonic Valve Endocarditis due to Mycobacterium fortuitum: A Case Report and Literature Review

    OpenAIRE

    Mulhall, Aaron M.; Hebbeler-Clark, Renee S.

    2015-01-01

    Endocarditis secondary to Mycobacterium fortuitum is a rare entity often involving prosthetic valves and rarely native valves. Pulmonic valve endocarditis secondary to any organism is rare. We report the first case of native pulmonic valve endocarditis secondary to M. fortuitum and a literature review of native valve M. fortuitum endocarditis.

  12. Native Pulmonic Valve Endocarditis due to Mycobacterium fortuitum: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Aaron M. Mulhall

    2015-01-01

    Full Text Available Endocarditis secondary to Mycobacterium fortuitum is a rare entity often involving prosthetic valves and rarely native valves. Pulmonic valve endocarditis secondary to any organism is rare. We report the first case of native pulmonic valve endocarditis secondary to M. fortuitum and a literature review of native valve M. fortuitum endocarditis.

  13. Mycobacterium abscessus Endocarditis: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Wei-Chung Tsai

    2008-09-01

    Full Text Available Infective endocarditis owing to Mycobacterium abscessus infection is rarely reported. Most cases of infective endocarditis caused by Mycobacterium abscessus are seen in patients after valve replacement. Although early surgical intervention is recommended and medical treatment with antibiotics according to the susceptibility to the pathogen, such as amikacin, imipenem, cefoxitin, quinolones and macrolides, are applied, the course of such endocarditis is usually subacute and often has fatal outcomes. The present case was a 29-year-old male patient who was an intravenous drug user who had recurrent endocarditis caused by Mycobacterium abscessus. Unusually, our reported case was infected on his native valve. However, we experienced recurrence despite antimicrobial therapy. For culture-negative endocarditis, physicians should consider the possibility of Mycobacterium abscessus infection and related treatment difficulties.

  14. Fatal myocarditis-associated Bartonella quintana endocarditis: a case report

    Directory of Open Access Journals (Sweden)

    Montcriol Ambroise

    2009-07-01

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

  15. Dermatopatías bacterianas de importancia en medicina equina.

    Directory of Open Access Journals (Sweden)

    Christian Tuemmers

    2016-12-01

    Full Text Available La dermatología representa una parte importante en la práctica equina. Las dermatopatías bacterianas comúnmente son causadas por patógenos oportunistas que son parte de la flora normal de la piel, que ingresan mediante disrupciones de la piel provocando el desarrollo de enfermedades; existen también patógenos que pueden provocar enfermedad sistémica que tienen manifestaciones cutáneas. Para el diagnóstico de las patologías cutáneas provocadas por bacterias es necesario realizar el examen clínico general y luego hacer un examen específico de la piel describiendo las características de la piel y las lesiones que se presentan. Hay numerosos métodos complementarios que ayudan a la identificación del agente etiológico; con el fin de instaurar el tratamiento adecuado. En nuestro país se han realizado pocos reportes y publicaciones respecto de las patologías cutáneas que afectan a los equinos, a su vez también es poca la variedad de antimicrobianos de uso en la clínica equina lo que impide el correcto tratamiento de las diferentes dermatopatías.

  16. The first reported case of Bartonella endocarditis in Thailand

    Directory of Open Access Journals (Sweden)

    Orathai Pachirat

    2011-06-01

    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.

  17. A severe infective endocarditis successfully treated with linezolid

    Directory of Open Access Journals (Sweden)

    Graziano Antonio Minafra

    2010-03-01

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

  18. Brucella Endocarditis as a Late Onset Complication of Brucellosis

    Directory of Open Access Journals (Sweden)

    Panagiotis Andriopoulos

    2015-01-01

    Full Text Available Brucella endocarditis (BE is a rare but life threatening complication of brucellosis. We present a case report of a patient with relapsing brucellosis complicated with aortic valve endocarditis. The patient underwent valve replacement and required prolonged antibiotic treatment because of rupture of the noncoronary leaflet and development of congestive heart failure. Since the onset of endocarditis in patients with brucellosis is not known, proper follow-up is required in order to identify any late onset complications, especially in endemic areas.

  19. Surgical management of left heart endocarditis.

    Science.gov (United States)

    Defraigne, J O; Dalem, A M; Demoulin, J C; Limet, R

    1989-01-01

    Between 1981 and 1987, 29 patients (20 men and 9 women, mean age 46 +/- 15) underwent a valvular replacement for endocarditis (19 aortic and 10 mitral). There were 25 native and 4 prosthetic valves. In 85% of cases, underlying valvular lesions were present. The oropharyngeal and the respiratory tracts were the most common sources of infection. In 81%, the infecting microorganism was gram-positive. In 21% of cases, a gram-negative was detected, always mixed with a gram-positive. One infection was caused by a Candida. Indications for surgery were severe valvular insufficiency or cardiac failure (90%), refractory sepsis (21%), thromboembolic events (11%). In 22%, multiple factors were present. A biologic valve was chosen in 12 cases (40%). Simultaneously with the valvular replacement, 4 ventricular septal perforations were occluded and 3 valvular annulus abscesses debrided. The operative mortality was 10% (3/29). The one-year survival is 96%. Two patients required reoperation at 6 months and 2 years, for partial dehiscence, with good subsequent evolution. The authors concluded that surgical operation is the most suitable treatment for unstable or complicated endocarditis, in case of cardiac failure, iterative thromboembolic events or refractory sepsis.

  20. Surgery in current therapy for infective endocarditis

    Directory of Open Access Journals (Sweden)

    Kappetein

    2011-04-01

    Full Text Available 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. 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 in patients who present with specific symptoms or microorganisms; nevertheless even then it often remains unclear when surgery should be performed. In this review we i systematically reviewed the current literature comparing medical to surgical therapy to evaluate if surgery is the preferred option, ii performed a meta-analysis of studies reporting propensity matched analyses, and iii, briefly summarized the current indications for surgery.Keywords: endocarditis, surgery, antibiotics, review, meta-analysis, propensity analysis, mortality, complications

  1. La placa bacteriana: conceptos básicos para el higienista bucodental

    OpenAIRE

    Poyato Ferrera, Manuel María; Segura-Egea, Juan J; Ríos-Santos, J.V.; Bullon, Pedro

    2001-01-01

    La placa bacteriana es el factor etiológico principal de las dos enfermedades bucodentales de mayor prevalencia, la caries y la enfermedad periodontal. El higienista bucodental y colaborador del odontoestomatólogo en la aplicación del programa de control de placa, debe conocer en profundidad la microbiología de la placa bacteriana dental, así como los mecanismos implicados en su patogenicidad cariogénica y periodontal, aspectos que se revisan a continuación. Dental plaque is the main etiol...

  2. FORUM Prevention of infective endocarditis in developing countries ...

    African Journals Online (AJOL)

    , India and Sweden) ... British Antimicrobial Society report in 2006,27 and the American. Heart Association guideline of .... antimicrobial prophylaxis against infective endocarditis in adults and children undergoing interventional procedures.

  3. Aspergillus endocarditis presenting as acute right lower limb pain

    Directory of Open Access Journals (Sweden)

    P Ghosh

    2013-10-01

    Full Text Available Corrigendum: On 31/10/2013 the name of the author K. Shah was corrected to read K. Saha.Aspergillus endocarditis is an 2nd most common cause of endocarditis having poor prognosis. We report a rare case of fungal endocarditis following cardiac valve replacement presenting as acute pain in the right lower limb. Embolism and endocarditis were primarily detected by CT angiography and echocardiography respectively. Diagnosis was established by histopathology and culture of the emboli and was confirmed later by isolation of the Aspergillus species from the resected valve tissue. DOI: http://dx.doi.org/10.3126/jpn.v3i6.9002   Journal of Pathology of Nepal (2013 Vol. 3, 502-504

  4. Subacute bacterial endocarditis: considerations for the pediatric patient

    National Research Council Canada - National Science Library

    Soxman, J A

    2000-01-01

    .... This is done to prevent bacterial endocarditis, which is a bacterial infection of the heart. Many children already take antibiotics for other conditions, such as otitis media, which is an ear infection...

  5. Infective endocarditis: diagnostic and therapeutic approach in emergency medicine

    Directory of Open Access Journals (Sweden)

    Rita Previati

    2007-02-01

    Full Text Available The infective endocarditis is an uncommon disease in the Emergency Department. Anyway, the emergency physician may be in front of the complications of this disease. A case of a patient with fever, laboratory signs of infection and an acute heart failure is described in this article. The final diagnosis was infective endocarditis with vegetations on the aortic valve and severe valvular regurgitation. The definition of infective endocarditis according to the major and minor criteria for the diagnosis is discussed. The echocardiography is central in the diagnosis and management of patients with infective endocarditis in the emergency setting, even if the clinical suspicion is very important. The main available therapeutic options in according to the Internation Guidelines are evaluated. The possible complications are also discussed. Several clinical and echocardiographic features identify patients at high risk for a complicated course or with a need for surgery.

  6. [Case of infective endocarditis diagnosed with renal infarction].

    Science.gov (United States)

    Nakayama, Takayuki; Yokoyama, Minato; Saito, Kazutaka; Takenaka, Shunsuke; Kubo, Yuichi; Iimura, Yasumasa; Numao, Noboru; Sakai, Yasuyuki; Koga, Fumitaka; Fujii, Yasuhisa; Kobayashi, Tsuyoshi; Kawakami, Satoru; Kihara, Kazunori

    2009-03-01

    A 46-year-old woman with sudden on set strong right flank pain was transferred to our hospital with the diagnosis of right renal infarction. Cardiac ultrasonography revealed a vegetation on the posterior cusp of the mitral valve, and the renal infarction was thought to be caused by renal artery embolism from infective endocarditis. Since the vegetation remained after antimicrobial therapy as conservative management, the patient was surgically treated by mitral annuloplasty. It has been known that infective endocarditis can cause renal infarction. Infective endocarditis requires immediate and adequate treatment because of high mortality. Therefore, the appropriate diagnosis of infective endocarditis is needed for patients with renal infarction without any other disorder causing renal infarction.

  7. Infective endocarditis: a history of the development of its understanding

    Directory of Open Access Journals (Sweden)

    Stephen A. Geller

    2013-12-01

    Full Text Available Inflammation of the inner layer of the heart, especially the valvular endothelium, chordae tendinae and mural endocardium was first recognized almost 350 years ago. Over the years it has had many names, but is now generally designated infective endocarditis (IE and has an associated infectious agent. A sterile vegetative process can also affect the valves and is usually referred to as Libman-Sacks endocarditis. The developments of medical science that allowed for our understanding of this entity included refinement of the autopsy, medical microscopy, microbiology, and in recent years, molecular studies. Some observations were misleading but clarification particularly followed the reports of Morgagni, Osler and Libman. As understanding of the pathobiology of infective endocarditis grew so did the effectiveness of therapy. This paper provides a detailed history of the development of the concept of Infective endocarditis citing many key morphological observations and concludes with brief comments about current concepts of pathogenesis as well as a few remarks about therapy.

  8. Staphylococcus endocarditis associated with infectious vasculitis and recurrent cerebral hemorrhages

    NARCIS (Netherlands)

    van de Beek, Diederik; Rabinstein, Alejandro A.; Peters, Steve G.; Cloft, Harry; Wijdicks, Eelco F. M.

    2008-01-01

    BACKGROUND: Patients with infectious endocarditis, who do not respond to conservative medical therapy usually need rapid valve surgery. This poses a difficult dilemma in patients with intracranial aneurysms and hemorrhage, although endovascular treatment of infectious aneurysms might be an advantage

  9. [Infective endocarditis : Update on prophylaxis, diagnosis, and treatment].

    Science.gov (United States)

    Dietz, S; Lemm, H; Janusch, M; Buerke, M

    2016-05-01

    The diagnosis of infective endocarditis is often delayed in clinical practice. Timely diagnosis and rapid antibiotic treatment is important. Higher age of patients, new risk factors, and increasing use of intravascular prosthetic materials resulted in changes in microbial spectrum. Nowadays, nonspecific symptoms, critically ill patients, and immunocompromised patients require a high level of diagnostic expertise.The new guidelines from the European Society of Cardiology provide various diagnostic algorithms and recommendations for antibiotic treatment. The new guidelines also recommend the formation of an endocarditis team with various medical disciplines, including a cardiac surgeon, to improve treatment because in half of all endocarditis patients, antibiotic therapy alone does not result in successful management of the infection. If complications occur, early surgical treatment should be performed.In this overview, diagnostic strategies and therapeutic approaches for the treatment of infectious endocarditis according to the current guidelines and aspects of surgical treatment are provided.

  10. Diagnostic value of imaging in infective endocarditis : a systematic review

    NARCIS (Netherlands)

    Gomes, Anna; Glaudemans, Andor W J M; Touw, Daan J; van Melle, Joost P; Willems, Tineke P; Maass, Alexander H; Natour, Ehsan; Prakken, Niek H J; Borra, Ronald J H; van Geel, Peter Paul; Slart, Riemer H J A; van Assen, Sander; Sinha, Bhanu

    Sensitivity and specificity of the modified Duke criteria for native valve endocarditis are both suboptimal, at approximately 80%. Diagnostic accuracy for intracardiac prosthetic material-related infection is even lower. Non-invasive imaging modalities could potentially improve diagnosis of

  11. Left-sided native valve Staphylococcus aureus endocarditis

    NARCIS (Netherlands)

    Slabbekoorn, M.; Horlings, H. M.; van der Meer, J. T. M.; Windhausen, A.; Van der Sloot, J. A. P.; Lagrand, W. K.

    2010-01-01

    Despite improved diagnostic tools and expanded treatment options, left-sided native valve endocarditis caused by Staphylococcus aureus infection remains a serious and destructive disease. The high morbidity and mortality, however, can be reduced by early recognition, correct diagnosis, and

  12. Echocardiographic agreement in the diagnostic evaluation for infective endocarditis

    DEFF Research Database (Denmark)

    Lauridsen, Trine Kiilerich; Selton-Suty, Christine; Tong, Steven Y C

    2016-01-01

    Echocardiography is essential for the diagnosis and management of infective endocarditis (IE). However, the reproducibility for the echocardiographic assessment of variables relevant to IE is unknown. Objectives of this study were: (1) To define the reproducibility for IE echocardiographic variab...

  13. Endocarditis infecciosa de válvula pulmonar nativa

    Directory of Open Access Journals (Sweden)

    Franco Romaní R

    2007-04-01

    Full Text Available La endocarditis infecciosa en válvulas derechas es predominantemente en la válvula tricuspídea, mientras la válvula pulmonar es excepcionalmente afectada (menos de 1,5%, por lo que son pocos los casos reportados en la literatura mundial. Las manifestaciones clínicas de endocarditis en válvula pulmonar no son las clásicas de endocarditis infecciosa, como son los síntomas de embolismo séptico pulmonar. La endocarditis aislada de válvula pulmonar nativa es inusual en personas que no consumen drogas intravenosas. Se presenta el caso de un paciente varón con diabetes mellitus tipo 2 y sin otro factor predisponente.

  14. Prevalence of infective endocarditis in patients with Staphylococcus aureus bacteraemia

    DEFF Research Database (Denmark)

    Rasmussen, Rasmus V; Høst, Ulla; Arpi, Magnus

    2011-01-01

    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...

  15. Infective endocarditis - the effect of liposomes as carrier substance ...

    African Journals Online (AJOL)

    1991-05-18

    antitrypsin and ampicillin. H. S. SCHAAF, W. D. BATES, C. HANEKOM, B. F. NEITELER,. A. B. KRIEGLER, P.-L. VAN DER MERWE. Summary. Infective endocarditis has a high mortality and morbidity rate despite all available treatment ...

  16. Endocarditis in burn patients: clinical and diagnostic considerations.

    Science.gov (United States)

    Regules, Jason A; Glasser, Jessie S; Wolf, Steven E; Hospenthal, Duane R; Murray, Clinton K

    2008-08-01

    Burned patients are at high risk for invasive procedures, bacteremia, and other infectious complications. Previous publications describe high incidence, delayed diagnosis, and high mortality for endocarditis in burned patients, but do not address use of contemporary diagnostic criteria. Further analysis of the clinical presentation and diagnosis may aid in the earlier recognition and decreased mortality of endocarditis in burned patients. At a 40 bed burn center, during the period from 1 January 2003 to 1 August 2006, blood culture, electronic inpatient, echocardiographic, and autopsy records were reviewed for cases of endocarditis and persistent bacteremia (blood culture positivity for the same organism separated by 24h). In addition, we reviewed cases of burn-related bacterial endocarditis published in the English language. We compared the clinical and diagnostic aspects of our identified cases with those in the published literature. There were 90 episodes of persistent bacteremia or fungemia in 56 of 1250 patients admitted during the study period. Echocardiography was performed on 19, identifying 4 cases of endocarditis. One additional case of endocarditis was identified post-mortem. Time until echocardiography ranged from 6 to 176 days after onset of bacteremia. Case patient age ranged from 31 to 64 years, and total burn surface area ranged from 34 to 80%. Endocarditis occurred in 0.4% of burn unit admissions and in 8.9% of these patients with persistent bacteremia. Sites involved included the mitral valve (3), tricuspid valve (2), aortic valve (1), and pulmonic valve (1). Pathogens included Staphylococcus aureus, Pseudomonas aeruginosa, and one case of Enterococcus faecium. Diagnostic clues were minimal. Case mortality was 100%. A literature review revealed 17 publications describing confirmed bacterial endocarditis in burned patients. These cases revealed a predilection for infection by S. aureus and P. aeruginosa, a relative paucity of diagnostic clues prior

  17. DUCHAS VAGINALES Y OTROS RIESGOS DE VAGINOSIS BACTERIANA

    Science.gov (United States)

    Chávez, Natividad; Molina, Helfer; Sánchez, Jorge; Gelaye, Bizu; Sánchez, Sixto E.

    2010-01-01

    Vaginosis bacteriana (VB) es una infección caracterizada por el cambio en la microflora de la vagina, asociándose a resultados adversos del embarazo y a la adquisición de infecciones de transmisión sexual (ITS), incluyendo el VIH. En este estudio se buscó la asociación entre el uso de duchas vaginales y otros factores de riesgos con VB. Se usó un diseño observacional descriptivo transversal prospectivo, en 1,252 mujeres que asistieron al servicio de planificación familiar de tres hospitales nacionales (Dos de Mayo, Arzobispo Loayza, San Bartolomé) y el Instituto Materno Perinatal, durante el año 1997. Se utilizó un cuestionario estructurado donde se registraron variables socio demográficas y características del estilo de vida de las participantes. VB fue diagnosticada mediante el puntaje de Nugent. Se empleó análisis de regresión logística para calcular odds ratio (OR) e intervalos de confianza al 95%. La edad promedio de las participantes fue 25.1 ± 4,7 años, el 23.4% tenían más de 11 años de educación. La prevalencía de VB fue 20,1%. Las mujeres que practicaban duchas vaginales tuvieron 2.28 veces (OR = 2.28, IC 95% [1.0–5.0]) mayor probabilidad de tener VB comparado con aquellas que no lo practicaban. Tener dos o más parejas sexuales estuvo asociado con 2.0 veces (OR =2.0, IC 95% [1.2–3.5]) mayor probabilidad de adquirir VB comparado con aquellas que habían tenido solo una pareja sexual. Las participantes que iniciaron una relación sexual a una edad temprana tuvieron 1.4 veces (OR=1.4, IC 95% [1.0 –1.9]) mayor probabilidad de adquirir VB. El uso de duchas vaginales es un factor de riesgo de VB. Los programas destinados a la salud de la mujer deben abordar las repercusiones perjudiciales para la salud asociados con las duchas vaginales. PMID:21132048

  18. Manejo hospitalario de la meningoencefalitis bacteriana por S. Neumoniae

    Directory of Open Access Journals (Sweden)

    Roberto Álvarez Fumero

    2003-12-01

    Full Text Available La actitud terapéutica ante la meningitis bacteriana (MEB es uno de los retos más importantes a los que se enfrenta el pediatra, pues de su oportuno y adecuado manejo depende el pronóstico. Los cambios en la epidemiología de los síndromes neurológicos infecciosos bacterianos observados en Cuba a partir del año 2000, promovieron la implementación de modificaciones al régimen terapéutico antibiótico convencional. En este artículo, sin olvidar que el tratamiento ideal es el preventivo, se expone una revisión actualizada del manejo hospitalario de las MEB por S.pneumoniae, que incluye: adopción de medidas generales, instauración temprana de acciones dirigidas a atenuar los efectos perjudiciales de la respuesta inflamatoria sistémica, conducta específica contra el agente (antibioticoterapia y finalmente la identificación precoz e inicio de la rehabilitación de secuelas. Se hace énfasis en las modificaciones al esquema antibiótico adoptadas recientemente por la Comisión Nacional de SNI. Se exponen consideraciones sobre la introducción de la vancomicina en esquema antimicrobiano de las MEB por S.pneumoniae.The therapeutic attitude to face bacterial meningitis (BME is one of the most important challenges for pediatricians, since the prognosis depends on its timely and adequate management The changes in the epidemiology of the bacterial infectious neurological syndromes ocurred in Cuba from 2000 on, promoted the implementation of modifications in the conventional therapeutical antibiotic regimen. In this article, without forgetting that the ideal treatment is the preventive one, it is exposed an updated review of the hospital management of BME due to S.Pneumoniae that includes: adoption of general measures, early establishment of actions directed to alleviate the harmful effects of the systemic inflammatory reponse, specific conduct against the agent (antibiotic therapy and, finally, the identification and beginning of the

  19. Duchas vaginales y otros riesgos de vaginosis bacteriana

    Directory of Open Access Journals (Sweden)

    Natividad Chávez

    2009-07-01

    Full Text Available La vaginosis bacteriana (VB es una infección caracterizada por el cambio en la microflora de la vagina, se asocia con resultados adversos del embarazo y a la adquisición de infecciones de transmisión sexual (ITS, que incluyen el VIH. Objetivos. Identificar la asociación entre el uso de duchas vaginales y otros factores de riesgo con VB. Materiales y métodos. Se realizó un estudio transversal en 1252 mujeres que asistieron al servicio de planificación familiar de tres hospitales nacionales y un instituto especializado de Lima, durante el año 1997. Se utilizó un cuestionario estructurado donde se registró las variables sociodemográficas y las características del estilo de vida de las participantes. La VB fue diagnosticada mediante el puntaje de Nugent. Se empleó análisis de regresión logística para calcular odds ratio (OR e intervalos de confianza al 95%. Resultados. La edad promedio fue 25,1 ± 4,7 años, el 23,4% tenían más de 11 años de educación. La prevalencia de VB fue 20,1%. Las mujeres que practicaban duchas vaginales (OR: 2,28; IC95%: 1,0- 5,0, que tenían dos o más parejas sexuales (OR: 2,0; IC95%: 1,2-3,5 y que iniciaron una relación sexual a una edad temprana (OR: 1,4; IC95%: 1,0 -1,9 tuvieron mayor probabilidad de adquirir VB. Conclusiones. El uso de duchas vaginales es un factor de riesgo de VB en mujeres peruanas. Los programas destinados a la salud de la mujer deben abordar las repercusiones perjudiciales para la salud asociados con las duchas vaginales.

  20. 'Streptococcus milleri' aortic valve endocarditis and hepatic abscess.

    Science.gov (United States)

    Rashid, Rashid M; Salah, Wajeeh; Parada, Jorge P

    2007-02-01

    Although well-recognized animal pathogens, group C streptococci are relatively rare causes of human infection. The phenotypically small-colony group C 'Streptococcus milleri' are typically associated with suppurative disease of soft tissue and organs, including liver abscesses, while bacteraemia and endocarditis are distinctly less common. Herein, a case of 'S. milleri' causing both endocarditis and liver abscess in the same patient is reported.

  1. [Role of procalcitonin in the diagnosis of uncomplicated infective endocarditis].

    Science.gov (United States)

    Hryniewiecki, Tomasz; Sitkiewicz, Dariusz; Rawczyńska-Englert, Irena

    2002-01-01

    Infective endocarditis especially where blood culture is negative frequently causes problems in diagnosis despite of many nonspecific inflammation parameters. Procalcitonin (PCT) concentration is a new marker of severe bacterial and fungal infection. The aim of this study was to evaluate the usefulness of PCT concentration assessment in the diagnosis of uncomplicated infective endocarditis of bacterial etiology. The study group consisted of 30 patients with ongoing infective endocarditis in the course of acquired valvular heart disease. The diagnosis of bacterial endocarditis was established according to the Duke criteria on the basis of: clinical examination, laboratory investigations (inflammatory parameters, transthoracic and transesophageal echocardiography) and positive blood cultures. Patients with sepsis, concomitant infections and in an early postoperative period were excluded. Two control groups consisted of: 10 patients without endocarditis and other infections and another 10 patients without endocarditis and with an urinary tract infection. Serum procalcitonin concentrations were measured by an immunoluminometric assay (LUMItest PCT set). Mean serum PCT concentrations in patients with endocarditis (0.12 +/- 0.13, range 0-0.4 ng/ml) were significantly higher than in control group without infection (0.03 +/- 0.05, range 0-0.1 ng/ml) and higher than in control group with an urinary tract infection (0.02 +/- 0.04, range 0-0.1 ng/ml). However in 12 patients (of 30) were below sensitivity of the method and in the rest were within normal range (< 0.5 ng/ml). Serum PCT concentration assessment seems to have no value in the diagnosis of uncomplicated infective endocarditis.

  2. Actinobacillus equuli subsp. equuli associated with equine valvular endocarditis

    DEFF Research Database (Denmark)

    Aalbæk, Bent; Østergaard, Stine; Buhl, Rikke

    2007-01-01

    Microbiological and pathological data from a case of equine valvular endocarditis are reported. Limited information is available on the pathogenic potential of equine Actinobacillus species as several strains originate from apparently healthy horses. After the establishment of two subspecies within...... this species, this seems to be the first report of an etiological association between A. equuli subsp. equuli and equine endocarditis. Furthermore, new information on some phenotypical characteristics of this subspecies are reported, compared to previous findings...

  3. Isolated Native Tricuspid Valve Endocarditis Caused by Viridans Streptococcus

    Directory of Open Access Journals (Sweden)

    John Swiston

    2001-01-01

    Full Text Available The present report describes a case of native tricuspid valve endocarditis caused by viridans group streptococcus in a 43-year-old man who had recently undergone dental extraction. The patient had no history of intravenous drug use, heart disease or right heart catheterization. Although there have been scattered reports of unusual organisms, to the authors' knowledge, this is the first case of viridans group streptococcal endocarditis involving only the tricuspid valve after dental manipulation.

  4. Nosocomial valve endocarditis due to corynebacterium striatum: a case report.

    Science.gov (United States)

    Marull, Jorge; Casares, Pablo A

    2008-12-12

    Staphylococcus aureus, Coagulase-negative staphylococci, and Enterococci sp. are the usual pathogens involved in nosocomial bacterial endocarditis. Corynebacterium species isolation in blood specimens is usually considered to be a contaminant. We present an interesting case of native mitral valve endocarditis in a 73 year old African American female that was diagnosed days after she was discharged from our institution. The infection was cleared with medical therapy alone.

  5. Nosocomial valve endocarditis due to corynebacterium striatum: a case report

    OpenAIRE

    Marull, Jorge; Casares, Pablo A

    2008-01-01

    Staphylococcus aureus, Coagulase-negative staphylococci, and Enterococci sp. are the usual pathogens involved in nosocomial bacterial endocarditis. Corynebacterium species isolation in blood specimens is usually considered to be a contaminant. We present an interesting case of native mitral valve endocarditis in a 73 year old African American female that was diagnosed days after she was discharged from our institution. The infection was cleared with medical therapy alone.

  6. La evolución de la resistencia bacteriana en México, 1973-2013

    Directory of Open Access Journals (Sweden)

    Eduardo Rodríguez-Noriega

    2014-04-01

    Full Text Available Introducción. La resistencia bacteriana a los antibióticos es un problema de salud mundial. Las investigaciones relacionadas con este problema emergente son indispensables para reconocer y desarrollar programas para su vigilancia y control. Objetivo. Revisar y comentar las contribuciones de los investigadores mexicanos en el área de la resistencia bacteriana a los antibióticos. Materiales y métodos. Se realizó una búsqueda de la literatura científica relacionada con la resistencia bacteriana a los antibióticos producida por investigadores mexicanos y registrada en Medline-PubMed entre 1973 y julio de 2013. Resultados. En 66 publicaciones, las contribuciones de investigadores mexicanos incluyeron datos sobre la resistencia de agentes patógenos entéricos como Salmonella Typhi, múltiples contribuciones sobre la producción de betalactamasas de espectro extendido, de metalobetalactamasas y de carbapenemasas, los mecanismos de resistencia en Pseudomonas aeruginosa y la evolución de la resistencia en cocos Gram positivos como Streptococcus pneumoniae, Staphylococcus aureus y Enterococcus spp., entre otros. Conclusiones. Los datos publicados en los últimos 40 años son fuente adecuada para entender la evolución de la resistencia bacteriana a los antibióticos y desarrollar programas para su control.

  7. Cumplimiento de las recomendaciones internacionales en la lucha contra las resistencias bacterianas

    DEFF Research Database (Denmark)

    Malo, Sara; Jose Rabanaque, Mara; Bjerrum, Lars

    2016-01-01

    Surveillance of Antimicrobial Resistance (AGISAR) de la Organización Mundial de la Salud (OMS), en España y Dinamarca, en cuanto al uso ambulatoriode Critically Important Antimicrobials (CIA), así como analizarla relación entre éste y las resistencias bacterianas a ellos. Material y métodos: Los sistemas...

  8. Surgical Management of Multiple Valve Endocarditis Associated with Dialysis Catheter

    Directory of Open Access Journals (Sweden)

    R. Zea-Vera

    2016-01-01

    Full Text Available Endocarditis associated with dialysis catheter is a disease that must be suspected in every patient with hemodialysis who develops fever. Multiple valve disease is a severe complication of endocarditis that needs to be managed in a different way. There is very limited data for treatment and every case must be considered individually. We present a patient with this complication and describe the medical treatment and surgical management. We report the case of a 15-year-old patient with acute renal failure that develops trivalvular endocarditis after the hemodialysis catheter was placed, with multiple positive blood culture for Staphylococcus aureus. Transesophageal echocardiography was done and aortic and tricuspid valvular vegetations and mitral insufficiency were reported. Patient was successfully treated by surgery on the three valves, including aortic valve replacement. There is limited data about the appropriate treatment for multiple valvular endocarditis; it is important to consider this complication in the setting of hemodialysis patients that develop endocarditis and, despite the appropriate treatment, have a torpid evolution. In countries where endovenous drug abuse is uncommon, right sided endocarditis is commonly associated with vascular catheters. Aggressive surgical management should be the treatment of choice in these kinds of patients.

  9. Current features of infective endocarditis in elderly patients: results of the International Collaboration on Endocarditis Prospective Cohort Study

    NARCIS (Netherlands)

    Durante-Mangoni, Emanuele; Bradley, Suzanne; Selton-Suty, Christine; Tripodi, Marie-Françoise; Barsic, Bruno; Bouza, Emilio; Cabell, Christopher H.; Ramos, Auristela Isabel de Oliveira; Fowler, Vance; Hoen, Bruno; Koneçny, Pam; Moreno, Asuncion; Murdoch, David; Pappas, Paul; Sexton, Daniel J.; Spelman, Denis; Tattevin, Pierre; Miró, José M.; van der Meer, Jan T. M.; Utili, Riccardo; Gordon, David; Devi, Uma; Kauffman, Carol; Armstrong, William; Giannitsioti, Efthymia; Giamarellou, Helen; Lerakis, Stamatios; del Rio, Ana; Mestres, Carlos A.; Paré, Carlos; Garcia de la Maria, Cristina; de Lazzario, Elisa; Marco, Francesc; Gatell, Jose M.; Miró, José M.; Almela, Manel; Azqueta, Manuel; Jiménez-Expósito, Maria Jesús; de Benito, Natividad; Perez, Noel; Almirante, Benito; Fernandez-Hidalgo, Nuria; Rodriguez de Vera, Pablo; Tornos, Pilar; Falcó, Vicente; Claramonte, Xavier; Armero, Yolanda; Sidani, Nisreen; Kanj-Sharara, Souha; Kanafani, Zeina; Raglio, Annibale; Goglio, Antonio; Gnecchi, Fabrizio; Suter, Fredy; Valsecchi, Grazia; Rizzi, Marco; Ravasio, Veronica; Chirouze, Catherine; Leroy, Joel; Plesiat, Patrick; Bernard, Yvette; Casey, Anna; Lambert, Peter; Watkin, Richard; Elliott, Tom; Patel, Mukesh; Dismukes, William; Pan, Angelo; Caros, Giampiero; Tribouilloy, Amel Brahim Mathiron Christophe; Goissen, Thomas; Delahaye, Armelle; Delahaye, Francois; Vandenesch, Francois; Vizzotti, Carla; Nacinovich, Francisco M.; Marin, Marcelo; Trivi, Marcelo; Lombardero, Martin; Cortes, Claudia; Horacio Casabe, José; Altclas, Javier; Kogan, Silvia; Clara, Liliana; Sanchez, Marisa; Commerford, Anita; Hansa, Cass; Deetlefs, Eduan; Ntsekhe, Mpiko; Commerford, Patrick; Wray, Dannah; Steed, Lisa L.; Church, Preston; Cantey, Robert; Morris, Arthur; Read, Kerry; Raymond, Nigel; Lang, Selwyn; Chambers, Stephen; Kotsanas, Despina; Korman, Tony M.; Peterson, Gail; Purcell, Jon; Southern, Paul M.; Shah, Manisha; Bedimo, Roger; Reddy, Arjun; Levine, Donald; Dhar, Gaurav; Hanlon-Feeney, Alanna; Hannan, Margaret; Kelly, Sinead; Wang, Andrew; Cabell, Christopher H.; Woods, Christopher W.; Benjamin, Danny; Corey, G. Ralph; McDonald, Jay R.; Federspiel, Jeff; Engemann, John J.; Reller, L. Barth; Drew, Laura; Caram, Lauren B.; Stryjewski, Martin; Morpeth, Susan; Lalani, Tahaniyat; Chu, Vivian; Mazaheri, Bahram; Neuerburg, Carl; Naber, Christoph; Athan, Eugene; Henry, Margaret; Harris, Owen; Alestig, Eric; Olaison, Lars; Wikstrom, Lotta; Snygg-Martin, Ulrika; Francis, Johnson; Venugopal, K.; Nair, Lathi; Thomas, Vinod; Chaiworramukkun, Jaruwan; Pachirat, Orathai; Chetchotisakd, Ploenchan; Suwanich, Tewan; Kamarulzaman, Adeeba; Tamin, Syahidah Syed; Premru, Manica Mueller; Logar, Mateja; Lejko-Zupanc, Tatjana; Orezzi, Christina; Klein, John; Moreno, Mar; Rodríguez-Créixems, Marta; Fernández, Miguel; Muñoz, Patricia; Fernández, Rocío; Ramallo, Victor; Raoult, Didier; Thuny, Franck; Habib, Gilbert; Casalta, Jean-Paul; Fournier, Pierre-Edouard; Chipigina, Natalia; Kirill, Ozerecky; Vinogradova, Tatiana; Kulichenko, Vadim P.; Butkevich, O. M.; Lion, Christine; Alla, Francois; Coyard, Hélène; Doco-Lecompte, Thanh; Iarussi, Diana; Ragone, Enrico; Dialetto, Giovanni; Tripodi, Marie Françoise; Casillo, Roberta; Kumar, A. Sampath; Sharma, Gautam; Dickerman, Stuart A.; Street, Alan; Eisen, Damon Peter; McBryde, Emma Sue; Grigg, Leeanne; Abrutyn, Elias; Michelet, Christian; Donnio, Pierre Yves; Fortes, Claudio Querido; Edathodu, Jameela; Al-Hegelan, Mashael; Font, Bernat; Anguera, Ignasi; Raimon Guma, Joan; Cereceda, M.; Oyonarte, Miguel J.; Montagna Mella, Rodrigo; Garcia, Patricia; Braun Jones, Sandra; de Oliveira Ramos, Auristela Isabel; Paiva, Marcelo Goulart; de Medeiros, Regina Aparecida; Woon, Lok Ley; Lum, Luh-Nah; Tan, Ru-San; Rees, David; Lawrence, Richard; Dever, Robyn; Post, Jeffrey; Jones, Phillip; Ryan, Suzanne; Harkness, John; Feneley, Michael; Rubinstein, Ethan; Strahilewitz, Jacob; Ionac, Adina; Mornos, Cristian; Dragulescu, Stefan; Forno, Davide; Cecchi, Enrico; de Rosa, Francesco; Imazio, Massimo; Trinchero, Rita; Wiesbauer, Franz; Gattringer, Rainer; Deans, Greg; Andrasevic, Arjana Tambic; Klinar, Igor; Vincelj, Josip; Bukovski, Suzana; Krajinovic, Vladimir; Cabell, Christopher; Stafford, Judy; Baloch, Khaula; Redick, Thomas; Harding, Tina; Karchmer, Adolf W.; Bayer, Arnie; Durack, David T.; Corey, Ralph; Moreillon, Phillipe; Eykynm, Susannah

    2008-01-01

    BACKGROUND: Elderly patients are emerging as a population at high risk for infective endocarditis (IE). However, adequately sized prospective studies on the features of IE in elderly patients are lacking. METHODS: In this multinational, prospective, observational cohort study within the

  10. Septic sacroiliitis revealing an infectious endocarditis

    Science.gov (United States)

    Mahfoudhi, Madiha; Hariz, Anis; Turki, Sami; Kheder, Adel

    2014-01-01

    We report the case of a 43-year-old man admitted for right hip ache and fever. Physical examination revealed a fever, an ache at the manipulation of the sacroiliac joint and a limitation of abduction and external rotation of the right hip. There was no murmur in cardiac auscultation. No anomaly was found at the conventional radiographs of the sacroiliac joint, while the pelvic MRI confirmed a right sacroiliitis. A sacroiliac puncture with a study of synovial fluid demonstrated the presence of Streptococcus viridans. The blood culture revealed the same germ. Transthoracic and transoesophageal echocardiography confirmed infectious endocarditis with vegetation in the mitral valve. He received penicillin G and gentamicin relayed by pristinamycin because of an allergy to penicillin G with a total duration of treatment of 40 days. His symptoms and the laboratory and radiological tests abnormalities resolved totally with no recurrence. PMID:25123569

  11. Septic sacroiliitis revealing an infectious endocarditis.

    Science.gov (United States)

    Mahfoudhi, Madiha; Hariz, Anis; Turki, Sami; Kheder, Adel

    2014-08-14

    We report the case of a 43-year-old man admitted for right hip ache and fever. Physical examination revealed a fever, an ache at the manipulation of the sacroiliac joint and a limitation of abduction and external rotation of the right hip. There was no murmur in cardiac auscultation. No anomaly was found at the conventional radiographs of the sacroiliac joint, while the pelvic MRI confirmed a right sacroiliitis. A sacroiliac puncture with a study of synovial fluid demonstrated the presence of Streptococcus viridans. The blood culture revealed the same germ. Transthoracic and transoesophageal echocardiography confirmed infectious endocarditis with vegetation in the mitral valve. He received penicillin G and gentamicin relayed by pristinamycin because of an allergy to penicillin G with a total duration of treatment of 40 days. His symptoms and the laboratory and radiological tests abnormalities resolved totally with no recurrence. 2014 BMJ Publishing Group Ltd.

  12. Microbiology of odontogenic bacteremia: beyond endocarditis.

    Science.gov (United States)

    Parahitiyawa, N B; Jin, L J; Leung, W K; Yam, W C; Samaranayake, L P

    2009-01-01

    The human gingival niche is a unique microbial habitat. In this habitat, biofilm organisms exist in harmony, attached to either enamel or cemental surfaces of the tooth as well as to the crevicular epithelium, subjacent to a rich vascular plexus underneath. Due to this extraordinary anatomical juxtaposition, plaque biofilm bacteria have a ready portal of ingress into the systemic circulation in both health and disease. Yet the frequency, magnitude, and etiology of bacteremias due to oral origin and the consequent end organ infections are not clear and have not recently been evaluated. In this comprehensive review, we address the available literature on triggering events, incidence, and diversity of odontogenic bacteremias. The nature of the infective agents and end organ infections (other than endocarditis) is also described, with an emphasis on the challenge of establishing the link between odontogenic infections and related systemic, focal infections.

  13. Gemella Species Endocarditis in a Child

    Directory of Open Access Journals (Sweden)

    Laura K Purcell

    2001-01-01

    Full Text Available Organisms of the genus Gemella can, on occasion, cause serious systemic illness. The present paper reports a successfully treated case of endocarditis in a 12-year-old girl with congenital heart disease caused by species of Gemella. The child presented with cough, fatigue and decreased appetite without fever. Echocardiogram demonstrated marked mitral insufficiency with flail posterior mitral valve leaflet, mitral valve vegetations, and an enlarged left atrium and ventricle. While being treated with vancomycin, the child initially had persistent bacteremia, which resolved after the addition of gentamycin; the course of therapy was completed with penicillin G and gentamycin once antimicrobial susceptibilities were available. Attempts to identify the species of Gemella were unsuccessful in the local laboratory, and at reference laboratories in Canada and the United States. The isolate is undergoing further evaluation to determine its taxonomic status.

  14. [Infective endocarditis in a dermatology unit].

    Science.gov (United States)

    Konstantinou, M-P; Valeyrie-Allanore, L; Lesprit, P; Terrazzoni, S; Ortonne, N; Roujeau, J-C; Bagot, M

    2009-12-01

    Although often clinically suspected, infectious endocarditis (IE) is frequently difficult to diagnose with certainty. Although the dermatological signs of endocarditis can vary, they must be routinely sought where there is a suspicion of IE. The aim of this study was to reveal the diversity of clinical manifestations of IE in a dermatology unit. This retrospective study was conducted between May 2006 and May 2007 and included all patients hospitalized in the dermatology unit in whom an IE was diagnosed according to the modified Duke criteria. Seven patients were included with a median age of 61 years. The reasons for hospital admission were: chronic ulcers (n=1), Sezary's syndrome (n=1), atopic dermatitis (n=1), epidermolysis bullosa acquisita (n=1) and purpura (n=1). Specific dermatological manifestations of IE included necrotic lesions on the lower limbs (n=2), purpura (n=5) and splinter haemorrhages (n=1). Blood cultures were positive in 3 cases (MSSA=2, MRSA=1). One patient had serological evidence of Coxiella burnetti IE. Cutaneous sources of IE were found in 6 cases, including acute dermohypodermitis or chronic dermatosis (3), peripheral venous catheter (n=2) and haemodialysis (n=1). Transthoracic echocardiography was negative in 6 patients, whereas transoesophageal echocardiography performed in 6 patients confirmed the diagnosis in 5 cases. The mean time to diagnosis was 21 days. Among these patients, 5 died after a mean period of 78 days. Diagnosing IE remains a clinical challenge and must be routinely considered in the presence of unusual dermatological findings such as purpura or distal necrosis, but also in patients with partially or poorly controlled chronic dermatosis, which comprise an underestimated potential source of IE. Physicians treating such patients must consider the risk of IE, especially in the event of chronic dermatosis or of an invasive cutaneous procedure involving affected skin.

  15. Infección bacteriana severa en recién nacidos febriles sin signos de focalización

    OpenAIRE

    Manuel Díaz Alvarez; María Teresa Fernández de la Paz; Olimpo Moreno Vázquez; Rubén Piloto Sendín; María Isabel Arango; Jorge Díaz Alvarez

    1995-01-01

    Este estudio estuvo dirigido a conocer la frecuencia de infección bacteriana severa, entre recién nacidos febriles sin signos de focalización inicial, e identificar los datos clínicos y de laboratorio que se relacionan con la presencia de infección bacteriana severa. Se estudió un grupo de 211 recién nacidos febriles ingresados y que no hubieran mostrado signos de focalización en la evaluación inicial. La incidencia de infección bacteriana severa fue de 17,5 %, del cual hubo 22 sepsis urinari...

  16. Aggregatibacter aphrophilus infective endocarditis confirmed by broad-range PCR diagnosis: A case report

    Directory of Open Access Journals (Sweden)

    Koji Hirano

    2017-01-01

    Conclusion: A rare disease, Aggregatibacter aphrophilus infective endocarditis was successfully treated with surgical repair and appropriate antibiotic therapy. To avoid misdiagnosis, br-PCR testing should be performed in patients with blood culture-negative endocarditis.

  17. The value of 18F-FDG PET/CT in diagnosing infectious endocarditis

    NARCIS (Netherlands)

    Kouijzer, I.J.; Vos, F.J.; Janssen, M.J.R.; Dijk, A.P.J. van; Oyen, W.J.G.; Bleeker-Rovers, C.P.

    2013-01-01

    PURPOSE: Early detection of infectious endocarditis is challenging. For diagnosing infectious endocarditis, the revised Duke criteria are the gold standard. Evidence of endocardial involvement on echocardiography is a major criterion, but sensitivity and specificity of echocardiography are not

  18. Onicolisis exudativa y paroniquia bacteriana aguda en relacion con BIBF-1120 y paclitaxel: respuesta a la terapia topica

    National Research Council Canada - National Science Library

    Freites-Martinez, Azael; Martinez-Sanchez, Diego; Puente de Pablo, Nieves; Calderon-Komaromy, Angelica; Cordoba, Susana; Burbujo, Jesus

    2014-01-01

    .... A la semana de iniciar la terapia topica, se observo una paroniquia bacteriana con la perdida de la una del quinto dedo de la mano izquierda, con cultivos positivos para Staphylococcus aureus sensible a meticilina...

  19. Chronic endocarditis due to Legionella anisa: a first case difficult to diagnose

    Directory of Open Access Journals (Sweden)

    F. Compain

    2015-11-01

    Full Text Available Endocarditis due to Legionella spp. is uncommon but presumably underestimated given the prevalence of Legionellae in the environment. We report a first and unusual case of chronic native valve endocarditis due to L. anisa and advocate that the diagnosis of endocarditis be made collaboratively between the cardiologist, surgeon, microbiologist and pathologist.

  20. Mitral endocarditis due to Rothia aeria with cerebral haemorrhage and femoral mycotic aneurysms, first French description

    Directory of Open Access Journals (Sweden)

    R. Collarino

    2016-09-01

    Full Text Available Rothia aeria is a Rothia species from the Micrococcaceae family. We report here the first French R. aeria endocarditis complicated by brain haemorrhage and femoral mycotic aneurysms. Altogether, severity and antimicrobial susceptibility should make us consider the management of R. aeria endocarditis as Staphylococcus aureus methicillin-susceptible endocarditis.

  1. In vitro Assays of Staphylococcus epidermidis Characteristics and Outcome in an Endocarditis Model

    Directory of Open Access Journals (Sweden)

    Betty Herndon

    1993-01-01

    Full Text Available Objective: Staphylococcus epidermidis adherence to indwelling polymers is important in prosthetic valve endocarditis. Earlier studies have related streptococcal endocarditis to isolates with high levels of cell-associated hexoses. The objective of the present study was to determine if a relationship exists between an S epidermidis isolate assay score and production/severity of experimental endocarditis.

  2. Dual Infection by Burkholderia Cepaciaand Pseudomonas Putida in an Infective Endocarditis Case.

    Science.gov (United States)

    Khan, Maria; Lalani, Farida Khurram; Ikram, Aamer; Zaman, Gohar; Ahmed, Parvez

    2017-06-01

    Infective endocarditis is rarely caused by Burkholderia cepacia. Pseudomonas putidahas not been reported to cause infective endocarditis so far. This is the first case of infective endocarditis being reported, that is caused by Pseudomonas putidaand Burkholderia cepaciain an immunocompetent host with no predisposing factors. Aortic valve replacement surgery was carried out and antibiotics were given, to which the patient responded well and recovered.

  3. 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)

    Holler, Jon Gitz; Pedersen, Line; Calum, Henrik

    2011-01-01

    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.......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....

  4. Diagnostic value of imaging in infective endocarditis: a systematic review.

    Science.gov (United States)

    Gomes, Anna; Glaudemans, Andor W J M; Touw, Daan J; van Melle, Joost P; Willems, Tineke P; Maass, Alexander H; Natour, Ehsan; Prakken, Niek H J; Borra, Ronald J H; van Geel, Peter Paul; Slart, Riemer H J A; van Assen, Sander; Sinha, Bhanu

    2017-01-01

    Sensitivity and specificity of the modified Duke criteria for native valve endocarditis are both suboptimal, at approximately 80%. Diagnostic accuracy for intracardiac prosthetic material-related infection is even lower. Non-invasive imaging modalities could potentially improve diagnosis of infective endocarditis; however, their diagnostic value is unclear. We did a systematic literature review to critically appraise the evidence for the diagnostic performance of these imaging modalities, according to PRISMA and GRADE criteria. We searched PubMed, Embase, and Cochrane databases. 31 studies were included that presented original data on the performance of electrocardiogram (ECG)-gated multidetector CT angiography (MDCTA), ECG-gated MRI, 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/CT, and leucocyte scintigraphy in diagnosis of native valve endocarditis, intracardiac prosthetic material-related infection, and extracardiac foci in adults. We consistently found positive albeit weak evidence for the diagnostic benefit of 18 F-FDG PET/CT and MDCTA. We conclude that additional imaging techniques should be considered if infective endocarditis is suspected. We propose an evidence-based diagnostic work-up for infective endocarditis including these non-invasive techniques. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Endocarditis-associated Brain Lesions in Slaughter Pigs

    DEFF Research Database (Denmark)

    Karstrup, C.C.; Jensen, H.E.; Aalbæk, B.

    2011-01-01

    Left-sided valvular endocarditis (LSVE) is a common finding in slaughter pigs. The lesion is often associated with renal thromboembolism, but information on embolization to other organs is sparse. This study focuses on the presence and type of endocarditis-associated brain lesions (EABLs). The br......Left-sided valvular endocarditis (LSVE) is a common finding in slaughter pigs. The lesion is often associated with renal thromboembolism, but information on embolization to other organs is sparse. This study focuses on the presence and type of endocarditis-associated brain lesions (EABLs......). The brains of 20 slaughter pigs with spontaneously arising LSVE and 11 controls were examined by sectioning half of a formalin-fixed brain into 4mm slices for histological examination. The aetiology of the endocarditis was determined by bacteriological and, in some cases, by fluorescence in...... was found in eight cases. EABLs are therefore common in slaughter pigs with LSVE. The number of lesions per animal is small, which may explain the limited attention paid to this sequela of LSVE. EABLs have rarely been reported in domestic animals and mostly in patients with neurological signs. The frequent...

  6. Isolated pulmonic valve endocarditis presenting as neck pain

    Directory of Open Access Journals (Sweden)

    Aditya Goud

    2015-12-01

    Full Text Available We discuss a unique case of a 52-year-old man with no history of intravenous drug use or dental procedures who presented with neck pain, 2 weeks of fevers, chills, night sweats, cough, and dyspnea found to have isolated pulmonic valve (PV endocarditis. The patient did not have an associated murmur, which is commonly seen in right-sided infectious endocarditis. A transthoracic echocardiogram showed a thickened PV leaflet, with subsequent transesophageal echocardiogram showing a PV mass. Speciation of blood cultures revealed Streptococcus oralis. In right-sided infective endocarditis, usually the tricuspid valve is involved; however, in our case the tricuspid valve was free of any mass or vegetation. The patient did meet Duke criteria and was thus started on long-term intravenous antibiotics for infectious endocarditis. The patient's symptoms quickly improved with antibiotics. A careful history and evaluating the patient's risk factors are key in earlier detection of infective endocarditis (IE. Because of early detection and a high index of suspicion, the patient had no further complications and did not require any surgery. In conclusion, clinical suspicion of right-sided IE should be high in patients who present with persistent fevers and pulmonary symptoms in order to reduce the risk of complications, and to improve outcomes.

  7. Role of granulocytes in experimental Streptococcus sanguis endocarditis.

    Science.gov (United States)

    Meddens, M J; Thompson, J; Eulderink, F; Bauer, W C; Mattie, H; van Furth, R

    1982-01-01

    We investigated the role of granulocytes during the induction and course of experimental Streptococcus sanguis endocarditis in rabbits by depleting blood granulocytes with nitrogen mustard. The induction of the endocarditis was not influenced by granulocytopenia: the 50% infectious dose was 5.4 X 10(4) colony-forming units in normal and granulocytopenic rabbits. However, granulocytopenia influenced the curse of the endocarditis, as shown by a significant increase in the number of colony-forming units per gram of vegetation (P less than 0.02) from 24 to 72 h after the injection of 10(5) colony-forming units of S. sanguis. This rise did not occur in the control rabbits. Furthermore, bacteremia was significantly higher in the granulocytopenic rabbits (P less than 0.05) during the first 48 h compared with the control rabbits. This was not because of altered clearance of the streptococcus inoculum or seeding of streptococci from extracardiac bacterial foci. We concluded that granulocytes have no measurable effect on the induction of S. sanguis endocarditis, but during the course of the endocarditis, granulocytes keep the endocardial infection in check. Images PMID:7076302

  8. Current status of taxonomic groups of oral streptococci in endocarditis. Can virulence factors discriminate between endocarditis and non-endocarditis strains?

    DEFF Research Database (Denmark)

    Larsen, Tove; Fiehn, Nils-Erik; Gutschik, Ernö

    1999-01-01

    OBJECTIVE: Infective endocarditis is frequently caused by oral streptococci, especially Streptococcus sanguis. In this group, many strains have recently been reclassified on the basis of new taxonomic schemes. The purpose of this study was to classify oral streptococci from patients with infective...

  9. Enterococcus faecalis Endogenous Endophthalmitis from Valvular Endocarditis

    Directory of Open Access Journals (Sweden)

    Sidnei Barge

    2013-01-01

    Full Text Available We report a case of a 74-year-old female, with a mitral heart valve, who presented with pain and blurred vision in the right eye for 2 days. Her visual acuity was light perception (LP in the right eye and 20/40 in the left eye. Slit lamp examination showed corneal edema and hypopyon, and a view of the right fundus was impossible. Echography showed vitreous condensation. One day after presentation, the patient developed acute lung edema requiring hospitalization, so she was not submitted to vitreous tap and intravitreal treatment. The cardiac and systemic evaluations revealed a mitral endocarditis secondary to Enterococcus faecalis. The patient improved systemically with treatment with gentamicin, vancomycin, and linezolid. Her visual acuity remained as no LP, and her intraocular pressure (IOP has been controlled with brimonidine bid despite developing a total cataract with 360° posterior synechia. A cardiac source for endogenous endophthalmitis should be considered in the presence of a prosthetic cardiac valve. The treatment and followup must be made in cooperation with a cardiologist specialist, but the ophthalmologist can play a key role in the diagnosis.

  10. BRUCELLA ENDOCARDITIS IN IRANIAN PATIENTS: COMBINED MEDICAL AND SURGICAL TREATMENT

    Directory of Open Access Journals (Sweden)

    Ebrahim Nematipour

    1995-06-01

    Full Text Available Brucella endocarditis is a Tare but serious complication ofbrucellosis and is the main cause of death reuuedto thisdisease: Itis not rare in the endemic areas and aaualiy accounts for up to 8~lO% ofendocarditis infections: We report seven adult cases of brucella endocarditis in lmam-Khorneini Hospual: Contrary to previous independent reports, female patients were not rare in this study and accountedfor three out ofseven. Four patients were cared for by combined medical and surgical treatment and were recovered Three of the patients that did not receive the combined theraPl could not he saved This report confirms the necessity of prompt combined medical and surgical treatment ofbrucella endocarditis.

  11. NEW POSSIBILITIES FOR THE TREATMENT OF ENTEROCOCCAL INFECTIOUS ENDOCARDITIS.

    Science.gov (United States)

    Tyurin, V P; Gudynovich, V G; Volkova, V L; Gvozdkov, A L; Zharkov, O B; Zhirova, L G; Mezenova, T V; Gusaim, T A

    This study was designed to analyze results of daptomycin therapy in 7 patients with enterococcal infectious endocarditis caused by Enterococcus faecium in two of them. Mean duration of therapy was 36.7 days. 70% of the strains proved resistant to gentamycin, 40% showed resistance to penicillin antibiotics, and 14.3% to vancomycin. Three patients suffered prosthetic valve endocarditis, six had elevated presepsin level (up to 768.8 pg/ml). 28,6% of the patients underwent valve prosthetic surgery. Hospital lethality was 14,3%. The effectiveness of ampicillin plus ceftriaxone treatment of gentanycin-resistant enterococci is discussed. Recommendation for the antibacterial treatment of enterococcal infectious endocarditis (ESC 2015) are provided.

  12. [Antineutrophil cytoplasmic antibodies associated with infective endocarditis: Literature review].

    Science.gov (United States)

    Langlois, V; Marie, I

    2017-07-01

    Antineutrophil cytoplasmic antibodies (ANCA) associated with infective endocarditis are a rare disorder. The condition can mimic primary systemic vasculitis (i.e. granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis). Thus, a wrong diagnosis of valvular involvement related to primary systemic vasculitis can be made in patients exhibiting ANCA associated with infective endocarditis. Because treatment of both conditions is different, this wrong diagnosis will lead to dramatic consequences in these latter patients. This review reports the state of knowledge and proposes an algorithm to follow when confronted to a possible case of ANCA associated with infective endocarditis. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  13. Stenotrophomonas maltophilia prosthetic valve endocarditis: a case report

    Directory of Open Access Journals (Sweden)

    Bayle Sophie

    2008-05-01

    Full Text Available Abstract Introduction Stenotrophomonas maltophilia is an environmental bacterium increasingly involved in nosocomial infections and resistant to most antibiotics. It is important to recognize and efficiently treat infections with this bacterium as soon as possible. Case presentation We present a case of Stenotrophomonas maltophilia prosthetic valve endocarditis secondary to an indwelling catheter infection. The patient was cured without surgery. We review other cases of S. maltophilia endocarditis from the literature and describe the peculiarities of this case. Conclusion S. maltophilia endocarditis is a rare disease that is often hospital-acquired and related to an indwelling catheter infection. The high lethality is likely related to the intrinsic resistance of nosocomial bloodstream infections to commonly prescribed antibiotics.

  14. Mitral valve aneurysm associated with aortic valve endocarditis and regurgitation.

    Science.gov (United States)

    Raval, Amish N; Menkis, Alan H; Boughner, Derek R

    2002-01-01

    Mitral valve aneurysms are rare complications occurring most commonly in association with aortic valve infective endocarditis. [Decroly 1989, Chua 1990, Northridge 1991, Karalis 1992, Roguin 1996, Mollod 1997, Vilacosta 1997, Cai 1999, Vilacosta 1999, Teskey 1999, Chan 2000, Goh 2000, Marcos- Alberca 2000] While the mechanism of the development of this lesion is unclear, complications such as perforation can occur and lead to significant mitral regurgitation. [Decroly 1989, Karalis 1992, Teskey 1999, Vilacosta 1999]; The case of a 69-year-old male with Streptococcus Sanguis aortic valve endocarditis and associated anterior mitral leaflet aneurysm is presented. Following surgery, tissue pathology of the excised lesion revealed myxomatous degeneration and no active endocarditis or inflammatory cells. This may add support to the hypothesis that physical stress due to severe aortic insufficiency and structural weakening, without infection of the anterior mitral leaflet, can lead to the development of this lesion.

  15. Tratamiento de agrandamiento gingival inducido por fenitoina asociado a placa bacteriana

    OpenAIRE

    Carmen Julia Rovira; Jennifer Orozco Páez; Antonio Díaz Caballero

    2013-01-01

    ResumenLa ingesta de algunos medicamentos puede producir un sobre crecimiento de las encías. Se reportan medicamentos tales como los bloqueadores de los canales de calcio, inmunosupresores, anticonvulsivantes que producen estos efectos adversos. Múltiples casos de agrandamientos gingivales están asociados a la ingesta de Fenitoína. El tratamiento de los agrandamientos gingivales inducidos por drogas por lo general es quirúrgico, pero mantener un buen control de placa bacteriana puede evitar e...

  16. Oftalmoplegia internuclear achado clínico inicial e único em endocardite bacteriana

    OpenAIRE

    Werneck,Antonio L. dos Santos; Gonçalves,Adrelírio J. Rios; Bezerra,José Marcelo

    1990-01-01

    Oftalmoplegia internuclear unilateral traduz-se por paralisia homolateral da adução ocular e nistagmo contralateral. As principais causas são a esclerose múltipla e a insuficiência vértebro-basilar. Apresentamos um caso secundário a endocardite bacteriana, em que este sinal iniciou o quadro e foi o único achado neurológico.

  17. Audit of antibiotic therapy used in 66 cases of endocarditis.

    Science.gov (United States)

    Demonchy, E; Dellamonica, P; Roger, P M; Bernard, E; Cua, E; Pulcini, C

    2011-11-01

    We wanted to assess the quality of antibiotic therapy prescribed for infective endocarditis in our ward. We conducted a retrospective audit of all adult patients with endocarditis hospitalized over a 3-year period in the Infectious Diseases Unit of the Nice University Hospital, France. The quality of antibiotic therapy was assessed using the 2004 European Society of Cardiology guidelines as a reference. Antibiotic therapy was considered as appropriate only if the five following items complied with guidelines: antibiotic, dose, route, interval of administration, and duration of antibiotic treatment. Sixty-six patients were included, 63years of age on average. Antibiotic therapy complied with guidelines in 14% of the cases. The most frequent causes of inappropriate therapy were: gentamicin prescribed as a single daily dose in 55% (27/49) of the cases, unnecessary prescriptions of rifampin in 72% (18/25) of the cases, and too long duration of gentamicin course for staphylococcal endocarditis in 32% (9/28) of the cases. Antibiotic therapy was switched from intravenous to oral route in 29% of the patients (n=19), 18±9 days after starting therapy on average. These endocarditis were mainly left-sided (n=12) and/or complicated (n=15). There was no significant association between mortality and inappropriate antibiotic therapy (14% if inappropriate vs. 22%, P=0.62) or between mortality and oral switch (0% if oral switch vs. 21%, P=0.052). Infective endocarditis antibiotic treatment rarely complied with the 2004 European guidelines, but this did not have a negative impact on mortality. Switching antibiotic therapy from intravenous to oral route was common, even for complicated left-sided endocarditis, and was associated with a favorable outcome in all cases. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  18. Axillary artery thrombus and infective endocarditis in lupus

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2011-01-01

    Full Text Available Systemic lupus erythematosus is a chronic systemic autoimmune disease, often associated with severe infection. A female patient was referred for surgical treatment of infective endocarditis after being treated for systemic lupus erythematosus and lupus nephritis. She developed symptoms of left axillary artery occlusion before heart operation. Bulky fungal hyphae were noted on pathological examination of the surgically removed thrombi. The patient had an uncomplicated recovery after receiving high doses of antibiotics and subsequent mitral valve replacement. Either infective endocarditis or fungal thrombi may be secondary to systemic lupus erythematosus and impaired renal function.

  19. First Reported Case of Bacterial Endocarditis Attributable to Actinomyces meyeri

    Directory of Open Access Journals (Sweden)

    Susan Moffatt

    1996-01-01

    Full Text Available A 48-year-old man presented to the Victoria General Hospital, Halifax, Nova Scotia in severe congestive heart failure. Echocardiographic studies revealed significant aortic valve insufficiency. Two anaerobic blood cultures performed two weeks apart were both positive for Actinomyces meyeri. The patient was treated with high dose intravenous penicillin. Three weeks after antibiotics were begun, he underwent aortic valve replacement. Intraoperative cultures were negative. Histopathological examination revealed findings in keeping with subacute bacterial endocarditis. The patient completed a six-week course of penicillin and was doing well three months after surgery. This is the first case of endocarditis attributable to A meyeri reported in the literature.

  20. [Which patients with infective endocarditis require emergency surgery?

    Science.gov (United States)

    Delahaye, François

    2016-10-01

    Half of patients with infectious endocarditis have surgery during the active phase of infective endocarditis (before the end of antibiotic therapy). The American Heart Association and the European Society of Cardiology, independently from each other, have published guidelines in September 2015. As regards surgical indications, these guidelines are similar. The surgical indication must be a common decision of a multidisciplinary team of experts in cardiology, cardiac surgery, imaging and infectious diseases. The main indications are heart failure, non-infectious process control and prevention of embolisms. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. Aortic valve endocarditis complicated by ST-elevation myocardial infarction.

    Science.gov (United States)

    Jenny, Benjamin E; Almanaseer, Yassar

    2014-12-01

    Infective endocarditis complicated by abscess formation and coronary artery compression is a rare clinical event with a high mortality rate, and diagnosis requires a heightened degree of suspicion. We present the clinical, angiographic, and echocardiographic features of a 73-year-old woman who presented with dyspnea and was found to have right coronary artery compression that was secondary to abscess formation resulting from diffuse infectious endocarditis. We discuss the patient's case and briefly review the relevant medical literature. To our knowledge, this is the first reported case of abscess formation involving a native aortic valve and the right coronary artery.

  2. Comparison of heart valve culture between two Danish endocarditis centres

    DEFF Research Database (Denmark)

    Voldstedlund, Marianne; Fuursted, Kurt; Bruun, Niels Eske

    2012-01-01

    The degree to which the results of valve culture depend on different laboratory procedures as well as other factors is unknown. The aim of this study was to compare the results of heart valve culture at 2 different endocarditis centres in order to clarify this.......The degree to which the results of valve culture depend on different laboratory procedures as well as other factors is unknown. The aim of this study was to compare the results of heart valve culture at 2 different endocarditis centres in order to clarify this....

  3. Virulence Factors Associated with Enterococcus Faecalis Infective Endocarditis

    DEFF Research Database (Denmark)

    Madsen, Kristian T; Skov, Marianne N; Gill, Sabine

    2017-01-01

    been associated with E. faecalis infective endocarditis. Absence of these factors entailed attenuation of strains in both mixed- and mono-bacterial infection endocarditis models as well as in in vitro and ex vivo assays when compared to their virulence factor expressing parental strains. PATHOGENESIS......: The virulence factors promote a broad spectrum of events that together allow for disease development and progression. The infection is initiated through bacterial binding to ligands present at the site of infection after which the colonization can be accelerated through inter-bacterial attachment and modulation...

  4. [The treatment of infectious endocarditis. Cefotaxime versus "traditional" medical management].

    Science.gov (United States)

    Felipe Flores, L; León, S; Casanova, J M; Reyes, P A

    1993-01-01

    We performed an open study to compare efficacy and renal toxicity of cephotaxime versus the usual beta lactam plus aminoglucoside treatment of infectious endocarditis. Twenty cases were studied, 10 treated with cephotaxime 4 g/day per 21 days and aminoglucoside for only 10 days. Comparison group received a combination of different beta lactam antibiotic plus aminoglucoside for 21 to 50 days, these patients were under care of nonparticipant physicians. Although cephotaxime treatment was as good as conventional antimicrobial scheme for control of infectious endocarditis, the treatment cost increases, and there is only marginal benefit in regard renal toxicity.

  5. Current controversies in infective endocarditis [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Thomas J. Cahill

    2015-11-01

    Full Text Available Infective endocarditis is a life-threatening disease caused by a focus of infection within the heart. For clinicians and scientists, it has been a moving target that has an evolving microbiology and a changing patient demographic. In the absence of an extensive evidence base to guide clinical practice, controversies abound. Here, we review three main areas of uncertainty: first, in prevention of infective endocarditis, including the role of antibiotic prophylaxis and strategies to reduce health care-associated bacteraemia; second, in diagnosis, specifically the use of multimodality imaging; third, we discuss the optimal timing of surgical intervention and the challenges posed by increasing rates of cardiac device infection.

  6. Infección bacteriana severa en recién nacidos febriles sin signos de focalización

    Directory of Open Access Journals (Sweden)

    Manuel Díaz Alvarez

    1995-08-01

    Full Text Available Este estudio estuvo dirigido a conocer la frecuencia de infección bacteriana severa, entre recién nacidos febriles sin signos de focalización inicial, e identificar los datos clínicos y de laboratorio que se relacionan con la presencia de infección bacteriana severa. Se estudió un grupo de 211 recién nacidos febriles ingresados y que no hubieran mostrado signos de focalización en la evaluación inicial. La incidencia de infección bacteriana severa fue de 17,5 %, del cual hubo 22 sepsis urinaria (10,4 %, 6 bacteriemias aisladas (2,8 % y 5 meningoencefalitis bacteriana (2,3 %. De los 37 recién nacidos con infección bacteriana severa se aisló germen causal en 36 (97,3 % de los cuales 26 fueron bacterias gramnegativa y 10 grampositiva. Por tipo de infección bacteriana severa se observó que predominó en la sepsis urinaria la Escherichia coli en 15/22 de los pacientes, en la meningoencefalitis el Streptococcus grupo B en 3/5 de los enfermos y en la bacteriemia aislada el Staphylococcus aureus en 3/6. Se encontró relación significativa con la presencia de infección bacteriana severa de los siguientes datos clínicos y de laboratorio: fiebre ³ 39 &oC, fiebre persistente o recurrente, impresión médica de niño con estado tóxico-infeccioso, antecedentes patológicos, sexo masculino, conteo de leucocitos sanguíneos ³ 20 000/mm3, eritrosedimentación ³ 20 mm/h y leucocituria 10 000/L en la orina no centrifugada.

  7. Acute aortic regurgitation due to infective endocarditis

    Directory of Open Access Journals (Sweden)

    Claudia M Cortés

    2017-10-01

    Full Text Available Acute aortic regurgitation (AAR due to infective endocarditis (IE is a serious disease and usually requires surgical treatment. Our study aims to compare the clinical, echocardiographic, and microbiological characteristics as well as in-hospital outcome of patients with AAR according to the severity of heart failure (HF and to evaluate predictors of in-hospital mortality in a tertiary centre. In a prospective analysis, we compared patients with NYHA functional class I-II HF (G1 vs. functional class III-IV HF (G2. From 06/92 to 07/16, 439 patients with IE were hospitalized; 86 presented AAR: (G1, 39: 45.4% y G2, 47: 54.7%. The G1 had higher prosthetic IE (43.6% vs. 17%, p 0.01. All G2 patients had dyspnoea vs. 30.8% of the G1 (p < 0.0001. There were no differences in clinical, echocardiographic and microbiological characteristics. Surgical treatment was indicated mainly due to infection extension or valvular dysfunction in G1 and HF in G2. In-hospital mortality was 15.4% vs. 27.7% (G1 and G2 respectively p NS. In multivariate analysis, health care-associated acquisition (p 0.001, negative blood cultures (p 0.004, and functional class III-IV HF (p 0.039 were in-hospital mortality predictors. One-fifth of the patients with EI had AAR. Half of them had severe HF which needed emergency surgery and the remaining needed surgery for extension of the infection and / or valvular dysfunction. Both groups remain to have high surgical and in-hospital mortality. Health care-associated acquisition, negative blood cultures and advanced HF were predictors of in-hospital mortality

  8. The surgical approach to infective endocarditis: 10 year experience.

    Science.gov (United States)

    Gerrah, Rabin; Rudis, Ehud; Elami, Amir; Milgalter, Eli; Izhar, Uzi; Merin, Gideon

    2003-09-01

    About 40% of patients with infective endocarditis will require surgical treatment. The guidelines for such treatment were formulated by the American College of Cardiology and American Heart Association in 1998. To examine our experience with surgical treatment of infective endocarditis in light of these guidelines. Surgery was performed in 59 patients with infective endocarditis between 1990 and 1999. The patients' mean age was 48 years (range 13-80). The indications for surgery were hemodynamic instability, uncontrolled infection, and peripheral embolic events. The surgical treatment was based on elimination of infection foci and correction of the hemodynamic derangement. These objectives were met with valve replacement in the majority of patients. Whenever conservative surgery was possible, resection of vegetation and subsequent valve repair were performed and the native valve was preserved. Six patients (10%) died perioperatively from overwhelming sepsis (n = 3), low cardiac output (n = 2) and multiogran failure (n = 1). The mean hospital stay was 15.6 days. Of 59 patients, 47 (80%) underwent valve replacement and in 11 (19%) the surgical treatment was based on valve repair. After 1 year of follow-up there was no re-infection. The new guidelines for surgical treatment of infective endocarditis allow better selection of patients and timing of surgery for this aggressive disease, which consequently decreases the mortality rate. Valve repair is feasible and is preferred whenever possible. According to the new guidelines, patients with neurologic deficit in our series would not have been operated upon, potentially decreasing the operative mortality to 7%.

  9. 149. Reparación valvular mitral en endocarditis

    Directory of Open Access Journals (Sweden)

    J. Rodríguez-Roda Stuart

    2010-01-01

    Conclusiones: Con la suficiente experiencia en reparación mitral, la reparación de la válvula mitral con endocarditis se puede realizar con una baja mortalidad quirúrgica además de aportar las ventajas de conservar la válvula nativa con una baja tasa de reoperación.

  10. Infective endocarditis: a consumptive disease among the elderly

    Directory of Open Access Journals (Sweden)

    Vilma Takayasu

    2011-12-01

    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.

  11. Endocarditis caused by Streptococcus canis: an emerging zoonosis?

    Science.gov (United States)

    Lacave, Guillaume; Coutard, Aymeric; Troché, Gilles; Augusto, Sandrine; Pons, Stéphanie; Zuber, Benjamin; Laurent, Virginie; Amara, Marlène; Couzon, Brigitte; Bédos, Jean-Pierre; Pangon, Béatrice; Grimaldi, David

    2016-02-01

    We report a human case of infective endocarditis caused by Streptococcus canis. Identification was carried out from positive blood culture using mass spectrometry and SodA gene sequencing. S. canis related zoonotic invasive infections may have been previously underdiagnosed due to inadequate identification of group G Streptococcus species.

  12. A case of infectious endocarditis due to BCG

    Directory of Open Access Journals (Sweden)

    Alice Fournier

    2015-06-01

    Full Text Available The occurrence of bacillus Calmette–Guérin (BCG disease following instillation for bladder cancer is commonly documented. The intravesical administration of BCG is generally safe, but may present severe complications. A fatal case of native aortic valve infectious endocarditis with septicemia due to BCG in a patient treated with intravesical instillation is reported herein.

  13. Enterococcal Infective Endocarditis following Periodontal Disease in Dogs.

    Directory of Open Access Journals (Sweden)

    Teresa Semedo-Lemsaddek

    Full Text Available In humans, one of the major factors associated with infective endocarditis (IE is the concurrent presence of periodontal disease (PD. However, in veterinary medicine, the relevance of PD in the evolution of dogs' endocarditis remains poorly understood. In order to try to establish a correlation between mouth-associated Enterococcus spp. and infective endocarditis in dogs, the present study evaluated the presence and diversity of enterococci in the gum and heart of dogs with PD. Samples were collected during necropsy of 32 dogs with PD and visually diagnosed with IE, which died of natural causes or euthanasia. Enterococci were isolated, identified and further characterized by Pulsed-Field Gel Electrophoresis (PFGE; susceptibility to antimicrobial agents and pathogenicity potential was also evaluated. In seven sampled animals, PFGE-patterns, resistance and virulence profiles were found to be identical between mouth and heart enterococci obtained from the same dog, allowing the establishment of an association between enterococcal periodontal disease and endocarditis in dogs. These findings represent a crucial step towards understanding the pathogenesis of PD-driven IE, and constitute a major progress in veterinary medicine.

  14. Valvular Endocarditis In A Captive Monkey In Ibadan, Nigeria: A ...

    African Journals Online (AJOL)

    Congestive heart failure which can be due to mural or valvular endocarditis has been found to be a product of a septicaemic condition (Robinson and Maxie, 1985). There have been various reports of the pathology of heart related conditions in primates in different parts of the world (Isoun et al., 1972; McConnell et al., 1974; ...

  15. Infective endocarditis due to non-toxigenic Corynebacterium ...

    African Journals Online (AJOL)

    A case of infective endocarditis (lE) in a 51/ 2-yearold boy in whom blood and bone marrow cultures yielded an unusual organism, a non-toxigenic strain of Corynebacterium diphtheriae, is reported. This proved fatal, and at autopsy congenital valvar aortic stenosis was found, but the vegetations occurred on an anatomically ...

  16. Infective endocarditis - the effect of liposomes as carrier substance ...

    African Journals Online (AJOL)

    Infective endocarditis has a high mortality and morbidity rate despite all available treatment. Little attention has been paid to the possible role of polymorphonuclear leucocytes in damage to the heart valves. It was postulated that if the elastases set free from these leucocytes could be neutralised, this would prevent damage ...

  17. Dentigenous infectious foci - a risk factor of infective endocarditis.

    Science.gov (United States)

    Wisniewska-Spychala, Beata; Sokalski, Jerzy; Grajek, Stefan; Jemielity, Marek; Trojnarska, Olga; Choroszy-Krol, Irena; Sójka, Anna; Maksymiuk, Tomasz

    2012-02-01

    Dentigenous, infectious foci are frequently associated with the development of various diseases. The role of such foci in the evolution of endocarditis still remains unclear. This article presents the concluding results of an interdisciplinary study verifying the influence of dentigenous, infectious foci on the development of infective endocarditis. The study subjects were 60 adult patients with history of infective endocarditis and coexistent acquired heart disease, along with the presence at least 2 odontogenic infectious foci (ie, 2 or more teeth with gangrenous pulp and periodontitis). The group had earlier been qualified for the procedure of heart valve replacement. Swabs of removed heart valve tissue with inflammatory lesions and blood were then examined microbiologically. Swabs of root canals and their periapical areas, of periodontal pockets, and of heart valves were also collected. Microbial flora, cultured from intradental foci, blood and heart valves, fully corresponded in 14 patients. This was accompanied in almost all cases by more advanced periodontitis (2nd degree, Scandinavian classification), irrespective of the bacterial co-occurrence mentioned. In the remaining patients, such consistency was not found. Among various dentigenous, infectious foci, the intradental foci appear to constitute a risk factor for infective endocarditis.

  18. Endocarditis caused by Abiotrophia defectiva | Al-Jasser | Libyan ...

    African Journals Online (AJOL)

    A diagnosis of infective endocarditis (IE) due to A.defectiva was made. Treatment, with penicillin and gentamicin, was administered for 4 weeks. Mechanical valve replacement was required few days after starting the antibiotic therapy. The patient had a favorable outcome on follow up. Although A.defectiva is an uncommon ...

  19. Isolated tricuspid valve infective endocarditis - A report of 6 cases ...

    African Journals Online (AJOL)

    Six cases of isolated tricuspid valve endocarditis in young women are described. Preceding genital sepsis was a predisposing factor in 4 patients. Cardiac signs are unusual at presentation, rendering the diagnosis difficult. Pleuropulmonary manifestations are the predominant findings, while overt signs of tricuspid ...

  20. Dentigenous infectious foci – a risk factor of infective endocarditis

    Science.gov (United States)

    Wisniewska-Spychala, Beata; Sokalski, Jerzy; Grajek, Stefan; Jemielity, Marek; Trojnarska, Olga; Choroszy-Król, Irena; Sójka, Anna; Maksymiuk, Tomasz

    2012-01-01

    Summary Background Dentigenous, infectious foci are frequently associated with the development of various diseases. The role of such foci in the evolution of endocarditis still remains unclear. This article presents the concluding results of an interdisciplinary study verifying the influence of dentigenous, infectious foci on the development of infective endocarditis. Material/Methods The study subjects were 60 adult patients with history of infective endocarditis and coexistent acquired heart disease, along with the presence at least 2 odontogenic infectious foci (ie, 2 or more teeth with gangrenous pulp and periodontitis). The group had earlier been qualified for the procedure of heart valve replacement. Swabs of removed heart valve tissue with inflammatory lesions and blood were then examined microbiologically. Swabs of root canals and their periapical areas, of periodontal pockets, and of heart valves were also collected. Results Microbial flora, cultured from intradental foci, blood and heart valves, fully corresponded in 14 patients. This was accompanied in almost all cases by more advanced periodontitis (2nd degree, Scandinavian classification), irrespective of the bacterial co-occurrence mentioned. In the remaining patients, such consistency was not found. Conclusions Among various dentigenous, infectious foci, the intradental foci appear to constitute a risk factor for infective endocarditis. PMID:22293883

  1. Particularities in diagnosis and treatment for infectious endocarditis in children.

    Science.gov (United States)

    Luca, Alina Costina; Begezsan, Isabela Ioana; Iordache, C

    2012-01-01

    Infectious endocarditis (IE) represents a rare pathology in children, but with lethal potential. The goal of the therapy is fast and total eradication of the infection. To study particularities in diagnosis and treatment for infectious endocarditis in children. Children with infectious endocarditis hospitalized between January 2007 - February 2012 in the Cardiology Department of the ,,Sfânta Maria" Children Emergency Hospital of lasi have been included in the study. The patients are aged between 23 days and 16 years, the average age being 4 years old. At approximately 88% of the patients (14 cases), the endocardial damage appeared in the pre-existent valvular lesions, specially mitral and aortal. As associated congenital malformations, the patients prevailingly presented ventricular septal defect, mitral valve prolapse, arterial canal persistence, aortic stenosis, coarctation of the aorta. Blood cultures were collected and the most frequent identified etiological agents were: Staphylococcus coagulase-positive, Streptococcus mitis, Staphylococcus speciae coagulase-negative, Staphylococcus haemolyticus, Streptococcus bovis, Escherichia coli, for which the antibiogram showed sensitivity for beta-lactam, cephalosporins, glycopeptides, trimethoprim-sulfamethoxazole, rifampicin, quinolone, lincosamides, oxazolidinones, and thus specific treatment was set up according to the antibiogram. The infectious endocarditis is a serious disease that affects young age too, leading towards exitus in some cases. Diagnostic imaging and early blood cultures are of relevance in order to intervene promptly. The treatment must be targeted and applied as fast as possible.

  2. Infective endocarditis presenting as acute coronary syndrome | El ...

    African Journals Online (AJOL)

    We report tow cases of infective endocarditis (IE) presenting as acute coronary syndrome (ACS). Case 1: A 60-year-old man with the diagnosis of mitral IE complicated by an ST segment elevation myocardial infarction. Primary percutaneous coronary intervention with aspiration of the thrombus at the distal leftanterior ...

  3. Once versus twice daily gentamicin dosing for infective endocarditis

    DEFF Research Database (Denmark)

    Buchholtz, Kristine; Larsen, Carsten Toftager; Schaadt, Bente

    2011-01-01

    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...

  4. Severe Tricuspid Valve Endocarditis Related to Tunneled Catheters ...

    African Journals Online (AJOL)

    Introduction: Hemodialysis (HD) patients are predisposed to infective endocarditis (IE) mainly due to repeated manipulation of the vascular access. However, catheter seeding and IE may also result from a distant infection site. Case series: A diabetic patient who was maintained on regular HD through a permanent catheter ...

  5. Low efficacy of tobramycin in experimental Staphylococcus aureus endocarditis

    DEFF Research Database (Denmark)

    Lerche, C. J.; Christophersen, L. J.; Trøstrup, H.

    2015-01-01

    The empiric treatment of infective endocarditis (IE) varies widely and, in some places, a regimen of penicillin in combination with an aminoglycoside is administered. The increasing incidence of Staphylococcus aureus IE, poor tissue penetration by aminoglycosides and low frequency of penicillin...

  6. Corynebacterium CDC group G native and prosthetic valve endocarditis

    Directory of Open Access Journals (Sweden)

    Adil Sattar

    2015-08-01

    Full Text Available We report the first case of native and recurrent prosthetic valve endocarditis with Corynebacterium CDC group G, a rarely reported cause of infective endocarditis (IE. Previously, there have been only two cases reported for prosthetic valve IE caused by these organisms. A 69-year-old female with a known history of mitral valve regurgitation presented with a 3-day history of high-grade fever, pleuritic chest pain and cough. Echocardiography confirmed findings of mitral valve thickening consistent with endocarditis, which subsequently progressed to become large and mobile vegetations. Both sets of blood cultures taken on admission were positive for Corynebacterium CDC group G. Despite removal of a long-term venous access port, the patient’s presumed source of line associated bacteremia, mitral valve replacement, and aggressive antibiotic therapy, the patient had recurrence of vegetations on the prosthetic valve. She underwent replacement of her prosthetic mitral valve in the subsequent 2 weeks, before she progressed to disseminated intravascular coagulation and expired. Although they are typically considered contaminants, corynebacteria, in the appropriate clinical setting, should be recognized, identified, and treated as potentially life-threatening infections, particularly in the case of line-associated bacteremias, and native and prosthetic valve endocarditis.

  7. Pacemaker Related Infective Endocarditis from Staphylococcus Lugdunensis: A Case Report

    Directory of Open Access Journals (Sweden)

    Michael Ward

    2013-01-01

    Full Text Available Staphylococcus lugdunensis is a common skin flora not typically associated with infection. There are, however, several cases reported in the literature of Staphylococcus lugdunensis as a causative bacterium of various infections. This paper reports an additional case of pacemaker associated endocarditis with Staphylococcus lugdunensis as the causative bacterium.

  8. Prosthetic valve endocarditis after transcatheter aortic valve implantation

    DEFF Research Database (Denmark)

    Olsen, Niels Thue; De Backer, Ole; Thyregod, Hans G H

    2015-01-01

    BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an advancing mode of treatment for inoperable or high-risk patients with aortic stenosis. Prosthetic valve endocarditis (PVE) after TAVI is a serious complication, but only limited data exist on its incidence, outcome, and procedural...

  9. Second Fatal Case of Infective Endocarditis caused by Gemella bergeriae

    Directory of Open Access Journals (Sweden)

    Aijan Ukudeeva

    2017-03-01

    Full Text Available Our case illustrates a fatal course of infection with Gemella bergeriae endocarditis that was complicated by cardiogenic shock due to perforation of the mitral valve with severe mitral regurgitation, extension of infection into the myocardium adjacent to the mitral valve, and coronary sinus thrombosis.

  10. Corynebacterium CDC Group G Native and Prosthetic Valve Endocarditis.

    Science.gov (United States)

    Sattar, Adil; Yu, Siegfried; Koirala, Janak

    2015-08-11

    We report the first case of native and recurrent prosthetic valve endocarditis with Corynebacterium CDC group G, a rarely reported cause of infective endocarditis (IE). Previously, there have been only two cases reported for prosthetic valve IE caused by these organisms. A 69-year-old female with a known history of mitral valve regurgitation presented with a 3-day history of high-grade fever, pleuritic chest pain and cough. Echocardiography confirmed findings of mitral valve thickening consistent with endocarditis, which subsequently progressed to become large and mobile vegetations. Both sets of blood cultures taken on admission were positive for Corynebacterium CDC group G. Despite removal of a long-term venous access port, the patient's presumed source of line associated bacteremia, mitral valve replacement, and aggressive antibiotic therapy, the patient had recurrence of vegetations on the prosthetic valve. She underwent replacement of her prosthetic mitral valve in the subsequent 2 weeks, before she progressed to disseminated intravascular coagulation and expired. Although they are typically considered contaminants, corynebacteria, in the appropriate clinical setting, should be recognized, identified, and treated as potentially life-threatening infections, particularly in the case of line-associated bacteremias, and native and prosthetic valve endocarditis.

  11. Verrucous endocarditis associated with Streptococcus bovis in mink (Mustela vison)

    DEFF Research Database (Denmark)

    Pedersen, Karl; Jørgensen, J.C.; Dietz, Hans-Henrik

    2003-01-01

    Between 1998 and 2001, mortalities due to verrucous endocarditis were experienced at several mink farms. Gram-positive cocci were isolated from the endocardium of all the animals examined but not always from other internal organs. Almost all the isolates were identified as Streptococcus bovis and...

  12. Native valve endocarditis due to Candida parapsilosis in an adult ...

    African Journals Online (AJOL)

    We describe a case of Candida parapsilosis endocarditis in an HIV-positive patient with pre-existing mitral valve disease and renal failure on haemodialysis. ... Blood cultures were positive for C. parapsilosis. β-D-glucan assay levels were elevated. .... presence of negative blood cultures suggests that this test is not reliable.

  13. Leptotrichia endocarditis: report of two cases from the International Collaboration on Endocarditis (ICE) database and review of previous cases

    NARCIS (Netherlands)

    Caram, L. B.; Linefsky, J. P.; Read, K. M.; Murdoch, D. R.; Lalani, T.; Woods, C. W.; Reller, L. B.; Kanj, S. S.; Premru, M. M.; Ryan, S.; Al-Hegelan, M.; Donnio, P. Y.; Orezzi, C.; Paiva, M. G.; Tribouilloy, C.; Watkin, R.; Harris, O.; Eisen, D. P.; Corey, G. R.; Cabell, C. H.; Petti, C. A.; Gordon, David; Devi, Uma; Spelman, Denis; van der Meer, Jan T. M.; Kauffman, Carol; Bradley, Suzanne; Armstrong, William; Giannitsioti, Efthymia; Giamarellou, Helen; Lerakis, Stamatios; del Rio, Ana; Moreno, Asuncion; Mestres, Carlos A.; Paré, Carlos; de la Maria, Cristina Garcia; de Lazzario, Elisa; Marco, Francesc; Gatell, Jose M.; Miró, José M.; Almela, Manel; Azqueta, Manuel; Jiménez-Expósito, Maria Jesús; de Benito, Natividad; Perez, Noel; Almirante, Benito; Fernandez-Hidalgo, Nuria; de Vera, Pablo Rodriguez; Tornos, Pilar; Falcó, Vicente; Claramonte, Xavier; Armero, Yolanda; Sidani, Nisreen; Kanj-Sharara, Souha; Kanafani, Zeina; Raglio, Annibale; Goglio, Antonio; Gnecchi, Fabrizio; Suter, Fredy; Valsecchi, Grazia; Rizzi, Marco; Ravasio, Veronica; Hoen, Bruno; Chirouze, Catherine; Leroy, Joel; Plesiat, Patrick; Bernard, Yvette; Casey, Anna; Lambert, Peter; Watkin, Richard; Elliott, Tom; FRCPath, D. Sc; Patel, Mukesh; Dismukes, William; Pan, Angelo; Caros, Giampiero; Tribouilloy, Amel Brahim Mathiron Christophe; Goissen, Thomas; Delahaye, Armelle; Delahaye, Francois; Vandenesch, Francois; Vizzotti, Carla; Nacinovich, Francisco M.; Marin, Marcelo; Trivi, Marcelo; Lombardero, Martin; Cortes, Claudia; Casabé, José Horacio; Altclas, Javier; Kogan, Silvia; Clara, Liliana; Sanchez, Marisa; Commerford, Anita; Hansa, Cass; Deetlefs, Eduan; Ntsekhe, Mpiko; Commerford, Patrick; Wray, Dannah; Steed, Lisa L.; Church, Preston; Cantey, Robert; Morris, Arthur; Holland, David; Murdoch, David; Graham, Katherine; Read, Kerry; Raymond, Nigel; Bridgman, Paul; Troughton, Richard; Lang, Selwyn; Chambers, Stephen; Kotsanas, Despina; Korman, Tony M.; Peterson, Gail; Purcell, Jon; Southern, Paul M.; Shah, Manisha; Bedimo, Roger; Reddy, Arjun; Levine, Donald; Dhar, Gaurav; Hanlon-Feeney, Alanna; Hannan, Margaret; Wang, Andrew; Cabell, Christopher H.; Woods, Christopher W.; Sexton, Daniel J.; Benjamin, Danny; Corey, G. Ralph; McDonald, Jay R.; Federspiel, Jeff; Engemann, John J.; Reller, L. Barth; Drew, Laura; Stryjewski, Martin; Morpeth, Susan; Lalani, Tahaniyat; Fowler, Vance; Chu, Vivian; Mazaheri, Bahram; Neuerburg, Carl; Naber, Christoph; Athan, Eugene; Henry, Margaret; Harris, Owen; Alestig, Eric; Olaison, Lars; Wikstrom, Lotta; Snygg-Martin, Ulrika; Francis, Johnson; Venugopal, K.; Nair, Lathi; Thomas, Vinod; Chaiworramukkun, Jaruwan; Pachirat, Orathai; Chetchotisakd, Ploenchan; Suwanich, Tewan; Kamarulzaman, Adeeba; Tamin, Syahidah Syed; Mueller Premru, Manica; Logar, Mateja; Lejko-Zupanc, Tatjana; Orezzi, Christina; Klein, John; Bouza, Emilio; Moreno, Mar; Rodríguez-Créixems, Marta; Marín, Mercedes; Fernández, Miguel; Muñoz, Patricia; Fernández, Rocío; Ramallo, Victor; Raoult, Didier; Thuny, Franck; Habib, Gilbert; Casalta, Jean-Paul; Fournier, Pierre-Edouard; Chipigina, Natalia; Kirill, Ozerecky; Vinogradova, Tatiana; Kulichenko, Vadim P.; Butkevich, O. M.; Lion, Christine; Selton-Suty, Christine; Alla, Francois; Coyard, Hélène; Doco-Lecompte, Thanh; Iarussi, Diana; Durante-Mangoni, Emanuele; Tripodi, Marie Françoise; Utili, Riccardo; Kumar, A. Sampath; Sharma, Gautam; Dickerman, Stuart A.; Street, Alan; Eisen, Damon Peter; McBryde, Emma Sue; Grigg, Leeanne; Abrutyn, Elias; Michelet, Christian; Tattevin, Pierre; Donnio, Pierre Yves; Fortes, Claudio Querido; de Janeiro, Rio; Edathodu, Jameela; Al-Hegelan, Mashael; Font, Bernat; Anguera, Ignasi; Guma, Joan Raimon; Cereceda, M.; Oyonarte, Miguel J.; Mella, Rodrigo Montagna; Garcia, Patricia; Jones, Sandra Braun; de Oliveira Ramos, Auristela Isabel; Paiva, Marcelo Goulart; de Medeiros Tranchesi, Regina Aparecida; Woon, Lok Ley; Tan, Ru-San; Rees, David; Kornecny, Pam; Lawrence, Richard; Dever, Robyn; Post, Jeffrey; Jones, Phillip; Ryan, Suzanne; Harkness, John; Feneley, Michael; Rubinstein, Ethan; Strahilewitz, Jacob; Ionac, Adina; Mornos, Cristian; Dragulescu, Stefan; Forno, Davide; Cecchi, Enrico; de Rosa, Francesco; Imazio, Massimo; Trinchero, Rita; Wiesbauer, Franz; Gattringer, Rainer; Deans, Greg; Andrasevic, Arjana Tambic; Barsic, Bruno; Klinar, Igor; Vincelj, Josip; Krajinovic, Vladimir; Cabell, Christopher; Stafford, Judy; Baloch, Khaula; Pappas, Paul; Redick, Thomas; Harding, Tina; Karchmer, A. W.; Bayer, Arnie; Durack, David T.; Phil, D.; Moreillon, Phillipe; Eykyn, Susannah

    2008-01-01

    Leptotrichia species typically colonize the oral cavity and genitourinary tract. We report the first two cases of endocarditis secondary to L. goodfellowii sp. nov. Both cases were identified using 16S rRNA gene sequencing. Review of the English literature revealed only two other cases of

  14. Coagulase-negative staphylococcal prosthetic valve endocarditis--a contemporary update based on the International Collaboration on Endocarditis: prospective cohort study

    NARCIS (Netherlands)

    Chu, V. H.; Miro, J. M.; Hoen, B.; Cabell, C. H.; Pappas, P. A.; Jones, P.; Stryjewski, M. E.; Anguera, I.; Braun, S.; Muñoz, P.; Commerford, P.; Tornos, P.; Francis, J.; Oyonarte, M.; Selton-Suty, C.; Morris, A. J.; Habib, G.; Almirante, B.; Sexton, D. J.; Corey, G. R.; Fowler, V. G.; Gordon, David; Devi, Uma; Spelman, Denis; van der Meer, Jan T. M.; Kauffman, Carol; Bradley, Suzanne; Armstrong, William; Giannitsioti, Efthymia; Giamarellou, Helen; Lerakis, Stamatios; del Rio, Ana; Moreno, Asuncion; Mestres, Carlos A.; Pare, Carlos; Garcia de la Maria, Cristina; Claramonte, Xavier; Armero, Yolanda; de Lazzario, Elisa; Marco, Francesc; Gatell, Jose M.; Miro, José M.; Almela, Manel; Azqueta, Manuel; Jiménez-Expósito, Maria Jesús; de Benito, Natividad; Ramirez, Jose; Perez, Noel; Almirante, Benito; Fernandez-Hidalgo, Nuria; Rodriguez de Vera, Pablo; Tornos, Pilar; Falcó, Vicente; Sidani, Nisreen; Kanj-Sharara, Souha; Kanafani, Zeina; Raglio, Annibale; Goglio, Antonio; Gnecchi, Fabrizio; Suter, Fredy; Valsecchi, Grazia; Rizzi, Marco; Ravasio, Veronica; Hoen, Bruno; Chirouze, Catherine; Leroy, Joel; Plesiat, Patrick; Bernard, Yvette; Casey, Anna; Lambert, Peter; Watkin, Richard; Elliott, Tom; Patel, Mukesh; Dismukes, William; Pan, Angelo; Caros, Giampiero; Tribouilloy, Amel Brahim Mathiron Christophe; Goissen, Thomas; Delahaye, Armelle; Delahaye, Francois; Vandenesch, Francois; Vizzotti, Carla; Nacinovich, Francisco M.; Marin, Marcelo; Trivi, Marcelo; Lombardero, Martin; Cortes, Claudia; Casabe, José Horacio; Altclas, Javier; Kogan, Silvia; Clara, Liliana; Sanchez, Marisa; Commerford, Anita; Hansa, Cass; Deetlefs, Eduan; Ntsekhe, Mpiko; Commerford, Patrick; Wray, Dannah; Steed, Lisa L.; Church, Preston; Cantey, Robert; Morris, Arthur; Holland, David; Murdoch, David; Read, Kerry; Raymond, Nigel; Lang, Selwyn; Chambers, Stephen; Kotsanas, Despina; Korman, Tony M.; Peterson, Gail; Purcell, Jon; Southern, Paul M.; Shah, Manisha; Bedimo, Roger; Reddy, Arjun; Levine, Donald; Dhar, Gaurav; Hanlon-Feeney, Alanna; Hannan, Margaret; Kelly, Sinead; Wang, Andrew; Cabell, Christopher H.; Woods, Christopher W.; Sexton, Daniel J.; Benjamin, Danny; Corey, G. Ralph; McDonald, Jay R.; Federspiel, Jeff; Engemann, John J.; Reller, L. Barth; Drew, Laura; Caram, L. B.; Stryjewski, Martin; Morpeth, Susan; Lalani, Tahaniyat; Fowler, Vance; Chu, Vivian; Mazaheri, Bahram; Neuerburg, Carl; Naber, Christoph; Athan, Eugene; Henry, Margaret; Harris, Owen; Alestig, Eric; Olaison, Lars; Wikstrom, Lotta; Snygg-Martin, Ulrika; Francis, Johnson; Venugopal, K.; Nair, Lathi; Thomas, Vinod; Chaiworramukkun, Jaruwan; Pachirat, Orathai; Chetchotisakd, Ploenchan; Suwanich, Tewan; Kamarulzaman, Adeeba; Tamin, Syahidah Syed; Premru, Manica Mueller; Logar, Mateja; Lejko-Zupanc, Tatjana; Orezzi, Christina; Klein, John; Bouza, Emilio; Moreno, Mar; Rodríguez-Créixems, Marta; Marín, Mercedes; Fernández, Miguel; Muñoz, Patricia; Fernández, Rocío; Ramallo, Victor; Raoult, Didier; Thuny, Franck; Habib, Gilbert; Casalta, Jean-Paul; Fournier, Pierre-Edouard; Chipigina, Natalia; Kirill, Ozerecky; Vinogradova, Tatiana; Kulichenko, Vadim P.; Butkevich, O. M.; Lion, Christine; Selton-Suty, Christine; Alla, Francois; Coyard, Hélène; Doco-Lecompte, Thanh; Iarussi, Diana; Durante-Mangoni, Emanuele; Ragone, Enrico; Dialetto, Giovanni; Tripodi, Marie Françoise; Utili, Riccardo; Casillo, Roberta; Kumar, A. Sampath; Sharma, Gautam; Dickerman, Stuart A.; Street, Alan; Eisen, Damon Peter; Grigg, Leeanne; Abrutyn, Elias; Michelet, Christian; Tattevin, Pierre; Donnio, Pierre Yves; Fortes, Claudio Querido; Edathodu, Jameela; Al-Hegelan, Mashael; Font, Bernat; Anguera, Ignasi; Guma, Joan Raimon; Cereceda, M.; Oyonarte, Miguel J.; Mella, Rodrigo Montagna; Garcia, Patricia; Jones, Sandra Braun; Ramos, Auristela Isabel de Oliveira; Paiva, Marcelo Goulart; Tranchesi, Regina Aparecida de Medeiros; Woon, Lok Ley; Lum, Luh-Nah; Tan, Ru-San; Rees, David; Kornecny, Pam; Lawrence, Richard; Dever, Robyn; Post, Jeffrey; Jones, Phillip; Ryan, Suzanne; Harkness, John; Feneley, Michael; Rubinstein, Ethan; Strahilewitz, Jacob; Ionac, Adina; Mornos, Cristian; Dragulescu, Stefan; Forno, Davide; Cecchi, Enrico; de Rosa, Francesco; Imazio, Massimo; Trinchero, Rita; Wiesbauer, Franz; Gattringer, Rainer; Deans, Greg; Andrasevic, Arjana Tambic; Barsic, Bruno; Klinar, Igor; Vincelj, Josip; Bukovski, Suzana; Krajinovic, Vladimir

    2009-01-01

    OBJECTIVE: To describe the contemporary features of coagulase-negative staphylococcal (CoNS) prosthetic valve endocarditis (PVE). DESIGN: Observational study of prospectively collected data from a multinational cohort of patients with infective endocarditis. Patients with CoNS PVE were compared to

  15. Escova dental e dedeira na remoção da placa bacteriana dental em cães

    OpenAIRE

    Lima,Tânia Berbert Ferreira; Eurides,Duvaldo; Rezende,Renata Junqueira; Milken,Vanessa Martins Fayad; Silva,Luiz Antonio Franco da; Fioravanti,Maria Clorinda Soares

    2004-01-01

    A placa bacteriana é fator primário na formação de gengivite, cálculo dentário, halitose e doença periodontal. Objetivou-se avaliar a quantidade de placa bacteriana dental removida pela escova dental e dedeira. Foram utilizados 60 cães machos e fêmeas de diferentes raças, idade e peso, divididos em dois grupos. O índice Logan & Boyce foi utilizados para quantificar a placa bacteriana antes e após a escovação. Observou-se diferença estatística (p0,05) entre a utilização da escova dental e ...

  16. Estrutura metabólica e genética de comunidades bacterianas em solo de cerrado sob diferentes manejos

    Directory of Open Access Journals (Sweden)

    Leandro Moraes de Souza

    2012-02-01

    Full Text Available O objetivo deste trabalho foi avaliar a estrutura metabólica e genética de comunidades bacterianas em Latossolo de cerrado sob vegetação nativa ou cultivado em sistema de rotação soja/milho sob preparo convencional e plantio direto. Foram utilizadas microplacas EcoPlate para determinar o perfil e a diversidade metabólica das comunidades bacterianas, e eletroforese em gel com gradiente desnaturante (DGGE para avaliar a estrutura genética. O teste estatístico de Mantel foi utilizado para avaliar a relação entre a estrutura metabólica e a genética. A comunidade bacteriana sob vegetação nativa apresentou perfil metabólico diferente do encontrado em solos cultivados. No solo cultivado com soja sob preparo convencional, o padrão de utilização das fontes de carbono diferenciou-se dos demais tratamentos. Com base nos resultados de DGGE, a comunidade bacteriana sob vegetação nativa apresentou 35% de similaridade com as de áreas cultivadas. Foram formados grupos distintos de comunidades bacterianas do solo entre as áreas sob preparo convencional e plantio direto. Houve correlação significativa de 62% entre as matrizes geradas pelas microplacas EcoPlate e pela DGGE. Variações no perfil metabólico estão relacionadas às variações na estrutura genética das comunidades bacterianas do solo.

  17. Neumonías bacterianas bacteriémicas post-influenza (NBBPI)

    OpenAIRE

    Sparo, Mónica; Delpech, Gastón; Schell, Celia María; De Luca, María Marta; Basualdo Farjat, Juan Ángel

    2010-01-01

    Influenza es una enfermedad respiratoria aguda, altamente transmisible, de distribución mundial y de ocurrencia estacional, causada por alguno de los 3 tipos de virus de la influenza que se conocen: A, B o C. Se caracteriza por la súbita aparición de signos y síntomas como fiebre (38-40ºC), mialgias, cefalea, escalofríos, decaimiento, tos no productiva, faringitis y rinitis. Una de las complicaciones frecuentes durante la convalecencia del cuadro viral es la neumonía bacteriana secundaria, so...

  18. Mancha bacteriana em Ruscus sp. causada por Burkholderia andropogonis no Brasil

    OpenAIRE

    Almeida, Irene M.G; Beriam, Luís O.S; Sannazzaro, Ana M; Rodrigues Neto, Júlio

    2009-01-01

    Em abril de 2008 foram recebidas folhas de Ruscus sp. originárias de plantios localizados na região de Santo Antonio de Posse SP com sintomas de manchas arredondadas, com 5 a 8 mm de diâmetro, de coloração marrom escura, com centro necrótico e circundadas por halo clorótico. Dos isolamentos realizados, foram obtidas colônias bacterianas de cor creme, de crescimento lento, com células Gram-negativas, oxidativas e não fluorescentes. Inoculações artificiais em Ruscus sp. reproduziram os sintomas...

  19. Oftalmoplegia internuclear achado clínico inicial e único em endocardite bacteriana

    OpenAIRE

    Werneck, Antonio L. dos Santos; Gonçalves, Adrelírio J. Rios; Bezerra, José Marcelo

    1990-01-01

    Oftalmoplegia internuclear unilateral traduz-se por paralisia homolateral da adução ocular e nistagmo contralateral. As principais causas são a esclerose múltipla e a insuficiência vértebro-basilar. Apresentamos um caso secundário a endocardite bacteriana, em que este sinal iniciou o quadro e foi o único achado neurológico. Unilateral internuclear ophthalmoplegia become manifest by homolateral paralysis of ocular adduction and contralateral nystagmus. Principal causes are multiple sclerosi...

  20. Penicillin-sensitive Moraxella prosthetic endocarditis. Near disaster caused by failure to treat with penicillin.

    OpenAIRE

    Chen, W; Lee, P K; Chau, P Y

    1982-01-01

    A patient with late prosthetic endocarditis resulting from Moraxella non-liquefaciens is reported. Correct laboratory indentification is of therapeutic importance as Moraxella is often highly sensitive to penicillin. Because of suspected penicillin sensitivity, antibiotics other than penicillin were used, but failed to control the endocarditis. Prompt response occurred when penicillin was given. Penicillin remains by far the most effective antibiotic for the treatment of endocarditis, particu...

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

    Directory of Open Access Journals (Sweden)

    Michèle Hamon

    2009-04-01

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

  2. Oral antibiotic treatment of left-sided infectious endocarditis verified by 16S-PCR

    DEFF Research Database (Denmark)

    Bruun, Louise E; Tønder, Niels; Hansen, Thomas Fritz

    2011-01-01

    Treatment of infectious endocarditis (IE) comprises intravenously administered antibiotic medications given at high doses for 4-6 weeks--sometimes even longer. Approximately 50% of patients referred to tertiary care centres require additional surgical intervention. At present there are few papers...... describing the effects of oral antibiotic treatment in IE, and only in patients with right-sided endocarditis. In this case report we present a patient with left-sided Streptococcus endocarditis successfully treated with oral antibiotic drugs....

  3. Haemophilus parainfluenzae Endocarditis Associated With Maxillary Sinusitis and Complicated by Cerebral Emboli in a Young Man.

    Science.gov (United States)

    Duzenli, Anthony E; Dwyer, John; Carey, Jeanne

    2017-01-01

    HACEK endocarditis is often difficult to diagnose given the slow-growing characteristics of the organisms involved. Haemophilus parainfluenzae, one of the HACEK organisms, is an uncommon cause of endocarditis. We describe a case of a previously healthy young man with H parainfluenzae endocarditis that was associated with maxillary sinusitis and severe systemic complications, including septic cerebral emboli and mitral valve perforation. Previously reported cases have also described a predilection for younger people, cardiac valve pathology, and a high prevalence of stroke.

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

    Directory of Open Access Journals (Sweden)

    Sachin K. Gupta

    2013-10-01

    Full Text Available 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.

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

    OpenAIRE

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

    2013-01-01

    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.

  6. Estrutura metabólica e genética de comunidades bacterianas em solo de cerrado sob diferentes manejos

    OpenAIRE

    Leandro Moraes de Souza; Franciele Schlemmer; Priscila Martins Alencar; André Alves de Castro Lopes; Samuel Ribeiro Passos; Gustavo Ribeiro Xavier; Marcelo Ferreira Fernandes; Ieda de Carvalho Mendes; Fábio Bueno dos Reis Junior

    2012-01-01

    O objetivo deste trabalho foi avaliar a estrutura metabólica e genética de comunidades bacterianas em Latossolo de cerrado sob vegetação nativa ou cultivado em sistema de rotação soja/milho sob preparo convencional e plantio direto. Foram utilizadas microplacas EcoPlate para determinar o perfil e a diversidade metabólica das comunidades bacterianas, e eletroforese em gel com gradiente desnaturante (DGGE) para avaliar a estrutura genética. O teste estatístico de Mantel foi utilizado para avali...

  7. Infective endocarditis of the Dacron patch-a report of 13 cases at autopsy.

    Science.gov (United States)

    Vaideeswar, Pradeep; Mishra, Prashant; Nimbalkar, Manglesh

    2011-01-01

    One of the complications of using a synthetic material as a patch in correction of left-to-right shunts is the development of infection. This is an autopsy report of 13 patients who developed infective endocarditis of the Dacron patch as a postoperative complication. We retrospectively reviewed the autopsy records of patients with infective endocarditis over a 15-year period (1994-2008) and selected cases with Dacron-patch infective endocarditis. The patch infective endocarditis was classified into early-onset and late-onset infective endocarditis. Patch infective endocarditis was seen in 13 patients affecting the patches covering an atrial septal defect and 12 ventricular septal defects. There were nine males and four females, with a mean age of 13.1 years. The episodes occurred 2 to 118 days (mean of 30) after operation, with early-onset infective endocarditis in 10 and late-onset infective endocarditis in three patients. Postoperative wound infection had been present in eight. The organisms isolated or demonstrated on microscopy included Staphylococcus aureus (5), gram-positive cocci (4), Pseudomonas (2), Aspergillus species (1), and Candida species (1). Death was related to embolization and/or accompanying septicemia. Correction of simple or complex congenital cardiac defects offers new substrates for organisms to colonize resulting in infective endocarditis, which are often difficult to treat. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Chemoprophylaxis with oral amoxycillin against bacterial endocarditis: when should second doses be administered after dentistry?

    National Research Council Canada - National Science Library

    Kumana, C R; Chau, K K; Chau, P Y; Kou, M; Lauder, I

    1986-01-01

    The adequacy of serum bactericidal activity after oral amoxycillin given as prophylaxis against infective endocarditis was studied using a double blind randomised protocol in healthy volunteers having dentistry...

  9. Infective Endocarditis: A Review of the Past and Present, and a Look into the Future

    Directory of Open Access Journals (Sweden)

    Eric I-Hun Jeng, MD, MBA

    2017-05-01

    Full Text Available Infective endocarditis is a lethal and challenging multifaceted disease that can involve any vascularized system. We believe that multimodality imaging is invaluable to provide a comprehensive diagnosis. Our management approach to infective endocarditis adheres to a combination of the AHA, ACC, STS, and ESC guidelines. With the rapidly increasing transcatheter valve population, we expect an increased caseload of infective endocarditis. Beyond patients with hemorrhagic strokes, we advocate for early surgery if medical management has failed. Furthermore, a multidisciplinary team approach is imperative in infective endocarditis, and clear communication reduces the time to diagnosis and definitive treatment for this patient population.

  10. Complicaciones neurológicas de la endocarditis infecciosa: controversias

    Directory of Open Access Journals (Sweden)

    Federico A. Silva, MD., MSc

    2011-07-01

    Full Text Available 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.

  11. Severe Staphylococcus aureus Endocarditis Presenting as Peripartum Thrombotic Thrombocytopenic Purpura.

    Science.gov (United States)

    Quinn, Kieran L; Osmond, Mark; Badiwala, Mitesh; Sermer, Mathew; Lapinsky, Stephen E

    2016-11-01

    Thrombotic thrombocytopenic purpura (TTP) is a life-threatening illness that occurs in both pregnant and non-pregnant women. Several other conditions can mimic the disease, which makes the diagnosis challenging. We describe a case of severe Staphylococcus aureus endocarditis that initially presented as peripartum TTP in a 39-year-old woman at 29+6 weeks' gestation. We give an overview of the diagnostic considerations and management of thrombocytopenia in pregnancy and review the literature related to TTP and peripartum infective endocarditis. Given the significant differences in definitive therapies for the spectrum of thrombocytopenic conditions that occur in pregnancy, timely and accurate diagnosis of TTP is critical for optimal management. Copyright © 2016 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

  12. [Brucella abortus endocarditis: survival of a 74 year old patient].

    Science.gov (United States)

    Olea M, Pilar

    2010-02-01

    Brucellosis is not frequent in Chile but it may present with life threatening complications like endocarditis. The case reported refers to a 74 year old man admitted to the Infectious Diseases Hospital Dr. Lucio Córdova in Santiago. He had been febrile for 3 months with no specific symptoms. The trans-esophageal echocardiography confirmed multiple large vegetations and important involvement of the aortic valve. Blood cultures yielded Brucella abortus. The patient required cardiac surgery, along with antibiotics, and he had a satisfactory outcome, being alive at the moment of this report???. Brucellosis can be the responsible for prolonged fever of unknown origin. It is necessary to take in mind brucellosis to obtain the specific laboratory tests. For a best prognosis an early treatment with associated antibiotics for at least 4 a 6 weeks is important. If endocarditis is present valve replacement is often necessary.

  13. Hypereosinophilic Syndrome: A Case of Fatal Löffler Endocarditis

    Directory of Open Access Journals (Sweden)

    Mario Enrique Baltazares-Lipp

    2016-01-01

    Full Text Available Hypereosinophilic syndrome (HES is a rare disorder with unknown global prevalence, barely reported in Hispanic population, and characterized by persistent eosinophilia in association with organ dysfunctions directly attributable to eosinophilic infiltration. Cardiac involvement may be present in 50 to 60% of the patients. This is known as Löffler endocarditis. We present a case of a 36-year-old Hispanic man with signs of heart failure. Laboratory studies showed eosinophilia (23,100/μL. Thoracic computer tomography showed bilateral pleural effusion and a large left ventricular mass. Transthoracic echocardiography showed left ventricle apical obliteration and a restrictive pattern. Pulmonary angiography demonstrated a thrombus in the lingular and middle lobe. Despite treatment, the patient deceased seven days after admission. Autopsy confirmed the diagnosis of Löffler endocarditis.

  14. [INFLAMMATION AND CARDIAC INSUFFICIENCY ASSOCIATED WITH INFECTIOUS ENDOCARDITIS].

    Science.gov (United States)

    Fedorova, T A; Tazina, S Ya; Kaktursky, L V; Kanareitseva, T D; Stefanenko, N I; Burtsev, V I; Semenenko, N A

    2016-01-01

    The study included 62 patients with uncomplicated primary and secondary infectious endocarditis admitted to S.PBotkin city hospital from 2011 to 2014. The emphasis is laid on diagnostic significance of dynamic measurements of the levels of C-reactive protein, tumour necrosis factor and highly sensitive troponin-1 for the evaluation of activity of the infectious/toxic process, severity of the disease, and detection of complications. The study revealed the relationship of the enhanced level of troponin-1 with changes of inflammation markers, morphofunctional characteristics of myocardium, and circulatory failure. Morphologicl study demonstrated inflammatory and dystrophic changes in myocardium, focal and diffuse cardiofibrosis suggesting development of non-coronarogenic myocardial lesions that play an important role in the progress of cardiac failure associated with infectious endocarditis.

  15. Infective endocarditis case due to streptococcus parasanguinis presented with spondylodiscitis

    Directory of Open Access Journals (Sweden)

    ismail Necati Hakyemez

    2016-09-01

    Full Text Available Streptococcus parasanguinis is a natural member of oral flora. It is an opportunistic pathogen, and rarely cause systemic infections due to it's low virulence. Subacute infective endocarditis may present with various clinical manifestations (eg., spondylodiscitis. A sixty-five years old male patient from Northern Iraq has referred to our emergency service with high fever, weight loss, back pain and inability to walk. The patient was a veterinarian. He was operated three years ago for colonic carcinoma and irradiated. In magnetic resonance imaging, spondylodiscitis was detected localized in lumbar 1-2 region. Transthorasic echocardiography demonstrated aortic valve vegetation. S. parasanguinis was identified in the blood cultures. In conclusion; all in all, it's remarkable to isolate S. parasanguinis as a causal agent of infective endocarditis in a patient who is a veterinarian with history of colonic carcinoma presented with clinical manifestation of spondylodiscitis. [Cukurova Med J 2016; 41(3.000: 591-594

  16. First case of infectious endocarditis caused by Parvimonas micra.

    Science.gov (United States)

    Gomez, Carlos A; Gerber, Daniel A; Zambrano, Eduardo; Banaei, Niaz; Deresinski, Stan; Blackburn, Brian G

    2015-12-01

    P. micra is an anaerobic Gram-positive cocci, and a known commensal organism of the human oral cavity and gastrointestinal tract. Although it has been classically described in association with endodontic disease and peritonsillar infection, recent reports have highlighted the role of P. micra as the primary pathogen in the setting of invasive infections. In its most recent taxonomic classification, P. micra has never been reported causing infectious endocarditis in humans. Here, we describe a 71 year-old man who developed severe native valve endocarditis complicated by aortic valvular destruction and perivalvular abscess, requiring emergent surgical intervention. Molecular sequencing enabled identification of P. micra. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Bilateral endogenous endophthalmitis associated with infective endocarditis: case report

    Directory of Open Access Journals (Sweden)

    Enyr Saran Arcieri

    Full Text Available Bilateral endogenous endophthalmitis is a rare condition initiated by infection by microbes in the bloodstream, such as those arising from a foci of infective endocarditis. We report a case and discuss the diagnostic aspects and the clinical outcome of a patient with characteristic findings of the disease. The patient was a 49 year old white male who had a metallic aortic valve implanted 7 months previously, and who presented to the hospital with 10 days of fever, cough and dyspnea, then diarrhea and mental confusion. On the second day of hospitalization, he experienced sudden loss of vision in both eyes. A Gram-positive coccobacillus was isolated from the bloodstream, he was treated with fluoroquinolone with disappearance of fever, decreased ocular inflammation, and improvement in his vision to light perception. He later underwent valve replacement surgery but died during the procedure. We review the occurrence of ocular signs and symptoms and their importance in patients with endocarditis.

  18. Subacute bacterial endocarditis presenting as left upper quadrant abdominal pain

    Directory of Open Access Journals (Sweden)

    Yung-Ta Kao

    2013-09-01

    Full Text Available Infective endocarditis is a microbial infection of the endocardial surface of the heart. Its symptoms and signs are varied, and include fever, heart murmur, peripheral embolism, and heart failure. The diagnosis of subacute bacterial endocarditis (SBE is suggested by a history of an indolent process characterized by fever, fatigue, anorexia, and unexplained weight loss. These patients may have had an invasive procedure, such as dental work, or abused intravenous drugs prior to the diagnosis of SBE. Although uncommon, the patients may present with nonspecific symptoms caused by peripheral embolic events. Herein, we report a 25-year-old male diagnosed with SBE, who presented with the unusual symptom of sudden onset of left upper quadrant abdominal pain for 2 days. His clinical history is also discussed.

  19. Staphylococcus aureus endocarditis and pyomyositis: Rare complications of rotavirus gastroenteritis.

    Science.gov (United States)

    Aldemir-Kocabaş, Bilge; Karbuz, Adem; Kara, Tuğçe Tural; Çiftçi, Ömer; Uçar, Tayfun; Fitöz, Suat; Çiftçi, Ergin; İnce, Erdal

    2015-08-01

    Rotavirus may cause life-threatening complications in untreated patients during the course of gastroenteritis. Electrolyte imbalance, bacteremia and sepsis are the most common complications of rotavirus gastroenteritis (RG). It is believed that translocation of intestinal microorganisms as a result of intestinal epithelium dysfunction is the underlying mechanism of bacteremia in RG. Although Gram-negative bacteremia has been noted as a complication in RG, Staphylococcus aureus bacteremia and endocarditis have not been reported previously. A 22-month-old boy was admitted with complaints of fever, diarrhea and dehydration. He was diagnosed with RG complicated with S. aureus bacteremia, pyomyositis and endocarditis. We call attention to these complications in patients with prolonged or late-onset fever during RG as rare complications of the disease. © 2015 Japan Pediatric Society.

  20. INVOLVEMENT OF BACTERICIDAL FACTORS FROM THROMBIN-STIMULATED PLATELETS IN CLEARANCE OF ADHERENT VIRIDANS STREPTOCOCCI IN EXPERIMENTAL INFECTIVE ENDOCARDITIS

    NARCIS (Netherlands)

    VANDERWERFF, J; ZAAT, SAJ; JOLDERSMA, W; HESS, J

    Platelets activated with thrombin release bactericidal factors. We studied the role of the susceptibility of viridans streptococci to these bactericidal factors in the development of infective endocarditis (IE). By using the experimental endocarditis rabbit model, the initial adherence and the

  1. Echocardiographic findings predict in-hospital and 1-year mortality in left-sided native valve Staphylococcus aureus endocarditis

    DEFF Research Database (Denmark)

    Lauridsen, Trine K.; Park, Lawrence; Tong, Steven Y C

    2015-01-01

    BACKGROUND: Staphylococcus aureus left-sided native valve infective endocarditis (LNVIE) has higher complication and mortality rates compared with endocarditis from other pathogens. Whether echocardiographic variables can predict prognosis in S aureus LNVIE is unknown. METHODS AND RESULTS: Consec...

  2. A orbifloxacina no tratamento das cistites bacterianas em gatos domésticos

    Directory of Open Access Journals (Sweden)

    Reche Junior Archivaldo

    2005-01-01

    Full Text Available O presente estudo teve como objetivos, avaliar o uso da orbifloxacina nas cistites bacterianas de felinos, e seus possíveis efeitos colaterais, mormente a nefro e/ou hepatotoxicidade. Para tanto, foram colhidas amostras de urina de 53 gatos com históricos variados, mas com predisposição à infecção urinária. A cistite bacteriana foi comprovada, através de exame microbiológico, em 13 pacientes. No entanto, apenas 10 apresentaram infecção por agentes sensíveis a orbifloxacina. Esses 10 pacientes foram então submetidos ao tratamento com orbifloxacina na dose de 2,5mg kg-1 a cada 24 horas por 10 dias. Não houve crescimento bacteriano nas amostras de urina submetidas à cultura, 72 horas após a interrupção do tratamento. Não foram observados sinais de nefro e/ou hepatotoxicidade nesses pacientes, uma vez que os níveis séricos de alanina aminotransferase (ALT, aspartato aminotransferase (AST, fosfatase alcalina (FA, albumina, uréia e creatinina não tiveram variação significativa após o uso do fármaco. Portanto, os resultados apresentados sugerem que a orbifloxacina pode ser usada como agente antimicrobiano nas infecções urinárias de felinos.

  3. Rarity of invasiveness in right-sided infective endocarditis.

    Science.gov (United States)

    Hussain, Syed T; Shrestha, Nabin K; Witten, James; Gordon, Steven M; Houghtaling, Penny L; Tingleff, Jens; Navia, José L; Blackstone, Eugene H; Pettersson, Gösta B

    2018-01-01

    The rarity of invasiveness of right-sided infective endocarditis (IE) compared with left-sided has not been well recognized and evaluated. Thus, we compared invasiveness of right- versus left-sided IE in surgically treated patients. From January 2002 to January 2015, 1292 patients underwent surgery for active IE, 138 right-sided and 1224 left-sided. Among patients with right-sided IE, 131 had tricuspid and 7 pulmonary valve IE; 12% had prosthetic valve endocarditis. Endocarditis-related invasiveness was based on echocardiographic and operative findings. Invasive disease was rare on the right side, occurring in 1 patient (0.72%; 95% confidence interval 0.02%-4.0%); rather, it was limited to valve cusps/leaflets or was superficial. In contrast, IE was invasive in 408 of 633 patients with aortic valve (AV) IE (65%), 113 of 369 with mitral valve (MV) IE (31%), and 148 of 222 with AV and MV IE (67%). Staphylococcus aureus was a more predominant organism in right-sided than left-sided IE (right 40%, AV 19%, MV 29%), yet invasion was observed almost exclusively on the left side of the heart, which was more common and more severe with AV than MV IE and more common with prosthetic valve endocarditis than native valve IE. Rarity of right-sided invasion even when caused by S aureus suggests that invasion and development of cavities/"abscesses" in patients with IE may be driven more by chamber pressure than organism, along with other reported host-microbial interactions. The lesser invasiveness of MV compared with AV IE suggests a similar mechanism: decompression of MV annulus invasion site(s) toward the left atrium. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  4. Infective endocarditis- (a survey of the past 50 years

    Directory of Open Access Journals (Sweden)

    Mehta Ajita

    1978-01-01

    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.

  5. Forward angiography in the identification of vegetations in tricuspid endocarditis.

    Science.gov (United States)

    Harris, C N; Dunne, E F; Farinha, J B; Zubiate, P; Kay, J H; Kaplan, M A

    1977-02-01

    A patient with staphylococcal endocarditis of unknown valvular location and resistant to antibiotic therapy was studied in order to localize the site of infection prior to cardiac surger. The injection of contrast material into the right atrium visualized tricuspid vegetations which were confirmed at surgery. In such situations, forward angiographic studies constitute a safe, simple, and potentially diagnostic procedure which avoids the hazards of advancing a catheter across an infected valve.

  6. Mycobacterium abscessus: Causing fatal endocarditis after cardiac catheterization

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    S Mahajan

    2015-01-01

    Full Text Available Mycobacterium abscessus is an unusual cause of infection in immunocompetent patients. The intrinsic and acquired resistance of this organism to multiple antibiotics is a major issue in planning treatment regimens. We report a case of M. abscessus endocarditis of the native aortic valve in an immunocompetent patient following coronary angiography with a fatal outcome. The case highlights an unfortunate intervention - related nosocomial infection and the difficulties in chemotherapeutic options for this organism, particularly in the presence of renal failure.

  7. Surgical treatment of aortic valve endocarditis: a 26-year experience

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    Taylan Adademir

    2014-03-01

    Full Text Available Objective: We have retrospectively analyzed the results of the operations made for aortic valve endocarditis in a single center in 26 years. Methods: From June 1985 to January 2011, 174 patients were operated for aortic valve endocarditis. One hundred and thirty-eight (79.3% patients were male and the mean age was 39.3±14.4 (9-77 years. Twenty-seven (15.5% patients had prosthetic valve endocarditis. The mean duration of follow-up was 7.3±4.2 years (0.1-18.2 adding up to a total of 1030.8 patient/years. Results: Two hundred and eighty-two procedures were performed. The most frequently performed procedure was aortic valve replacement with mechanical prosthesis (81.6%. In-hospital mortality occurred in 27 (15.5% cases. Postoperatively, 25 (14.4% patients had low cardiac output and 17 (9.8% heart block. The actuarial survival rates for 10 and 15 years were 74.6±3.7% and 61.1±10.3%, respectively. In-hospital mortality was found to be associated with female gender, emergency operation, postoperative renal failure and low cardiac output. The long term mortality was significantly associated with mitral valve involvement. Male gender was found to be a significant risk factor for recurrence in the follow-up. Conclusion: Surgery for aortic valve endocarditis has significant mortality. Emergency operation, female gender, postoperative renal failure and low cardiac output are significant risk factors. Risk for recurrence and need for reoperation is low.

  8. Enterococcus faecium small colony variant endocarditis in an immunocompetent patient

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    S. Hernández Egido

    2016-01-01

    Full Text Available Small colony variants (SCV are slow-growing subpopulations of bacteria usually associated with auxotrophism, causing persistent or recurrent infections. Enterococcus faecalis SCV have been seldom described, and only one case of Enterococcus faecium SCV has been reported, associated with sepsis in a leukaemia patient. Here we report the first case described of bacteraemia and endocarditis by SCV E. faecium in an immunocompetent patient.

  9. Daptomycin-Vancomycin–Resistant Enterococcus faecium Native Valve Endocarditis

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    Khandakar Hussain MD

    2016-09-01

    Full Text Available Multidrug-resistant enterococcal nosocomial invasive infections are a rising concern faced by the medical community. Not many options are available to treat these highly virulent organisms. Risk factors for developing these highly resistant organisms include prolonged hospital stay, previous antibiotic use, and immunosuppression. In this article, we report a case of daptomycin-resistant enterococcal native infective endocarditis treated with off-label use of quinupristin-dalfopristin.

  10. Protease production by Streptococcus sanguis associated with subacute bacterial endocarditis.

    OpenAIRE

    Straus, D. C.

    1982-01-01

    A viridans streptococcus (Streptococcus sanguis biotype II) isolated from the blood of a patient with subacute bacterial endocarditis was examined for protease production. In broth culture, extracellular proteolytic enzymes were not produced by this organism until after the early exponential phase of growth, with maximal protease production occurring during the stationary phase. Four distinct proteases were isolated and purified from the supernatant fluids of stationary-phase cultures, employ...

  11. Prosthetic valve endocarditis caused by Bordetella holmesii, an Acinetobacter lookalike.

    Science.gov (United States)

    Jonckheere, Stijn; De Baere, Thierry; Schroeyers, Pascal; Soetens, Oriane; De Bel, Annelies; Surmont, Ignace

    2012-06-01

    We report a case of fulminant endocarditis on a prosthetic homograft aortic valve caused by Bordetella holmesii, which was successfully managed by surgical valve replacement and antibiotic treatment. B. holmesii, a strictly aerobic, small, Gram-negative coccobacillus, has been implicated as an infrequent cause of a pertussis-like syndrome and other respiratory illnesses. However, B. holmesii is also a rare cause of septicaemia and infective endocarditis, mostly in immunocompromised patients. To our knowledge, this is the first report of B. holmesii endocarditis on a prosthetic aortic valve. Routine laboratory testing initially misidentified the strain as Acinetobacter sp. Correct identification was achieved by 16S rRNA gene and outer-membrane protein A (ompA) gene sequencing. Interestingly, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry also produced an accurate species-level identification. Subsequent susceptibility testing and review of the literature revealed ceftazidime, cefepime, carbapenems, aminoglycosides, fluoroquinolones, piperacillin/tazobactam, tigecycline and colistin as possible candidates to treat infections caused by B. holmesii.

  12. A Case of Systemic Lupus Erythematosus Confused with Infective Endocarditis

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    Sibel Serin

    2014-09-01

    Full Text Available Systemic lupus erythematosus (SLE is a multisystemic autoimmune disease resulting from immune system-mediated tissue damage. Clinical findings of SLE can involve skin, kidney, central nervous system, cardiovascular system, serosal membranes, and the hematologic and immune systems. In the differential diagnosis, other connective tissue diseases, infective endocarditis, infections such as viral hepatitis, endocrine disorders such as hypothyroidism, sarcoidosis, and some malignant tumors should be considered. Infective endocarditis can imitate all the symptoms of SLE depending on immune complex accumulation glomerulonephritis. Hemolytic anemia, skin lesions, arthralgia, arthritis, decreased complement levels, and autoantibody positivity, including antinuclear autoantibody (ANA, positivity can be seen. Therefore, high fever, blood cultures, eye examination, and echocardiographic findings are of particular value. Here, we present a case of SLE that was confused with infective endocarditis (IE due to the presence of high fever associated with autoimmune hemolytic anemia (AHA and proteinuria as well as increased erythrocyte sedimentation rate (ESR, cardiac murmur, and Roth’s spots. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 212-15

  13. Infective endocarditis in the real world: the Italian Registry of Infective Endocarditis (Registro Italiano Endocardite Infettiva - RIEI).

    Science.gov (United States)

    Cecchi, Enrico; Imazio, Massimo; De Rosa, Francesco Giuseppe; Chirillo, Fabio; Enia, Francesco; Pavan, Daniela; Cecconi, Moreno; Squeri, Angelo; Trinchero, Rita

    2008-05-01

    In the last 30 years, major improvements have been made in understanding the pathogenesis, diagnosis and treatment of infective endocarditis. Nevertheless, mortality still remains high, close to 30-40% at 1 year, and its reduction remains the main challenge. Moreover, important epidemiological changes have been recorded. Social changes in Western countries have led to an increase in the mean length of life, and thus in degenerative valvular diseases, whereas rheumatic heart disease has almost disappeared. Increasing medicalization has led to a rise in complications and diseases related to longer hospital stay, surgical therapies and other invasive interventions. At the same time, there is an increase in immunosuppressive therapies, diseases such as cancer, diabetes mellitus and renal insufficiency that may enhance the disease. Further knowledge is needed for specific subgroups to improve both treatment and prognosis. Nevertheless, randomized trials are lacking to guide the management of the disease, and the role and indications of antibiotic prophylaxis are still the subject of debate. International multicenter studies are providing new important findings based on the experience of tertiary centers; these results may reflect referral biases. The proposal of an Italian national registry on infective endocarditis (RIEI) will overcome these limitations and provide a wide picture of the national presentation of the disease. The aim of the registry is to improve the management of infective endocarditis, through a better understanding of demographic, clinical, therapeutic and prognostic features of the disease in the real world. The background, rationale, aims and expected results of the registry are reviewed.

  14. Variables predictoras de embolias en endocarditis infecciosa Embolism predictors of infective endocarditis

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    Alberto R. Cremona

    2007-02-01

    Full Text Available El evento embólico (EE aumenta la morbi-mortalidad de la endocarditis infecciosa (EI. La prevalencia de EE oscila entre 22% y 50%, pudiendo ocasionar hasta el 25% de las muertes de los pacientes que lo presentan. El EE puede ocurrir previamente al diagnóstico, durante el tratamiento o bien posteriormente al mismo. Nuestro objetivo fue analizar las características demográficas, clínicas, microbiológicas, ecocardiográficas y terapeúticas, de pacientes con EI (con y sin embolias para tratar de establecer variables predictoras del EE. Se realizó en el Hospital Italiano de La Plata, desde marzo de 1996 hasta diciembre de 2004, un estudio descriptivo observacional de una cohorte de pacientes con diagnóstico de EI. Se analizaron en forma retrospectiva 53 pacientes con EI (35 sin EE y 18 con EE. La presencia de vegetación (en el ecocardiograma transtorácico (ETT y/o en el transesofágico (ETE al momento del diagnóstico, el tamaño ³ 10 mm y el compromiso de la válvula mitral nativa, fueron las variables en las que existió una asociación estadísticamente significativa con el EE para ser consideradas como predictoras. El tamaño ³ 10 mm fue la única variable asociada a EE en el análisis de regresión logística. Durante el tratamiento antibiótico electivo hubo una reducción de EE, no observándose a partir de la segunda semana.The embolic event (EE increases the morbidity and mortality of infective endocarditis (IE. Prevalence of EE ranges between 22% and 50%, death rates being up to 25% of patients. EE may occur prior to diagnosis, during treatment or afterwards. The objective of this study was to evaluate the demographic, clinical, microbiological, echocardiographic and therapeutic characteristics in patients suffering from IE (with or without emboli in order to determine predictors for EE. A descriptive study based on observations of patient population diagnosed with IE was conducted at the Hospital Italiano of La Plata during

  15. Estudo da incidência de vaginose bacteriana em parturientes pré-termo ou gestantes com amniorrexe prematura

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    Raquel G. A. Torres

    2008-01-01

    Full Text Available Objetivos: relacionar a incidência de vaginose bacteriana entre parturientes com diagnóstico de trabalho de parto prematuro ou gestantes com amniorexe prematura em Sorocaba/SP. Metodologia: estudamos, de setembro/2003 a junho/2004, 30 pacientes internadas com diagnóstico clínico de trabalho de parto prematuro e/ou amniorexe prematura com idade gestacional inferior a 37 semanas. Como grupo controle tivemos 30 gestantes internadas para tratamento de outras intercorrências clínicas e/ou obstétricas, pareadas com o grupo de estudo pela idade cronológica e idade gestacional. A vaginose bacteriana foi diagnosticada pelo pH vaginal superior a 4.5, liberação de odor de “peixe podre” ao adicionar KOH (10% ao conteúdo vaginal, presença de “clue-cell” nesse material, e a caracterização de esfregaço sugestivo de vaginose bacteriana pelo método de Gram. Resultados: a vaginose bacteriana foi encontrada em 10.0% das pacientes do grupo de estudo e em 13.3% das pacientes do grupo controle. Encontramos também a presença de processos infecciosos vaginais, especialmente causados por leveduras, ambos achados não apresentaram significância estatística. Conclusão: a vaginose bacteriana não se associou de maneira significante com a ocorrência de trabalho de parto prematuro e/ou amniorexe prematura. Trabalho subsidiado por bolsa PIBIC-CNPq.

  16. Rothia dentocariosa Septicemia without Endocarditis in a Neonatal Infant with Meconium Aspiration Syndrome

    Science.gov (United States)

    Shin, Jeong Hwan; Shim, Jae Dong; Kim, Hye Ran; Sinn, Jong Beom; Kook, Joong-Ki; Lee, Jeong Nyeo

    2004-01-01

    Rothia dentocariosa, a gram-positive coccoid- to rod-shaped bacterium with irregular morphology, is a rare cause of bacteremia in patients without endocarditis. We report the first case of R. dentocariosa septicemia without endocarditis, which occurred in a neonatal infant with meconium aspiration syndrome. PMID:15472374

  17. A case of Klebsiella oxytoca endocarditis in an intravenous drug user

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    Naomi Hauser

    2017-01-01

    Full Text Available Non-HACEK Gram-negative bacilli account for only a small percentage of infective endocarditis cases globally. Among those, Klebsiella species account for only about 10% of cases and are most often health-care acquired. We present a rare case of Klebsiella oxytoca endocarditis in a young intravenous drug user.

  18. Bartonella spp. and Coxiella burnetii Associated with Community-Acquired, Culture-Negative Endocarditis, Brazil.

    Science.gov (United States)

    Siciliano, Rinaldo Focaccia; Castelli, Jussara Bianchi; Mansur, Alfredo Jose; Pereira dos Santos, Fabiana; Colombo, Silvia; do Nascimento, Elvira Mendes; Paddock, Christopher D; Brasil, Roosecelis Araújo; Velho, Paulo Eduardo Neves Ferreira; Drummond, Marina Rovani; Grinberg, Max; Strabelli, Tania Mara Varejao

    2015-08-01

    We evaluated culture-negative, community-acquired endocarditis by using indirect immunofluorescent assays and molecular analyses for Bartonella spp. and Coxiella burnetii and found a prevalence of 19.6% and 7.8%, respectively. Our findings reinforce the need to study these organisms in patients with culture-negative, community-acquired endocarditis, especially B. henselae in cat owners.

  19. Right-heart infective endocarditis: apropos of 10 cases | Sarr | Pan ...

    African Journals Online (AJOL)

    The prevalence and characteristics of right heart endocarditis in Africa are not well known. The aim of this study was to describe the epidemiological, clinical and laboratory profiles of patients with right-heart infective endocarditis. This was a 10-year retrospective study conducted in 2 cardiology departments in Dakar, ...

  20. Fatal bacterial endocarditis as a complication of permanent indwelling catheters. Report of two cases.

    Science.gov (United States)

    Power, J; Wing, E J; Talamo, T S; Stanko, R

    1986-07-01

    Two cases of endocarditis secondary to permanent indwelling catheters are described. In both cases, the catheters were used for parenteral nutrition and became infected with Staphylococci. Secondary endocarditis developed on the tricuspid and aortic valves. Despite removal of the catheters and appropriate antibiotics, both patients died.

  1. Trends in Infective Endocarditis in California and New York State, 1998-2013.

    Science.gov (United States)

    Toyoda, Nana; Chikwe, Joanna; Itagaki, Shinobu; Gelijns, Annetine C; Adams, David H; Egorova, Natalia N

    2017-04-25

    Prophylaxis and treatment guidelines for infective endocarditis have changed substantially over the past decade. In the United States, few population-based studies have explored the contemporary epidemiology and outcomes of endocarditis. To quantify trends in the incidence and etiologies of infective endocarditis in the United States. Retrospective population epidemiology study of patients hospitalized with a first episode of endocarditis identified from mandatory state databases in California and New York State between January 1, 1998, and December 31, 2013. Infective endocarditis. Outcomes were crude and standardized incidence of endocarditis and trends in patient characteristics and disease etiology. Trends in acquisition mode, organism, and mortality were analyzed. Among 75 829 patients with first episodes of endocarditis (mean [SD] age, 62.3 [18.9] years; 59.1% male), the standardized annual incidence was stable between 7.6 (95% CI, 7.4 to 7.9) and 7.8 (95% CI, 7.6 to 8.0) cases per 100 000 persons (annual percentage change [APC], -0.06%; 95% CI, -0.3% to 0.2%; P = .59). From 1998 through 2013, the proportion of patients with native-valve endocarditis decreased (from 74.5% to 68.4%; APC, -0.7%; 95% CI, -0.9% to -0.5%; P 1998 through 2013, with changes in patient characteristics and etiology over this time.

  2. Unusual location of the Libman-Sacks endocarditis in a teenager: a case report.

    Science.gov (United States)

    Wałdoch, Anna; Kwiatkowska, Joanna; Dorniak, Karolina

    2016-02-01

    Libman-Sacks endocarditis may be the first manifestation of systemic lupus erythematosus. The risk of its occurrence increases with the co-existence of the anti-phospholipid syndrome. Changes usually involve the mitral valve and the aortic valve. In this report, we present a case of Libman-Sacks endocarditis of the tricuspid valve in a teenage girl.

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

    LENUS (Irish Health Repository)

    Ali, Mohammed

    2011-04-08

    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.

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

    LENUS (Irish Health Repository)

    Ali, Mohammed

    2012-02-01

    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.

  5. Right-heart infective endocarditis: apropos of 10 cases | Sarr | Pan ...

    African Journals Online (AJOL)

    We studied the epidemiological, clinical as well as their laboratory profiles. There were 10 cases of right-heart infective endocarditis representing 3.04% of cases of infective endocarditis. There was a valvulopathy in 3 patients, an atrial septal defect in 1 patient, parturiency in 2 patients and the presence of a pacemaker in ...

  6. Placa bacteriana dentária em cães Dental bacterial plaque in dogs

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    Duvaldo Eurides

    1996-12-01

    Full Text Available Com objetivo de avaliar a incidência de placa bacteriana dentária, foram utilizados 30 cães, sem raça definida, distribuídos em três grupos iguais, de acordo com a faixa etária, sendo o grupo I de 0 a 2 anos, o grupo II de 3 a 5 anos e o grupo III acima de 6 anos. Os animais foram submetidos a anestesia geral e sobre os dentes foi aplicado cloreto de metilrosanilina, para evidenciar acúmulos bacterianos. As placas encontravam-se distribuídas em 80,99% no grupo I, 71,45% no grupo II e 83,96% no grupo III. Os grupos dentários foram considerados separadamente, apresentando índices de 64,84% nos dentes incisivos, 84,80% nos caninos, 87,23% nos pré-molares e 78,34% nos molares. Nos três grupos de cães observou-se índices semelhantes de placa bacteriana nos diferentes grupos dentários. Os animais do grupo II e o grupo de dentes incisivos apresentaram menores índices de placa bacteriana.To avaliate the incidence of bacterial plaque 30 mogreal dogs were utilizated, distributed among three equal groups. According to age, group I was composed of 0 to 2 years-old dogs, group II was 3 to 5 years-old, and group III over 6 years-old. The animals underwent a general anesthesia and metilrosanilin cloret was applied over the tooth, to evidence the bacterial mass. The plaques were distributed to 80.99% in group I, 71.42% in group II and 83.96% in group III. The dental groups were considerated apart, showing index of 64.84% on the incisar tooth, 84.80% on the canine tooth, 87.23% on the premolar tooth, and 78.34% on the molar tooth. At the dogs groups, similar Índex of bacterial plaque were observed on the diffèrent dental groups. The dogs from group II and the incisive tooth group showed minar bacterial plaque index.

  7. Meningoencefalitis bacteriana en niños menores de 15 años

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    Niuvis Chávez González

    Full Text Available Introducción: la meningoencefalitis bacteriana es una enfermedad de distribución universal que afecta individuos de todas las edades, pero especialmente a los niños. Objetivo: identificar las características clínicas y microbiológicas de la meningoencefalitis bacteriana. Métodos: se realizó un estudio descriptivo y retrospectivo en niños menores de 15 años ingresados en la Unidad de Cuidados Intensivos Pediátricos del Hospital Pediátrico "Luis Ángel Milanés Tamayo", de Bayamo, Granma, en el periodo comprendido desde el 1ro. de enero de 2008 al 31 de diciembre de 2012. El universo estuvo conformado por 22 pacientes egresados con el diagnóstico de meningoencefalitis bacteriana, y la muestra por 18 casos que cumplieron con los criterios de inclusión y exclusión. Resultados: predominó el grupo de edad de 1 a 4 años con el 50 %; la desnutrición se presentó en 5 de los casos estudiados. La media del tiempo transcurrido entre el inicio de los síntomas hasta el diagnóstico, y al inicio del tratamiento médico fue de ±3 días (DS: 1,129; los síntomas inespecíficos y la hipertensión endocraneana se presentaron en un 38,9 % y 88,8 % respectivamente. El Streptococcus pneumoniae fue el germen más frecuentemente aislado en el estudio del líquido cefalorraquídeo, y el edema cerebral la complicación más frecuente de la enfermedad. Conclusiones: la enfermedad estudiada afectó las edades más tempranas, con predominio de los síntomas de hipertensión endocraneana, y una celularidad elevada, y el tiempo entre el inicio de los síntomas al diagnóstico y al tratamiento médico fue corto.

  8. Is there a need for bacterial endocarditis prophylaxis in patients undergoing gastrointestinal endoscopy?

    Science.gov (United States)

    Patanè, Salvatore

    2014-04-01

    Heart valve repair or replacement is a serious problem. Patients can benefit from an open dialogue between both cardiologists and gastroenterologists for the optimal effective patients care. The focused update on infective endocarditis of the American College of Cardiology/American Heart Association 2008 (ACC/AHA guidelines) and guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009) of the European Society of Cardiology (ESC guidelines) describe prophylaxis against infective endocarditis (IE) as not recommended for gastroscopy and colonoscopy in the absence of active infection but increasing evidence suggests that the role of IE antibiotic prophylaxis remains a dark side of the cardio-oncology prevention. New evidences concerning infective endocarditis due to Streptococcus bovis, Streptococcus agalactiae, Enterococcus faecalis, Enterococcus faecium, Enterococcus durans, and new findings indicate that there is a need for bacterial endocarditis prophylaxis in patients undergoing gastrointestinal endoscopy especially in elderly patients and in cancer and immunocompromised patients, to avoid serious consequences.

  9. Infectious Endocarditis from Enterococcus faecalis Associated with Tubular Adenoma of the Sigmoid Colon

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    Emilly Caroline de Freitas Silva

    2017-01-01

    Full Text Available Introduction. Enterococcus faecalis (E. faecalis, a constituent of the gut microbiota, can be associated with both colonic lesions and endocarditis. Since this microorganism is one of the endocarditis etiological agents, there is a need for greater study in regard to the association with endocarditis and colonic lesions. Case Presentation. This is the case description of a 53-year-old man with history of prolapse of the anterior mitral valve leaflet who was diagnosed with endocarditis by E. faecalis and treated with ampicillin and gentamicin. Upon investigation by colonoscopy, he was found to have a tubular adenoma with low grade dysplasia. Conclusion. There are a few descriptions in scientific literature of an association between endocarditis by E. faecalis and colonic lesions. However, further studies with significant correlation between the two pathologies are required, so that proper measures can be implemented in clinical practice.

  10. [Isolated infectious endocarditis of the pulmonary valve: a case report].

    Science.gov (United States)

    Hrudka, Jan; Grussmannová, Monika; Mandys, Václav

    2017-01-01

    Isolated infectious endocarditis of the pulmonary valve is a rare condition and represents 1,5-2% of all cases of infectious endocarditis. We present a case of a 37year-old woman without any relevant medical history. The woman was hospitalized with hallmarks of severe sepsis and bilateral pneumonia; she died several hours after admission with progressive multiorgan failure and disseminated intravascular coagulopathy. Microbiologic examination approved Staphylococcus aureus as the etiological agent. The autopsy showed isolated endocarditis of the pulmonary valve, without any known predisposing factor. Literary data refer single cases or small groups of patients with isolated pulmonary infectious endocarditis. The clinical suspicion of this rare disease in differential diagnosis of febrile conditions is an essential factor in prognosis of afflicted persons. The crucial diagnostic methods for infectious endocarditis are echocardiography and CT examination.

  11. Tratamiento con caspofungina de endocarditis por Candida tropicalis resistente a fluconazol Treatment with caspofungin of Candida tropicalis endocarditis resistant to fluconazol

    Directory of Open Access Journals (Sweden)

    Marcelo del Castillo

    2004-04-01

    Full Text Available Las endocarditis causadas por hongos, (Candida en particular, requieren tratamiento médico-quirúrgico, siendo la anfotericina B la droga de elección. Caspofungina es una equinocandina con gran actividad sobre Candida y Aspergillus. Se presenta un paciente con una endocarditis por Candida tropicalis resistente a fluconazol tratado con caspofungina bajo un esquema de salvataje, luego de haber presentado efectos adversos por anfotericina B. El paciente tuvo respuesta microbiológica.Fungal endocarditis, in particular due to Candida species, requires medical and surgical treatment and amphotericin B is the drug of choice. Caspofungin is an echinocandin very effective against Candida and Aspergillus. We present a patient with Candida tropicalis endocarditis, fluconazol resistant, treated with caspofungin, on a compassional basis as a result of adverse effects with amphotericin B. The patient had a microbiological response.

  12. Placa bacteriana dentária em cães

    OpenAIRE

    Eurides,Duvaldo; Gonçalves,Gentil Ferreira; Mazzanti,Alexandre; Buso,Antônio Mário

    1996-01-01

    Com objetivo de avaliar a incidência de placa bacteriana dentária, foram utilizados 30 cães, sem raça definida, distribuídos em três grupos iguais, de acordo com a faixa etária, sendo o grupo I de 0 a 2 anos, o grupo II de 3 a 5 anos e o grupo III acima de 6 anos. Os animais foram submetidos a anestesia geral e sobre os dentes foi aplicado cloreto de metilrosanilina, para evidenciar acúmulos bacterianos. As placas encontravam-se distribuídas em 80,99% no grupo I, 71,45% no grupo II e 83,96% n...

  13. Translocação bacteriana para o rim na icterícia obstrutiva experimental

    OpenAIRE

    Medeiros,Aldo da Cunha; Ramos,Ana Maria de Oliveira; Carvalho,Maria Goretti Freire de; Silva,Marli Pinheiro da; Dantas Filho,Antônio Medeiros; Dantas Júnior,José Hipólito; Freitas,Fernando César M

    1997-01-01

    Estudo com o objetivo de verificar a possibilidade de ocorrência de translocação bacteriana para os rins de ratos, após ligadura de colédoco. Foram utilizados 29 ratos Wistar com peso médio de 171 ± 12,6g. Os animais foram divididos aleatoriamente em grupo I (n=14) e grupo II (n=15). Com técnica asséptica, nos ratos no grupo I foi feita ligadura de colédoco com fio de seda nº 3 zeros e no grupo II foi simulada a ligadura com a simples manipulação do colédoco com pinça de Adson ("sham operatio...

  14. Celulosa bacteriana en gluconacetobacter xylinum: biosíntesis y aplicaciones

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    Juan Luis Chávez- Pacheco

    2004-01-01

    Full Text Available La celulosa es la molécula orgánica más abundante en la naturaleza y posee gran importancia a nivel industrial; es sintetizada por una variedad de organismos, incluyendo plantas, algas, hongos, bacterias y animales. Gluconacetobacter xylinum es la bacteria con mayor capacidad productora de celulosa y es el organismo modelo en la investigación sobre los procesos que regulan la biosíntesis del polímero. El presente documento ofrece una revisión de los progresos en la comprensión del proceso de síntesis de celulosa, las características particulares de la celulosa bacteriana como fuente alterna a la celulosa vegetal y sus aplicaciones biotecnológicas

  15. Efeitos do algodão Bt (Bollgard evento 531) na comunidade bacteriana da rizosfera.

    OpenAIRE

    Luciana Aparecida Avila

    2008-01-01

    O algodão transgênico Bollgard® (algodão Bt) contém o gene cry1Ac da bactéria Bacillus thuringiensis, que confere a planta resistência a Lepidopteros. A expressão deste gene na planta pode acarretar efeitos ecológicos adversos à microbiota do solo e da rizosfera. Em casa-de-vegetação, a comunidade bacteriana associada ao algodão Bt foi comparada a do algodão convencional, em dois tipos de solos e quatro estádios fenológicos. Amostras de rizosfera foram avaliadas por técnicas dependentes e ind...

  16. Suero autólogo al 50 % en las queratitis bacterianas

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    Arelys Ariocha Cambas Andreu

    Full Text Available Objetivo: evaluar el comportamiento de las queratitis bacterianas con el tratamiento coadyuvante de suero autólogo tópico al 50 %. Métodos: estudio comparativo, longitudinal y prospectivo. La muestra estuvo constituida por 60 pacientes, divididos de forma aleatoria en dos grupos: A utilizó tratamiento antibiótico convencional y suero autólogo y B utilizó solo tratamiento antibiótico convencional (cefazolina y amikacina. Los datos almacenados se procesaron utilizando el paquete estadístico SPSS 15. Las variables se expresaron según sus respectivas medidas de resumen y para la comparación de las terapias se aplicaron pruebas de hipótesis, con un nivel de confianza del 95 % y de error inferior al 0,05 %. Resultados: predominaron en los aislamientos microbiológicos Staphylococcus y Pseudomonas; seguidas por los Streptococcus, gonococos y enterobacterias. En cuanto al tiempo de aparición de los signos que favorecen la cicatrización corneal y la respuesta terapéutica, encontramos que con la aplicación tópica del suero autólogo, en casi dos tercios de los pacientes, estos se manifestaron a partir de la segunda semana de tratamiento y se obtuvo una respuesta terapéutica favorable. Conclusiones: El suero autólogo al 50 % resulta ser un complemento terapéutico efectivo en el manejo de las queratitis infecciosas de etiología bacteriana.

  17. Nuevos métodos bacteriológicos para detectar y evitar la resistencia bacteriana

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    Margaret Ordoñez-Smith de Danies

    2003-09-01

    Full Text Available

    DEFINICIÓN DE LA RESISTENCIA

    De acuerdo al COC (Centro de Control de Enfermedades de Estados Unidos, la resistencia se da cuando un medicamento deja de inhibir el crecimiento o matar un microorganismo. 

    Hay dos tipos de resistencia la adquirida y la clínica. La adquirida se realiza en el laboratorio a través de las mutaciones o por transferencia de genes, sistemas de conjugación, transducción y transformación.

    La resistencia clínica es la observada en la práctica médica, donde no todos los organismos son igualmente sensibles o resistentes a cierto antibiótico y que requiere la ayuda de técnicas de laboratorio para medir cuantitativamente o cualitativamente dicho proceso.

    MECANISMOS DE LA RESISTENCIA BACTERIANA

    En la detección de la Resistencia Bacteriana se han identificado diferentes mecanismos utilizados por las bacterias: destrucción o inactivación enzimática, cambios en la permeabilidad de la membrana interna, alteraciones de los precursores de la pared celular, de la membrana y de los ribosomas.

    Para los años 90 se dispuso de una serie de antimicrobianos como betalactámicos, aminoglucósidos, macrólidos, sulfonamidas, trimetoprim, cloranfenicol, glicopéptidos, rifampicina, quinolonas, tetraciclinas....

     

  18. Infective endocarditis in chronic hemodialysis patients: Experience from Morocco

    Directory of Open Access Journals (Sweden)

    Dina Montasser

    2011-01-01

    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.

  19. Acquired ventricular septal defect due to infective endocarditis

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    Randi E Durden

    2018-01-01

    Full Text Available Acquired intracardiac left-to-right shunts are rare occurrences. Chest trauma and myocardial infection are well-known causes of acquired ventricular septal defect (VSD. There have been several case reports describing left ventricle to right atrium shunt after infective endocarditis (IE. We present here a patient found to have an acquired VSD secondary to IE of the aortic and tricuspid valves in the setting of a known bicuspid aortic valve. This is the first case reported of acquired VSD in a pediatric patient in the setting of IE along with literature review of acquired left-to-right shunts.

  20. Mycobacterium goodii endocarditis following mitral valve ring annuloplasty.

    Science.gov (United States)

    Parikh, Rohan B; Grant, Matthew

    2017-03-21

    Mycobacterium goodii is an infrequent human pathogen which has been implicated in prosthesis related infections and penetrating injuries. It is often initially misidentified as a gram-positive rod by clinical microbiologic laboratories and should be considered in the differential diagnosis. We describe here the second reported case of M. goodii endocarditis. Species level identification was performed by 16S rDNA (ribosomal deoxyribonucleic acid) gene sequencing. The patient was successfully treated with mitral valve replacement and a prolonged combination of ciprofloxacin and trimethoprim/sulfamethoxazole. Confirmation of the diagnosis utilizing molecular techniques and drug susceptibility testing allowed for successful treatment of this prosthetic infection.

  1. Risk Factors of Endocarditis in Patients with Enterococcus faecalis Bacteremia

    DEFF Research Database (Denmark)

    Dahl, Anders; Lauridsen, Trine K; Arpi, Magnus

    2016-01-01

    BACKGROUND:  The NOVA score is a recently developed diagnostic tool to identify patients with increased risk of infective endocarditis (IE) among patients with Enterococcus faecalis (EF) bacteremia. We aim to validate an adapted version of the NOVA score and to identify risk factors for IE...... in a sensitivity of 97%, specificity of 23%, a negative predictive value of 95% and a positive predictive value of 38%. CONCLUSION:  Monomicrobial EF bacteremia, community acquisition, prosthetic heart valve and male sex are associated with increased risk of IE. In our retrospective cohort, the adapted NOVA score...

  2. Tricuspid endocarditis in hyper-IgE syndrome

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    Gupta S

    2010-01-01

    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.

  3. Two cases and a review of Streptococcus pyogenes endocarditis in children.

    Science.gov (United States)

    Weidman, Danielle R; Al-Hashami, Hilal; Morris, Shaun K

    2014-09-10

    Infective endocarditis is a rare diagnosis in pediatrics. Group A beta-hemolytic Streptococcus pyogenes is known to cause a range of type and severity of infections in childhood. However, S. pyogenes is a rarely described cause of endocarditis in children. This paper presents two cases of S. pyogenes endocarditis and the largest and most up-to-date review of cases previously reported in the literature. Here we describe two pediatric cases of S. pyogenes endocarditis with associated toxic shock. Case 1 was a previously well Caucasian 6-year-old female who presented with sepsis. Case 2 was an 8-month-old South Asian female who presented with sepsis and pneumonia. We present a review of the literature since the beginning of the antibiotic era of this unusual cause of bacterial endocarditis in children. In addition to the two cases presented here, a total of 13 children have been reported since 1940 with endocarditis caused by S. pyogenes for which clinical details are available. Although few cases exist, literature review reveals a high mortality rate (27%) and the majority of patients who recovered had residual morbidities. We emphasize the importance of considering a diagnosis of endocarditis in cases of S. pyogenes sepsis or toxic shock in order to ensure early diagnosis and timely treatment, which are necessary for good outcomes. This information is relevant to both general and subspecialty pediatricians, especially emergency room and infectious disease physicians.

  4. Bartonella Endocarditis and Pauci-Immune Glomerulonephritis: A Case Report and Review of the Literature.

    Science.gov (United States)

    Raybould, Jillian E; Raybould, Alison L; Morales, Megan K; Zaheer, Misbah; Lipkowitz, Michael S; Timpone, Joseph G; Kumar, Princy N

    2016-09-01

    Among culture-negative endocarditis in the United States, Bartonella species are the most common cause, with Bartonella henselae and Bartonella quintana comprising the majority of cases. Kidney manifestations, particularly glomerulonephritis, are common sequelae of infectious endocarditis, with nearly half of all Bartonella patients demonstrating renal involvement. Although a pauci-immune pattern is a frequent finding in infectious endocarditis-associated glomerulonephritis, it is rarely reported in Bartonella endocarditis. Anti-neutrophil cytoplasmic antibody (ANCA) positivity can be seen with many pathogens causing endocarditis and has been previously reported with Bartonella species. In addition, ANCA-associated vasculitis can also present with renal and cardiac involvement, including noninfectious valvular vegetations and pauci-immune glomerulonephritis. Given the overlap in their clinical presentation, it is difficult to differentiate between Bartonella endocarditis and ANCA-associated vasculitis but imperative to do so to guide management decisions. We present a case of ANCA-positive Bartonella endocarditis with associated pauci-immune glomerulonephritis that was successfully treated with medical management alone.

  5. Characteristics and prognosis of pneumococcal endocarditis: a case-control study.

    Science.gov (United States)

    Daudin, M; Tattevin, P; Lelong, B; Flecher, E; Lavoué, S; Piau, C; Ingels, A; Chapron, A; Daubert, J-C; Revest, M

    2016-06-01

    Case series have suggested that pneumococcal endocarditis is a rare disease, mostly reported in patients with co-morbidities but no underlying valve disease, with a rapid progression to heart failure, and high mortality. We performed a case-control study of 28 patients with pneumococcal endocarditis (cases), and 56 patients with non-pneumococcal endocarditis (controls), not matched for sex and age, during the years 1991-2013, in one referral centre. Alcoholism (39.3% versus 10.7%; p endocarditis. Cardiac surgery was required in 64.3% of patients with pneumococcal endocarditis, much earlier than in patients with non-pneumococcal endocarditis (mean time from symptom onset, 14.1 ± 18.2 versus 69.0 ± 61.1 days). In-hospital mortality rates were similar (7.1% versus 12.5%). Streptococcus pneumoniae causes rapidly progressive endocarditis requiring life-saving early cardiac surgery in most cases. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  6. Risk of infective endocarditis in patients with end stage kidney disease

    DEFF Research Database (Denmark)

    Chaudry, Mavish S; Carlson, Nicholas; Gislason, Gunnar H

    2017-01-01

    BACKGROUND AND OBJECTIVES: Endocarditis is a serious complication in patients treated with RRT. The study aimed to examine incidence and risk factors of endocarditis in patients with ESRD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Danish National Registry on Regular Dialysis and Transpla......BACKGROUND AND OBJECTIVES: Endocarditis is a serious complication in patients treated with RRT. The study aimed to examine incidence and risk factors of endocarditis in patients with ESRD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Danish National Registry on Regular Dialysis...... and Transplantation contains data on all Danish patients receiving renal replacement (hemodialysis, peritoneal dialysis, or kidney transplantation) for ESRD. Incidence of endocarditis was estimated for each RRT modality. Independent risk factors of endocarditis were identified in multivariable Cox regression models....... RESULTS: From January 1st, 1996 to December 31st, 2012, 10,612 patients (mean age 63 years, 36% female) initiated RRT (7233 hemodialysis, 3056 peritoneal dialysis, 323 pre-emptive kidney transplantation). Endocarditis developed in 267 (2.5%); of these 31 (12%) underwent valve surgery. The overall...

  7. Trends in Hospitalization Rates and Outcomes of Endocarditis among Medicare Beneficiaries

    Science.gov (United States)

    Bikdeli, Behnood; Wang, Yun; Kim, Nancy; Desai, Mayur M.; Quagliarello, Vincent; Krumholz, Harlan M.

    2015-01-01

    Objectives To determine the hospitalization rates and outcomes of endocarditis among older adults. Background Endocarditis is the most serious cardiovascular infection and is especially common among older adults. Little is known about recent trends for endocarditis hospitalizations and outcomes. Methods Using Medicare inpatient Standard Analytic Files, we identified all Fee-For-Service beneficiaries aged ≥65 years with a principal or secondary diagnosis of endocarditis from 1999-2010. We used Medicare Denominator Files to report hospitalizations per 100,000 person-years. Rates of 30-day and 1-year mortality were calculated using Vital Status Files. We used mixed-effects models to calculate adjusted rates of hospitalization and mortality and to compare the results before and after 2007, when the American Heart Association revised recommendations for endocarditis prophylaxis. Results Overall, 262,658 beneficiaries were hospitalized with endocarditis. The adjusted hospitalization rate increased from 1999-2005, reaching 83.5 per 100,000 person-years in 2005, and declined during 2006-2007. After 2007, the decline continued, reaching 70.6 per 100,000 person-years in 2010. Adjusted 30-day and 1-year mortality rates ranged from 14.2% to 16.5% and from 32.6% to 36.2%, respectively. There were no consistent changes in adjusted rates of 30-day and 1-year mortality after 2007. Trends in rates of hospitalization and outcomes were consistent across demographic subgroups. Adjusted rates of hospitalization and mortality declined consistently in the subgroup with principal diagnosis of endocarditis. Conclusions Our study highlights the high burden of endocarditis among older adults. We did not observe an increase in adjusted rates of hospitalization or mortality associated with endocarditis after publication of the 2007 guidelines. PMID:23994421

  8. [Infective endocarditis in intensive cardiac care unit - clinical and biochemical differences of blood-culture negative infective endocarditis].

    Science.gov (United States)

    Kaziród-Wolski, Karol; Sielski, Janusz; Ciuraszkiewicz, Katarzyna

    2017-01-23

    Diagnosis and treatment of infective endocarditis (IE) is still a challenge for physicians. Group of patients with the worst prognosis is treated in Intensive Cardiac Care Unit (ICCU). Etiologic agent can not be identified in a substantial number of patients. The aim of study is to find differences between patients with blood culture negative infective endocarditis (BCNIE) and blood culture positive infective endocarditis (BCPIE) treated in ICCU by comparing their clinical course and laboratory parameters. Retrospective analysis of 30 patients with IE hospitalized in ICCU Swietokrzyskie Cardiac Centre between 2010 and 2016. This group consist of 26 men (86,67%) and 4 women (13,3%). Mean age was 58 years ±13. Most of the cases were new disease, recurrence of the disease was observed in 2 cases (6,7%). 8 patients (26,7%) required artificial ventilation, 11 (36,7%) received inotropes and 6 (20%) vasopresors. In 14 (46,7%) cases blood cultures was negative (BCNIE), the rest of patients (16, 53,3%) was blood cultures - positive infective endocarditis (BCIE). Both of the groups were clinically similar. There were no statistically significant differences in incidence of cardiac implants, localization of bacterial vegetations, administered catecholamines, antibiotic therapy, artificial ventilation, surgical treatment, complication and in-hospital mortality. Incidence of cardiac complications in all of BCNIE cases and in 81,3% cases of BCPIE draws attention, but it is not statistically significant difference (p=0,08). There was statistically significant difference in mean BNP blood concentration (3005,17 ng/ml ±2045,2 vs 1013,42 ng/ml ±1087,6; p=0,01), but there were no statistically significant differences in rest of laboratory parameters. BCNIE group has got higher mean BNP blood concentration than BCPIE group. There were no statistically significant differences between these groups in others laboratory parameters, clinical course and administered antibiotic therapy

  9. Cuerpos de inclusión, células bacterianas y composiciones que los contienen y sus usos

    OpenAIRE

    Villaverde Corrales, Antonio Pedro; Vázquez Gómez, Esther; Díez Gil, César; García Fruitós, Elena; Ratera Bastardas, Inmaculada; Veciana Miró, Jaume

    2008-01-01

    Cuerpos de inclusión, células bacterianas y composiciones que los contienen y sus usos. La presente invención se refiere a un cuerpo de inclusión aislado que comprende un polipéptido caracterizado porque el cuerpo da inclusión está en forma particulada. La presente invención también se refiere a una célula bacteriana que comprenda dicho cuerpo de inclusión. La presente invención se refiere además a una composición que comprende dicho cuerpo de inclusión y una célula eu...

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

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Nicodemo

    2014-09-01

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

  11. Successful salvage treatment of native valve Enterococcus faecalis infective endocarditis with telavancin: two case reports.

    Science.gov (United States)

    Thompson, Mickala M; Hassoun, Ali

    2017-07-01

    Infective endocarditis (IE) one-year mortality rates approach 40%. Here, we report two native valve Enterococcus faecalis IE cases in patients successfully treated with telavancin. An 88-year-old with mitral valve endocarditis and a penicillin allergy, initially treated with intravenous vancomycin, was switched to telavancin. A 69-year-old, who previously received amoxicillin and intravenous vancomycin for presumed enterococcal bacteraemia, was diagnosed with dual valve endocarditis for which he received telavancin. Both received six weeks of telavancin. Neither had telavancin-related adverse events, evidence of infection at six months, nor required telavancin dosing adjustments. Documented use of novel treatments for serious enterococcal infections is needed.

  12. Streptococcus bovis infectious endocarditis and occult gastrointestinal neoplasia: experience with 25 consecutive patients treated surgically.

    Science.gov (United States)

    Alozie, Anthony; Köller, Kerstin; Pose, Lumi; Raftis, Maximilian; Steinhoff, Gustav; Westphal, Bernd; Lamprecht, Georg; Podbielski, Andreas

    2015-01-01

    To assess the prevalence of gastrointestinal neoplasia in patients with Streptococcus bovis infectious endocarditis we performed a retrospective cohort analysis of all episodes of S. bovis infectious endocarditis treated at our institution between January 2000 through December 2014. Twenty-five patients were identified for this purpose. 12/25 patients received colonoscopy and 1/25 of the patients was assessed with CT colonography. Of the 13 who underwent colonic assessment, 11 were diagnosed with colonic neoplasms at different stages of development. In the absence of any strong contraindication, gastroenteroscopic evaluation in all patients diagnosed with S. bovis infectious endocarditis should be pursued.

  13. Usefulness of a partial median sternotomy for acute infectious endocarditis in patients with tracheostoma.

    Science.gov (United States)

    Kaneda, Toshio; Saga, Toshihiko; Nishino, Takako; Fujii, Kohsuke; Shintaro, Yukami

    2011-01-01

    Infectious endocarditis patients occasionally need emergency cardiac surgery even if they have a tracheostoma. However, a median full-sternotomy approach carries increased risk for sternal infection and lethal mediastinitis in cardiac surgery for patients with tracheostomas. We successfully performed valve replacement procedures using a lower partial median sternotomy approach in 6 infectious endocarditis patients with tracheostomas. There were neither operative deaths nor complications related to wound infection in these cases. The partial sternotomy approach represents a safe alternative in cardiac surgery for acute infectious endocarditis patients with tracheostomas who need emergent surgery.

  14. Haemophilus parainfluenzae Endocarditis Associated With Maxillary Sinusitis and Complicated by Cerebral Emboli in a Young Man

    Directory of Open Access Journals (Sweden)

    Anthony E. Duzenli MD

    2017-04-01

    Full Text Available HACEK endocarditis is often difficult to diagnose given the slow-growing characteristics of the organisms involved. Haemophilus parainfluenzae, one of the HACEK organisms, is an uncommon cause of endocarditis. We describe a case of a previously healthy young man with H parainfluenzae endocarditis that was associated with maxillary sinusitis and severe systemic complications, including septic cerebral emboli and mitral valve perforation. Previously reported cases have also described a predilection for younger people, cardiac valve pathology, and a high prevalence of stroke.

  15. Conducto arterioso patente complicado por endocarditis y anemia hemolítica en un adulto

    OpenAIRE

    Feridoun Sabzi; Reza Faraji

    2015-01-01

    Un adulto con un gran ductus arterioso permeable puede presentar fatiga, disnea y palpitaciones y menos frecuentemente presentar endocarditis. El caso muestra el papel de la vegetación de la endocarditis en la anemia hemolítica con el conducto arterioso patente (CAP) en adultos. A pesar del tratamiento de la endocarditis con la terapia antibiótica completa, la normalidad en la proteína C-reactiva, la tasa de sedimentación globular y leucocitaria, y un estado de bienestar general del paciente,...

  16. Endocarditis lenta-patient survived septic shock: a case report

    Directory of Open Access Journals (Sweden)

    Amra Macić Džanković

    2012-09-01

    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.

  17. [Liver abscess and infective endocarditis cases caused by Ruminococcus productus].

    Science.gov (United States)

    Sucu, Nurgün; Köksal, Iftihar; Yilmaz, Gürdal; Aydin, Kemalettin; Caylan, Rahmet; Aktoz Boz, Gönülden

    2006-10-01

    The genus Ruminococcus which are anaerobe Gram positive cocci, previously classified as Peptostreptococcus, may colonize the upper respiratory tract, gastrointestinal tract, vagina and skin of humans and animals. In this report a case of liver abscess and a case of infective endocarditis caused by Ruminoccocus productus, which is very rarely encountered in the clinical practice were presented. The first case was a 32 years old male who was admitted to the hospital in 2002, with the complaints of fever lasting for 20 days and pain while breathing. The abdominal ultrasonography revealed the presence of a liver abscess, and the drainage material from the abscess yielded Ruminococcus productus, identified in BACTEC 9200 (Becton Dickinson, Sparks, Md) anaerobe system. As the isolate was found to be sensitive to penicilin, the empirical gentamicin and ampicillin/sulbactam therapy was continued. The second case was a 25 years old male who was admitted to the hospital in 2005, with the signs of fever lasting for 3-4 months, chills, bone and joint pains. As multiple vegetations were detected in echocardiography, blood cultures were collected and empirical therapy with ceftriaxone and gentamicin was initiated with the preliminary diagnosis of infective endocarditis. Bacteria which were isolated from blood cultures by BACTEC 9200 system have been identified as R. productus. As this strain was also sensitive to penicillin, the empirical therapy was changed to penicilin and gentamicin. These two cases indicated that R. productus should be considered in complicated infections even if it is a rarely isolated species from the clinical samples.

  18. Nuclear Medicine in Diagnosis of Prosthetic Valve Endocarditis: An Update

    Science.gov (United States)

    Musso, Maria; Petrosillo, Nicola

    2015-01-01

    Over the past decades cardiovascular disease management has been substantially improved by the increasing introduction of medical devices as prosthetic valves. The yearly rate of infective endocarditis (IE) in patient with a prosthetic valve is approximately 3 cases per 1,000 patients. The fatality rate of prosthetic valve endocarditis (PVE) remains stable over the years, in part due to the aging of the population. The diagnostic value of echocardiography in diagnosis is operator-dependent and its sensitivity can decrease in presence of intracardiac devices and valvular prosthesis. The modified Duke criteria are considered the gold standard for diagnosing IE; their sensibility is 80%, but in clinical practice their diagnostic accuracy in PVE is lower, resulting inconclusively in nearly 30% of cases. In the last years, these new imaging modalities have gained an increasing attention because they make it possible to diagnose an IE earlier than the structural alterations occurring. Several studies have been conducted in order to assess the diagnostic accuracy of various nuclear medicine techniques in diagnosis of PVE. We performed a review of the literature to assess the available evidence on the role of nuclear medicine techniques in the diagnosis of PVE. PMID:25695043

  19. Case report: Infective endocarditis caused by Brevundimonas vesicularis

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    Chen Tun-Chieh

    2006-12-01

    Full Text Available Abstract Background There are few reports in the literature of invasive infection caused by Brevundimonas vesicularis in patients without immunosuppression or other predisposing factors. The choice of antimicrobial therapy for bacteremia caused by the pathogen requires more case experience to be determined. Case presentation The case of a 40-year-old previously healthy man with subacute endocarditis proposed to be contributed from an occult dental abscess is described. The infection was found to be caused by B. vesicularis on blood culture results. The patient recovered without sequelae after treatment with ceftriaxone followed by subsequent ciprofloxacin therapy owing to an allergic reaction to ceftriaxone and treatment failure with ampicillin/sulbactam. Conclusion To our knowledge, this is the first report of B. vesicularis as a cause of infective endocarditis. According to an overview of the literature and our experience, we suggest that third-generation cephalosporins, piperacillin/tazobactam, and ciprofloxacin are effective in treating invasive B. vesicularis infections, while the efficacy of ampicillin-sulbactam needs further evaluation.

  20. Cerebral imaging in infectious endocarditis: A clinical study.

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    Champey, Julia; Pavese, Patricia; Bouvaist, Hélène; Vittoz, Jean-Philippe; Tahon, Florence; Eker, Omer F; Goutier, Sandrine; Recule, Christine; Francois, Patrice

    2016-01-01

    Because neurological failure is the most frequent extra-cardiac complication in Infectious Endocarditis (IE), a brain computerised tomography (CT) scan is usually performed. The benefits of magnetic resonance imaging (MRI) have not been clearly established. This study aims to clarify the prevalence and type of cerebral lesions in IE detected using MRI and to compare them with those detected using CT scans. In the Grenoble University Hospital, patients diagnosed with definite or possible endocarditis according to Duke's criteria were screened from 2010-2012. Brain CT and MRI were performed as soon as possible after diagnosis. Of the 62 patients with IE who underwent at least one cerebral imaging within 3 weeks of diagnosis, Streptococcus (29) and Staphylococcus (14) were the main micro-organisms present. Twenty-eight (45%) patients underwent cardiac surgery. Eight (13%) died before discharge. Twenty (32%) had neurological symptoms. A brain CT-scan was performed on 53 (85%) patients and a MRI was performed on 43 (69%) patients. CT was pathological in 26 (49%) patients, whereas 32 (74%) MRI demonstrated abnormalities. The MRI lesions were classified as follows: ischaemia (48%), microbleeds (34%), haemorrhages (16%), abscesses (9%) and microbial aneurysms (4%). Of the 37 patients who underwent both MRI and CT examinations, ischaemia (48% vs 35%) and microbleeds (34%) demonstrated the difference between the two imaging methods. Through the early diagnosis of cerebral damage, even in asymptomatic cases, MRI may have a role in the IE management, influence any surgical decision and assist in prognosis assessment.

  1. Cecocentral scotoma as the initial manifestation of subacute bacterial endocarditis

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    Danielle Savitsky Strauss

    2011-03-01

    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

  2. Infective endocarditis and phlebotomies may have killed mozart.

    Science.gov (United States)

    Lee, Simon Jong-Koo

    2010-12-01

    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.

  3. [Bacillus cereus endocarditis and a probable cutaneous gateway].

    Science.gov (United States)

    Soudet, S; Becquart, C; Dezoteux, F; Faure, K; Staumont-Salle, D; Delaporte, E

    2017-01-01

    Bacillus cereus is a ubiquitous telluric organism. B. cereus endocarditis is a rare condition seen mostly in prosthetic heart valves and among intravenous drug users. We report a new case of a patient without risk factors and with a good clinical outcome not requiring valve replacement. In October 2014, a 50-year-old woman was referred to the dermatology department of Lille University Hospital for lower-limb wounds developing 6 months earlier. She presented fever without clinical signs of infection, except for the lower-limbs wounds. Blood cultures revealed the presence of B. cereus. Transesophageal echocardiography was performed and revealed two foci of aortic valve vegetation with a diameter of 5mm. After bacterial sensitivity testing, rifampicin and levofloxacin treatment was given for six weeks, with complete remission. A skin graft was performed and good improvement was seen. Nineteen cases of B. cereus endocarditis have been described previously, only one of which was without risk factors. We described a case of complete remission after a 6-week course of antibiotics. Our case demonstrates that BC should not be considered as a blood culture contamination, and that treatment may be complex due to antibiotic resistance. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Antibiotic prophylaxis in infective endocarditis: Use or abuse?

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    Nisha Thakur

    2012-01-01

    Full Text Available Introduction: The American Heart Association (AHA recommendations for antimicrobial prophylaxis for infective endocarditis (IE are controversial. According to the new guidelines released by the AHA now, the only patients to receive antibiotics will be those at highest risk, i.e. those with a prosthetic heart valve, a history of endocarditis, certain forms of congenital heart disease or valvulopathy after heart transplantation, and only before certain dental procedures. Unfortunately, these guidelines are still based largely on expert opinion, with very little hard evidence to show that antibiotic therapy actually prevents IE. The Hypothesis: The reported incidence of bacteremia during dental intervention ranges from 10% to 100% and, with daily brushing and flossing, from 20% to 68%. Because bacteremia also occurs during brushing and flossing of teeth, why give prophylaxis just for dental procedures? Moreover, the risks of causing adverse or anaphylactic reactions from antibiotics as well as contributing to the nationwide antibiotic resistance problem are issues not to be taken lightly. Evaluation of the Hypothesis: The hypothesis discusses the AHA recommendations for antimicrobial prophylaxis for IE, indicating some inherent limitations associated with it, and stresses upon the fact that these recommendation should also be updated, if not completely changed, to cope up with the advancements in the proper treatment plan.

  5. Marvelous but Morbid: Infective endocarditis due to Serratia marcescens

    Science.gov (United States)

    Phadke, Varun K.; Jacob, Jesse T.

    2016-01-01

    A 46-year-old man with HIV infection and active intravenous drug use presented with approximately two weeks of fevers and body aches. On physical examination he was somnolent, had a new systolic murmur, bilateral conjunctival hemorrhages, diffuse petechiae, and left-sided arm weakness. Echocardiography revealed a large mitral valve vegetation and brain imaging demonstrated numerous embolic infarctions. Blood cultures grew Serratia marcescens. Despite aggressive treatment with meropenem the patient died due to intracranial hemorrhage complicated by herniation. Serratia marcescens is an uncommon cause of infective endocarditis. While this disease has historically been associated with intravenous drug use, more recent reports suggest that it is now largely a consequence of opportunistic infections of the chronically ill. Our case highlights several characteristic features of this infection, including isolation of a non-pigmented strain of the organism, an antibiotic susceptibility profile suggestive of AmpC β-lactamase production, and rapid clinical deterioration with multiple embolic complications resulting in death. In this review we discuss the history, epidemiology, and management of endovascular infections due to Serratia spp., emphasizing the continued importance of considering this organism in the differential diagnosis of endocarditis among intravenous drug users and as a potential indication for surgical therapy. PMID:27346925

  6. Protease production by Streptococcus sanguis associated with subacute bacterial endocarditis.

    Science.gov (United States)

    Straus, D C

    1982-01-01

    A viridans streptococcus (Streptococcus sanguis biotype II) isolated from the blood of a patient with subacute bacterial endocarditis was examined for protease production. In broth culture, extracellular proteolytic enzymes were not produced by this organism until after the early exponential phase of growth, with maximal protease production occurring during the stationary phase. Four distinct proteases were isolated and purified from the supernatant fluids of stationary-phase cultures, employing a combination of ion-exchange column chromatography, gel filtration column chromatography, and polyacrylamide gel electrophoresis. All four proteases could be eluted from a diethylaminoethyl cellulose column at a sodium chloride gradient concentration of 0.25 M but were separable by gel filtration chromatography on a Sephadex G-100 column. They varied in molecular weights as determined by gel filtration and sodium dodecyl sulfate-polyacrylamide gel electrophoresis from approximately 13,000 to 230,000. All four proteases had pH optima of between 8.0 and 9.0, and two of the proteases were active against casein, human serum albumin, and gelatin but were not active against elastin and collagen. The remaining two proteases were able to degrade only casein and gelatin. These results show that S. sanguis is able to excrete maximal levels of potentially destructive enzymes when the organisms are not actively multiplying. This finding may explain some of the damage caused in heart tissue by these organisms during subacute bacterial endocarditis. Images PMID:6759404

  7. Rarity of invasiveness in right-sided infective endocarditis

    DEFF Research Database (Denmark)

    Hussain, Syed T; Shrestha, Nabin K; Witten, James

    2018-01-01

    , 1292 patients underwent surgery for active IE, 138 right-sided and 1224 left-sided. Among patients with right-sided IE, 131 had tricuspid and 7 pulmonary valve IE; 12% had prosthetic valve endocarditis. Endocarditis-related invasiveness was based on echocardiographic and operative findings. RESULTS......: Invasive disease was rare on the right side, occurring in 1 patient (0.72%; 95% confidence interval 0.02%-4.0%); rather, it was limited to valve cusps/leaflets or was superficial. In contrast, IE was invasive in 408 of 633 patients with aortic valve (AV) IE (65%), 113 of 369 with mitral valve (MV) IE (31......%), and 148 of 222 with AV and MV IE (67%). Staphylococcus aureus was a more predominant organism in right-sided than left-sided IE (right 40%, AV 19%, MV 29%), yet invasion was observed almost exclusively on the left side of the heart, which was more common and more severe with AV than MV IE and more common...

  8. [Candida albicans endocarditis after treatment of complete atrioventricular canal].

    Science.gov (United States)

    El Alami, S; Handor, N; Moutaki Allah, Y; Bouchrik, M; El Mellouki, W; Boulahya, A; Lmimouni, B

    2013-09-01

    Infective endocarditis is rare in children, it is rarer after a surgical treatment of atrioventricular canal, and it is exceptional that Candida albicans is the etiologic agent. This is a serious infection found in congenital heart disease with or without surgery. It is potentially lethal, despite diagnostic and therapeutic advances. We report a case of infective endocarditis due to C. albicans after the treatment of a congenital systemic atrioventricular canal in a child with trisomy 21. The diagnosis was suspected on clinical manifestations and cardiac auscultation. Confirmation was provided by positive blood cultures and echocardiography. The large size of the vegetation in the patient was in favor of a fungal etiology, blood cultures allowed to identify the fungus. This observation illustrates a poorly understood disease, with very poor prognosis and which is a potential complication of heart surgery. The improved prognosis should be achieved by shortening the time to diagnosis and optimizing the therapeutic support. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  9. Predictors of inhospital mortality in patients with infective endocarditis

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    Batool Al-Mogheer

    2013-09-01

    Full Text Available Despite advances in therapy, infective endocarditis (IE remains a serious disease with high mortality. We evaluated 155 Egyptian patients with Duke definite/possible IE to determine incidence, causes and predictors of inhospital mortality. The mean time from symptoms onset to diagnosis was 66.4 ± 97 days. The causes of mortality (38.7% included congestive heart failure (CHF, sepsis, surgery related, stroke, cerebral hemorrhage, pulmonary embolism, sudden cardiac death, and hyperkalemia. Predictors of mortality on univariate analysis were duration of symptoms before hospital admission (p = 0.017, health care associated endocarditis (p = 0.039, CHF (p < 0.001, fulminant sepsis (p < 0.001, embolization (p = 0.011, need for dialysis (p = 0.003, need for cardiac surgery (p = 0.027, unperformed indicated cardiac surgery (p = 0.002 and higher C-reactive protein level (p = 0.05. In multivariate analysis, only CHF remained an independent predictor of mortality (p = 0.033. IE mortality was high in this cohort probably due to delayed diagnosis. Patients having these mortality predictors especially CHF deserve more aggressive treatment.

  10. Endocardite por brucelose: relato de caso Brucella endocarditis: case report

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    Desanka Dragosavac

    2007-09-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A endocardite é rara e grave complicação de brucelose humana. O diagnóstico é suspeito em casos de endocardite sem resposta ao tratamento comum e é confirmado com sorologia com teste de ELISA maior que 1:160. O tratamento na maioria dos casos é cirúrgico, associado a antibioticoterapia prolongada. Alguns casos são resolvidos com tratamento clínico, que inclui doxiciclina, rifampicina, ciproproxacina, gentamicina e tetraciclina. O objetivo deste estudo foi relatar um caso raro de endocardite por brucelose. RELATO DO CASO: Paciente do sexo masculino, 51 anos, trabalhador rural, admitido com quadro de febre e emagrecimento. O ecocardiograma mostrou espessamento e vegetação de válvula aórtica. Uma hemocultura foi positiva para Staphylococcus epidermidis. O tratamento foi iniciado no dia da internação com penicilina cristalina, associada com garamicina, sem melhora em três semanas. Foi suspeitada endocardite por brucelose, colhida sorologia e iniciado o tratamento. Os antibióticos usados foram rifampicina e ciprofloxacin associado à vancomicina, devido o resultado da primeira hemocultura. A sorologia de aglutinação para brucelose foi positiva com resultado de 1:360. O paciente melhorou e recebeu alta da UTI, hemodinamicamente estável e em uso de ciprofloxacin e gentamicina. CONCLUSÕES: A endocardite por brucelose não é comum, mas deve ser sempre lembrada quando o tratamento convencional de endocardite não tem boa resposta, principalmente nos pacientes com possível contato com animais e derivados de leite.BACKGROUND AND OBJECTIVES: Endocarditis is a rare and serious complication of human brucellosis. The diagnosis is suspected in cases of endocarditis without response to conservative antibiotic treatment and it is confirmed with enzyme-linked immunosorbent assay (ELISA test, titers being higher than 1:160. The treatment is usually a surgery, followed with antibiotics for long period of time. Some

  11. Vaginosis bacteriana por Gardnerella vaginalis: Nuevas enseñanzas desde la ecología molecular

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    Andrés Zúñiga

    2015-06-01

    Full Text Available La vaginosis bacteriana (VB, es la afección vaginal más frecuente en las mujeres en edad reproductiva generada por un desbalance en el ecosistema vaginal que ocasiona complicaciones severas para la salud reproductiva. Existen hipótesis de origen biológico que relacionan la presencia de organismos como Gardnerella vaginalis, Prevotella sp, Atopobium vaginae como la causa más frecuente relacionada con la vaginosis, los cuales logran desplazar poblacionalmente microorganismos con capacidad protectora del epitelio vaginal como Lactobacillus crispatus y Lactobacillus jensenii. En la actualidad y de acuerdo a la OMS, la vaginosis bacteriana estaría implicada en alteraciones durante el embarazo como parto pre termino, bajo peso al nacer, corioamnionitis, ruptura prematura de membranas (RPM, endometritis post parto, entre otras. En los últimos años, con base estudios apoyados en datos de patrones moleculares, así como tecnología de análisis de genomas, surge una visión mucho más completa de condiciones ecológicas y agentes participantes en la vaginosis bacteriana.

  12. Eficacia de cinco desinfectantes para la reducción bacteriana doméstica

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    Julián Stambullian

    2011-06-01

    Full Text Available El uso adecuado de hipoclorito de sodio, sales de amonio cuaternario y triclosán ha demostrado ser eficaz para eliminar gérmenes dentro del hogar. Nuestro objetivo fue evaluar la eficacia inmediata, a la semana y al mes del uso controlado de cinco productos con estos componentes, comparados con otros productos de uso habitual. Se incluyeron 32 hogares de clase media de la Ciudad de Buenos Aires y la periferia en un estudio con intervención, abierto, aleatorizado, y de grupos paralelos, durante 6 meses. La mitad de los hogares fue seleccionada para usar hipoclorito de sodio, sales de amonio cuaternario y triclosán en la cocina y el baño durante un mes. El grupo control mantuvo prácticas habituales de limpieza doméstica. Se tomaron muestras para recuento y tipificación bacteriana de los sitios estudiados: muestras basales (sin discriminación de grupo en cocina, que presentaron recuento bacteriano promedio de 66.0 UFC/cm²; baño: 40.1 UFC/cm². Las muestras inmediatas a la limpieza (sin discriminación de grupo: en cocina: 0.8 UFC/cm²; baño: <1 UFC/cm². A la semana (grupo intervenido vs. grupo control: cocina 18.0 vs. 32.5 UFC/cm²; baño 12.7 vs. 7.7 UFC/cm². Al mes (intervenido vs. control: cocina: 60.1 vs. 62.1 UFC/cm²; baño: 37.0 vs. 42.0 UFC/cm². Se observó una notable disminución de la carga bacteriana en ambos grupos, lo que sugiere que no sólo la calidad de los productos sino también la educación en el uso desempeñan un papel clave en la desinfección del hogar. Este enfoque podría ser una herramienta importante para prevenir infecciones transmitidas por alimentos, dado que los coliformes fecales predominaron ampliamente en todas las muestras tipificadas.

  13. Actividad sialidasa en mujeres con vaginosis bacteriana Sialidase activity in women with bacterial vaginosis

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    Adriana M. Ombrella

    2006-04-01

    Full Text Available La vaginosis bacteriana (VB es un síndrome caracterizado por el sobrecrecimiento bacteriano de flora endógena Gram negativa, que desplaza a la flora lactobacilar normal. Dentro de las enzimas bacterianas, las sialidasas han sido consideradas factores de virulencia de muchos microorganismos patógenos que colonizan las distintas mucosas. Su presencia en fluidos vaginales puede estar correlacionada con VB. El propósito de este estudio fue comprobar la actividad de dicha enzima en mujeres con este síndrome y sin evidencia clínica de infección genital. Se estudiaron 112 mujeres (51 fueron pacientes con VB y 61 mujeres con flora colonizante habitual. Para la cuantificación de la actividad sialidasa se empleó la técnica basada en la hidrólisis enzimática de un derivado ácido del ácido metoxifenil acetil murámico. En la población estudiada se encontró que ambos grupos mostraron valores comprendidos entre 0.5 a 5.1 nmoles de metoxifenol, mientras que 11 de 52 pacientes con VB (21.17%, registraron valores superiores a 5.1 nmoles. La presencia de actividad sialidasa solamente no es índice de VB, excepto para valores mayores de 5.5 nmoles de metoxifenol, producidos en la reacción enzimática.Bacterial vaginosis (VB is a syndrome characterized by overgrowth of endogenous Gram negative bacterial flora and the lack of the normal flora. Within bacterial enzymes, sialidases have been considered a virulence factor of many pathogenic microorganisms colonizing the different mucous membranes. Their presence in vaginal discharges can be correlated with VB. The aim of this study was to detect the activity of this enzyme in women with this syndrome and without clinical evidence of genital infection. Out of a total 112 women studied, 51 were patients with VB and the other 61 women presented normal vaginal flora. For the quantification of enzyme activity, the technique based on the enzymatic hydrolysis of a derivative acid of the acetyl metoxifenil

  14. IDENTIFICACIÓN MOLECULAR DE POBLACIONES BACTERIANAS ASOCIADAS AL CARACOL PALA (Strombus gigas DEL CARIBE COLOMBIANO

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    EDINSON ANDRÉS ACOSTA

    2009-01-01

    Full Text Available El caracol Pala, Strombus gigas (Strombidae, es de gran importancia ecológica y so- cioeconómica en el área caribeña colombiana. Sin embargo, es una especie catalogada como "vulnerable" y existe muy poca información referente a las especies bacterianas asociadas al caracol que puedan ser importantes para el desarrollo, manejo productivo y de seguridad acuícola de estos gastrópodos. En este trabajo, nosotros empleamos un estudio microbiológico y molecular de la región intergénica entre los genes 16S y 23S rDNA, análisis del gen rDNA 16S y secuenciación, para analizar las bacterias asociadas al caracol Pala (S. gigas. La composición de bacterias cultivables asociadas fue evaluada por su capacidad para crecer en agar marino y en medios de cultivos selectivos. De un total de 28 muestras analizadas encontramos que el número de bacterias cultivadas en condiciones aerobias fue de alrededor 106 ufc mL-1 donde las bacterias pertenecientes a la familia Vibrionacea fueron las más abundantes, cerca de >105 ufc mL-1 . El análisis molecular de la región intergénica entre los genes 16S y 23S rDNA de las diferentes muestras, reveló una gran complejidad bacteriana asociada a S. gigas. Las secuencias de los amplificados del gen rDNA 16S identificó Pseudoalteromonas sp., Halomonas sp., Psycrobacter sp., Cobetia sp., Pseudomonas sp. y Vibrios sp. Nuestros resultados podrían sugerir un rol importante de estas bacterias como componentes de la comunidad asociada al S. gigas. Esta información puede complementar los estudios que se están implementando en los procesos para la conservación y repoblamiento de las poblaciones de S. gigas en Colombia.

  15. Tricuspid valve endocarditis caused by Haemophilus parainfluenzae: a case report and review of the literature.

    Science.gov (United States)

    Nwaohiri, Nnamdi; Urban, Carl; Gluck, Jason; Ahluwalia, Maneesha; Wehbeh, Wehbeh

    2009-06-01

    Haemophilus parainfluenzae is a Gram-negative bacterium that is often difficult to isolate and identify. We report a rare case of tricuspid valve and pacemaker endocarditis caused by this organism and explore factors related to etiopathogenesis, prevention, and treatment.

  16. Oral antibiotic treatment of left-sided infectious endocarditis verified by 16S-PCR

    DEFF Research Database (Denmark)

    Bruun, Louise E; Tønder, Niels; Hansen, Thomas Fritz

    2011-01-01

    Treatment of infectious endocarditis (IE) comprises intravenously administered antibiotic medications given at high doses for 4-6 weeks--sometimes even longer. Approximately 50% of patients referred to tertiary care centres require additional surgical intervention. At present there are few papers...... describing the effects of oral antibiotic treatment in IE, and only in patients with right-sided endocarditis. In this case report we present a patient with left-sided Streptococcus endocarditis successfully treated with oral antibiotic drugs.......Treatment of infectious endocarditis (IE) comprises intravenously administered antibiotic medications given at high doses for 4-6 weeks--sometimes even longer. Approximately 50% of patients referred to tertiary care centres require additional surgical intervention. At present there are few papers...

  17. An angry cat causing Pasteurella multocida endocarditis and aortic valve replacement—A case report

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    Anders Ahlsson

    2016-01-01

    Conclusion: Cat bites are often deep, and in rare circumstances can lead to life-threatening endocarditis. Proper surgical revision, antibiotic treatment, and patient compliance are necessary components in patient care to avoid this complication.

  18. The Same Systemic Autoimmune Disease Provokes Arthritis and Endocarditis via Distinct Mechanisms

    National Research Council Canada - National Science Library

    Bryce A. Binstadt; Jennifer L. Hebert; Adriana Ortiz-Lopez; Roderick Bronson; Christophe Benoist; Diane Mathis

    2009-01-01

    ...—in K/BxN T cell receptor (TCR) transgenic mice. The same adaptive immune system elements were required for initiation of arthritis and endocarditis, and both diseases were dependent on autoantibodies...

  19. Infective Endocarditis Presented as a Right Atrium Mass in a Patient with Ulcerative Colitis

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    Ali Asghar Moeinipour

    2015-01-01

    Full Text Available Involvement of the heart is infrequently seen in irritable bowel syndrome (IBD. We present a case of severe acute infective endocarditis diagnosed as ulcerative colitis in further workup.

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

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    Porokhnya N.G.

    2014-09-01

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

  1. Association Between Transcatheter Aortic Valve Replacement and Subsequent Infective Endocarditis and In-Hospital Death

    DEFF Research Database (Denmark)

    Regueiro, Ander; Linke, Axel; Latib, Azeem

    2016-01-01

    IMPORTANCE: Limited data exist on clinical characteristics and outcomes of patients who had infective endocarditis after undergoing transcatheter aortic valve replacement (TAVR). OBJECTIVE: To determine the associated factors, clinical characteristics, and outcomes of patients who had infective e...

  2. THE INFECTIVE ENDOCARDITIS (PREVENTION, DIAGNOSIS CRITERIA AND TREATMENT: KEY POINTS 2010

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    A. A. Demin

    2010-01-01

    Full Text Available Key positions of Guidelines on the prevention, diagnosis, and treatment of infective endocarditis issued by the Task Force of ESC in 2009 are explained in the comments. Recent opinions on these items are presented.

  3. Tratamiento quirúrgico de la endocarditis infecciosa

    Directory of Open Access Journals (Sweden)

    Alain Eusse

    2014-02-01

    Full Text Available 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, descriptivo, 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.

  4. Streptococcus bovis endocarditis and colon cancer: myth or reality? A case report and literature review

    OpenAIRE

    Galdy, Salvatore; Nastasi, Giuseppe

    2012-01-01

    A relationship between infective endocarditis and colon cancer was established in 1950, and Streptococcus bovis was successfully isolated in 1970. However, this association and its pathogenesis still remain unclear. In this paper, we describe the clinical case of a patient with a history of colon cancer and infective endocarditis caused by Streptococcus bovis. The role of S bovis as an aetiological agent in the development of colon cancer is intriguing but uncertain. S bovis infection should ...

  5. Validated Risk Score for Predicting 6-Month Mortality in Infective Endocarditis

    OpenAIRE

    Park, Lawrence P.; Chu, Vivian H.; Peterson, Gail; Skoutelis, Athanasios; Lejko-Zupa, Tatjana; Bouza, Emilio; Tattevin, Pierre; Habib, Gilbert; Tan, Ren; Gonzalez, Javier; Altclas, Javier; Edathodu, Jameela; Fortes, Claudio Querido; Siciliano, Rinaldo Focaccia; Pachirat, Orathai

    2016-01-01

    International audience; BACKGROUND: Host factors and complications have been associated with higher mortality in infective endocarditis (IE). We sought to develop and validate a model of clinical characteristics to predict 6-month mortality in IE.METHODS AND RESULTS: Using a large multinational prospective registry of definite IE (International Collaboration on Endocarditis [ICE]-Prospective Cohort Study [PCS], 2000-2006, n=4049), a model to predict 6-month survival was developed by Cox propo...

  6. The value of {sup 18}F-FDG PET/CT in diagnosing infectious endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Kouijzer, Ilse J.E. [Radboud University Nijmegen Medical Centre, Department of Internal Medicine, P.O. Box 9101, Nijmegen (Netherlands); Vos, Fidel J. [Radboud University Nijmegen Medical Centre, Department of Internal Medicine, P.O. Box 9101, Nijmegen (Netherlands); Sint Maartenskliniek, Nijmegen (Netherlands); Janssen, Marcel J.R. [Radboud University Nijmegen Medical Centre, Department of Nuclear Medicine, Nijmegen (Netherlands); Dijk, Arie P.J. van [Radboud University Nijmegen Medical Centre, Department of Cardiology, Nijmegen (Netherlands); Oyen, Wim J.G. [Radboud University Nijmegen Medical Centre, Department of Nuclear Medicine, Nijmegen (Netherlands); Radboud University Nijmegen Medical Centre, Nijmegen Institute for Infection, Inflammation and Immunity (N4i), Nijmegen (Netherlands); Bleeker-Rovers, Chantal P. [Radboud University Nijmegen Medical Centre, Department of Internal Medicine, P.O. Box 9101, Nijmegen (Netherlands); Radboud University Nijmegen Medical Centre, Nijmegen Institute for Infection, Inflammation and Immunity (N4i), Nijmegen (Netherlands)

    2013-07-15

    Early detection of infectious endocarditis is challenging. For diagnosing infectious endocarditis, the revised Duke criteria are the gold standard. Evidence of endocardial involvement on echocardiography is a major criterion, but sensitivity and specificity of echocardiography are not optimal. Here we investigated the utility of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) to diagnose infectious endocarditis in patients with gram-positive bacteraemia. Seventy-two patients with gram-positive bacteraemia were prospectively included. Patients with a positive blood culture growing Staphylococcus aureus, Streptococcus species or Enterococcus species were eligible when a risk factor for developing metastatic infectious foci was present. Infectious endocarditis was defined according to the revised Duke criteria. All patients underwent {sup 18}F-FDG PET/CT and echocardiography. {sup 18}F-FDG uptake in or around the heart valves was evaluated independently by two nuclear medicine physicians. Sensitivity for diagnosing infectious endocarditis with {sup 18}F-FDG PET/CT was 39 % and specificity was 93 %. The positive predictive value was 64 % and negative predictive value was 82 %. The mortality rate in patients without infectious endocarditis and without increased {sup 18}F-FDG uptake in or around the heart valves was 18 %, and in patients without infectious endocarditis but with high {sup 18}F-FDG uptake in or around the heart valves the mortality rate was 50 % (p = 0.181). {sup 18}F-FDG PET/CT is currently not sufficiently adequate for the diagnosis of infectious endocarditis because of its low sensitivity. Improvements such as patient preparation with low carbohydrate-fat allowed diet and technical advances in the newest PET/CT scanners may increase sensitivity in future studies. (orig.)

  7. Genomic analysis of a Streptococcus pyogenes strain causing endocarditis in a child

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    M. Beye

    2017-05-01

    Full Text Available We sequenced the genome of Streptococcus pyogenes strain G773 that caused an infective endocarditis in a 4-year-old boy suffering from acute endocarditis. The 1.9-Mb genome exhibited a specific combination of virulence factors including a complete integrative and conjugative element, sp2905, previously described as incomplete in S. pyogenes, and five bacteriocin-coding genes. However, strain G773 lacked a CRISPR-Cas system.

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

    OpenAIRE

    Ardeshir Lafzi; Nader Abolfazli; Amir Eskandari

    2008-01-01

    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.

  9. Simulation of amoxicillin pharmacokinetics in humans for the prevention of streptococcal endocarditis in rats.

    OpenAIRE

    Fluckiger, U.; Moreillon, P.; Blaser, J.; Bickle, M.; Glauser, M P; Francioli, P.

    1994-01-01

    The pharmacokinetic determinants of successful antibiotic prophylaxis of endocarditis are not precisely known. Differences in half-lives of antibiotics between animals and humans preclude extrapolation of animal results to human situations. To overcome this limitation, we have mimicked in rats the amoxicillin kinetics in humans following a 3-g oral dose (as often used for prophylaxis of endocarditis) by delivering the drug through a computerized pump. Rats with catheter-induced vegetations we...

  10. Biodegradable materials for surgical management of infective endocarditis: new solution or a dead end street?

    Science.gov (United States)

    Myers, Patrick O; Cikirikcioglu, Mustafa; Kalangos, Afksendiyos

    2014-08-03

    One third of patients with infective endocarditis will require operative intervention. Given the superiority of valve repair over valve replacement in many indications other than endocarditis, there has been increasing interest and an increasing number of reports of excellent results of valve repair in acute infective endocarditis. The theoretically ideal material for valve repair in this setting is non-permanent, "vanishing" material, not at risk of seeding or colonization. The goal of this contribution is to review currently available data on biodegradable materials for valve repair in infective endocarditis. Rigorous electronic and manual literature searches were conducted to identify reports of biodegradable materials for valve repair in infective endocarditis. Articles were identified in electronic database searches of Medline, Embase and the Cochrane Library, using a predetermined search strategy. 49 manuscripts were included in the review. Prosthetic materials needed for valve repair can be summarized into annuloplasty rings to remodel the mitral or tricuspid annulus, and patch materials to replace resected valvar tissue. The commercially available biodegradable annuloplasty ring has shown interesting clinical results in a single-center experience; however further data is required for validation and longer follow-up. Unmodified extra-cellular matrix patches, such as small intestinal submucosa, have had promising initial experimental and clinical results in non-infected valve repair, although in valve repair for endocarditis has been reported in only one patient, and concerns have been raised regarding their mechanical stability in an infected field. These evolving biodegradable devices offer the potential for valve repair with degradable materials replaced with autologous tissue, which could further improve the results of valve repair for infective endocarditis. This is an evolving field with promising experimental or initial clinical results, however long

  11. Right-Sided Endocarditis due to Staphylococcus lugdunensis: First Reported Case

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    CL Cooper

    1998-01-01

    Full Text Available 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.

  12. The value of 18F-FDG PET/CT in diagnosing infectious endocarditis.

    Science.gov (United States)

    Kouijzer, Ilse J E; Vos, Fidel J; Janssen, Marcel J R; van Dijk, Arie P J; Oyen, Wim J G; Bleeker-Rovers, Chantal P

    2013-07-01

    Early detection of infectious endocarditis is challenging. For diagnosing infectious endocarditis, the revised Duke criteria are the gold standard. Evidence of endocardial involvement on echocardiography is a major criterion, but sensitivity and specificity of echocardiography are not optimal. Here we investigated the utility of (18)F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) to diagnose infectious endocarditis in patients with gram-positive bacteraemia. Seventy-two patients with gram-positive bacteraemia were prospectively included. Patients with a positive blood culture growing Staphylococcus aureus, Streptococcus species or Enterococcus species were eligible when a risk factor for developing metastatic infectious foci was present. Infectious endocarditis was defined according to the revised Duke criteria. All patients underwent (18)F-FDG PET/CT and echocardiography. (18)F-FDG uptake in or around the heart valves was evaluated independently by two nuclear medicine physicians. Sensitivity for diagnosing infectious endocarditis with (18)F-FDG PET/CT was 39% and specificity was 93%. The positive predictive value was 64% and negative predictive value was 82%. The mortality rate in patients without infectious endocarditis and without increased (18)F-FDG uptake in or around the heart valves was 18%, and in patients without infectious endocarditis but with high (18)F-FDG uptake in or around the heart valves the mortality rate was 50% (p = 0.181). (18)F-FDG PET/CT is currently not sufficiently adequate for the diagnosis of infectious endocarditis because of its low sensitivity. Improvements such as patient preparation with low carbohydrate-fat allowed diet and technical advances in the newest PET/CT scanners may increase sensitivity in future studies.

  13. Indium-111 leukocyte scintigraphic detection of myocardial abscess formation in patients with endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Cerqueira, M.D.; Jacobson, A.F.

    1989-05-01

    Myocardial abscess formation in patients with bacterial endocarditis in most clinical settings, especially in patients with prosthetic valves, is a primary indicator for surgical valve replacement. We report the detection of myocardial abscesses using /sup 111/In leukocyte scintigraphy in three patients with prosthetic or native valve endocarditis and nondiagnostic echocardiograms. Leukocyte scintigraphy may allow identification of myocardial abscess formation earlier than other imaging modalities.

  14. Successful treatment of mitral valve endocarditis in a dog associated with 'Actinomyces canis-like' infection.

    Science.gov (United States)

    Balakrishnan, N; Alexander, K; Keene, B; Kolluru, S; Fauls, M L; Rawdon, I; Breitschwerdt, E B

    2016-09-01

    Infective endocarditis, an inflammation of the endocardial surface due to invasion by an infectious agent, is more common in middle sized to large breed dogs. We herein report a case of mitral valve endocarditis in a 9-year-old male-castrated Weimaraner caused by an Actinomyces canis-like bacterium, not previously reported in association with infection in dogs. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Mitral regurgitation jet around neoannulus: Mitral valve replacement in erysipelothrix rhusiopathiae endocarditis

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    Rahul Basu

    2013-01-01

    Full Text Available A 50-year-old male presented with erysipelothrix rhusiopathiae (ER endocarditis of the mitral valve, severe mitral regurgitation, and heart failure. The ER endocarditis destroyed the native mitral annulus therefore a new annulus was created for the suspension of the mitral bioprosthesis. Postoperative neoannulus dehiscence and leak prompted to redo surgery where transesophageal echocardiography (TEE played an important role in pointing out the exact location of perineoannular leaks for repair.

  16. Infecções bacterianas tratadas com Ro 6-2580

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    Paulo F. A. Lopes

    1970-10-01

    Full Text Available Nova combinação medicamentosa composta de sulfametoxazól e trimetoprim ("Bactrim", com efeito bactericida sobre germes Gram negativos e Gram positivos, foi ensaiada no tratamento de 15 casos de salmonelose e 9 casos de infecções bacterianas. Os resultados foram favoráveis, tanto nas salmoneloses, como em infecções por estafilococos, shigelas, pneumococos e coliformes. A remissão do estado tóxico nos casos de febre tifóide foi observada dentro de 48 horas, e o tempo médio para desaparecimento da febre e demais sintomas, nessa infecção, foi de 3 dias. Foram constatados efeitos secundários em alguns pacientes, tais como hipertermia medicamentosa, farmacodermia, vômitos, linfomonocitose e eosinofilia, possivelmente relacionados a posologia excessiva, e todos remissíveis. Os autores concluem pela utilidade do novo medicamento na terapêutica de salmoneloses, estafilococcias e outras infecções.

  17. A RIFAMPICINA NA DESCONTAMINAÇÃO BACTERIANA DE EXPLANTES DE MAMOEIRO PROVENIENTES DO CAMPO

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    GIOVANNI RODRIGUES VIANNA

    1997-01-01

    Full Text Available Observou-se alta contaminação bacteriana nos explantes de mamoeiro introduzidos in vitro, a partir de plantas matrizes desenvolvidas no campo, independentemente da época do ano em que se realizaram as coletas. O uso de desinfestantes superficiais, como álcool e hipoclorito de sódio, garantiram níveis aceitáveis de controle apenas para fungos, não para bactérias. A rifampicina, por tratamento de imersão ou introdução em meio de cultura, controlou satisfatoriamente as contaminações de caráter endofítico, obtendo-se 70% de explantes sadios, sem sinais de fitotoxicidade.High contamination by bacteria was observed in papaya tissue cuttings introduced in vitro from plants grown in the field, independent of the period of the year that samples were collected. The use of alcohol and sodium hypoclorite did not guarantee good bacteria control. Rifampicin, added as an immersion solution treatment or in the culture media, controlled the internal contamination of explants, without damaging the cuttings. Up to 70% of healthy tissue explants were obtained by the use of rifampicin.

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

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    Greub Gilbert

    2010-08-01

    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.

  19. Emerging infectious endocarditis due to Scedosporium prolificans: a model of therapeutic complexity.

    Science.gov (United States)

    Fernandez Guerrero, M L; Askari, E; Prieto, E; Gadea, I; Román, A

    2011-11-01

    Scedosporium prolificans is an emerging agent for severe infections. Although among the dematiaceous fungi Scedosporium is the most frequently isolated in blood cultures, Scedosporium endocarditis is rarely reported. We show herein a patient with acute leukaemia who developed S. prolificans endocarditis. Twelve cases were found in an extensive review of the English literature. In six cases (46%), there was predisposing heart conditions such as a prosthetic valve or an intracavitary device. Only 4 patients (31%) were immunocompromised hosts with haematologic neoplasia, solid-organ transplantation or acquired immunodeficiency syndrome (AIDS). Exposure to Scedosporium was observed in immunocompetent patients who developed infection while in the community. Scedosporium endocarditis occurred on both sides of the heart. Systemic and pulmonary emboli and other metastatic complications were seen in all of these patients. The overall mortality was 77% and, specifically, all of the immunocompromised hosts and 6 out of 7 patients with mitral or aortic valve endocarditis died. Patients with right-sided endocarditis associated with a removable intracardiac device exhibited a better prognosis. Scedosporium endocarditis, although still rare, is an emerging infection with an ominous prognosis. At the present time, valve replacement or the removal of cardiac devices plus combined antifungal treatment may offer the best possibility of cure.

  20. Infective endocarditis causing mitral valve stenosis - a rare but deadly complication: a case report.

    Science.gov (United States)

    Hart, Michael A; Shroff, Gautam R

    2017-02-17

    Infective endocarditis rarely causes mitral valve stenosis. When present, it has the potential to cause severe hemodynamic decompensation and death. There are only 15 reported cases in the literature of mitral prosthetic valve bacterial endocarditis causing stenosis by obstruction. This case is even more unusual due to the mechanism by which functional mitral stenosis occurred. We report a case of a 23-year-old white woman with a history of intravenous drug abuse who presented with acute heart failure. Transthoracic echocardiography failed to show valvular vegetation, but high clinical suspicion led to transesophageal imaging that demonstrated infiltrative prosthetic valve endocarditis causing severe mitral stenosis. Despite extensive efforts from a multidisciplinary team, she died as a result of her critical illness. The discussion of this case highlights endocarditis physiology, the notable absence of stenosis in modified Duke criteria, and the utility of transesophageal echocardiography in clinching a diagnosis. It advances our knowledge of how endocarditis manifests, and serves as a valuable lesson for clinicians treating similar patients who present with stenosis but no regurgitation on transthoracic imaging, as a decision to forego a transesophageal echocardiography could cause this serious complication of endocarditis to be missed.

  1. Linezolid in prophylaxis against experimental aortic valve endocarditis due to Streptococcus oralis or Enterococcus faecalis.

    Science.gov (United States)

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

    2006-02-01

    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 approximately 10(7) 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 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.

  2. Molecular identification of an Enterococcus faecalis endocarditis antigen efaA in root canals of therapy-resistant endodontic infections

    OpenAIRE

    Thomas Preethee; Deivanayagam Kandaswamy; Rosaline Hannah

    2012-01-01

    Introduction: Enterococcus faecalis has long been implicated in persistent root canal infections and therapy-resistant endodontic infections. It has also been associated with bacteremia, that is, infective endocarditis arising from certain invasive dental procedures. E. faecalis endocarditis antigen (efaA) has been identified as one of the principal virulence factors associated with infective endocarditis. Aim: To detect the presence of putative E. faecalis virulence factor, efaA in root ...

  3. Linezolid as rescue treatment for left-sided infective endocarditis

    DEFF Research Database (Denmark)

    Lauridsen, Trine Kiilerich; Bruun, Louise E; Rasmussen, R V

    2012-01-01

    The increasing number of resistant bacterial strains in infective endocarditis (IE) emphasizes the need for a constant development of antimicrobials. Linezolid is an oxazolidinone with an effect on Gram-positive cocci. Only a few casuistic reports describe its utilization in the treatment of IE...... linezolid were antibiotic intolerance (n = 13), nephrotoxicity (n = 5), pharmaceutical interactions (n = 1), inadequate clinical response (n = 14), or inadequate microbial response (n = 5). No significant differences in the cure rate (74 % vs. 71 %, p > 0.05), in-hospital mortality (13 % vs. 14 %, p > 0.......05), or post-discharge mortality at 12 months follow-up (26 % vs. 26 %, p > 0.05) were observed. In the current study, we found that linezolid, in general, was well tolerated and associated with the same outcome as in patients with Gram-positive IE treated with other antibiotics....

  4. Isolation of Stomatococcus mucilaginosus from drug user with endocarditis.

    Science.gov (United States)

    Coudron, P E; Markowitz, S M; Mohanty, L B; Schatzki, P F; Payne, J M

    1987-01-01

    Stomatococcus mucilaginosus was isolated from the blood of a patient with endocarditis and a past history of drug abuse and aortic valve replacement. At autopsy, Gram stain of the aortic valve revealed gram-positive cocci. Our isolate was atypical for S. mucilaginosus in that colonies were nonmucoid and nonadherent to agar surfaces. Cellular capsules were demonstrated by light and electron microscopy. Phenotypic characteristics identified by conventional methods as well as profile numbers obtained by using two commercial identification systems for staphylococci, the API Staph-Ident and the dms Staph Trac, are presented. Practical tests that differentiate S. mucilaginosus from the genera Micrococcus and Staphylococcus include growth on nutrient agar containing salt and lysostaphin susceptibility. Additional tests that helped differentiate our isolate from group D streptococci included hydrolysis of L-pyrrolidonyl-beta-naphthylamide and streptococcal serogrouping. Images PMID:3624435

  5. [A severe form of falciparum malaria associated with staphylococcal endocarditis].

    Science.gov (United States)

    Mikic, D; Djokic, M; Bojic, I; Pavlovic, M; Balint, B; Vucinic, Z; Maksic, Dj

    2001-01-01

    A case is presented of a patient, aged 56 years, with severe form of imported malaria caused by Plasmodia falciparum. Hyperparasitemia of erythrocytes > 30% was registered, and during the course of the disease CNS dysfunction, severe anemia, acute renal failure, disseminated intravenous coagulation with manifest hemorrhagic syndrome, icterus, enterocolitis, pneumonia and staphylococcal endocarditis were developed Due to hyperparasitemia and numerous complications, antimalarial drugs such as quinidine (1,200 mg/day) and artemether (160 mg/day) were administered parenterally. Infected erythrocytes were exchanged with 2.5 litres of healthy erythrocytes suspension. Hemodialysis was also performed as well as nine-week antistaphylococcal therapy. During the treatment preparation of deplasmated blood, concentrated thrombocytes, fresh frozen plasma, cryoprecipitates, human albumins and immunoglobulins were applied, along with the correction of electrolytic dysbalance, administration of diuretic, cardiotonic, antiarrhythmic, anxiolytic, antipsychotic and antidepressive drugs. Two months after the admission the patient was released from the Clinic in good condition, with normal clinical-laboratory findings.

  6. High readmission rates and mental distress after infective endocarditis

    DEFF Research Database (Denmark)

    Rasmussen, Trine Bernholdt; Zwisler, Ann-Dorthe; Thygesen, Lau Caspar

    2017-01-01

    BACKGROUND: Infective endocarditis (IE) is a severe disease requiring lengthy hospitalisation. Little is known about patients' recovery after IE. The aims of this study in IE patients were; (i) to describe mortality, readmission, self-reported health and rehabilitation up to 1year post-discharge,......-off score of 8. Almost half (47%) had not been offered cardiac rehabilitation (CR). CONCLUSIONS: After IE, mortality and readmission rates were high and self-reported physical and mental health poor. These findings call for changes in in-hospital and post-discharge management....... in a questionnaire survey (responders n=122). Responses were compared with those of a background reference population and a heart valve surgery population. Mortality and readmission data from registers 12months post-discharge were investigated. RESULTS: Patients discharged after treatment for IE had a mortality...

  7. Infective Endocarditis Presenting as Bilateral Orbital Cellulitis: An Unusual Case.

    Science.gov (United States)

    Asif, Talal; Hasan, Badar; Ukani, Rehman; Pauly, Rebecca R

    2017-06-14

    Orbital cellulitis is a severe and sight-threatening infection of orbital tissues posterior to the orbital septum. The most common causes of orbital cellulitis are rhinosinusitis, orbital trauma, and surgery. Infective endocarditis (IE) is a systemic infection that begins on cardiac valves and spreads by means of the bloodstream to peripheral organs. Septic emboli can spread to any organ including the eyes and can cause focal or diffuse ophthalmic infection. Ocular complications of IE classically include Roth's spots, subconjunctival hemorrhages, chorioretinitis, and endophthalmitis. IE as a cause of orbital cellulitis has been described by only one author in the literature. Here, we present a very rare case of bilateral orbital cellulitis caused by IE. Through this case, we aim to create awareness of the potential for serious ocular complications in IE and provide an overview of the management.

  8. Staphylococcus simulans associated with endocarditis in broiler chickens.

    Science.gov (United States)

    Stępień-Pyśniak, D; Wilczyński, J; Marek, A; Śmiech, A; Kosikowska, U; Hauschild, T

    2017-02-01

    This report suggests a strong association between coagulase-negative Staphylococcus simulans and endocarditis in broiler chickens of a single flock. Clinical signs included increased mortality and lameness, and some dead chickens were found on their backs. Lesions included cauliflower-like, fibrinous vegetative lesions on the left atrioventricular valve; cream-coloured, necrotic foci of varying size in the liver; and necrosis of the femoral head. Histopathological examination of the heart revealed multifocal conglomerates of bacterial colonies attached to the valvular endocardium, threads of fibrin, and inflammatory cells with the presence of heterophils. S. simulans strains were first identified by API ID32, and then confirmed with Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry and by partial sequencing of the rpoB and dnaJ genes. These bacteria were resistant to methicillin but sensitive to vancomycin and characterized by slime production and protease activity.

  9. Infective Endocarditis with Uveitis: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Hsiang-Chun Lee

    2007-01-01

    Full Text Available We report a case of a 51-year-old diabetic male who presented with a complaint of intermittent chills and fever that he had experienced for 10 days. No obvious respiratory tract, genitourinary tract, gastrointestinal tract, or skin lesions were observed. Blood culture data were positive for group B β-streptococcus. Transthoracic and transesophageal echocardiography revealed vegetation in the anterior leaflet of the mitral valve. The patient was diagnosed with infective endocarditis (IE and prescribed a parenteral antibiotic. Three days after admission, the patient complained of progressively blurred vision. Slit lamp examination found fine keratic precipitates and aqueous cells in the anterior chambers in both eyes, implying that the patient had uveitis. He was then prescribed a topical steroid for 4 months, and his vision improved gradually. This case is an important reminder that uveitis, not only endophthalmitis, can occur with IE. Treatment for one condition, if misapplied, may worsen the other.

  10. Effects of monocytopenia and anticoagulation in experimental Streptococcus sanguis endocarditis.

    Science.gov (United States)

    Thörig, L.; Thompson, J.; Eulderink, F.; Emeis, J. J.; Van Furth, R.

    1980-01-01

    The role of blood monocytes in the attachment of streptococci to endocardial vegetations was investigated in an experimental Streptococcus sanguis endocarditis by depletion of blood monocytes with the cytostatic drug VP 16-213 alone and combined with anticoagulant treatment with warfarin sodium. The numbers of streptococci in the vegetations of control, monocytopenic, and monocytopenic/anticoagulated rabbits were comparable. In the vegetations streptococci were found mainly in areas free of phagocytic cells. It is concluded that streptococci do not have to be phagocytosed by monocytes in the circulation before being deposited on the surface of endocardial vegetations. Even the vegetations of intensively anticoagulated/monocytopenic rabbits showed colonies of streptococci embedded in polymerized fibrin and cellular material, this matrix possibly being held together by streptococcal dextran. Images Fig. 3 Fig. 4 Fig. 5 Figs. 6-8 PMID:7378272

  11. Association Between Transcatheter Aortic Valve Replacement and Subsequent Infective Endocarditis and In-Hospital Death.

    Science.gov (United States)

    Regueiro, Ander; Linke, Axel; Latib, Azeem; Ihlemann, Nikolaj; Urena, Marina; Walther, Thomas; Husser, Oliver; Herrmann, Howard C; Nombela-Franco, Luis; Cheema, Asim N; Le Breton, Hervé; Stortecky, Stefan; Kapadia, Samir; Bartorelli, Antonio L; Sinning, Jan Malte; Amat-Santos, Ignacio; Munoz-Garcia, Antonio; Lerakis, Stamatios; Gutiérrez-Ibanes, Enrique; Abdel-Wahab, Mohamed; Tchetche, Didier; Testa, Luca; Eltchaninoff, Helene; Livi, Ugolino; Castillo, Juan Carlos; Jilaihawi, Hasan; Webb, John G; Barbanti, Marco; Kodali, Susheel; de Brito, Fabio S; Ribeiro, Henrique B; Miceli, Antonio; Fiorina, Claudia; Dato, Guglielmo Mario Actis; Rosato, Francesco; Serra, Vicenç; Masson, Jean-Bernard; Wijeysundera, Harindra C; Mangione, Jose A; Ferreira, Maria-Cristina; Lima, Valter C; Carvalho, Luiz A; Abizaid, Alexandre; Marino, Marcos A; Esteves, Vinicius; Andrea, Julio C M; Giannini, Francesco; Messika-Zeitoun, David; Himbert, Dominique; Kim, Won-Keun; Pellegrini, Costanza; Auffret, Vincent; Nietlispach, Fabian; Pilgrim, Thomas; Durand, Eric; Lisko, John; Makkar, Raj R; Lemos, Pedro A; Leon, Martin B; Puri, Rishi; San Roman, Alberto; Vahanian, Alec; Søndergaard, Lars; Mangner, Norman; Rodés-Cabau, Josep

    2016-09-13

    Limited data exist on clinical characteristics and outcomes of patients who had infective endocarditis after undergoing transcatheter aortic valve replacement (TAVR). To determine the associated factors, clinical characteristics, and outcomes of patients who had infective endocarditis after TAVR. The Infectious Endocarditis after TAVR International Registry included patients with definite infective endocarditis after TAVR from 47 centers from Europe, North America, and South America between June 2005 and October 2015. Transcatheter aortic valve replacement for incidence of infective endocarditis and infective endocarditis for in-hospital mortality. Infective endocarditis and in-hospital mortality after infective endocarditis. A total of 250 cases of infective endocarditis occurred in 20 006 patients after TAVR (incidence, 1.1% per person-year; 95% CI, 1.1%-1.4%; median age, 80 years; 64% men). Median time from TAVR to infective endocarditis was 5.3 months (interquartile range [IQR], 1.5-13.4 months). The characteristics associated with higher risk of progressing to infective endocarditis after TAVR was younger age (78.9 years vs 81.8 years; hazard ratio [HR], 0.97 per year; 95% CI, 0.94-0.99), male sex (62.0% vs 49.7%; HR, 1.69; 95% CI, 1.13-2.52), diabetes mellitus (41.7% vs 30.0%; HR, 1.52; 95% CI, 1.02-2.29), and moderate to severe aortic regurgitation (22.4% vs 14.7%; HR, 2.05; 95% CI, 1.28-3.28). Health care-associated infective endocarditis was present in 52.8% (95% CI, 46.6%-59.0%) of patients. Enterococci species and Staphylococcus aureus were the most frequently isolated microorganisms (24.6%; 95% CI, 19.1%-30.1% and 23.3%; 95% CI, 17.9%-28.7%, respectively). The in-hospital mortality rate was 36% (95% CI, 30.0%-41.9%; 90 deaths; 160 survivors), and surgery was performed in 14.8% (95% CI, 10.4%-19.2%) of patients during the infective endocarditis episode. In-hospital mortality was associated with a higher logistic EuroSCORE (23.1% vs 18.6%; odds ratio

  12. Is hyperbaric oxygen or ozone effective in experimental endocarditis?

    Science.gov (United States)

    Özkan, Muhammed Turgut Alper; Vural, Ahmet; Çiçek, Ömer Faruk; Yener, Ali Ümit; Özcan, Sedat; Toman, Hüseyin; Ünver, Ahmet; Saçar, Mustafa

    2016-05-01

    Infective endocarditis, a disease with high mortality and morbidity, is most commonly caused by Staphylococcus aureus; mortality and morbidity further increase in the presence of methicillin-resistant strains of S. aureus. Linezolid is the first of the oxazolidinones, a new antibiotic group that has been approved for the treatment of infections caused by gram-positive cocci. Linezolid reduces the quantity of microorganisms in vegetation to some extent; in addition, the use of hyperbaric oxygen (HBO) and ozone (O3) therapies is likely to improve targeted antibacterial effect. Fifty-six adult male Wistar rats weighing 300-350 g were used. The subjects were divided into groups as follows: Group 1 (n = 8): control group that was not inoculated with microorganisms and was untreated; Group 2 (n = 8): control group that was inoculated with microorganisms but was untreated; Group 3 (n = 8): linezolid treatment group; Group 4 (n = 8): O3 therapy group; Group 5 (n = 8): HBO therapy group; Group 6 (n = 8): linezolid + O3 therapy group; Group 7 (n = 8): linezolid + HBO therapy group. In terms of reducing the number of colonies in the aortic valve, linezolid + HBO therapy was found to be the most effective treatment. Then, respectively linezolid + O3, linezolid, HBO, and O3 were found to be effective. We found that linezolid significantly reduced the number of bacteria in the vegetation in the experimental endocarditis model, and HBO therapy increases the effectiveness of linezolid and makes this better than O3. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Management of Septic emboli in patients with infectious endocarditis.

    Science.gov (United States)

    Aalaei-Andabili, Seyed Hossein; Martin, Tomas; Hess, Phillip; Hoh, Brian; Anderson, Meshka; Klodell, Charles T; Beaver, Thomas M

    2017-05-01

    Septic emboli (SE) associated with infectious endocarditis (IE) can result in splenic abscesses and infectious intracranial aneurysms (IIA). We investigated the impact of SE on patient outcomes following surgery for IE. From January-2000 to October-2015, all patients with surgical IE (n = 437) were evaluated for incidence and management of SE. Overall SE was found in 46/437 (10.52%) patients (n = 17 spleen, 13 brain, and 16 both). No mortality was seen in the brain emboli groups, but in the splenic abscess group the in-hospital mortality was 8.69% (n = 4); and was associated with Age >35 (OR = 2.63, 1.65-4.20) and congestive heart failure (OR = 14.40, 1.23-168.50). Patients with splenic emboli had excellent mid-term outcome following discharge (100% survival at 4-years). Splenic emboli requiring splenectomy was predicted by a >20 mm valve vegetation (OR = 1.37, 1.056-1.77) and WBC >12000 cells/mm (OR = 5.58, 1.2-26.3). No patient with streptococcus-viridians infection had a nonviable spleen (OR = 0.67, 0.53-0.85). Postoperative acute-kidney-injury was higher in the splenectomy group (45.45% vs 9%) (p = 0.027). There were 6 patients with symptomatic IIAs that required coiling/clipping which was associated with age endocarditis patients. Patients with high preoperative WBC level and large valve vegetations require CT imaging of the spleen. Both spleen and brain interventions in the setting of IE can be performed safely with excellent early and mid-term outcomes. © 2017 Wiley Periodicals, Inc.

  14. Endocarditis fatal con localización mitral producida por Erysipelothrix rhusiopathiae Fatal mitral valve endocarditis by Erysipelothrix rhusiopathiae

    Directory of Open Access Journals (Sweden)

    G.V. Vallespi

    2005-06-01

    Full Text Available Se describe un caso fatal de endocarditis en válvula mitral por Erysipelothrix rhusiopathiae, en un paciente varón de 45 años con antecedentes de etilismo crónico y sin contacto previo con animales. Presentaba un síndrome febril prolongado con poliartralgias, pérdida de peso y dolor en región lumbar y miembros inferiores. Los hemocultivos (2/2 fueron positivos a las 48 hs. de incubación y en el examen directo se observaron bacilos gram-positivos pleomórficos. En el subcultivo en agar sangre ovina al 5% desarrollaron colonias puntiformes con alfa hemólisis, catalasa y oxidasa negativas, PYR y LAP positivas y con producción de H2S en medio TSI. La cepa aislada fue identificada como E. rhusiopathiae de acuerdo a la metodología convencional y confirmada con API Coryne. El cuadro se asumió como una probable endocarditis demostrada mediante un ecocardiograma transtorácico. Se comenzó el tratamiento endovenoso con ampicilina y gentamicina. El paciente evolucionó favorablemente y se tornó afebril, sin embargo falleció a los 19 días de internación por edema agudo de pulmón. La prueba de sensibilidad por E-test demostró resistencia a vancomicina y gentamicina y sensibilidad a penicilina y cefotaxima. Es importante valorar los aislamientos de bacilos gram-positivos pleomórficos, catalasa y oxidasa negativos y realizar la prueba de producción de SH2 en el medio TSI. La resistencia a vancomicina ayuda a la identificación y permite establecer una correcta terapia antimicrobiana. Si bien se considera que las infecciones por E. rhusiopathiae son de carácter ocupacional, el contacto con cerdos u otros animales puede no ser evidente.A fatal case of Erysipelothrix rhusiopathiae mitral valve endocarditis is described in a 45 years old male, with a history of chronic alcohol abuse and without animals contact. He presented intermittent fever, polyarthralgia, weight loss, and low back pain. In blood cultures (2 bottles, gram

  15. IDENTIFICACIÓN MOLECULAR DE POBLACIONES BACTERIANAS ASOCIADAS AL CARACOL PALA (Strombus gigas DEL CARIBE COLOMBIANO

    Directory of Open Access Journals (Sweden)

    ROMERO MAGALLY

    2009-08-01

    Full Text Available RESUMEN

    El caracol Pala, Strombus gigas (Strombidae, es de gran importancia ecológica y socioeconómica en el área caribeña colombiana. Sin embargo, es una especie catalogada como “vulnerable” y existe muy poca información referente a las especies bacterianas asociadas al caracol que puedan ser importantes para el desarrollo, manejo productivo y de seguridad acuícola de estos gastrópodos. En este trabajo, nosotros empleamos un estudio microbiológico y molecular de la región intergénica entre los genes 16S y 23S rDNA, análisis del gen rDNA 16S y secuenciación, para analizar las bacterias asociadas al caracol Pala (S. gigas. La composición de bacterias cultivables asociadas fue evaluada por su capacidad para crecer en agar marino y en medios de cultivos selectivos. De un total de 28 muestras analizadas encontramos que el número de bacterias cultivadas en condiciones aerobias fue de alrededor 106 ufc mL-1 donde las bacterias pertenecientes a la familia Vibrionacea fueron las más abundantes, cerca de >105 ufc mL-1 . El análisis molecular de la región intergénica entre los genes 16S y 23S rDNA de las diferentes muestras, reveló una gran complejidad bacteriana asociada a S. gigas. Las secuencias de los amplificados del gen rDNA 16S identificó Pseudoalteromonas sp., Halomonas sp., Psycrobacter sp., Cobetia sp., Pseudomonas sp. y Vibrios sp. Nuestros resultados podrían sugerir un rol importante de estas bacterias como componentes de la comunidad asociada al S. gigas. Esta información puede complementar los estudios que se están implementando en los procesos para la conservación y repoblamiento de las poblaciones de S. gigas en Colombia.

    Palabras clave: Strombus gigas, Caracol pala, Bacteria, Región intergénica 16S-23S, rDNA 16S.

    ABSTRACT

    The Queen Conch, Strombus gigas (Strombidae, is a species of great ecological and socioeconomic importance in the Caribbean area of Colombia

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

    Directory of Open Access Journals (Sweden)

    Ardeshir Lafzi

    2008-04-01

    Full Text Available

    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.

  17. Platelet receptor polymorphisms do not influence Staphylococcus aureus–platelet interactions or infective endocarditis

    Science.gov (United States)

    Daga, Shruti; Shepherd, James G.; Callaghan, J. Garreth S.; Hung, Rachel K.Y.; Dawson, Dana K.; Padfield, Gareth J.; Hey, Shi Y.; Cartwright, Robyn A.; Newby, David E.; Fitzgerald, J. Ross

    2011-01-01

    Cardiac vegetations result from bacterium–platelet adherence, activation and aggregation, and are associated with increased morbidity and mortality in infective endocarditis. The GPIIb/IIIa and FcγRIIa platelet receptors play a central role in platelet adhesion, activation and aggregation induced by endocarditis pathogens such as Staphylococcus aureus, but the influence of known polymorphisms of these receptors on the pathogenesis of infective endocarditis is unknown. We determined the GPIIIa platelet antigen PlA1/A2 and FcγRIIa H131R genotype of healthy volunteers (n = 160) and patients with infective endocarditis (n = 40), and investigated the influence of these polymorphisms on clinical outcome in infective endocarditis and S. aureus–platelet interactions in vitro. Platelet receptor genotype did not correlate with development of infective endocarditis, vegetation characteristics on echocardiogram or the composite clinical end-point of embolism, heart failure, need for surgery or mortality (P > 0.05 for all), even though patients with the GPIIIa PlA1/A1 genotype had increased in vivo platelet activation (P = 0.001). Furthermore, neither GPIIIa PlA1/A2 nor FcγRIIa H131R genotype influenced S. aureus-induced platelet adhesion, activation or aggregation in vitro (P > 0.05). Taken together, our data suggest that the GPIIIa and FcγRIIa platelet receptor polymorphisms do not influence S. aureus–platelet interactions in vitro or the clinical course of infective endocarditis. PMID:21044892

  18. Aortic allografts in treatment of aortic valve and ascending aorta prosthetic endocarditis

    Directory of Open Access Journals (Sweden)

    S.V. Spiridonov

    2017-03-01

    Full Text Available The aim – to assess short- and long-term results of aortic root replacement using aortic allografts in patients with prosthetic endocarditis. Materials and methods. Since February 2009 until June 2016 aortic valve and ascending aorta replacement using aortic allografts was performed in 26 patients with prosthetic endocarditis. In 50 % of cases at initial operation aortic valve replacement was performed, in another 50 % of cases – aortic valve and ascending aorta replacement. Echocardiography was performed 10 days, 3, 6 and 12 months, 2, 3 and 5 years after surgery. Analysis of long-term results included all cases of deaths, prosthesis-related complications and recurrence of endocarditis. Results. 30-day mortality was 23.1 %. Extracorporeal membranous oxygenation (ECMO was used only in 5 patients (19.2 %. Four patients were weaned from ECMO. We did not observe any allograft-related complications. During follow-up period there were no cases of reoperation due to structural allograft failure. Relapse of infection occurred in 1 patient (3.8 % four years after the operation and led to lethal outcome. Conclusion. Reoperations using allografts are an effective surgical treatment of prosthetic endocarditis. In majority of cases prosthetic endocarditis was caused by gram-positive cocci (Staphylococcus. In 84.6 % of cases it was associated with destruction of paravalvular structures and abscesses formation. Heart failure was a causative factor of different complications in these patients, which required ECMO in 19.2 % of patients. In 80 % of cases patients were weaned from ECMO. Allografts using for the treatment of prosthetic endocarditis is associated with high resistance to infection and with a significant rate of freedom from recurrence of endocarditis within 3 years after surgery.

  19. Sobre la resistencia bacteriana hacia antibióticos de acción bactericida y bacteriostática

    OpenAIRE

    Jhoana P. Romero L.; Eduardo Ibargüen Mondragón

    2014-01-01

    En este artículo se formula un modelo matemático simple que describe la interacción entre bacterias sensibles y resistentes a múltiples antibióticos de acción bactericida y bacteriostática de forma simultánea, en el supuesto de que la adquisición de resistencia bacteriana se da a través de mutaciones espontáneas y adquiridas por la exposición a diferentes antibióticos. El análisis cualitativo revela la existencia de un equilibrio libre de bacterias, un equilibrio solo con ba...

  20. Expressão do gene que codifica a alanina desidrogenase bacteriana em células de Saccharomyces cerevisiae

    OpenAIRE

    Carla Moreira Basílio, Anna

    2007-01-01

    Uma das alternativas para suprir o aumento pela demanda por etanol combustível é a engenharia metabólica de linhagens industriais de Saccharomyces cerevisiae visando o aumento do rendimento em etanol. Portanto, a deleção ou superexpressão de algumas desidrogenases pode contribuir para se alcançar este objetivo. Nesse contexto, a expressão epissomal do gene que codifica para a alanina desidrogenase bacteriana em linhagem laboratorial de S. cerevisiae resultou na diminuição da pr...

  1. Prevalencia de vaginitis y vaginosis bacteriana en pacientes con flujo vaginal anormal en el Hospital Nacional Arzobispo Loayza.

    OpenAIRE

    MEDINA, Ruth; RECHKEMMER PRIETO, Adolfo; GARCIA-HJARLES, Marco

    2013-01-01

    Objetivo: Determinar la prevalencia de vaginitis y vaginosis bacteriana en pacientes con flujo vaginal y su asociación con características clínicas y de laboratorio. Material y métodos: Se llevó a cabo un estudio transversal. Se estudiaron 370 pacientes que acudieron a la consulta ginecológica del Hospital Nacional Arzobispo Loayza de enero a marzo de 1998. A todas las pacientes se les tomó muestras de flujo vaginal para la medición del pH, del test de amina y la identificación microscópica d...

  2. Estudo prospectivo dos fatores de risco para complicações neurológicas na meningite bacteriana infantil

    Directory of Open Access Journals (Sweden)

    Sadie Namani

    2013-06-01

    Full Text Available OBJETIVO: Análise prospectiva de fatores de prognóstico para complicações neurológicas da meningite bacteriana infantil. MÉTODOS: Este estudo prospectivo recrutou 77 crianças de um mês a 16 anos de idade tratadas de meningite bacteriana durante o período de 1/1/2009 a 31/12/2010. Foram escolhidos 16 preditores relevantes para analisar sua associação com a incidência de complicações neurológicas. Valores P abaixo de 0,05 foram considerados estatisticamente significativos. RESULTADOS: Das 77 crianças tratadas para meningite bacteriana, desenvolveram-se complicações neurológicas em 33 pacientes (43%, e duas crianças morreram (2,6%. A etiologia dos casos de meningite bacteriana foi comprovada em 57/77 (74% dos casos: foram encontrados 32 isolados de meningococos; 8 de pneumococos; 6 de bacilos gram-negativos; 5 de H. influenzae; 5 de estafilococos e 1 de S. viridans. Os fatores que se mostraram associados a aumento do risco de desenvolvimento de complicações neurológicas foram idade 5.000 células/mm³, pleiocitose > 5.000 células/mm³ depois de 48 horas, baixa relação da glicose no LCS/sangue 48 horas, presença de comorbidade e foco primário de infecção não se associaram a aumento do risco para o desenvolvimento de complicações neurológicas. CONCLUSÃO: Idade inferior a 12 meses e gravidade da apresentação clínica na admissão foram identificadas como os preditores mais fortes de complicações neurológicas e podem ter valor para selecionar pacientes para tratamento mais intensivo.

  3. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study

    NARCIS (Netherlands)

    Murdoch, David R.; Corey, G. Ralph; Hoen, Bruno; Miró, José M.; Fowler, Vance G.; Bayer, Arnold S.; Karchmer, Adolf W.; Olaison, Lars; Pappas, Paul A.; Moreillon, Philippe; Chambers, Stephen T.; Chu, Vivian H.; Falcó, Vicenç; Holland, David J.; Jones, Philip; Klein, John L.; Raymond, Nigel J.; Read, Kerry M.; Tripodi, Marie Francoise; Utili, Riccardo; Wang, Andrew; Woods, Christopher W.; Cabell, Christopher H.; Gordon, David; Devi, Uma; Spelman, Denis; van der Meer, Jan T. M.; Kauffman, Carol; Bradley, Suzanne; Armstrong, William; Giannitsioti, Efthymia; Giamarellou, Helen; Lerakis, Stamatios; del Rio, Ana; Moreno, Asuncion; Mestres, Carlos A.; Ninot, Carlos A.; Pare, Carlos; de la Maria, Cristina Garcia; Armero, Yolanda; de Lazzari, Elisa; Marco, Francesc; Gatell, Jose M.; Almela, Manel; Azqueta, Manuel; Sitges, Marta; Claramonte, Xavier; Jiménez-Expósito, Maria Jesús; de Benito, Natividad; Ramirez, Jose; Perez, Noel; Miro, José M.; Almirante, Benito; Fernandez-Hidalgo, Nuria; de Vera, Pablo Rodriguez; Tornos, Pilar; Falco, Vicenç; Sidani, Nisreen; Kanj-Sharara, Souha; Kanafani, Zeina; Raglio, Annibale; Goglio, Antonio; Gnecchi, Fabrizio; Suter, Fredy; Valsecchi, Grazia; Rizzi, Marco; Ravasio, Veronica; Chirouze, Catherine; Leroy, Joel; Plesiat, Patrick; Bernard, Yvette; Casey, Anna; Lambert, Peter; Watkin, Richard; Elliott, Tom; Patel, Mukesh; Dismukes, William; Pan, Angelo; Caros, Giampiero; Mathiron, Amel Brahim; Tribouilloy, Christophe; Goissen, Thomas; Delahaye, Armelle; Delahaye, Francois; Vandenesch, Francois; Vizzotti, Carla; Nacinovich, Francisco M.; Marin, Marcelo; Trivi, Marcelo; Lombardero, Martin; Cortes, Claudia; Casabé, José Horacio; Altclas, Javier; Kogan, Silvia; Clara, Liliana; Sanchez, Marisa; Commerford, Anita; Hansa, Cass; Deetlefs, Eduan; Ntsekhe, Mpiko; Commerford, Patrick; Wray, Dannah; Steed, Lisa L.; Church, Preston; Cantey, Robert; Morris, Arthur; Lang, Selwyn; Kotsanas, Despina; Korman, Tony M.; Peterson, Gail; Purcell, Jon; Southern, Paul M.; Shah, Manisha; Bedimo, Roger; Reddy, Arjun; Levine, Donald; Dhar, Gaurav; Hanlon-Feeney, Alanna; Hannan, Margaret; Kelly, Sinead; Sexton, Daniel J.; Benjamin, Daniel J.; McDonald, Jay R.; Federspiel, Jeff; Engemann, John J.; Reller, Barth; Drew, Laura; Caram, L. B.; Stryjewski, Martin; Morpeth, Susan; Lalani, Tahaniyat; Mazaheri, Bahram; Neuerburg, Carl; Naber, Christoph; Athan, Eugene; Henry, Margaret; Harris, Owen; Alestig, Eric; Wikstrom, Lotta; Snygg-Martin, Ulrika; Francis, Johnson; Venugopal, K.; Nair, Lathi; Thomas, Vinod; Chaiworramukkun, Jaruwan; Pachirat, Orathai; Chetchotisakd, Ploenchan; Suwanich, Tewan; Kamarulzaman, Adeeba; Tamin, Syahidah Syed; Premru, Manica Mueller; Logar, Mateja; Lejko-Zupanc, Tatjana; Orezzi, Christina; Bouz, Emilio; Rodríguez-Créixems, Marta; Marín, Mercedes; Fernández, Miguel; Muñoz, Patricia; Fernández, Rocío; Ramallo, Victor; Raoult, Didier; Thuny, Franck; Habib, Gilbert; Casalta, Jean-Paul; Fournier, Pierre-Edouard; Chipigina, Natalia; Kirill, Ozerecky; Vinogradova, Tatiana; Kulichenko, Vadim P.; Butkevich, O. M.; Lion, Christine; Selton-Suty, Christine; Coyard, Hélène; Doco-Lecompte, Thanh; Iarussi, Diana; Durante-Mangoni, Emanuele; Ragone, Enrico; Dialetto, Giovanni; Casillo, Roberta; Kumar, A. Sampath; Sharma, Gautam; Dickerman, Stuart A.; Street, Alan; Eisen, Damon Peter; McBryde, Emma Sue; Grigg, Leeanne; Abrutyn, Elias; Michelet, Christian; Tattevin, Pierre; Donnio, Pierre Yves; Fortes, Claudio Querido; Edathodu, Jameela; Al-Hegelan, Mashael; Font, Bernat; Anguera, Ignasi; Guma, Joan Raimon; Cereceda, M.; Oyonarte, Miguel J.; Mella, Rodrigo Montagna; Garcia, Patricia; Jones, Sandra Braun; Ramos, Auristela Isabel de Oliveira; Paiva, Marcelo Goulart; Tranchesi, Regina Aparecida de Medeiros; Woon, Lok Ley; Lum, Luh-Nah; Tan, Ru-San; Rees, David; Kornecny, Pam; Lawrence, Richard; Dever, Robyn; Post, Jeffrey; Ryan, Suzanne; Harkness, John; Feneley, Michael; Rubinstein, Ethan; Strahilewitz, Jacob; Ionac, Adina; Mornos, Cristian; Dragulescu, Stefan; Forno, Davide; Cecchi, Enrico; de Rosa, Francesco; Imazio, Massimo; Trinchero, Rita; Wiesbauer, Franz; Gattringer, Rainer; Deans, Greg; Andrasevic, Arjana Tambic; Barsic, Bruno; Klinar, Igor; Vincelj, Josip; Bukovski, Suzana; Krajinovic, Vladimir; Stafford, Judy; Baloch, Khaula; Redick, Thomas; Harding, Tina; Corey, Ralph; Durack, David T.; Eykyn, Susannah

    2009-01-01

    BACKGROUND: We sought to provide a contemporary picture of the presentation, etiology, and outcome of infective endocarditis (IE) in a large patient cohort from multiple locations worldwide. METHODS: Prospective cohort study of 2781 adults with definite IE who were admitted to 58 hospitals in 25

  4. O uso de antibióticos e as resistências bacterianas: breves notas sobre a sua evolução

    OpenAIRE

    Loureiro, Rui João; Roque, Fátima; Teixeira Rodrigues, António; Herdeiro, Maria Teresa; Ramalheira, Elmano

    2016-01-01

    A resistência bacteriana aos antibióticos é atualmente um dos problemas de saúde pública mais relevantes a nível global, dado que apresenta consequências clínicas e económicas preocupantes, estando associada ao uso inadequado de antibióticos. Portugal é, no contexto europeu, um país com um elevado consumo de antibióticos, apesar de uma diminuic¸ão no consumo destes fármacos nos últimos anos. A resistência bacteriana tem crescido acentuadamente, sendo que as bactérias Gram-posit...

  5. Compuestos útiles para el tratamiento de infecciones bacterianas, composiciones farmaceúticas que los contienen, procedimiento de identificación de los mismos y sus aplicaciones

    OpenAIRE

    Pozueta Romero, Javier; Baroja-Fernández, Edurne; Muñoz Pérez, Francisco José; Rahimpour, Mehdi; Montero, Manuel; Almagro, Goizeder

    2012-01-01

    La presente invención describe una serie de compuestos útiles para reducir o anular procesos determinantes de la patogenicidad y virulencia bacterianas y de la adherencia bacteriana a superficies inertes o células tales como la producción de adhesinas, la motilidad flagelar y la formación de EPSs y biofilms bacterianos. Estos compuestos pueden usarse para la elaboración de composiciones farmacéuticas antibacterianas o de composiciones antisépticas para el tratamient...

  6. Implementación de una práctica virtual de biotecnología: la transformación bacteriana

    OpenAIRE

    Roque Gamarra, Alberto

    2013-01-01

    En este documento se realiza la implementación de la fase "Transformación Bacteriana" en el "Laboratorio Virtual de Biotecnología Agroforestal" de la Universidad Politécnica de Madrid. Esta fase representa una continuación de un trabajo previo, en el que se implementó el laboratorio virtual y se diseñó una arquitectura para el desarrollo de las fases posteriores. La Transformación Bacteriana es la tercera fase del proceso de modificación genética de un chopo para dotarle de resistencia frente...

  7. Evaluación del efecto de la ozonoterapia en perros con problemas de dermatitis bacteriana en la ciudad de Cuenca provincia del Azuay

    OpenAIRE

    Bernal Ramírez, Max Roberto

    2014-01-01

    La aplicación de la ozonoterapia fue utilizada para el tratamiento de dermatitis bacteriana; la investigación se realizó a 24 caninos a los cuales se les aplico ozono en una concentración de 40 ug de ozono/ml de oxígeno en periodos de 15 minutos cada 24 horas por 8 días vía cutánea. Los resultados obtenidos fueron totalmente positivos ya que tuvimos una considerable disminución de la carga bacteriana. The application of ozone therapy was used to treat bacterial dermatitits; the research wa...

  8. Predicting the occurrence of embolic events: an analysis of 1456 episodes of infective endocarditis from the Italian Study on Endocarditis (SEI)

    Science.gov (United States)

    2014-01-01

    Background Embolic events are a major cause of morbidity and mortality in patients with infective endocarditis. We analyzed the database of the prospective cohort study SEI in order to identify factors associated with the occurrence of embolic events and to develop a scoring system for the assessment of the risk of embolism. Methods We retrospectively analyzed 1456 episodes of infective endocarditis from the multicenter study SEI. Predictors of embolism were identified. Risk factors identified at multivariate analysis as predictive of embolism in left-sided endocarditis, were used for the development of a risk score: 1 point was assigned to each risk factor (total risk score range: minimum 0 points; maximum 2 points). Three categories were defined by the score: low (0 points), intermediate (1 point), or high risk (2 points); the probability of embolic events per risk category was calculated for each day on treatment (day 0 through day 30). Results There were 499 episodes of infective endocarditis (34%) that were complicated by ≥ 1 embolic event. Most embolic events occurred early in the clinical course (first week of therapy: 15.5 episodes per 1000 patient days; second week: 3.7 episodes per 1000 patient days). In the total cohort, the factors associated with the occurrence of embolism at multivariate analysis were prosthetic valve localization (odds ratio, 1.84), right-sided endocarditis (odds ratio, 3.93), Staphylococcus aureus etiology (odds ratio, 2.23) and vegetation size ≥ 13 mm (odds ratio, 1.86). In left-sided endocarditis, Staphylococcus aureus etiology (odds ratio, 2.1) and vegetation size ≥ 13 mm (odds ratio, 2.1) were independently associated with embolic events; the 30-day cumulative incidence of embolism varied with risk score category (low risk, 12%; intermediate risk, 25%; high risk, 38%; p endocarditis, a simple scoring system, which combines etiology and vegetation size with time on antimicrobials, might contribute to a

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

    Directory of Open Access Journals (Sweden)

    Ivanović Branislava

    2010-01-01

    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

  10. Surgical Management of Active Infective Endocarditis During 1996-06 in Tabriz, Northwestern Iran

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    Azin Alizadehasl1,

    2008-03-01

    Full Text Available Objective: 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.Patients and Methods: One hundred and sixty-four consecutive patients underwent valve surgery for active IE in Madani heart centre (Tabriz, Iran from 1996 to 2006. The patients with diagnosis of IE (according to Duke Criteria were eligible for the study.Results: The mean age of patients was 36.3 ± 16 years, with 34.6±17.5 yrs for native valve endocarditis and 38.6±15.2 yrs for prosthetic valve endocarditis (p= 0.169. Ninety-one (55.5% of patients were males. The infected valve was native in 112 (68.3% of patients and prosthetic in 52 (31.7%. There was no predisposing heart disease in 61 (37% of patients. The aortic valve was infected in 78(47.6%, the 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 implantedin 69 patients (42.1% and bioprostheses in 95 (57.9%, including homograft in 19 (11.5% cases. There were 16 (9% operation-related deaths, but only 1 death in patients undergoing aortic homograft replacement. Reoperation was required in 18 (10.9% cases.Based 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 hospital mortality.Conclusions: Surgery for infective endocarditis continues to be challenging and associated with high operation-related mortality and

  11. [Enterococcal endocarditis: a multicenter study of 76 cases].

    Science.gov (United States)

    Martínez-Marcos, Francisco Javier; Lomas-Cabezas, José Manuel; Hidalgo-Tenorio, Carmen; de la Torre-Lima, Javier; Plata-Ciézar, Antonio; Reguera-Iglesias, José María; Ruiz-Morales, Josefa; Márquez-Solero, Manuel; Gálvez-Acebal, Juan; de Alarcón-González, Arístides

    2009-12-01

    Although enterococci occupy the third position among microorganisms producing infectious endocarditis (IE) following streptococci and Staphylococcus aureus, few multicenter studies have provided an in-depth analysis of enterococcal IE. Description of the characteristics of 76 cases of enterococcal left-sided infectious endocarditis (LSIE) (native: 59, prosthetic: 17) retrieved from the database of the Cardiovascular Infections Study Group of the Andalusian Society of Infectious Diseases, with emphasis on the comparison with non-enterococcal LSIE. Enterococci were the causal agent in 76 of the 696 episodes of LSIE (11%). Compared with non-enterococcal LSIE, enterococcal LSIE was more commonly seen in patients older than 65 (47.4% vs. 27.6%, P<0.0005), and those with chronic diseases (75% vs. 54.6%, P<0.001), calcified valves (18.6% vs. 10%, P<0.05), and previous urinary (30.3% vs. 2.1%, P<0.00001) or abdominal (10.5% vs. 3.1%, P<0.01) infections, and produced a higher rate of relapses (6.6% vs. 2.3%, P<0.05). Enterococcal LSIE was associated with fewer peripheral vascular or skin manifestations (14.5% vs. 27.1%, P<0.05) and fewer immunological phenomena (10.5% vs. 24%, P<0.01). Among the total of patients with enterococcal LSIE, 36.8% underwent valve surgery during hospitalization. In-hospital mortality was 32.9% for enterococcal LSIE, 9.3% for viridans group streptococci (VGS) LSIE and 48.6% for S. aureus LSIE (enterococci vs VGS: P<0.0001; enterococci vs S. aureus: P=0.02). Enterococcal LSIE patients treated with the combination of a penicillin or vancomycin plus an aminoglycoside (n=60) and those treated with ampicillin plus ceftriaxone (n=6) showed similar in-hospital mortality (26.7% vs 33.3%, P=0.66). High-level resistance to gentamicin was detected in 5 of 38 episodes of enterococcal LSIE (13.1%). Enterococcal LSIE appears in patients with well-defined clinical characteristics, and causes few peripheral vascular or skin manifestations and few immunological

  12. Subacute bacterial endocarditis and subsequent shunt nephritis from ventriculoatrial shunting 14 years after shunt implantation

    DEFF Research Database (Denmark)

    Burström, Gustav; Andresen, Morten; Bartek, Jiri Jr.

    2014-01-01

    of causing subacute bacterial endocarditis and subsequent shunt nephritis. The patient was successfully treated with antibiotics combined with ventriculoatrial shunt removal and endoscopic third ventriculocisternostomy (VCS). This case illustrates the nowadays rare, but potentially severe complication...... of subacute bacterial endocarditis and shunt nephritis. It also exemplifies the VCS as an alternative to implanting foreign shunt systems for CSF diversion....

  13. Aortocavitary fistula as a complication of infective endocarditis and subsequent complete heart block in a patient with severe anemia

    Directory of Open Access Journals (Sweden)

    Jose N. Galeas

    2015-12-01

    Full Text Available Infective endocarditis has different presentations depending on the involvement of valvular and perivalvular structures, and it is associated with high morbidity and mortality. Aortocavitary fistula is a rare complication. We introduce the case of a 48-year-old female with native valve endocarditis, complicated by aortocavitary fistula to the right atrium, and consequently presented with syncope.

  14. Medtronic Freestyle Aortic Root Bioprosthesis Implantation for the Infective Endocarditis on Aortic Root

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    Zekeriya Arslan

    2013-10-01

    Full Text Available    Infective endocarditis and periannular abscess formation are serious problems in cardiac valve surgery, requiring extensive surgical debridement and reconstruction of the aortic annulus. We aimed to report two cases which were successfully treated with bioprosthetic valve implantation for infective endocarditis. Transosephageal echocardiography were performed for the diagnosis of one prosthetic and one native destructive aortic valve endocarditis in association with congestive heart failure (NYHA class-VI and abscess formation. Medtronic Freestyle stentless aortic root bioprosthesis was implanted into the left ventricular outflow tract after surgical radical aortic root debridement for each patient followed with medical treatment, which was extended to six weeks. Neither early nor late mortality was detected. One patient required prolonged ventilatory support (two days and permanent DDD-R pacing. Echocardiography showed no signs of valve dysfunction or recurrent endocarditis for both patients in 10 months follow up.Medtronic Freestyle stentless aortic root bioprosthesis may be a good alternative way of treatment to aortic valve and root endocarditis instead of homograft.

  15. Infective endocarditis: call for education of adults with CHD: review of the evidence.

    Science.gov (United States)

    Hays, Laura H

    2016-03-01

    Advanced surgical repair procedures have resulted in the increased survival rate to adulthood of patients with CHD. The resulting new chronic conditions population is greater than one million in the United States of America and >1.2 million in Europe. This review describes the risks and effects of infective endocarditis - a systemic infectious process with high morbidity and mortality - on this population and examines the evidence to determine whether greater patient education on recognition of symptoms and preventative measures is warranted. The literature search included the terms "infective endocarditis" and "adult congenital heart disease". Search refinement, the addition of articles cited by included articles, as well as addition of supporting articles, resulted in utilisation of 24 articles. Infective endocarditis, defined by the modified Duke Criteria, occurs at a significantly higher rate in the CHD population due to congenitally or surgically altered cardiac anatomies and placement of prosthetic valves. This literature review returned no studies in the past five years assessing knowledge of the definition, recognition of symptoms, and preventative measures of infective endocarditis in the adult CHD population. Existing data are more than 15 years old and show significant knowledge deficits. Studies have consistently shown the need for improved CHD patient knowledge with regard to infective endocarditis, and there is no recent evidence that these knowledge deficits have decreased. It is important to address and decrease knowledge deficits in order to improve patient outcomes and decrease healthcare utilisation and costs.

  16. Imaging experimental infective endocarditis with indium-111-labeled blood cellular components

    Energy Technology Data Exchange (ETDEWEB)

    Riba, A.L.; Thakur, M.L.; Gottschalk, A.; Andriole, V.T.; Zaret, B.L.

    1979-02-01

    The capability of radionuclide imaging to detect experimental aortic valve infective endocarditis was assessed with indium-111 (/sup 111/In)-labeled blood cells. Sequential cardiac imaging and tissue distribution studies were obtained in 17 rabbits with infective endocarditis after administration of /sup 111/-In-platelets and in five after /sup 111/In-polymorphonuclear leukocytes. Forty-eight to 72 hours after platelet administration, in vivo imaging demonstrated abnormal /sup 111/In uptake in all animals in the region of the aortic valve in an anatomically distinct pattern. Images of the excised heart showed discrete cardiac uptake conforming to the in vivo image and gross pathological examination. /sup 111/In platelet uptake in vegetations from the 17 animals averaged 240 +- 41 times greater than that in normal myocardium and 99 +- 15 times greater uptake in blood. In contrast, /sup 111/In-leukocyte cardiac imaging showed no abnormal aortic valve uptake 24 hours after tracer administration and the lesion myocardium activity ratio was only 5 +- 2 (3 +- 1 for lesion/blood activity). Four normal rabbits demonstrated neither positive /sup 111/In platelet scintigraphs nor abnormal cardiac tissue uptake. Likewise, noncellular /sup 111/In was not concentrated to any significant extent in three animals with infective endocarditis.This study demonstrates that /sup 111/In platelet, but not leukocyte cardiac imaging, is a sensitive technique for detecting experimental infective endocarditis. The imaging data conform to the cellular pathology of the infective endocarditis vegetation.

  17. Imaging endocarditis with Tc-99m-labeled antibody--an experimental study: concise communication

    Energy Technology Data Exchange (ETDEWEB)

    Wong, D.W.; Dhawan, V.K.; Tanaka, T.; Mishkin, F.S.; Reese, I.C.; Thadepalli, H.

    1982-03-01

    The sensitivity and specificity of Tc-99m-labeled antibacterial antibody (Tc-99m Ab) for detecting bacterial endocarditis were evaluated in an experimental model. Rabbit-produced antistaphylococcal antibody was extracted using Rivanol and chemically labeled with Tc-99m. This Tc-99m Ab was injected intravenously in New Zealand rabbits 24 hr after producing Staphylococcus aureus endocarditis of the aortic valve. Imaging and tissue analyses were performed on the following day. All 11 animals developed S. aureus aortic-valve vegetations and showed increased uptake of Tc-99m Ab at the aortic valve, 118 times higher than at the uninfected tricuspid valve. Although high hepatic radioactivity and anatomic uncertainties interfered with in vivo delineation of these lesions, images of the excised hearts showed all affected valves. Two rabbits inoculated with Escherichia coli did not develop endocarditis and had little uptake of Tc-99m Ab, while six rabbits with enterococcal endocarditis had no uptake of the Tc-99m Ab in their vegetations. The findings suggest potential value of Tc-99m Ab on the rapid diagnosis of endocarditis.

  18. Imaging experimental infective endocarditis with indium-111-labeled blood cellular components. [Rabbits, aortic valve

    Energy Technology Data Exchange (ETDEWEB)

    Riba, A.L.; Thakur, M.L.; Gottschalk, A.; Andriole, V.T.; Zaret, B.L.

    1979-02-01

    The capability of radionuclide imaging to detect experimental aortic valve infective endocarditis was assessed with indium-111 (/sup 111/In)-labeled blood cells. Sequential cardiac imaging and tissue distribution studies were obtained in 17 rabbits with infective endocarditis after administration of /sup 111/In-platelets and in five after /sup 111/In-polymorphonuclear leukocytes. Forty-eight to 72 hours after platelet administration, in vivo imaging demonstrated abnormal /sup 111/In uptake in all animals in the region of the aortic valve in an anatomically distinct pattern. Images of the excised heart showed discrete cardiac uptake conforming to the in vivo image and gross pathological examination. /sup 111/In-platelet uptake in vegetations from the 17 animals averaged 240 +- 41 times greater than that in normal myocardium and 99 +- 15 times greater uptake in blood. In contrast, /sup 111/In-leukocyte cardiac imaging showed no abnormal aortic valve uptake 24 hours after tracer administration and the lesion myocardium activity ratio was only 5 +- 2 (3 +- 1 for lesion/blood activity). Four normal rabbits demonstrated neither positive /sup 111/In-platelet scintigraphs nor abnormal cardiac tissue uptake. Likewise, noncellular /sup 111/In was not concentrated to any significant extent in three animals with infective endocarditis. This study demonstrates that /sup 111/In-platelet, but not leukocyte cardiac imaging, is a sensitive technique for detecting experimental infective endocarditis. The imaging data conform to the cellular pathology of the infective endocarditis vegetation.

  19. Enterococcus faecalis colonisation and endocarditis in five intensive care patients as late sequelae of selective decontamination.

    Science.gov (United States)

    Sijpkens, Y W; Buurke, E J; Ulrich, C; van Asselt, G J

    1995-03-01

    To describe Enterococcus faecalis colonisation and endocarditis in 5 intensive care patients after treatment with selective decontamination (SDD). Intensive care unit (ICU) in a general hospital. The patients were admitted to the ICU because of adult respiratory distress syndrome, polytrauma (2 patients), abdominal aortic surgery and gastrointestinal surgery. Because these patients needed mechanical ventilation they received systemic cefotaxime and SDD (polymyxin E, amphotericin B and norfloxacin). Colonisation with E. faecalis was documented in all patients. Intravascular catheter-related infection with E. faecalis occurred in 4 patients. None of the patients received antibiotics active against, E. faecalis, because body temperature normalised after catheter removal. In the course of his ICU stay one patient died. Autopsy showed E. faecalis endocarditis. The other 4 patients recovered from their primary illness, but had to be readmitted after several months because of E. faecalis endocarditis. One of these patients died. One patient recovered of endocarditis, but one year later valve surgery was necessary. The other 2 patients needed acute valve replacement. The latter 3 patients survived. We observed 5 patients with E. faecalis endocarditis as a late and severe sequela of SDD during their ICU stay.

  20. Inhibitory effect of beta-pinene, alpha-pinene and eugenol on the growth of potential infectious endocarditis causing Gram-positive bacteria Efeito inibitório de eugenol, beta-pineno e alfa-pineno sobre o crescimento de bactérias Gram-positivas potencialmente causadoras de endocardite infecciosa

    Directory of Open Access Journals (Sweden)

    Aristides Medeiros Leite

    2007-03-01

    Full Text Available This study was led with the purpose of evaluating the effectiveness of eugenol, beta-pinene and alpha-pinene in inhibiting the growth of potential infectious endocarditis causing gram-positive bacteria. The phytochemicals Minimum Inhibitory Concentration-MIC was determined by solid medium diffusion procedure, while the interference of the MIC values on the bacterial cell viability was performed by viable cells count. Staphylococcus aureus, S. epidermidis, Streptococcus pneumoniae and S. pyogenes strains were used as test microorganisms. The assayed phytochemicals showed effectiveness in inhibiting all assayed bacteria strains presenting MIC values between 2.5 and 40 µL/mL. Eugenol showed the lowest MIC values which were between 2.5 and 5 µL/mL for the most bacteria strains. MIC values found to the phytochemicals were able to inhibit the cell viability of S. aureus providing a total elimination of the bacteria inoculum in a maximum time of 24 hours of exposure. These data showed the interesting antibacterial property of the assayed phytochemicals and support their possible and rational use in the antimicrobial therapy.Este estudo foi conduzido com a proposta de avaliar a efetividade de eugenol, beta-pineno e alfa-pineno em inibir o crescimento de cepas de bactérias Gram-positivas potencialmente causadoras de endocardite infecciosa. A Concentração Inibitória Mínima-CIM dos fitoconstituintes foi determinada através do método de difusão em meio sólido, enquanto a interferência da CIM sobre a viabilidade celular bacteriana foi avaliada através da contagem de células viáveis. Cepas de Staphylococcus aureus, S. epidermidis, Streptococcus pneumoniae e S. pyogenes foram utilizadas como microrganismos teste nos ensaios antimicrobianos. Os fitoconstituintes ensaiados mostraram efetividade em inibir todas as cepas bacterianas utilizadas como microrganismos testes apresentando valores de CIM entre 2.5 e 40 µL/mL. Eugenol apresentou os menores

  1. Infective endocarditis of a rare etiology: Serratia marcescens

    Directory of Open Access Journals (Sweden)

    Đokić Milomir

    2004-01-01

    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.

  2. Sudden infant death due to Lactococcal infective endocarditis.

    Science.gov (United States)

    Taniguchi, K; Nakayama, M; Nakahira, K; Nakura, Y; Kanagawa, N; Yanagihara, I; Miyaishi, S

    2016-03-01

    Infective endocarditis (IE) of infants is rare, most of which occur associated with congenital heart disease or its cardiac surgery. We experienced a case of sudden death of a four-month-old male infant without congenital heart disease. It was elucidated by postmortem examination that the dead had suffered severe IE, which led him to death. In the microbiological genetic analysis using histological section, the pathogen causing inflammation in the present case was identified as Lactococcus lactis subspecies, although Staphylococci have been reported to be common and important one. Previously reported infectious diseases by Lactococcus lactis subspecies were all adult cases and this is the first report of an infantile death due to Lactococcal IE according to our knowledge. Any fatal disease may be included in sudden death cases targeted for forensic autopsy, even if it is rare. It is expected for forensic pathologists that they note such case and share each experience among themselves and other medical fields to develop a strategy for prevention. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Antibiotic prophylaxis against infective endocarditis in adult and child patients

    Science.gov (United States)

    Al-Fouzan, Afnan F.; Al-Shinaiber, Rafif M.; Al-Baijan, Refal S.; Al-Balawi, Mohammed M.

    2015-01-01

    Objectives: To evaluate dentists’ knowledge regarding the prevention of infective endocarditis in Saudi Arabia and their implementation of the 2007 American Heart Association guidelines. Methods: In this cross-sectional study, in March 2014, 801 dentists who practice in different regions of Saudi Arabia completed a questionnaire regarding the need for antibiotic prophylaxis for specific cardiac conditions and specific dental procedures, prophylaxis regimens in adults and children, and recommendations for patients on chronic antibiotics, and in dental emergencies. The data were analyzed using one-way analyses of variance (ANOVAs) and independent t-tests, and a p-value <0.05 was considered statistically significant. Results: The total knowledge level regarding antibiotic prophylaxis among all participants was 52.2%, with a significant difference between dentists who graduated before and after 2007. Comparing the level of knowledge among different dental specialists, surgeons and periodontists had the highest level of knowledge regarding the use of antibiotic prophylaxis. Amoxicillin was prescribed as the drug of choice by 63.9% of the participants. Conclusion: This study emphasized the need for continuous education and for formal inclusion of the guidelines in the students’ curriculum, as well as for strategic placement of the guidelines in locations throughout dental clinics. PMID:25935175

  4. Infective Endocarditis in Children in Italy from 2000 to 2015.

    Science.gov (United States)

    Esposito, Susanna; Mayer, Alessandra; Krzysztofiak, Andrzej; Garazzino, Silvia; Lipreri, Rita; Galli, Luisa; Osimani, Patrizia; Fossali, Emilio; Di Gangi, Maria; Lancella, Laura; Denina, Marco; Pattarino, Giulia; Montagnani, Carlotta; Salvini, Filippo; Villani, Alberto; Principi, Nicola; Italian Pediatric Infective Endocarditis Registry

    2016-01-01

    The Italian Society for Pediatric Infectious Diseases created a registry on children with infective endocarditis (IE) hospitalized in Italy. A cross-sectional survey was conducted on patients hospitalized due to IE in Italian paediatric wards between January 1, 2000, and June 30, 2015. Over the 15-year study period, 47 IE episodes were observed (19 males; age range, 2-17 years). Viridans Streptococci were the most common pathogens among patients with predisposing cardiac conditions and Staphylococcus aureus among those without (37.9% vs. 5.5%, p = 0.018, and 6.9% vs. 27.8%, p = 0.089, respectively). Six of the 7 (85.7%) S. aureus strains were methicillin-resistant. The majority of patients with and without predisposing cardiac conditions recovered without any complications. In Italy, paediatric IE develops without any previous predisposing factors in a number of children, methicillin-resistant S. aureus has emerged as a common causative agent and the therapeutic approach is extremely variable.

  5. [Clinical guidelines for the prevention of infective endocarditis].

    Science.gov (United States)

    Pérez-Lescure Picarzo, J; Crespo Marcos, D; Centeno Malfaz, F

    2014-03-01

    This article sets out the recommendations for the prevention of infective endocarditis (IE), contained in the guidelines developed by the American Heart Association (AHA) and the European Society of Cardiology (ESC), from which the recommendations of the Spanish Society of Paediatric Cardiology and Congenital Heart Disease have been agreed. In recent years, there has been a considerable change in the recommendations for the prevention of IE, mainly due to the lack of evidence on the effectiveness of antibiotic prophylaxis in prevention, and the risk of the development of antibiotic resistance. The main change is a reduction of the indications for antibiotic prophylaxis, both in terms of patients and procedures considered at risk. Clinical practice guidelines and recommendations should assist health professionals in making clinical decisions in their daily practice. However, the ultimate judgment regarding the care of a particular patient must be taken by the physician responsible. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  6. Bilateral Macular Roth Spots as a Manifestation of Subacute Endocarditis

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    Karolina Ceglowska

    2015-01-01

    Full Text Available A 42-year-old man presented with a 2-day history of impaired vision in the right eye (OD. The best corrected visual acuity (BCVA (LogMAR was 1.1 for the right eye and 0.0 for the left eye (OS. Fundus examination revealed white-centered hemorrhages resembling Roth spots in both macular regions. The spectral-domain optical coherence tomography (SD-OCT showed intraretinal pseudocysts and hyperreflective deposits in the areas corresponding to the Roth spots. Conducted blood tests revealed elevated D-dimer concentration, increased total number of neutrophils, high C-reactive protein concentration, and elevated erythrocyte sedimentation rate. Procalcitonin concentration, platelet count, and body temperature were within normal ranges. A blood culture was ordered and yielded Streptococcus mitis and intravenous antibiotics were started immediately. The patient started complaining of chest and left calf pain. The systemic examination revealed infective endocarditis accompanied by bicuspid aortic valve and paravalvular abscess formation. The patient underwent cardiac surgery with mechanical aortic valve implantation. After recovery, the patient’s visual acuities improved fully. Control ophthalmic examination, including SD-OCT, showed no abnormalities.

  7. Double-valve Libman-Sacks endocarditis causing ventricular fibrillation cardiac arrest.

    Science.gov (United States)

    Tanawuttiwat, Tanyanan; Dia, Muhyaldeen; Hanif, Tabassum; Mihailescu, Mihaela

    2011-01-01

    Libman-Sacks endocarditis is a well-known and rather common cardiac manifestation of systemic lupus erythematosus. Transesophageal and transthoracic echocardiography are the definitive imaging methods used to evaluate cardiac valvular involvement in this disease. Valvular masses (vegetations) and valvular thickening are 2 common morphologic echocardiographic patterns. Libman-Sacks lesions are typically characterized by single-valve involvement and their small size of 1 to 4 mm.Herein, we present the unusual case of a 22-year-old woman with newly diagnosed systemic lupus erythematosus who had large, sterile vegetations of Libman-Sacks endocarditis that involved the mitral and aortic valves. This compromised coronary blood flow and resulted in ventricular fibrillation cardiac arrest. The vegetations were surgically excised, and the patient's cardiac function recovered. We discuss the treatment of the patient and that of Libman-Sacks endocarditis.

  8. Infective endocarditis and osteomyelitis caused by Cellulomonas: a case report and review of the literature.

    Science.gov (United States)

    Lai, Ping-Chang; Chen, Yao-Shen; Lee, Susan Shin-Jung

    2009-10-01

    Cellulomonas spp. are often believed to be of low virulence and have never been reported as a pathogen causing human disease before. We report the first case of endocarditis caused by Cellulomonas and complicated with osteomyelitis of the lumbar spine in a 78-year-old woman. General weakness and aggravated lower back pain followed by sudden-onset of fever and chills were the major presentation. The diagnosis of infective endocarditis in this case was definitely using the Duke criteria. The magnetic resonance imaging of the lumbar spine revealed infective spondylodisciitis at an early stage. After a full course of antibiotics treatment, the patient's fever subsided but her lower back pain persisted. A slow clinical response to appropriate antimicrobial agents was characteristic of Gram-positive bacillary endocarditis.

  9. A case of culture-negative endocarditis due to Streptococcus tigurinus.

    Science.gov (United States)

    Kanamori, Hajime; Kakuta, Risako; Yano, Hisakazu; Suzuki, Tomoyuki; Gu, Yoshiaki; Oe, Chihiro; Inomata, Shinya; Aoyagi, Tetsuji; Hatta, Masumitsu; Endo, Shiro; Tokuda, Koichi; Weber, David J; Nakamura, Yasuhiro; Saiki, Yoshikatsu; Kaku, Mitsuo

    2015-02-01

    Culture-negative endocarditis remains a diagnostic and therapeutic challenge despite recent medical advances. Streptococcus tigurinus, a novel member of the Streptococcus mitis group, was first identified in Zurich. S. tigurinus possesses virulence determinants and causes invasive infections. We report a case of culture-negative endocarditis with serious complications due to S. tigurinus, which was identified by 16S ribosomal RNA gene sequence analysis of excised valve tissue specimens. This technique is useful for identification of the causative microorganism in patients with culture-negative endocarditis and may facilitate early diagnosis and appropriate antimicrobial treatment. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  10. Experimental reproduction of endocarditis with Pasteurella gallinarum in mature leghorn chickens.

    Science.gov (United States)

    Tjahjowati, G; Orr, J P; Chirino-Trejo, M; Mills, J H

    1995-01-01

    The pathogenicity of Pasteurella gallinarum for mature leghorn chickens was investigated by inoculating thirty 52-week-old chickens intravenously with live P. gallinarum. Each chicken was inoculated once daily for 5 days at one of three different dosage levels with either the type strain ATCC 13361 or a field isolate from a chicken with endocarditis. Chickens were necropsied after death or euthanasia. Valvular endocarditis was present in seven chickens given the field isolate and five chickens given the type strain. Other lesions detected were myocarditis, hepatic and splenic infarcts, nephritis, pneumonia, and encephalitis. At necropsy, P. gallinarum was reisolated from hearts, livers, spleens, lungs, kidneys, and blood. Controls injected with sterile broth had no lesions of endocarditis, nor was P. gallinarum isolated from them. The results confirm the pathogenicity of P. gallinarum for the heart valves of mature chickens.

  11. [Iris abscess after bacterial endocarditis in a patient with leukaemia. Differential diagnosis].

    Science.gov (United States)

    Manrique Lipa, R; González Sánchez, E; Asencio Duran, M; Gonzalez-Peramato, P; Fonseca Santodomingo, A

    2014-04-01

    To report a case of iris abscess due to bacterial endocarditis. A 46-year-old male under diagnosis of promielocitic leukemia and endocarditis presented with decreased vision in left eye (OS). Ophthalmic exploration revealed iris abscess and hypopyon with fibrinous exudate in iris of the left eye and tyndall +1 in right eye (OD). Blood culture and anterior chamber paracentesis was positive for methicillin-sensitive Staphylococcus aureus and negative for blastic cells in citology. Treatment with systemic antibiotic was initiated with total resolution of inflammation. Iris abscess is an unusual septic focus in bacterial endocarditis. It is crucial to rule out an extramedullary metastasis in a patient with leukemia due to the general prognosis. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  12. Tricuspid valve endocarditis following central venous cannulation: The increasing problem of catheter related infection

    Directory of Open Access Journals (Sweden)

    Suresh Babu Kale

    2013-01-01

    Full Text Available A central venous catheter (CVC is inserted for measurement of haemodynamic variables, delivery of nutritional supplements and drugs and access for haemodialysis and haemofiltration. Catheterization and maintenance are common practices and there is more to the technique than routine placement as evident when a procedure-related complication occurs. More than 15% of the patients who receive CVC placement have some complications and infectious endocarditis involving the tricuspid valve is a rare and serious complication with high morbidity and mortality. Overenthusiastic and deep insertion of the guide wire and forceful injection through the CVC may lead to injury of the tricuspid valve and predispose to bacterial deposition and endocarditis. We report a case of tricuspid valve endocarditis, probably secondary to injury of the anterior tricuspid leaflet by the guide wire or the CVC that required open heart surgery with vegetectomy and repair of the tricuspid valve.

  13. The associations between socioeconomic status and risk of Staphylococcus aureus bacteremia and subsequent endocarditis

    DEFF Research Database (Denmark)

    Oestergaard, Louise Bruun; Schmiegelow, Michelle D.; Bruun, Niels Eske

    2017-01-01

    BACKGROUND: Staphylococcus aureus bacteremia (SAB) is the leading cause of infective endocarditis in several countries. Since socioeconomic status (SES) is known to influence the risk of infectious diseases in general, we aimed to investigate the association between SES and SAB, and risk...... of subsequent endocarditis in a nationwide adult population. METHODS: All Danish residents were consecutively included at age ≥ 30 years during 1996-2010. We obtained information on SES (highest attained educational level), comorbidities, and microbiologically verified SAB by cross-linking nationwide registries....... The incidence rate ratios (IRRs) of SAB and later endocarditis were investigated using Poisson regression models adjusted for sex, age and year (reference = highest SES). RESULTS: Our study population comprised 3,394,936 individuals (median age = 43.2 years). Over a median follow-up of 15.9 years, 13...

  14. Eikenella corrodens endocarditis and liver abscess in a previously healthy male, a case report

    DEFF Research Database (Denmark)

    Nordholm, Anne Christine; Vøgg, Ruth Ottilia Birgitta; Permin, Henrik

    2018-01-01

    BACKGROUND: Eikenella corrodens is one of the HACEK bacteria constituting part of the normal flora of the oropharynx, however, still an uncommon pathogen. We report a case of a large Eikenella corrodens liver abscess with simultaneously endocarditis in a previously healthy male. CASE PRESENTATION...... on pneumonia treatment, a PET-CT scan was performed, which showed a large multiloculated abscess in the liver. The abscess was drained using ultrasound guidance. Culture demonstrated Eikenella corrodens. Transesophageal echocardiography revealed aortic endocarditis. The patient was treated with antibiotics...... corrodens concurrent liver abscess and endocarditis. The case report highlights that Eikenella corrodens should be considered as a cause of liver abscess. Empirical treatment of pyogenic liver abscess will most often cover Eikenella corrodens, but the recommended treatment is a third generation...

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

    Science.gov (United States)

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

    2014-12-01

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

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

    Science.gov (United States)

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

    2014-03-01

    Ceftaroline fosamil is a new subclass of cephalosporins with high intrinsic activity against various multi-resistant Gram-positive organisms, including Staphylococcus aureus and Streptococcus pneumoniae, as well as against Enterobacteriaceae causing bacteremia and infective endocarditis. Because of its pharmacokinetic profile and pharmacodynamic characteristics, this drug is a good therapeutic option for these infections. Experimental studies have shown good clinical efficacy for the treatment of endocarditis caused by S. aureus, regardless of their sensitivity to methicillin or vancomycin. Clinical experience is limited, although clinical trials and case series have reported a favorable clinical response in patients with bacteremia associated with skin and soft tissue infections, pneumonia, or infective endocarditis. Future studies should define more precisely the role of this new antibiotic in the treatment of these infections. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  17. Multiorgan Involvement Confounding the Diagnosis of Bartonella henselae Infective Endocarditis in Children With Congenital Heart Disease.

    Science.gov (United States)

    Ouellette, Christopher P; Joshi, Sarita; Texter, Karen; Jaggi, Preeti

    2017-05-01

    Two children with congenital heart disease status post surgical correction presented with prolonged constitutional symptoms, hepatosplenomegaly and pancytopenia. Concern for malignancy prompted bone marrow biopsies that were without evidence thereof. In case 1, echocardiography identified a multilobulated vegetation on the conduit valve. In case 2, transthoracic, transesophageal and intracardiac echocardiography were performed and were without evidence of cardiac vegetations; however, pulmonic emboli raised concern for infective endocarditis. Both patients underwent surgical resection of the infected material and had histopathologic evidence of infective endocarditis. Further diagnostics identified elevated cytoplasmic antineutrophil cytoplasmic antibodies and antiproteinase 3 antibodies in addition to acute kidney injury with crescentic glomerulonephritis on renal biopsy. Serologic evidence of infection with Bartonella henselae was observed in both patients. These 2 cases highlight the potential multiorgan involvement that may confound the diagnosis of culture-negative infective endocarditis caused by B. henselae.

  18. Endocarditis with ruptured sinus of Valsalva aneurysm caused by nonvaccine Streptococcus pneumoniae serotype 21.

    Science.gov (United States)

    Patra, Kamakshya P; Vanchiere, John A; Bocchini, Joseph A; Wu, Amy C; Jackson, Robert D; Kiel, Ernest A; Mello, Dennis

    2012-01-01

    Sinus of Valsalva aneurysm is a rare, catastrophic complication of endocarditis. We report an unusual case of ruptured sinus of Valsalva aneurysm associated with endocarditis that was caused by Streptococcus pneumoniae serotype 21. The patient, a 12-year-old girl, underwent surgical repair of the aneurysm and was given intravenous antibiotics for 6 weeks. She was doing well at the 6-week follow-up visit. This case is unusual because of the patient's young age at presentation, the absence of predisposing factors, and the isolation of a nonvaccine serotype 21, which revealed the epidemiologic changes of invasive pneumococcal disease. To our knowledge, this is the first reported case of endocarditis caused by this S. pneumoniae serotype.

  19. Donor-Derived Coccidioides immitis Endocarditis and Disseminated Infection in the Setting of Solid Organ Transplantation.

    Science.gov (United States)

    Nelson, Joanna K; Giraldeau, Genevieve; Montoya, Jose G; Deresinski, Stan; Ho, Dora Y; Pham, Michael

    2016-09-01

    Background.  Endocarditis is a rare manifestation of infection with Coccidioides. This is the first reported case of donor-derived Coccidioides endocarditis obtained from a heart transplant. Methods.  We present a unique case of donor-derived Coccidioides immitis endocarditis and disseminated infection in a heart transplant patient. We also conducted a review of the literature to identify other cases of donor-derived coccidioidomycosis in solid organ transplant recipients and reviewed their clinical characteristics. Results.  Fifteen prior cases of donor-derived coccidioidomycosis were identified. A majority of these cases were diagnosed by positive culture (83%). Mortality was high at 58%. Conclusions.  Clinicians should maintain a high index of suspicion for disseminated coccidioidomycosis in patients who received transplants with organs from donors with a history of residing in endemic regions.

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

    Directory of Open Access Journals (Sweden)

    Manuel Wilbring

    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.

  1. Histologic and bacteriologic findings in valvular endocarditis of slaughter-age pigs

    DEFF Research Database (Denmark)

    Jensen, Henrik E.; Gyllensten, Johanna; Hofman, Carolina

    2010-01-01

    Endocarditis lesions from 117 slaughter pigs were examined pathologically and etiologically in addition to 90 control hearts with cardiac valves. Lesions were located on the valves; however, the lesions had extended to the walls in 21 cases (18%). Lesions predominated on the mitral valve (59....... The propensity for streptococci to be localized on more than 1 valve in single hearts may be because S. suis-infected pigs tend to have been infected for a longer period compared with E. rhusiopathiae. Mineralization of endocarditis lesions was significantly associated with infection by streptococci...... to dystrophic mineralization. Local proliferation of valvular endothelial cells, found in 9 hearts in the current study, may increase the risk of developing thrombosing endocarditis in pigs....

  2. Prevalencia de vaginosis bacteriana en trabajadoras sexuales chilenas Prevalence of bacterial vaginosis in Chilean sex workers

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    Gloria Venegas

    2011-07-01

    Full Text Available OBJETIVO: Determinar la prevalencia de vaginosis bacteriana (VB en trabajadoras sexuales chilenas y relacionar los hallazgos con variables sociodemográficas, sexuales y clínicas. MÉTODO: Se estudió una muestra de 379 trabajadoras sexuales que asistían para control a Unidades de Atención y Control de Salud Sexual de Chile. A todas se las entrevistó para obtener antecedentes sociodemográficos y sexuales, se les realizó evaluación clínica que incluyó características del flujo vaginal, pH y prueba de aminas, y se les tomó una muestra vaginal para tinción de Gram. Para el diagnóstico de VB se empleó el criterio de Nugent. Los datos fueron analizados con EPI-INFO 3.4.1 y BioStat, utilizándose un grado de significación de P OBJECTIVE: To determine the prevalence of bacterial vaginosis (BV in Chilean sex workers and relate the findings to sociodemographic, sexual, and clinical variables. METHODS: A sample of 379 sex workers seen in Chilean Sexual Health Monitoring and Care Units for check-ups was studied. All of them were interviewed to obtain their sociodemographic and sexual history. A clinical examination was performed that included the characteristics of vaginal discharge, pH, and amine test. A vaginal sample was taken for Gram stain. The Nugent criteria were used for the diagnosis of BV. The data was analyzed with EPI-INFO 3.4.1 and BioStat, using a degree of significance of P < 0.005. RESULTS: BV prevalence was 69.1%. The syndrome was not associated with the sociodemographic variables, age or education. BV was less common in women (married or unmarried who lived with their partners than in single women (P < 0.001. There were no sexual variables associated with BV, whereas use of intrauterine devices was related (P < 0.0001. The presence of vaginal discharge, abnormal vaginal pH, and positive amine test were associated with infection (P < 0.0001. CONCLUSIONS: Like other studies conducted in different countries, this study

  3. Infecciones por bacterias poco comunes y oncogénesis bacteriana

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    Horacio A. Lopardo

    Full Text Available La recuperación de algunos microorganismos de aislamiento esporádico en el laboratorio de microbiología clínica podría significar la existencia de algún defecto inmunitarioespecial en el paciente. Por ejemplo, se ha descrito una importante correlación entre Clostridium septicum y carcinoma de colon, y se han visto relacionadas con leucemias y linfomas a especies que aparecen casi siempre como contaminantes (Bacillus spp., Corynebacterium spp. y a otras raramente aisladas en otros contextos (Capnocytophaga spp.. Hay bacterias que se aíslan casi exclusivamente de pacientes con sida (Rhodococcus equi. Se ha observado una mayor frecuencia de infecciones por Campylobacter spp., Aeromonas spp. y estreptococos del grupo G y del grupo mitis en individuos con algún tipo de cáncer que en el resto de los pacientes. También hay bacterias que son marcadoras de algún cáncer no detectado o que afectan más a pacientes neutropénicos que a individuos normoinmunes. La alteración de la reacción inflamatoria, la linfoproliferación mediada por antígenos bacterianos y la inducción de hormonas que aumentan la proliferación de las células epiteliales podrían ser causas de la oncogénesis bacteriana. Los ejemplos clásicos son el adenocarcinoma gástrico inducido por Helicobacter pylori, la asociación de la bacteriemia por estreptococos del grupo bovis y el cáncer de colon y los linfomas de tejido linfoide asociado a mucosas (MALT en vinculación con especies de Helicobacter (MALT gástricos y con Chlamydophila spp. (MALT oculares. El aislamiento de alguno de estos patógenos debería ser un llamado de atención para inducir al estudio de alguna enfermedad maligna.

  4. Tratamiento de agrandamiento gingival inducido por fenitoina asociado a placa bacteriana

    Directory of Open Access Journals (Sweden)

    Carmen Julia Rovira

    2013-10-01

    Full Text Available ResumenLa ingesta de algunos medicamentos puede producir un sobre crecimiento de las encías. Se reportan medicamentos tales como los bloqueadores de los canales de calcio, inmunosupresores, anticonvulsivantes que producen estos efectos adversos. Múltiples casos de agrandamientos gingivales están asociados a la ingesta de Fenitoína. El tratamiento de los agrandamientos gingivales inducidos por drogas por lo general es quirúrgico, pero mantener un buen control de placa bacteriana puede evitar en muchos casos que se presente un exagerado aumento de volumen gingival. Se presenta un caso de agrandamiento gingival en paciente masculino de 22 años de edad, bajo tratamiento antiepiléptico con fenitoína. Al examen clínico se observó aumento del volumen gingival de forma generalizada, en maxilar superior e inferior, predominante en sector anterior, produciendo ardor y sangrado durante el cepillado y la ingestión de alimentos. Al sondaje presenta múltiples pseudobolsas en los diferentes cuadrantes. La radiografía panorámica reveló pérdida ósea moderada horizontal, predominante en el sector posterosuperior, posteroinferior y anteroinferior. El plan de tratamiento consistió en fase higiénica, instrucción y motivación en higiene oral a la madre, gingivectomía y gingivoplastía en ambos maxilares. (DUAZARY 2011 No. 2, 226 - 231Abstract The importance of endodontic treatment is to achieve a complete filling and sealing of the root canal to prevent the transport of contaminants to and from root canal, with materials compatible with the surrounding tissues. Occasionally a situation may arise in which the purpose of the maintenance of working length is compromised such as overenlargement. This situation allows the extrusion of filling materials, mainly sealer cements, causing post treatment complications such as inflammatory reactions, injury to adjacent structures (orbital pain, inferior alveolar nerve injury, headache, etc., and infections

  5. Las meningoencefalitis bacterianas en la población infantil cubana: 1998-2000

    Directory of Open Access Journals (Sweden)

    Félix Orlando Dickinson Meneses

    2002-06-01

    Full Text Available Se describen algunos aspectos epidemiológicos de las meningoencefalitis bacterianas (MEB en Cuba entre 1998 y el año 2000, según los datos de la Vigilancia Nacional de las MEB (VNMEB disponibles. Se reportaron un total de 530 casos en menores de 15 años en todo el país durante el período. El grupo de edad más afectado resultó el de menos de 5 años. Los agentes más frecuentemente identificados fueron Haemophilus influenzae tipo b (Hib, Streptococcus pneumoniae (Spn y Neisseria meningitidis (Nm. La incidencia de Hib disminuyó 4 veces por el efecto de la vacunación masiva, especialmente en los menores de 5 años, a partir del año 2000 Spn es el principal agente causante de MEB y el más letal en Cuba. La letalidad general se incrementó de 10,6 a 20,4 %, y fue el grupo de los de menos de 1 año uno de los más afectados. Futuros estudios permitirán profundizar en la epidemiología de estas infecciones y monitorear los cambios que ocurran como consecuencia de intervenciones.Somme epidemiological aspects of bacterial meningoencephalities that occurred in Cuba from 1998-2000 are described according to available data from the National Surveillance Service. A total of 530 cases involving children under 15 years old were reported throughout the country in this period of time. The most affected age group was under 5 years. The most frequent identified agents were Haemophilus influenzae type B(Hib, Streptococcus pneumoniae (Spn and Neisseria meningitidis (Nm. The incidence of Hib decreased by 4 times thanks to massive vaccination program, particularly in under 5 years-old children, from the year 2000 on. Spn is the main causative agent of bacterial meningoencephalities and the most lethal one in Cuba. General lethality rate increased from 10.6 to 20.4% and the under one-year old age group was the most affected. Further studies will allow deepening into the epidemiology of these infections and monitoring the changes that might occur as a

  6. The unique clinical features and outcome of infectious endocarditis and vertebral osteomyelitis co-infection.

    Science.gov (United States)

    Koslow, Matthew; Kuperstein, Rafael; Eshed, Iris; Perelman, Marina; Maor, Elad; Sidi, Yechezkel

    2014-07-01

    The clinical significance of vertebral osteomyelitis and infectious endocarditis co-infection is unclear. This study investigates the rate, clinical features, and outcome of vertebral osteomyelitis with and without concomitant infectious endocarditis. A retrospective study of all cases of osteomyelitis with spinal imaging (n = 176), from January 2007 to April 2013, that were diagnosed as vertebral osteomyelitis. Sixty-two patients with spontaneous vertebral osteomyelitis were identified after excluding postsurgical, decubitus ulcers and spinal metastases. Seventeen (27%) were identified with concomitant infectious endocarditis. All patients presented with back pain and 59% were diagnosed with infectious endocarditis subsequent to vertebral osteomyelitis. Distinguishing features among the co-infection group include the increased use of transesophageal echocardiography (94% vs 58%, P = .004), predisposing cardiac conditions (59% vs 16%, P = .001), and Gram-positive bacteremia, of which Streptococcus sp. and Enterococcus sp. were more common (35% vs 11%, P = .026). Adverse neurologic events were increased significantly in the co-infection group (59% vs 22%, P = .006). On transesophageal echocardiography, 88% of co-infection patients had highly mobile vegetations, 9 of which measured 10 mm or more. The overall mortality was 41% and 29% in the co-infection and lone vertebral osteomyelitis groups, respectively (P = .356). One-year mortality was identical for both groups at 24% (P = .999), and higher than previously reported (11.3% for lone vertebral osteomyelitis). Patients with vertebral osteomyelitis, in whom infectious endocarditis is not excluded, are at increased risk for adverse neurologic events and mortality. The prompt diagnosis of infectious endocarditis, and associated high-risk features that may benefit from surgical intervention, require early evaluation by transesophageal echocardiography. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Tiempo libre de enfermedad en infecciones urinarias recurrentes según profilaxis con antibiótico o con vacuna bacteriana

    OpenAIRE

    Santo Bueno, Pedro José

    2014-01-01

    [ES]Estudio comparativo de dos tipos de tratamientos profilacticos, antibioterapia supresiva y vacuna bacteriana, en infecciones urinarias de repetición, para determinar el tiempo libre de enfermedad, entendida como el tiempo transcurrido entre la finalización de la profilaxis y la aparición de un episodio de infeccion urinario.

  8. Blood culture negative endocarditis: analysis of 63 cases presenting over 25 years.

    Science.gov (United States)

    Lamas, C C; Eykyn, S J

    2003-03-01

    To analyse cases of blood culture negative endocarditis (BCNE) seen at St Thomas' Hospital, London, between 1975 and 2000. Data on all episodes of endocarditis with negative blood cultures seen at St Thomas' Hospital between 1975 and 2000 were collected prospectively and analysed retrospectively. Sixty three patients with BCNE were seen during the study period: 48 (76%) with native and 15 (24%) prosthetic valve infection. BCNE accounted for 12.2% of the 516 cases of endocarditis seen at St Thomas' Hospital. The diagnosis of endocarditis was clinically definite by the Duke criteria in only 21% (7 of 34) of cases of pathologically proven native valve endocarditis but in 62% (21 of 34) of cases by the St Thomas' modifications of the criteria. Comparable figures for the 11 cases of pathologically proven prosthetic valve endocarditis were 45% and 73%. Despite negative blood cultures a causative organism was identified in 31 (49%) of the 63 cases: in 15 by serology (8 Coxiella burnetii, 6 Bartonella species, and 1 Chlamydia psittaci); in 9 cases by culture of the excised valve; in 3 by microscopy of the excised valve, on which large numbers of Gram positive cocci were seen although the culture was sterile; and in the other 4 by isolation from a site other than the excised valve (2 respiratory specimens, 1 from the pacemaker tip, and 1 from an excised embolus). In addition 5 of the 6 cases of Bartonella infection were confirmed by polymerase chain reaction study of the excised valve. Two thirds of the 32 patients for whom no pathogen was identified had received antibiotics before blood was cultured. Thus truly "negative" endocarditis was very uncommon (6% of the cases). If blood cultures are negative in definite or suspected endocarditis, serum should be analysed for Bartonella, Coxiella, and Chlamydia species antibodies, and the excised valve or (rarely) embolus should be analysed by microscopy, culture, histology, and relevant polymerase chain reaction. Other specimens

  9. Endocarditis caused by Staphylococcus warneri on a normal aortic valve following vasectomy.

    Science.gov (United States)

    Dan, M; Marien, G J; Goldsand, G

    1984-08-01

    Endocarditis caused by Staphylococcus warneri and necessitating valve replacement occurred in a previously healthy 32-year-old patient following vasectomy. No sign of an underlying valvular defect was noted during the operation. S. warneri is a recently identified species of coagulase-negative staphylococci. Endocarditis caused by coagulase-negative staphylococci is uncommon in young, healthy patients with normal heart valves and has not previously been described as a complication of vasectomy. Similarly, infections caused by S. warneri have not previously been described in humans.

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

    Science.gov (United States)

    Logar, Mateja; Lejko-Zupanc, Tatjana

    2013-06-01

    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.

  11. Rapidly Progrediating Aortic Valve Infective Endocarditis in an Intravenous Drug User Treated by Antibiotics and Surgery

    Directory of Open Access Journals (Sweden)

    Malkia S. Swedi

    2012-01-01

    Full Text Available We report the case of a 22-year old male, a self-confessed recreational drug user who developed cardiogenic shock because of severe destruction of the aortic valve by rapidly progressive aortic valve endocarditis. The disease progression was acute; in a matter of days, the clinical manifestations were life-threatening necessitating urgent aortic valve replacement surgery. Cultivation revealed Streptococcus viridans as the microbial agent. Subsequent recovery with antibiotic treatment was without complication. This case report shows that immediately performed transoesophageal echocardiography and early consultation with a cardiac surgeon has fundamental importance in diagnosis and management of acute infective endocarditis in haemodynamically instable patients.

  12. Infectious Endocarditis Presenting as Intracranial Hemorrhage in a Patient Admitted for Lumbar Radiculopathy

    Directory of Open Access Journals (Sweden)

    David Ethan Kahn

    2011-01-01

    Full Text Available Infectious endocarditis is frequently found in the neurologic intensive care unit and may rarely be the cause of intracranial hemorrhage. In such instances, further diagnostic imaging to search for an underlying structural lesion is prudent. Well-known causes of these hemorrhages include cardioembolism with hemorrhagic transformation, septic emboli, and mycotic aneurysms. We present a case of a patient who was admitted for routine evaluation and pain management of lumbar radiculopathy, who developed a large intraparenchymal hemorrhage and was found to have bacterial endocarditis. This was diagnosed retrospectively from positive hematoma cultures and a vegetation on transesophageal echocardiogram. Further evaluation revealed a mycotic aneurysm.

  13. Warfarin therapy and incidence of cerebrovascular complications in left-sided native valve endocarditis

    DEFF Research Database (Denmark)

    Snygg-Martin, U; Rasmussen, Rasmus Vedby; Hassager, C

    2011-01-01

    Anticoagulant therapy has been anticipated to increase the risk of cerebrovascular complications (CVC) in native valve endocarditis (NVE). This study investigates the relationship between ongoing oral anticoagulant therapy and the incidence of symptomatic CVC in left-sided NVE. In a prospective...... factors for CVC, while warfarin on admission (aOR 0.26, 95% CI 0.07-0.94), history of congestive heart failure (adjusted OR 0.22, 95% CI 0.1-0.52) and previous endocarditis (aOR 0.1, 95% CI 0.01-0.79) correlated with lower CVC frequency....

  14. Delayed diagnosis of Q fever endocarditis in a rheumatoid arthritis patient

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    Shailee Y. Shah

    2015-01-01

    Full Text Available Chronic Q fever caused by Coxiella burnetii is uncommon in the United States and is most often associated with infective endocarditis. We present a 52-year-old woman with a history of aortic valve replacement and rheumatoid arthritis treated with Etanercept with chronic Q fever manifesting as prosthetic valve infective endocarditis. Explanted valve tissue showed organisms confirmed to be C. burnetii by PCR (polymerase chain reaction sequencing. She subsequently reported consumption of unpasteurized cow milk which was the likely source of C. burnetii. She continues to do well 6 months after valve replacement on oral doxycycline and hydroxychloroquine.

  15. Infective endocarditis epidemiology over five decades: a systematic review.

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    Leandro Slipczuk

    Full Text Available AIMS: To Assess changes in infective endocarditis (IE epidemiology over the last 5 decades. METHODS AND RESULTS: We searched the published literature using PubMed, MEDLINE, and EMBASE from inception until December 2011. DATA FROM: Einstein Medical Center, Philadelphia, PA were also included. Criteria for inclusion in this systematic review included studies with reported IE microbiology, IE definition, description of population studied, and time frame. Two authors independently extracted data and assessed manuscript quality. One hundred sixty studies (27,083 patients met inclusion criteria. Among hospital-based studies (n=142; 23,606 patients staphylococcal IE percentage increased over time, with coagulase-negative staphylococcus (CNS increasing over each of the last 5 decades (p<0.001 and Staphylococcus aureus (SA in the last decade (21% to 30%; p<0.05. Streptococcus viridans (SV and culture negative (CN IE frequency decreased over time (p<0.001, while enterococcal IE increased in the last decade (p<0.01. Patient age and male predominance increased over time as well. In subgroup analysis, SA frequency increased in North America, but not the rest of the world. This was due, in part, to an increase in intravenous drug abuse IE in North America (p<0.001. Among population-based studies (n=18; 3,477 patients no significant changes were found. CONCLUSION: Important changes occurred in IE epidemiology over the last half-century, especially in the last decade. Staphylococcal and enterococcal IE percentage increased while SV and CN IE decreased. Moreover, mean age at diagnosis increased together with male:female ratio. These changes should be considered at the time of decision-making in treatment of and prophylaxis for IE.

  16. Clinical experience of infective endocarditis complicated by acute cerebrovascular accidents.

    Science.gov (United States)

    Hsu, Chan-Yang; Chi, Nai-Hsin; Wang, Shoei-Shen; Chen, Yih-Sharng; Yu, Hsi-Yu

    2017-04-01

    To evaluate the clinical results of patients with infective endocarditis (IE) complicated by acute cerebrovascular accidents (CVAs). A total of 44 patients with IE complicated by CVA at admission were retrospectively analyzed in a single medical institute from 2005 to 2011. At the time of admission, 18 patients were diagnosed with hemorrhagic stroke, and 26 patients were diagnosed with ischemic stroke. Fifteen patients received surgical intervention during hospitalization. The hospital mortality rate was 38.9% for the hemorrhagic stroke group and 42.3% for the ischemic stroke group (p = 0.821). The mortality rate was 33.3% for the surgical group and 44.8% for the nonsurgical group (p = 0.531). At 30 days of hospitalization, 45.8% of the patients experienced an adverse event (defined as death due to organ failure, restroke, cardiogenic shock, or septic shock during the treatment period), and the attrition rate was 1.5% per day. Surgery performed after the adverse events increased mortality (80.0%) compared with surgery performed on patients with no adverse events (10.0%; p = 0.017). A Cox regression analysis revealed that creatinine > 2 mg/dL, diabetes, and staphylococcal infection were the risk factors of the adverse events. Early surgical intervention for IE with ischemic stroke may prevent adverse events, particularly in patients with impaired renal function, diabetes, or staphylococcal infection. A delay in operation of > 30 days is recommended after hemorrhagic stroke. Copyright © 2017. Published by Elsevier Taiwan.

  17. Prosthetic Valve Endocarditis: Early Outcome following Medical or Surgical Treatment

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    Banafsheh Alinejad

    2008-12-01

    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.

  18. Prevalencia de vaginitis y vaginosis bacteriana en pacientes con flujo vaginal anormal en el Hospital Nacional Arzobispo Loayza

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    Ruth Medina

    1999-10-01

    Full Text Available Objetivo: Determinar la prevalencia de vaginitis y vaginosis bacteriana en pacientes con flujo vaginal y su asociación con características clínicas y de laboratorio. Material y métodos: Se llevó a cabo un estudio transversal. Se estudiaron 370 pacientes que acudieron a la consulta ginecológica del Hospital Nacional Arzobispo Loayza de enero a marzo de 1998. A todas las pacientes se les tomó muestras de flujo vaginal para la medición del pH, del test de amina y la identificación microscópica de "células clave", Trichomonas vaginalis, levaduras e hifas. Resultados: La prevalencia de infección vaginal fue de 42.2%; siendo vaginosis bacteriana la infección más frecuente (23.24%, seguido de candidiasis vaginal (16.2% y tricomoniasis vaginal (7.8%. Vaginosis bacteriana estuvo asociada a mal olor postcoital, ausencia de signos inflamatorios en vagina, flujo vaginal blanquecino, lechoso, homogéneo y fétido. La candidiasis vaginal estuvo asociada a prurito, ardor vulvovaginal, eritema vulvar y vaginal, flujo vaginal amarillento, grumoso sin olor, test de amina negativo; así como ausencia de relaciones sexuales, ningún compañero sexual en el último año, ninguna gestación, una vida sexual menor de dos años y paridad de ninguno a un hijo. La tricomoniasis vaginal estuvo asociada a eritema vaginal, flujo vaginal amarillo verdoso, espumoso, homogéneo y fétido y test de amina positivo. Conclusión: Un diagnóstico correcto y oportuno de las infecciones vaginales no debe basarse sólo en las características clínicas sino en la confirmación con métodos sencillos de laboratorio. ( Rev Med Hered 1999; 10:144-150 .

  19. Risk of infective endocarditis in patients with systemic lupus erythematosus in Taiwan: a nationwide population-based study.

    Science.gov (United States)

    Chang, Y S; Chang, C C; Chen, Y H; Chen, W S; Chen, J H

    2017-10-01

    Objectives Patients with systemic lupus erythematosus are considered vulnerable to infective endocarditis and prophylactic antibiotics are recommended before an invasive dental procedure. However, the evidence is insufficient. This nationwide population-based study evaluated the risk and related factors of infective endocarditis in systemic lupus erythematosus. Methods We identified 12,102 systemic lupus erythematosus patients from the National Health Insurance research-oriented database, and compared the incidence rate of infective endocarditis with that among 48,408 non-systemic lupus erythematosus controls. A Cox multivariable proportional hazards model was employed to evaluate the risk of infective endocarditis in the systemic lupus erythematosus cohort. Results After a mean follow-up of more than six years, the systemic lupus erythematosus cohort had a significantly higher incidence rate of infective endocarditis (42.58 vs 4.32 per 100,000 person-years, incidence rate ratio = 9.86, p lupus erythematosus cohort had lower risk (adjusted hazard ratio 11.64) than that of the younger-than-60-years systemic lupus erythematosus cohort (adjusted hazard ratio 15.82). Cox multivariate proportional hazards analysis revealed heart disease (hazard ratio = 5.71, p lupus erythematosus patients. Conclusions A higher risk of infective endocarditis was observed in systemic lupus erythematosus patients. Risk factors for infective endocarditis in the systemic lupus erythematosus cohort included heart disease, chronic kidney disease, steroid pulse therapy within 30 days, and a recent invasive dental procedure within 30 days.

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

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    Elsa Fleitas Ruisánchez

    2011-12-01

    Full Text Available Objetivo: estudiar las características clínicas, epidemiológicas y microbiológicas, así como el tratamiento médico quirúrgico de los pacientes ingresados con el diagnóstico de endocarditis infecciosa, con el propósito de profundizar en su estudio y contribuir a un mejor tratamiento a estos pacientes. Métodos: se estudiaron 24 pacientes procedentes de todo el país, egresados con el diagnóstico de endocarditis infecciosa. Los datos fueron recogidos de las historias clínicas procedentes del archivo del Hospital "William Soler", y de la base de datos del servicio de cirugía del cardiocentro. Se determinó la frecuencia de las diferentes manifestaciones de la endocarditis infecciosa según: grupos etarios, factores de riesgo, y los datos clínicos, de laboratorio y microbiológicos más frecuentes. Además, se determinó la toma valvular predominante, la etiología y su respuesta a los antibióticos. Resultados: el grupo de edad más afectado fue entre 5 y 18 años; la cardiopatía previa fue el factor de riesgo predominante; los síntomas y signos más frecuentes fueron la fiebre, la anorexia y la pérdida de peso. La insuficiencia cardiaca y el embolismo pulmonar fueron complicaciones frecuentes. La mayoría de los pacientes tuvo una eritrosedimentación acelerada, y la cuarta parte de los casos presentaron hemocultivos negativos. Las válvulas aórtica y mitral resultaron las más afectadas, y el curso clínico que predominó fue el subagudo. En casi la mitad de los pacientes la infección tuvo un origen nosocomial. Los antimicrobianos más utilizados fueron la amikacina, la vancomicina y la ceftriaxona. Conclusiones: la endocarditis infecciosa es poco frecuente en nuestra institución, ocurre más a menudo en relación con las cardiopatías congénitas. Los hechos clínicos más constantes fueron la fiebre y el antecedente de cardiopatía previa.Objective: to study the clinical, epidemiological and microbiological characteristics as

  1. Mitral valve replacement in a patient with infective endocarditis and aneurysm of the cerebral artery: A case report

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    Senka Mesihović-Dinarević

    2014-11-01

    Full Text Available Objective. Endocarditis can have profound and devastating neurological consequences, with the vast majority of these complications in patients with left-sided valvular disease. The approach to the acute management of stroke in children with infective endocarditis is limited by the inadequacy of published data on their clinical course and outcome. Case report. This case report presents a 12 year old girl with diagnosed endocarditis, complicated with intracranial hemorrhage, due to the rupture of an aneurysm of the peripheral branch medial cerebral artery and gradient therapeutic approach, with an excellent final result. Conclusion. Congestive heart failure resulting from valvular insufficiency required mitral valve replacement, after cerebral aneurysm clipping.

  2. Infective Endocarditis Associated with Streptococcal Toxic Shock Syndrome due to Streptococcus dysgalactiae subsp. equisimilis Infection in a Hemodialysis Patient

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    Momoko Kan

    2017-11-01

    Full Text Available The risk of infective endocarditis in chronic hemodialysis patients is markedly higher than that in the general population. We report the first case of a hemodialysis patient with infective endocarditis caused by Streptococcus dysgalactiae subsp. equisimilis (SDSE who presented with streptococcal toxic shock syndrome. In the last decade, there has been an increase in the incidence of SDSE infections. Therefore, it is important to recognize SDSE as a possible causative agent of infective endocarditis in an immunocompromised population, such as hemodialysis patients.

  3. Löffler endocarditis: a rare cause of acute cardiac failure

    NARCIS (Netherlands)

    N.D. Niemeijer; P.L.A. van Daele (Paul); K. Caliskan (Kadir); F.B. Oei (Frans); O.J.L. Loosveld (Olaf); N.J.M. van der Meer (Nardo)

    2012-01-01

    textabstractWe describe a patient with acute cardiogenic shock due to cardiac involvement in idiopathic hypereosinophilic syndrome (Löffler endocarditis). At the echocardiography, there was a huge mass in the left ventricular cavity, resulting in inflow- and outflow tract obstruction. The posterior

  4. Aorto-enteric Fistula 15 Years After Uncomplicated Endovascular Aortic Repair with Unforeseen Onset of Endocarditis

    DEFF Research Database (Denmark)

    Kadhim, M M K; Rasmussen, J B G; Eiberg, J P

    2016-01-01

    Introduction Aorto-enteric fistula after endovascular aortic repair is an exceedingly rare but serious condition. Report A rare case of a fistula between the excluded aortic sac and the transverse colon 15 years after endovascular aortic repair is described. Onset was endocarditis without...

  5. Cardiac computed tomography angiography results in diagnostic and therapeutic change in prosthetic heart valve endocarditis

    NARCIS (Netherlands)

    Habets, Jesse; Tanis, Wilco; van Herwerden, Lex A.; van den Brink, Renee B. A.; Mali, Willem P. Th M.; de Mol, Bas A. J. M.; Chamuleau, Steven A. J.; Budde, Ricardo P. J.

    2014-01-01

    Echocardiography may miss prosthetic heart valve (PHV) endocarditis which advocates for novel imaging techniques to improve diagnostic accuracy and patient outcome. The purpose of this study was to determine the complementary diagnostic value of cardiac computed tomography angiography (CTA) to the

  6. Libman–Sacks endocarditis, and other echocardiographic findings in systemic lupus erythematosus: Case report

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    Mohamed Atef Hamza

    2012-09-01

    Full Text Available Case report of a 19 year-old female patient with systemic lupus erythematosus (SLE who was presented to Ain Shams University Hospital complaining of dyspnea on moderate exertion. Echocardiography showed the presence of sterile vegetation on the mitral valve, Libman–Sacks endocarditis (LSE.

  7. Bilateral Acromioclavicular Septic Arthritis as an Initial Presentation of Streptococcus pneumoniae Endocarditis

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    Neda Hashemi-Sadraei

    2014-01-01

    Full Text Available Infective endocarditis (IE is infrequently associated with septic arthritis. Moreover, septic arthritis of the acromioclavicular (AC joint is rarely reported in the literature. We report a case of Streptococcus pneumoniae IE in a patient who presented with bilateral AC joint septic arthritis and we review the literature on the topic.

  8. Bilateral Acromioclavicular Septic Arthritis as an Initial Presentation of Streptococcus pneumoniae Endocarditis

    OpenAIRE

    Hashemi-Sadraei, Neda; Gupta, Rohan; Machicado, Jorge D.; Govindu, Rukma

    2014-01-01

    Infective endocarditis (IE) is infrequently associated with septic arthritis. Moreover, septic arthritis of the acromioclavicular (AC) joint is rarely reported in the literature. We report a case of Streptococcus pneumoniae IE in a patient who presented with bilateral AC joint septic arthritis and we review the literature on the topic.

  9. [Embolic stroke by thrombotic non bacterial endocarditis in an Antiphospholipid Syndrome patient].

    Science.gov (United States)

    Graña, D; Ponce, C; Goñi, M; Danza, A

    2016-01-01

    The antiphospholipid syndrome (APS) is an acquired thrombophilia, considered a systemic autoimmune disorder. We report a patient with APS who presented multiple cerebral infarcts (stroke) as a complication of a thrombotic non bacterial endocarditis. We review the literature focused on the physiological mechanism that produce this disease and its complications. Clinical features and their prognostic value and the different therapeutic options were also studied.

  10. Pediatric Infective Endocarditis: Has Staphylococcus aureus Overtaken Viridans Group Streptococci as the Predominant Etiological Agent?

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    Aisha Alshammary

    2008-01-01

    Full Text Available BACKGROUND: Viridans group streptococci (VGS have traditionally been the most common etiological agents of infective endocarditis (IE. Advances in cardiovascular surgery and the increasing use of long-term central venous catheters may have altered the epidemiology of pediatric IE.

  11. Involvement of Kytococcus schroeteri in a case of prosthetic valve endocarditis

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    Antonella D’Andria

    2008-03-01

    Full Text Available We report a fourth case of prosthetic valve endocarditis caused by the newly described micrococcal species: Kytococcus schroeteri. A 38-year old male was admitted to our hospital with suspected prosthetic valve endocarditis. In three blood cultures and in the prosthetic heart valve culture grew the same type of microrganism, initially identified as Micrococcus luteus. Presuntive assignment to the genus Kytococcus was suggested by the arginina dihydrolase activity and by the resistence to penicillin, oxacillin and methicillin, characteristics which are not shared by other micrococci. Further biochemical tests confirmed that the isolates belonged to the genus Kytococcus (negative reaction for oxydase, esculin and urease, positive for catalase and arginine dihydrolase species schroeteri (alpha-glucosidase positive. The patient was treated with vancomycin, gentamicin and rifampicin. After the valve replacement, on the 20th day of hospitalization, the patient’s biological parameters returned to normal values, and after one mounth the resolution of the disease was completed. The diagnosis of four cases by K. schroeteri endocarditis, described within a short period of time (2003-2006, might indicate a specific pathogenicity of this new species. In case of endocarditis diagnosis, the suspect of the genus Kytococcus involvement should be considered each time the aerobic Gram positive cocci, with arginina dihidrolase activiy and the resistence to penicillin, oxacillin and methicillin, are isolated by significative biological samples.

  12. [A case with tricuspid valve brucella endocarditis presenting with acute right heart failure].

    Science.gov (United States)

    Yazıcı, Hüseyin Uğur; Mert, Kadir Uğur; Senol, Utku; Ulus, Taner

    2012-06-01

    Although the presence of brucella endocarditis is encountered rarely, it is the most fetal complication of brucellosis, which is shown to affect the aortic valve primarily and the mitral valve secondarily. Involvement of the tricuspid valve is extremely rare. A 62-year-old female was admitted with complaints of fever, fatigue, difficulty in breathing, and swellings in her legs. A transthoracic echocardiogram was performed since acute right heart failure was considered due to her symptoms. The echocardiogram showed enlarged right heart chambers, serious tricuspid valve insufficiency, and a mass on the tricuspid valve compatible with a vegetation moving in and out of the right ventricle. Although no growths were observed in the blood culture, antibody titration for brucellosis was found to be 1/640 (+) in the serological examination. The patient was diagnosed with brucella endocarditis and placed on doxycycline, rifampicin, and ceftriaxone treatment for eight weeks. At the end of the eight-week treatment, the symptoms of right heart failure receded and the patient recovered from the endocarditis. Tricuspid valve brucella endocarditis should be considered in patients suffering from acute right heart failure accompanied by systemic infection findings since brucellosis is presently endemic in Turkey.

  13. An unusual etiological agent of implantable cardioverter device endocarditis: Corynebacterium mucifaciens

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    Adnan Kaya

    2016-03-01

    Full Text Available Cardiac pacing devices and implantable cardioverter defibrillator (ICD are becoming the mainstay of therapy in cardiology and infective endocarditis (IE and pocket infection; however, these devices require careful monitoring. Here, we describe a case of a 68-year-old female with an ICD presenting with a previously unknown etiological agent of IE, Corynebacterium mucifaciens.

  14. Turning 18 with congenital heart disease : prediction of infective endocarditis based on a large population

    NARCIS (Netherlands)

    Verheugt, Carianne L.; Uiterwaal, Cuno S. P. M.; van der Velde, Enno T.; Meijboom, Folkert J.; Pieper, Petronella G.; Veen, Gerrit; Stappers, Jan L. M.; Grobbee, Diederick E.; Mulder, Barbara J. M.

    Aims The risk of infective endocarditis (IE) in adults with congenital heart disease is known to be increased, yet empirical risk estimates are lacking. We sought to predict the occurrence of IE in patients with congenital heart disease at the transition from childhood into adulthood. Methods and

  15. Turning 18 with congenital heart disease: prediction of infective endocarditis based on a large population

    NARCIS (Netherlands)

    Verheugt, Carianne L.; Uiterwaal, Cuno S. P. M.; van der Velde, Enno T.; Meijboom, Folkert J.; Pieper, Petronella G.; Veen, Gerrit; Stappers, Jan L. M.; Grobbee, Diederick E.; Mulder, Barbara J. M.

    2011-01-01

    The risk of infective endocarditis (IE) in adults with congenital heart disease is known to be increased, yet empirical risk estimates are lacking. We sought to predict the occurrence of IE in patients with congenital heart disease at the transition from childhood into adulthood. We identified

  16. Subacute bacterial endocarditis presenting as polymyalgia rheumatica or giant cell arteritis.

    Science.gov (United States)

    Auzary, C; Le Thi Huong, D; Delarbre, X; Sbai, A; Lhote, F; Papo, T; Wechsler, B; Cacoub, P; Martin-Hunyadi, C; Piette, J-C

    2006-01-01

    To report on several patients with subacute bacterial endocarditis who were initially presumed, incorrectly, to have polymyalgia rheumatica or giant cell arteritis. We report 3 cases of subacute streptococcal endocarditis mimicking giant cell arteritis in 2 cases and polymyalgia rheumatica in one. We reviewed the literature through Medline search of French and English-language articles published between 1966 and 2005 and found 5 similar cases. Shoulder and/or pelvic girdle pain was associated with neck or back pain in all patients. Scalp tenderness, bilateral jaw pain, amaurosis fugax were present in 2 patients. One patient had no fever. Two patients were treated with corticosteroids with initial good clinical response in one. Appropriate antibiotic therapy resulted in the rapid disappearance of rheumatic complaints in 2 patients and achieved a definitive cure of endocarditis in all cases. Rheumatologic symptoms may hinder the correct diagnosis of infective endocarditis in patients who present with a clinical picture suggesting polymyalgia rheumatica or giant cell arteritis. In such cases, blood cultures should be systematically drawn.

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

    Science.gov (United States)

    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

    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; pendocarditis 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

  18. Platelet microbicidal activity is an important defense factor against viridans streptococcal endocarditis

    NARCIS (Netherlands)

    Krijgsveld, J; Joldersma, W; Zaat, SAJ; van der Werff, J.

    2001-01-01

    To study the role of platelet microbicidal activity in host defense against infective endocarditis (IE) due to viridans streptococci (VS), the susceptibility to platelet releasate of blood and oral VS isolates from patients with and without IE was compared. The influence of neutralization of

  19. Fatal fungal endocarditis by Aspergillus udagawae: an emerging cause of invasive aspergillosis.

    Science.gov (United States)

    Seki, Atsuko; Yoshida, Atsushi; Matsuda, Yoko; Kawata, Mitsuhiro; Nishimura, Takashi; Tanaka, Jun; Misawa, Yoshiki; Nakano, Yuta; Asami, Ryoko; Chida, Koji; Kikuchi, Ken; Arai, Tomio

    Aspergillus udagawae has morphological similarities to Aspergillusfumigatus; however, it shows a low susceptibility to common antifungal drugs and poor in vitro sporulation. We present the first reported case of infectious endocarditis caused by A. udagawae. An awareness of this newly described Aspergillus species is vital for further clarification. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Gallium/sup 67/ scintigraphy in fibrinous pericarditis associated with bacterial endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Martin, P.; Verhas, M.; Devriendt, J.; Goffin, Y.

    1982-04-01

    An 80-year-old man presented with pyrexia, progressive cardiac failure and inflammation. A diagnosis of pericarditis associated with bacterial endocarditis was suggested from Gallium 67 scintigraphy and confirmed at autopsy. This case of fibrinous pericarditis without effusion could not be diagnosed by echography or routine cardiopulmonary scintigraphy.

  1. Detection of microbial diversity in endocarditis usingcultivation-independent molecular techniques

    DEFF Research Database (Denmark)

    Wolf, T. Y.; Moser, C.; Bundgaard, H.

    2011-01-01

    Background: The aim of this study was to investigate whether the diagnosis of infective endocarditis (IE) could be improved using molecular tools in addition to standard microscopy and cultivation methods. Methods: Cultivation was performed on blood or tissue samples as recommended in the modified...

  2. Technetium-99m stannous pyrophosphate imaging of experimental infective endocarditis. [Rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Riba, A.L.; Downs, J.; Thakur, M.L.; Gottschalk, A.; Andriole, V.T.; Zaret, B.L.

    1978-07-01

    Technetium-99m stannous pyrophosphate (/sup 99m/Tc-PYP) cardiac scintigraphy was performed in 15 rabbits with experimental Streptococcus sanguis aortic-valve infective endocarditis. The animals were imaged five to seven days after the administration of bacteria, and in each case abnormal accumulation of the tracer was visualized in the region of the aortic valve. Three types of cardiac scintigraphic patterns were demonstrated: focal, multifocal, and extensive, each correlating well with the anatomical extent of the lesion as defined by gross pathology. Tissue distribution studies demonstrated a 30 +- 5.3 (mean +- SEM) fold excess of radionuclide uptake in the infective endocarditis lesion compared with that of normal myocardium. Imaging of excised hearts from four animals showed an excellent correlation with in vivo imaging as well as gross pathology. Five animals with nonbacterial thrombotic aortic valve endocarditis demonstrated similar scintigraphic and tissue distribution results. In contrast, four normal animals failed to demonstrate abnormal /sup 99m/Tc-PYP cardiac scintigrams or tissue uptake. This study demonstrates that /sup 99m/Tc-PYP cardiac scintigraphy is a sensitive technique to detect experimental aortic valve endocarditis.

  3. Persistent immune thrombocytopenia heralds the diagnosis of Mycobacterium chimaera prosthetic valve endocarditis

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    Keith A. Sacco

    2017-01-01

    Full Text Available A 63 year old female was admitted for investigation of worsening renal insufficiency. During hospitalization she developed persistent immune thrombocytopenia refractory to supportive or immunosuppressive treatment. She was diagnosed with Mycobacterium chimaera prosthetic valve endocarditis and thrombocytopenia resolved with anti-mycobacterial therapy.

  4. First case report of endocarditis caused by haematobacter massiliensis in China.

    Science.gov (United States)

    Cheng, Jing-Wei; Wang, Peng; Xiao, Meng; Yuan, Ying; Kudinha, Timothy; Zhao, Ying; Kong, Fanrong; Xu, Ying-Chun

    2017-10-31

    Haematobacter massiliensis, a rare species of fastidious Gram-negative, non-motile, non-sporing, non-fermentative, pleomorphic, aerobic bacilli, has rarely been documented as the cause of infectious endocarditis in literature. Here we report the first case of infectious endocarditis (IE) caused by H. massiliensis in China. A 44-year-old woman presented to the infectious department of Peking Union Medical College Hospital (Beijing) in August 2013, with a 7-week history of fevers, chills, sore throat, muscular soreness, occasional joint pain, and cough. The organism obtained by blood culture, identified as H. massiliensis by 16S rRNA gene sequencing, was finally implicated as the cause of infectious endocarditis. The patient was cured with amoxicillin/clavulanate combined with amikacin for 6 weeks. This is the first case report in China, of the isolation of H. massiliensis from the bloodstream of a patient with endocarditis. The microbiology and clinical study of the organism will help us understand it better in future clinical practice.

  5. [Rapidly progressive ANCA positive glomerulonephritis as the presenting feature of infectious endocarditis].

    Science.gov (United States)

    Hanf, W; Serre, J-E; Salmon, J-H; Fabien, N; Ginon, I; Dijoud, F; Trolliet, P

    2011-12-01

    The association of positive cytoplasmic antineutrophil antibody (ANCA) necrotizing crescentic glomerulonephritis with endocarditis raises diagnostic issues. Indeed, it is often difficult to determine if the kidney injury is either secondary to an infectious disease or caused by an ANCA-associated small vessel vasculitis. We report a 59-year-old man admitted in nephrology for acute glomerular syndrome in whom the renal biopsy showed a crescentic necrotizing glomerulonephritis. A diagnosis of vasculitis was initially considered in the presence of high titer of ANCA (anti-proteinase 3). Because of associated Staphyloccocus aureus endocarditis the patient received both corticosteroids and antibiotics that allowed remission of both kidney injury and endocarditis. The renal presentation and the disappearance of ANCA support the infectious etiology of this glomerulonephritis rather than an ANCA-associated small vessel vasculitis. It is important to be cautious in the presence of ANCA positive extracapillary glomerulonephritis and endocarditis should be ruled out before initiation of corticosteroids that may be nevertheless necessary in severe acute glomerulonephritis. Copyright © 2011 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  6. One-year mortality in coagulase-negative Staphylococcus and Staphylococcus aureus infective endocarditis

    DEFF Research Database (Denmark)

    Rasmussen, Rasmus V; Snygg-Martin, Ulrika; Olaison, Lars

    2009-01-01

    The aim of this study was to investigate in-hospital mortality and 12-month mortality in patients with coagulase-negative Staphylococcus (CoNS) compared to Staphylococcus aureus (S. aureus) infective endocarditis (IE). We used a prospective cohort study of 66 consecutive CoNS and 170 S. aureus IE...

  7. Staphylococcus aureus endocarditis of the tricuspid valve after septic abortion: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Nelson López-Garzón

    2011-06-01

    Full Text Available We report a case of a female patient, 22 years old, with a diagnosis of tricuspid valve endocarditis by S. aureus following septic abortion. The diagnosis was established by the Duke University criteria and it was confirmed by the echocardiographic findings.

  8. Listerial endocarditis in a penicillin-allergic woman successfully treated with a combination of 4 drugs.

    Science.gov (United States)

    Benes, Jiri; Viechova, Jana; Kabelkova, Maria; Horova, Blanka

    2002-01-01

    A 69-y-old woman with bioprosthetic endocarditis due to Listeria monocytogenes developed an allergic reaction after beginning ampicillin treatment. She was cured with the combination of trimethoprim-sulfamethoxazole, rifampicin and teicoplanin. No immune deficiency was found in the patient.

  9. Health care-associated native valve endocarditis: importance of non-nosocomial acquisition

    NARCIS (Netherlands)

    Benito, Natividad; Miró, José M.; de Lazzari, Elisa; Cabell, Christopher H.; del Río, Ana; Altclas, Javier; Commerford, Patrick; Delahaye, Francois; Dragulescu, Stefan; Giamarellou, Helen; Habib, Gilbert; Kamarulzaman, Adeeba; Kumar, A. Sampath; Nacinovich, Francisco M.; Suter, Fredy; Tribouilloy, Christophe; Venugopal, Krishnan; Moreno, Asuncion; Fowler, Vance G.; Gordon, David; Devi, Uma; Spelman, Denis; van der Meer, Jan T. M.; Kauffman, Carol; Bradley, Suzanne; Armstrong, William; Giannitsioti, Efthymia; Lerakis, Stamatios; Mestres, Carlos A.; Pare, Carlos; de la Maria, Cristina Garcia; Marco, Francesc; Gatell, Jose M.; Almela, Manuel; Azqueta, Manuel; Jiménez-Expósito, Maria Jesús; Sitges, Marta; Claramonte, Xavier; Armero, Yolanda; Cervera, Carlos; Falces, Carlos; Heras, Magda; Miro, José M.; Fernandez-Hidalgo, Nuria; de Vera, Pablo Rodriguez; Tornos, Pilar; Falco, Vicente; Sidani, Nisreen; Kanj-Sharara, Souha; Kanafani, Zeina; Raglio, Annibale; Goglio, Antonio; Gnecchi, Fabrizio; Valsecchi, Grazia; Rizzi, Marco; Ravasio, Veronica; Hoen, Bruno; Chirouze, Catherine; Giannitsiot, Efthymia; Leroy, Joel; Plesiat, Patrick; Bernard, Yvette; Casey, Anna; Lambert, Peter; Watkin, Richard; Elliott, Tom; Baddley, John; Patel, Mukesh; Dismukes, William; Caros, Giampiero; Mathiron, Amel Brahim; Goissen, Thomas; Delahaye, Armelle; Delahaye, François; Vandenesch, François; Vizzotti, Carla; Marin, Marcelo; Trivi, Marcelo; Lombardero, Martin; Cortes, Claudia; Casabe, José Horacio; Kogan, Silvia; Clara, Liliana; Sanchez, Marisa; Commerford, Anita; Hansa, Cass; Deetlefs, Eduan; Ntsekhe, Mpiko; Wray, Dannah; Steed, Lisa L.; Church, Preston; Cantey, Robert; Morris, Arthur; Holland, David; Murdoch, David; Chambers, Stephen; Read, Kerry; Raymond, Nigel; Lang, Selwyn; Kotsanas, Despina; Korman, Tony M.; Peterson, Gail; Southern, Paul M.; Shah, Manisha; Bedimo, Roger; Reddy, Arjun; Levine, Donald; Dhar, Gaurav; Hanlon-Feeney, Alanna; Hannan, Margaret; Kelly, Sinead; Wang, Andrew; Woods, Christopher W.; Sexton, Daniel J.; Corey, Ralph; Drew, Laura; Lalani, Tahaniyat; Chu, Vivian H.; Mazaheri, Bahram; Neuerburg, Carl; Naber, Christoph; Athan, Eugene; Henry, Margaret; Harris, Owen; Alestig, Eric; Olaison, Lars; Wikstrom, Lotta; Snygg-Martin, Ulrika; Francis, Johnson; Nair, Lathi; Thomas, Vinod; Chaiworramukkun, Jaruwan; Pachirat, Orathai; Chetchotisakd, Ploenchan; Suwanich, Tewan; Tamin, Syahidah Syed; Premru, Manica Mueller; Logar, Mateja; Lejko-Zupanc, Tatjana; Orezzi, Christina; Klein, John; Bouza, Emilio; Moreno, Mar; Rodríguez-Créixems, Marta; Marín, Mercedes; Fernández, Miguel; Muñoz, Patricia; Fernández, Rocío; Ramallo, Victor; Raoult, Didier; Thuny, Franck; Casalta, Jean-Paul; Fournier, Pierre-Edouard; Chipigina, Natalia; Kirill, Ozerecky; Vinogradova, Tatiana; Kulichenko, Vadim P.; Butkevich, O. M.; Lion, Christine; Selton-Suty, Christine; Alla, François; Coyard, Hélène; Doco-Lecompte, Thanh; Durante-Mangoni, Emanuele; Ragone, Enrico; Dialetto, Giovanni; Tripodi, Marie Françoise; Utili, Riccardo; Casillo, Roberta; Sharma, Gautam; Dickerman, Stuart A.; Street, Alan; Eisen, Damon Peter; McBryde, Emma Sue; Grigg, Leeanne; Abrutyn, Elias; Michelet, Christian; Tattevin, Pierre; Donnio, Pierre Yves; Fortes, Claudio Querido; Edathodu, Jameela; Al-Hegelan, Mashael; Font, Bernat; Anguera, Ignasi; Guma, Joan Raimon; Cereceda, M.; Oyonarte, Miguel J.; Mella, Rodrigo Montagna; Garcia, Patricia; Jones, Sandra Braun; de Oliveira Ramos, Auristela Isabel; Paiva, Marcelo Goulart; de Medeiros Tranchesi, Regina Aparecida; Woon, Lok Ley; Lum, Luh-Nah; Tan, Ru-San; Rees, David; Kornecny, Pam; Lawrence, Richard; Dever, Robyn; Post, Jeffrey; Jones, Phillip; Ryan, Suzanne; Harkness, John; Feneley, Michael; Rubinstein, Ethan; Strahilewitz, Jacob; Ionac, Adina; Mornos, Cristian; Forno, Davide; Cecchi, Enrico; de Rosa, Francesco; Imazio, Massimo; Trinchero, Rita; Wiesbauer, Franz; Gattringer, Rainer; Deans, Greg; Andrasevic, Arjana Tambic; Barsic, Bruno; Klinar, Igor; Vincelj, Josip; Bukovski, Suzana; Krajinovic, Vladimir; Corey, G. Ralph; Stafford, Judy; Baloch, Khaula; Redick, Thomas; Harding, Tina; Karchmer, A. W.; Bayer, Arnie; Durack, David T.; Moreillon, Phillipe; Eykyn, Susannah

    2009-01-01

    BACKGROUND: The clinical profile and outcome of nosocomial and non-nosocomial health care-associated native valve endocarditis are not well defined. OBJECTIVE: To compare the characteristics and outcomes of community-associated and nosocomial and non-nosocomial health care-associated native valve

  10. 265. Afectación del bazo en la endocarditis infecciosa: Un enemigo silencioso

    Directory of Open Access Journals (Sweden)

    E. Quintana

    2012-04-01

    Conclusiones: Debe sospecharse absceso esplénico en los pacientes con endocarditis, fiebre y dolor abdominal. La esplenectomía y la intervención valvular pueden realizarse en el mismo acto dependiendo de la condición del paciente.

  11. [Extensive burns complicated with infective endocarditis and septic pulmonary embolism: case report and literature review].

    Science.gov (United States)

    Li, T S; Qi, Y; Wang, Y; Wang, Y X; Liu, F Y; Dai, L; Xia, G G

    2016-10-12

    Objective: To improve the clinical recognition of infective endocarditis (IE) and septic pulmonary embolism (SPE) in patients with extensive burns. Methods: A case of large area burn complicated with IE and SPE confirmed by blood cultures and echocardiography was described. A literature review was performed with "burn" and "infective endocarditis" as the Chinese key words in Wanfang database; with "burn" and "infective endocarditis" as Mesh terms in PubMed. Results: The patient was a 37-year-old male with large area burn, who presented with fever and hemoptysis. Blood cultures were positive for methicillin resistant Staphylococcus aureus (MRSA). Echocardiography disclosed vegetations located in the tricuspid valve. Multiple wedge-shaped lesions were found on chest CT. From January 1978 to December 2015, 26 related articles were retrieved and 134 burned patients complicated with endocarditis were reported, of which, 97 cases were IE and 1 case with SPE. Of the 134 cases, 120 cases were dead, 12 cases cured and 2 cases unknown. The mortality was 89.6%. Conclusions: There was a high mortality of burned patients complicated with IE. SPE should be considered for patients with multiple peripheral nodules in both lungs and a positive blood culture. Combination and prolonged anti-infective therapy may increase the treatment success and reduce the risk of recurrence.

  12. Native Valve Endocarditis due to Ralstonia pickettii: A Case Report and Literature Review.

    Science.gov (United States)

    Orme, Joseph; Rivera-Bonilla, Tomas; Loli, Akil; Blattman, Negin N

    2015-01-01

    Ralstonia pickettii is a rare pathogen and even more rare in healthy individuals. Here we report a case of R. pickettii bacteremia leading to aortic valve abscess and complete heart block. To our knowledge this is the first case report of Ralstonia species causing infective endocarditis with perivalvular abscess.

  13. Native Valve Endocarditis due to Ralstonia pickettii: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Joseph Orme

    2015-01-01

    Full Text Available Ralstonia pickettii is a rare pathogen and even more rare in healthy individuals. Here we report a case of R. pickettii bacteremia leading to aortic valve abscess and complete heart block. To our knowledge this is the first case report of Ralstonia species causing infective endocarditis with perivalvular abscess.

  14. Clinical and Molecular Epidemiology of Infective Endocarditis in Intravenous Drug Users

    Directory of Open Access Journals (Sweden)

    Pei-Jiuan Chao

    2009-12-01

    Conclusion: Our results suggest that coinfection with hepatitis C was common in intravenous drug users with IE, and that molecular patterns of MRSA isolates had high similarity. SCCmec type III, which is usually hospital-acquired, could have caused the community-associated MRSA endocarditis in our patients.

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

    OpenAIRE

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

    2000-01-01

    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

  16. Native aortic valve endocarditis caused by Brevibacterium epidermidis in an immunocompetent patient.

    Science.gov (United States)

    Manetos, Christos M; Pavlidis, Antonios N; Kallistratos, Manolis S; Tsoukas, Athanasios S; Chamodraka, Eytixia S; Levantakis, Ioannis; Manolis, Athanasios J

    2011-09-01

    Although Brevibacterium species used to be considered as nonpathogenic microorganisms until recently, it seems that they can cause a wide variety of clinical diseases by acting mostly as opportunistic pathogens. The present case is the second reported case of infective endocarditis by Brevibacterium species; however, it is the first reported infected native aortic valve in an immunocompetent patient.

  17. Failure of cloxacillin in treatment of a patient with borderline oxacillin-resistant Staphylococcus aureus endocarditis.

    Science.gov (United States)

    Skinner, Stuart; Murray, Melanie; Walus, Tom; Karlowsky, James A

    2009-03-01

    Clinical evidence for failure with beta-lactam therapy has been lacking for patients with borderline oxacillin-resistant Staphylococcus aureus (BORSA) infections. We describe a failure of cloxacillin for a patient with endocarditis due to BORSA. The isolate also had false-negative thermonuclease and coagulase test results.

  18. Identity of streptococcal blood isolates and oral isolates from two patients with infective endocarditis

    DEFF Research Database (Denmark)

    Fiehn, N E; Gutschik, E; Larsen, Tove

    1995-01-01

    The purpose of this study was to isolate streptococcal strains from the oral cavities of streptococcal endocarditis patients and compare these strains biochemically and genetically with the corresponding streptococcal blood isolates. Total identity was observed between the blood and oral cavity...

  19. Anterior mitral valve aneurysm perforation secondary to aortic valve endocarditis detected by Doppler colour flow mapping.

    Science.gov (United States)

    Decroly, P; Vandenbossche, J L; Englert, M

    1989-02-01

    We report a case of mitral valve aneurysm formation and perforation, secondary to Streptococcus sanguis endocarditis of the aortic valve. Aneurysm formation was documented by cross-sectional echocardiography and its perforation was established by Doppler colour flow mapping, and subsequently confirmed at surgery.

  20. Meningitis and infective endocarditis caused by Rhodotorula mucilaginosa in an immunocompetent patient.

    Science.gov (United States)

    Loss, Sergio Henrique; Antonio, Ana Carolina Peçanha; Roehrig, Cíntia; Castro, Priscylla Souza; Maccari, Juçara Gasparetto

    2011-12-01

    The authors report the case of an immunocompetent man who presented with acute impairment of the neurological system, hypertensive crisis and renal failure. The patient was eventually diagnosed with Rhodotorula mucilaginosa meningitis and infective endocarditis. To the best of our knowledge, this is the first description of simultaneous infection of the meninges and endothelium caused by Rhodotorula in a non-immunocompromised patient.

  1. Should acute Q-fever patients be screened for valvulopathy to prevent endocarditis?

    NARCIS (Netherlands)

    de Lange, Marit M A; Gijsen, Laura E V; Wielders, Cornelia C H; van der Hoek, Wim; Scheepmaker, Arko; Schneeberger, Peter M

    2018-01-01

    Echocardiographic screening of acute Q-fever patients and antibiotic prophylaxis for patients with cardiac valvulopathy are considered an important approach to prevent chronic Q-fever-related endocarditis. During a large Q-fever epidemic in the Netherlands, routine screening echocardiography was

  2. Retrospective Examination of Q Fever Endocarditis: An Underdiagnosed Disease in the Mainland of China

    Directory of Open Access Journals (Sweden)

    Xiao Han

    2017-01-01

    Conclusions: Q fever endocarditis is a serious yet treatable condition. Lacking awareness of the disease may prevent BCNE patients from being identified, despite having Q fever risk factors. Increasing awareness and guideline adherence are crucial in avoiding misdiagnosing and missed diagnosing of the disease.

  3. Interleukin 1 alpha increases the susceptibility of rabbits to experimental viridans streptococcal endocarditis

    NARCIS (Netherlands)

    Dankert, J; Joldersma, W; Zaat, SAJ; van der Werff, J.

    Major predisposing conditions for infective endocarditis (IE) are the presence of a cardiac platelet-fibrin vegetation and of circulating bacteria with relatively low susceptibility to microbicidal activity of blood platelets. The influence of proinflammatory conditions on development of IE is

  4. The platelet interactivity phenotype of Streptococcus sanguis influences the course of experimental endocarditis.

    Science.gov (United States)

    Herzberg, M C; MacFarlane, G D; Gong, K; Armstrong, N N; Witt, A R; Erickson, P R; Meyer, M W

    1992-01-01

    A strain of Streptococcus sanguis that induced rabbit platelets to aggregate in vitro (Agg+ phenotype) was hypothesized to be a more virulent pathogen than an Agg- strain in experimental endocarditis in rabbits. A left ventricular catheter was implanted, and then an Agg+ or Agg- strain was inoculated intravenously. Vegetations formed on the aortic semilunar valves but were unaffected by the duration of implantation of the catheter. Vegetations enlarged by accumulating platelets and their mass increased directly with the duration of endocarditis. Inoculation of the Agg+ strain consistently caused endocarditis with significantly larger vegetations, a more severe clinical course (including febrile episodes, hematological changes, and signs of myocardial ischemia), more gross lesions in major organs, and greater mortality than inoculation with the Agg- strain, saline, or the Agg+ strain pretreated with monospecific rabbit immunoglobulin G or Fab fragments against its platelet aggregation-associated protein (PAAP; class II). In experimental endocarditis, PAAP expressed by Agg+ S. sanguis appeared to be an important virulence factor. Images PMID:1398992

  5. Apparent culture-negative prosthetic valve endocarditis caused by Peptostreptococcus magnus

    NARCIS (Netherlands)

    van der Vorm, E. R.; Dondorp, A. M.; van Ketel, R. J.; Dankert, J.

    2000-01-01

    In two patients with prosthetic valve endocarditis due to Peptostreptococcus magnus, blood cultures in the BacT/Alert and BACTEC 9240 systems were signal negative. The capability of the BacT/Alert system to detect various Peptostreptococcus species was assessed. P. magnus and P. anaerobius could not

  6. Achromobacter xylosoxidans subsp. xylosoxidans prosthetic aortic valve infective endocarditis and aortic root abscesses.

    Science.gov (United States)

    van Hal, S; Stark, D; Marriott, D; Harkness, J

    2008-04-01

    We report a case of prosthetic valve infective endocarditis and aortic root abscesses caused by Achromobacter xylosoxidans subsp. xylosoxidans. The patient was an intravenous drug user and had injected amphetamines using 'duck pond water' as a diluent. After surgical intervention and 6 weeks of intravenous meropenem therapy, the patient made an uneventful recovery.

  7. First Report of Granulicatella sp. Endocarditis in a Kidney Transplant Patient

    Directory of Open Access Journals (Sweden)

    Flávio Jota de Paula

    Full Text Available Abstract Granulicatella and Abiotrophia are genera of fastidious Gram-positive cocci commensal of the oral, genitourinary, and intestinal flora. We report the first case of infective endocarditis caused by Granulicatella sp. in a kidney transplant recipient. A 67-year-old male kidney transplant recipient was admitted to the hospital for investigation of fever, abdominal pain, and diarrhea. On physical examination, he was dehydrated. Laboratory tests identified impaired renal function (creatinine level of 15.5 mg/dl; reference, 3.0 mg/dl, metabolic acidosis, and electrolyte disturbances. Cryptosporidium sp. was identified as the cause of the diarrhea, and the infection was treated with nitazoxanide. On admission, cultures of blood, urine, and stool samples were negative. Echocardiography results were normal. Despite the antimicrobial treatment, the fever persisted. A transthoracic echocardiogram revealed infective endocarditis of the mitral valve, and Granulicatella spp. were isolated in blood cultures. Although the patient was treated with penicillin and amikacin, he evolved to septic shock of pulmonary origin and died. Infective endocarditis caused by Granulicatella sp. should be suspected in cases of culture-negative endocarditis.

  8. Cuerpos de inclusión, células bacterianas y composiciones que los contienen y sus usos

    OpenAIRE

    Veciana Miró, Jaume; Ratera Bastardas, Inmaculada; Díez Gil, César; Villaverde Corrales, Antonio Pedro; Vázquez Gómez, Esther; García Fruitós, Elena

    2008-01-01

    [ES] La presente invención se refiere a un cuerpo de inclusión aislado que comprende un polipéptido caracterizado porque el cuerpo de inclusión está en forma particulada. La presente invención también se refiere a una célula bacteriana que comprende dicho cuerpo de inclusión. La presente invención se refiere además a una composición que comprende dicho cuerpo de inclusión y una célula eucariota. La presente invención se refiere también a una composición que comprende dicho cuerpo de ...

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

    Science.gov (United States)

    Bor, David H.; Woolhandler, Steffie; Nardin, Rachel; Brusch, John; Himmelstein, David U.

    2013-01-01

    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 hospitalizations, bacteriology, co-morbidities, outcomes and costs. Hospital admissions for endocarditis rose from 25,511 in 1998 to 38, 976 in 2009 (12.7 per 100,000 population in 2009). The age-adjusted endocarditis admission rate increased 2.4% annually. The proportion of patients with intra-cardiac devices rose from 13.3% to 18.9%, while the share with drug use and/or HIV fell. Mortality remained stable at about 14.5%, as did cardiac valve replacement (9.6%). Other serious complications increased; 13.3% of patients in 2009 suffered a stroke or CNS infection, and 5.5% suffered myocardial infarction. Amongst cases with identified pathogens, Staphylococcus aureus was the most common, increasing from 37.6% in 1998 to 49.3% in 2009, 53.3% of which were MRSA. Streptococci were mentioned in 24.7% of cases, gram-negatives in 5.6% and Candida species in 1.0%. We detected no inflection in hospitalization rates after changes in prophylaxis recommendations in 2007. Mean age rose from 58.6 to 60.8 years; elderly patients suffered higher rates of myocardial infarction and death, but slightly lower rates of Staphylococcus aureus infections and neurologic complications. Our study relied on clinically diagnosed cases of endocarditis that may not meet strict criteria. Moreover, since some patients are discharged and readmitted during a single episode of endocarditis, our hospitalization figures probably slightly overstate the true incidence of this illness. Conclusions Endocarditis is more common in

  10. Infective endocarditis in the U.S., 1998-2009: a nationwide study.

    Directory of Open Access Journals (Sweden)

    David H Bor

    Full Text Available 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 hospitalizations, bacteriology, co-morbidities, outcomes and costs. Hospital admissions for endocarditis rose from 25,511 in 1998 to 38, 976 in 2009 (12.7 per 100,000 population in 2009. The age-adjusted endocarditis admission rate increased 2.4% annually. The proportion of patients with intra-cardiac devices rose from 13.3% to 18.9%, while the share with drug use and/or HIV fell. Mortality remained stable at about 14.5%, as did cardiac valve replacement (9.6%. Other serious complications increased; 13.3% of patients in 2009 suffered a stroke or CNS infection, and 5.5% suffered myocardial infarction. Amongst cases with identified pathogens, Staphylococcus aureus was the most common, increasing from 37.6% in 1998 to 49.3% in 2009, 53.3% of which were MRSA. Streptococci were mentioned in 24.7% of cases, gram-negatives in 5.6% and Candida species in 1.0%. We detected no inflection in hospitalization rates after changes in prophylaxis recommendations in 2007. Mean age rose from 58.6 to 60.8 years; elderly patients suffered higher rates of myocardial infarction and death, but slightly lower rates of Staphylococcus aureus infections and neurologic complications. Our study relied on clinically diagnosed cases of endocarditis that may not meet strict criteria. Moreover, since some patients are discharged and readmitted during a single episode of endocarditis, our hospitalization figures probably slightly overstate the true incidence of this illness. CONCLUSIONS: Endocarditis

  11. Meningite bacteriana aguda na infância: fatores de risco para complicações agudas e sequelas

    Directory of Open Access Journals (Sweden)

    Sérgio A. Antoniuk

    2011-12-01

    Full Text Available OBJETIVO: Estudo retrospectivo que visa avaliar as complicações neurológicas agudas e sequelas neurológicas das meningites bacterianas agudas na infância, a fim de determinar possíveis sinais de alerta. MÉTODOS: Foram avaliadas crianças (entre 1 mês e 14 anos internadas entre 2003 e 2006, com meningite bacteriana aguda. RESULTADOS: Dos 44 pacientes incluídos, 17 (38,6% apresentaram complicações neurológicas agudas, sendo crise convulsiva a mais frequente (31,8%. Os pacientes com complicações neurológicas agudas apresentaram com mais frequência: menor contagem de neutrófilos (p = 0,03, crise convulsiva na admissão (p 200 mg/dL (p < 0,01 e menor relação glicorraquia/glicemia (p < 0,01 foram identificadas como variáveis de risco para sequelas. CONCLUSÃO: Contagem de neutrófilos < 60%, crise convulsiva na admissão e S. pneumoniae como agente etiológico foram identificados como sinais de alerta para a ocorrência de complicação neurológica aguda, enquanto que proteinorraquia, menor relação glicorraquia/glicemia e crise convulsiva na internação foram observados como fatores de risco para a ocorrência de sequelas neurológicas.

  12. Endocarditis por Brucella canis: primer caso documentado en un paciente adulto en Argentina Brucella canis endocarditis: first documented case in Argentina

    Directory of Open Access Journals (Sweden)

    Valeria Manias

    2013-03-01

    Full Text Available Se describe el primer caso documentado de endocarditis por Brucella canis en Argentina. El paciente fue un varón adulto que consultó por edemas en miembros inferiores, registros febriles aislados de 2 meses de evolución y dolor precordial opresivo que irradiaba a brazo izquierdo. Negaba contacto con animales de cría o consumo de productos sin pasteurización. Estudios cardiológicos constataron endocarditis infecciosa. Se resuelve cirugía de recambio valvular ante fracaso terapéutico empírico con cefalotina, ampicilina y gentamicina. Los hemocultivos fueron positivos (4 de 4 muestras con bacilos gram negativos. Se realizó la identificación con técnica API 20 NE (bioMérieux, el método automatizado Phoenix (BD y las pruebas bioquímicas convencionales, sin concluir género ni especie. Se derivó la cepa al departamento de Bacteriología Especial INEI-ANLIS "Dr. Carlos G. Malbrán" donde se identificó al aislamiento como Brucella canis. Se rotó el esquema terapéutico a doxiciclina, rifampicina y trimetoprima-sulfametoxazol con buena evolución. La importancia del caso radica en la posible falla del tratamiento antimicrobiano empírico administrado para endocarditis, ya que B. canis no responde a los antimicrobianos convencionales para esta patología.We herein present the case of an adult male patient who consulted for lower extremity edema, a 2- month history of fever and oppressive chest pain radiating to the left arm. He referred neither contact with breeding animals nor consumption of unpasteurized dairy products. A diagnosis of endocarditis was confirmed by cardiac studies. Since the empirical treatment with cephalotin, ampicillin and gentamicin failed, the patient underwent aortic valve replacement. A total of four blood cultures were positive with a gram-negative rod. Bacterial identification was performed using the API 20 NE technique (bioMerieux, the Phoenix automated method (BD and conventional biochemical tests which were

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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)

  14. Infective Endocarditis in 60 Years Old Man at Dr. Kariadi Hospital

    Directory of Open Access Journals (Sweden)

    Ridha Wahyutomo

    2013-06-01

    Full Text Available Infective endocarditis is an infection of the lining of the heart, particularly the cusps of valves characterized by fever and heart murmur, with or without malaise and fatigue. Clinical features can be divided into early manifestations of infection, embolic events, and late complications of sepsis and inflammation. It was reported that 60 years old man was brought to Kariadi hospital with prolong febris as his chief complaint. Patient has history of high grade fever and accompanied by weight loss, 3 kilograms for about 2 months. From physical examination result, in internal ward, we found he looked moderate ill. Heart systolic bruit at triscupidal valve and lungs were within normal limit. The result of blood culture from 3 different sites and throat swab culture were possitive, lead to the performance Streptococcus b haemolyticus’s colonies. From the result of the ASTO, Echocardiography and physical examination show infective endocarditis’s sign. The theraphy was Ceftriaxone 2 gram daily. Having obtained the results of negative cultures, and show an improvement of symptoms, finally the patient was getting improvement clinically and then treat as an outpatient. Patient was programmed to get Ceftriaxone 2 gram daily for 4 weeks. The decision of treatment not only from clinical manifestation but also from microbiology examination on the first admission in emergency unit. Blood culture with 3 bottles, interval 30 minutes is important for infective endocarditis. Furthermore, swab of throat area were taken to confirm for endocarditis cultures too. Finally there is no growth in culture until eighth day hospitalizasition. Spesific method on blood culture sampling is important to confirm the diagnostic of infective endocarditis and very useful for the clinicians to do the right clinical management for it. Subsequently, the role of clinical microbiologist in this case not only to support the clinical diagnostic but also the treatment in

  15. [Left-sided endocarditis due to gram-negative bacilli: epidemiology and clinical characteristics].

    Science.gov (United States)

    Noureddine, Mariam; de la Torre, Javier; Ivanova, Radka; Martínez, Francisco José; Lomas, Jose María; Plata, Antonio; Gálvez, Juan; Reguera, Jose María; Ruiz, Josefa; Hidalgo, Carmen; Luque, Rafael; García-López, María Victoria; de Alarcón, Arístides

    2011-04-01

    The aim of this study is to describe the epidemiological, clinical characteristics, and outcome of patients with left-side endocarditis caused by gram-negative bacteria. Prospective multicenter study of left-sided infective endocarditis reported in the Andalusian Cohort for the Study of Cardiovascular Infections between 1984 and 2008. Among the 961 endocarditis, 24 (2.5%) were caused by gram-negative bacilli. The most common pathogens were Escherichia coli, Pseudomonas aeruginosa and Salmonella enterica. Native valves (85.7%) were mainly affected, most of them with previous valve damage (57%). Comorbidity was greater (90% vs 39%; P=.05) than in endocarditis due to other microorganism, the most frequent being, diabetes, hepatic cirrhosis and neoplasm. A previous manipulation was found in 47.6% of the cases, and 37% were considered hospital-acquired. Renal failure (41%), central nervous system involvement (33%) and ventricular dysfunction (45%) were the most frequent complications. Five cases (21%) required cardiac surgery, mostly due to ventricular dysfunction. More than 50% of cases were treated with aminoglycosides, but this did not lead to a better outcome or prognosis. Mortality (10 patients) was higher than that reported with other microorganisms (41% vs 35%; P=.05). Left-sided endocarditis due to gram-negative bacilli is a rare disease, which affects patients with major morbidities and often with a previous history of hospital manipulations. Cardiac, neurological and renal complications are frequent and associated with a high mortality. The association of aminoglycosides in the antimicrobial treatment did not involve a better outcome or prognosis. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  16. Eikenella corrodens endocarditis and liver abscess in a previously healthy male, a case report.

    Science.gov (United States)

    Nordholm, Anne Christine; Vøgg, Ruth Ottilia Birgitta; Permin, Henrik; Katzenstein, Terese

    2018-01-12

    Eikenella corrodens is one of the HACEK bacteria constituting part of the normal flora of the oropharynx, however, still an uncommon pathogen. We report a case of a large Eikenella corrodens liver abscess with simultaneously endocarditis in a previously healthy male. A 49-year-old Danish man was admitted because of one-month malaise, fever, cough and unintentional weight loss. On admission there was elevated white blood cell count and C-reactive protein, as well as affected liver function tests. Initially pneumonia was suspected, but due to lack of improvement on pneumonia treatment, a PET-CT scan was performed, which showed a large multiloculated abscess in the liver. The abscess was drained using ultrasound guidance. Culture demonstrated Eikenella corrodens. Transesophageal echocardiography revealed aortic endocarditis. The patient was treated with antibiotics and abscess drainage, on which he slowly improved. He was discharged after 1.5 months of hospitalisation. On follow-up 2 months later, the patient was asymptomatic with normalized biochemistry and ultrasound showed complete regression of the abscess. This is the first case of documented Eikenella corrodens concurrent liver abscess and endocarditis. The case report highlights that Eikenella corrodens should be considered as a cause of liver abscess. Empirical treatment of pyogenic liver abscess will most often cover Eikenella corrodens, but the recommended treatment is a third generation cephalosporin or a fluoroquinolon. A multiloculated liver abscess may require drainage several times during treatment. The finding of Eikenella corrodens should elicit an echocardiography to diagnose endocarditis even in patients without clinical signs of endocarditis.

  17. The relationship between cerebrovascular complications and previously established use of antiplatelet therapy in left-sided infective endocarditis

    DEFF Research Database (Denmark)

    Snygg-Martin, Ulrika; Rasmussen, Rasmus Vedby; Hassager, Christian

    2011-01-01

    Cerebrovascular complications (CVC) in infective endocarditis (IE) are common. The only established treatments to reduce the incidence of CVC in IE are antibiotics and in selected cases early cardiac surgery. Potential effects of previously established antiplatelet therapy are under debate....

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

    LENUS (Irish Health Repository)

    2009-03-28

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

  19. Ruptured mycotic aneurysm of the superior mesenteric artery secondary to bacterial endocarditis in a 6-year-old-girl

    Energy Technology Data Exchange (ETDEWEB)

    Christophe, C.; Spehl, M.; Cogaert, C.; Perlmutter, N.; Burniat, W.; Biarent, D.; Delaet, F.; Amalou, N.

    1985-02-01

    By non-invasive examination we demonstrated as false mycotic aneurysm on a branch of the superior mesenteric artery (SMA). It suddenly ruptured but was managed successfully. The patient had mitral valve disease and probably bacterial endocarditis also.

  20. Deleted in Malignant Brain Tumors 1 is up-regulated in bacterial endocarditis and binds to components of vegetations

    DEFF Research Database (Denmark)

    Müller, Hanna; Renner, Marcus; Helmke, Burkhard M

    2009-01-01

    OBJECTIVE: Bacterial endocarditis is a frequent infectious cardiac disease, especially in patients with congenital or acquired heart defects. It is characterized by bacterial colonization of the heart valves and the appearance of vegetations consisting of fibrin, blood cells, and bacteria....... The glycoprotein Deleted in Malignant Brain Tumors 1 is a scavenger receptor cysteine-rich protein with functions in innate immunity and epithelial differentiation. Because of the aggregating capacity of Deleted in Malignant Brain Tumors 1, we hypothesized that an up-regulation in bacterial endocarditis may...... be linked to the development of vegetations. METHODS: Heart tissue of 19 patients with bacterial endocarditis and 10 controls without bacterial endocarditis was analyzed by immunohistochemistry. The effect of human recombinant Deleted in Malignant Brain Tumors 1 on erythrocyte aggregation was measured using...

  1. Proportions of Streptococcus sanguis, an Organism Associated with Subacute Bacterial Endocarditis, in Human Feces and Dental Plaque

    Science.gov (United States)

    van Houte, J.; Jordan, H. V.; Bellack, S.

    1971-01-01

    The relative absence of Streptococcus sanguis in human feces, in contrast to its high concentration on teeth, supports the concept of the mouth as the likely bacterial source in cases of subacute bacterial endocarditis involving this organism. PMID:5154899

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

    OpenAIRE

    Ghaderi F.; Oshagh M; Dehghani R.; Hasanshahi R.c

    2013-01-01

    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 receiv...

  3. Hepatic Artery Mycotic Aneurysm Associated with Staphylococcal Endocarditis with Successful Treatment: Case Report with Review of the Literature

    Directory of Open Access Journals (Sweden)

    Dhara Chaudhari

    2013-01-01

    Full Text Available Mycotic hepatic artery aneurysm is a vascular pathology associated with bacterial endocarditis. It is rare in occurrence after the introduction of effective antibiotics. We present a young patient with injection drug abuse associated staphylococcal endocarditis which was successfully treated with antibiotics and valve replacement who presented with abdominal pain. He was found to have mycotic aneurysm of hepatic artery which was successfully treated with coil embolization.

  4. Comparison of a Rabbit Model of Bacterial Endocarditis and an In Vitro Infection Model with Simulated Endocardial Vegetations

    OpenAIRE

    Hershberger, Ellie; Coyle, Elizabeth A.; Kaatz, Glenn W.; Zervos, Marcus J.; Rybak, Michael J.

    2000-01-01

    Animal models are commonly used to determine the efficacy of various antimicrobial agents for treatment of bacterial endocarditis. Previously we have utilized an in vitro infection model, which incorporates simulated endocardial vegetations (SEVs) to evaluate the pharmacodynamics of various antibiotics. In the present study, we compared four experimental rabbit endocarditis protocols to an in vitro infection model in an effort to determine if these models are comparable. We have evaluated the...

  5. Reconstruction of aorto-mitral continuity with a handmade aorto-mitral bioprosthetic valve for extensive bivalvular endocarditis.

    Science.gov (United States)

    Tedoriya, Takeo; Hirota, Masanori; Ishikawa, Noboru; Omoto, Tadashi

    2013-03-01

    Surgical treatment is effective to exclude all infected tissue in patients with infective endocarditis. Although various techniques have been reported, it has remained a great challenge for patients with extensive infected regions. A patient with extensive bivalvular endocarditis including the aortic and mitral valve and aorto-mitral continuity is described. A handmade aorto-mitral bioprosthetic valve was created to reconstruct the defect after extensive debridement. The patient was discharged on the 30th postoperative day without inflammatory signs.

  6. Resistência genética à mancha-bacteriana em genótipos de pimentão

    OpenAIRE

    Costa Roberto Alexandre; Rodrigues Rosana; Sudré Cláudia Pombo

    2002-01-01

    A mancha-bacteriana, principal doença bacteriana do pimentão causa desfolha intensa quando em condições favoráveis, deixando os frutos expostos ao sol, depreciando-os e diminuindo a produção. Para estimar, nas condições de Campos dos Goytacazes, os efeitos genéticos da reação do hospedeiro ao patógeno, tanto em folhas como em frutos, foram obtidos híbridos F1, sem recíprocos, a partir de cruzamentos dialélicos entre cinco genótipos de pimentão, sendo três suscetíveis ('UENF 1420', 'UENF 1421'...

  7. Perfil etiológico das meningites bacterianas em crianças Etiological profile of bacterial meningitis in children

    Directory of Open Access Journals (Sweden)

    Orlando C. Mantese

    2002-12-01

    Full Text Available Objetivo: analisar o perfil etiológico e alguns aspectos epidemiológicos das crianças com meningite bacteriana, internadas em um hospital público universitário. Métodos: foram seguidas, prospectivamente, as crianças internadas com meningite bacteriana, diagnosticada segundo os critérios clínicos e laboratoriais habituais. Foram excluídos os casos de meningite pós-trauma, de meningite na vigência de derivação liquórica, ou de defeitos congênitos do tubo neural, e de meningite tuberculosa. Resultados: foram analisadas 415 crianças internadas com diagnóstico de meningite bacteriana, no Hospital de Clínicas da Universidade Federal de Uberlândia, no período de 01/01/1987 a 31/01/2001. O agente etiológico foi identificado em 315 pacientes (75,9%, sendo de modo definitivo em 289 (69,3% e presuntivo, por intermédio da bacterioscopia, em outros 26 (6,6%. Os agentes mais comumente identificados foram o Haemophilus influenzae b (54,2%, o meningococo (20,6% e o pneumococo (18,1% dos 315 pacientes. O tratamento antimicrobiano prévio, detectado em 47,2% dos casos, causou uma diminuição significante no rendimento das culturas de sangue (de 50,8% para 38,7% e de liquor (71,7% para 57,6%. Houve um predomínio do acometimento de crianças com idade até 48 meses pelo Haemophilus influenzae b, particularmente em relação ao meningococo. A letalidade geral foi de 10,1%, com diferença significante entre a letalidade do pneumococo, de 17,5%, e a do meningococo, de 4,6%. Conclusões: as crianças afetadas por Haemophilus influenzae b e por pneumococo foram mais jovens que aquelas com meningite por meningococo. A hemocultura e a cultura de liquor continuam sendo importantes recursos laboratoriais para o diagnóstico etiológico da meningite bacteriana, apesar do impacto negativo causado em seu rendimento pelo tratamento antibiótico prévio. Os agentes mais comumente isolados foram o Haemophilus influenzae b, o meningococo e o pneumococo. A

  8. Validación del método LAL para determinar endotoxinas bacterianas en el inyectable heparina sódica

    Directory of Open Access Journals (Sweden)

    Nancy Burguet

    2012-12-01

    Full Text Available Dentro del control de la calidad de los productos farmacéuticos, la United State Pharmacopeia establece la cuantificación de endotoxinas bacterianas por el método de lisado de amebocito de Limulus , como monitor de pirógenos para más del 90% de los parenterales que regula. Este método se aplicó de forma específica a vacunas bacterianas y virales, agentes antineoplásicos, radiofármacos y parenterales que se producen en la industria médico farmacéutica. En el presente trabajo se mostró la metodología a seguir para realizar la validación de la técnica de determinación de endotoxinas bacterianas por el método de gelificación. Para ello se confirmó la sensibilidad del reactivo utilizado (0,03125 UE/mL y la validez de los analistas para poder obtener resultados confiables. Las pruebas preliminares para el producto ensayado, heparina sódica 5000 UI/mL, demostraron que este producto no potencia ni inhibe la reacción del reactivo. Se escogió la dilución de trabajo (1/128 para la validación del método. De esta manera quedaron estandarizadas las condiciones para la validación del test de lisado de amebocito de Limulus por gelificación en este producto parenteral, método que se hace extensivo a la determinación de endotoxinas bacterianas en vacunas y en otros medicamentos por vía de administración intravenosa.

  9. Native Valve Streptococcus bovis Endocarditis and Refractory Transfusion Dependent Iron Deficiency Anaemia Associated with Concomitant Carcinoma of the Colon: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Abdul Azeez Ahamed Riyaaz

    2016-01-01

    Full Text Available Streptococcus bovis is found as a commensal organism in human gut and may become opportunistically pathogenic. Infective endocarditis is one of the commonest modes of presentation of this infection. The association between Streptococcus bovis endocarditis and colorectal cancer is well recognized. We report a case of Streptococcus bovis endocarditis along with a refractory iron deficiency anaemia associated with concomitant carcinoma of ascending colon in a 63-year-old male. Cooccurrence of these two conditions may cause a challenge in the management. Considering the strong association of colon cancer with Streptococcus bovis endocarditis, a detailed screening colonoscopy is mandatory following the diagnosis of the latter.

  10. 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

    Directory of Open Access Journals (Sweden)

    Daas Hanady

    2009-05-01

    Full Text Available 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 infection with Candida or Pseudomonas endocarditis per se carries a very high mortality rate approaching 85% and 80%, respectively. The combination of P. aeruginosa and C. parapsilosis has never been encountered and there have been no earlier reports of the combination of C. parapsilosis and P. aeruginosa in adult intravenous drug users as a cause of endocarditis. Case presentation We present a 49-year-old man with bivalvular endocarditis with P. aeruginosa and C. parapsilosis. He had a prior bivalvular replacement in 2005 that became infected with the above microorganisms and he was treated with intravenous antibiotics. Because of ongoing intravenous drug use, a second valve replacement was denied. A few days later, the patient presented with septic shock secondary to P. aeruginosa and C. parapsilosis recurrent endocarditis. The infection was cured with a second bivalvular replacement and extended therapy with antibiotics and antifungals. Conclusion This is the first time a patient has presented with P. aeruginosa and C. parapsilosis endocarditis. Relapsing polymicrobial endocarditis can be cured with medical and surgical therapy.

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

    Directory of Open Access Journals (Sweden)

    Joaquín Gómez Armando Gonga

    2013-03-01

    Full Text Available Objetivo: describir las causas de morbilidad y mortalidad perioperatorias en los pacientes afectos de endocarditis infecciosa activa y significar cómo pueden ser disminuidas. Métodos: se realizó un estudio retrospectivo de las complicaciones posoperatorias y mortalidad en 139 pacientes operados por presentar endocarditis infecciosa en un período de 16 años. Se efectuaron 147 operaciones a los 139 pacientes de las cuales 83 (57,1 % fueron electivas y 64 (42,9 % fueron de urgencia. El 24 % de los pacientes fueron remitidos de otros centros en los que habían sido sometidos a tratamiento médico no exitoso por más de 4 semanas. Resultados: las operaciones efectuadas fueron: Sustituciones valvulares aórticas,mitrales y tricuspídeas 75 (41,1 %, extracción de electrodos de marcapasos o desfibriladores automáticos implantables del ventrículo derecho 57 (41 % , otras operaciones en número de 7 (4,9 %y 8 reintervenciones. La complicación más frecuente fue la sepsis generalizada (10,07 % pObjective: To describe the causes of perioperative morbidity and mortality of patients suffering active infectious endocarditis and to explain how both aspects can be reduced. Methods: A retrospective study of postoperative complications and mortality observed in 139 patients operated on from infectious endocarditis in 16 years. One hundred forty seven surgeries were performed, of which 83 (57.1 % were elective and 64 (42.9 % were emergency surgeries. In this group, 24 % had been referred from other medical centers where they had been unsuccessfully treated for 4 weeks. Results: The performed surgeries comprised 15 aortic, mitral and tricuspid valve replacements, 57 (41 % removals of pacemaker electrodes or of implanted automatic defibrillators in the right ventricle, seven other types of surgeries and 8 reoperations. The most frequent complication was generalized sepsis ((10.07 % p< 0.01, followed by the low heart output and postoperative bleeding. The

  12. Liberação intraocular de ofloxacina associada a lente de contato biossintética em ceratite bacteriana experimental em cães

    Directory of Open Access Journals (Sweden)

    D.N. Cremonini

    2010-08-01

    Full Text Available Avaliou-se a concentração de ofloxacina liberada por uma lente de contato de membrana de celulose biossintética, para tratamento de ceratite bacteriana experimental em cães, pela inoculação de Staphylococcus aureus intraestromal. Comparou-se o tratamento com a lente de contato biossintética impregnada com ofloxacina à terapia tópica convencional. Realizou-se avaliação microbiológica e dosagem de ofloxacina no humor aquoso por meio do método de cromatografia líquida de alto rendimento (HPLC. Houve diferença estatística na contagem de colônias bacterianas entre os olhos com ceratite e os demais grupos, no primeiro dia de coleta. O biomaterial, impregnado com ofloxacina, promoveu liberação gradual durante o período de avaliação, aos três e sete dias; no terceiro dia, o grupo tratado com a lente de contato obteve mediana de 3,72μg/mL, enquanto o grupo tratado com colírio resultou em 49,56μg/mL. Apesar do valor inferior, o grupo com lente de contato atingiu a concentração inibitória mínima, sendo eficaz no controle da infecção bacteriana.

  13. Cuidados en el tratamiento odontologico de pacientes pediatricos cardiopatas con transposicion de grandes vasos: reporte de un caso

    National Research Council Canada - National Science Library

    Valenzuela Ontiveros, Yaneth Yadira; Sanchez Rubio Carrillo, Raul Armando; Sanchez Rubio Carrillo, Ricardo Manuel; Bojorquez Anaya, Yolanda

    2011-01-01

    ... que lo atendio, asi como con especialistas en periodoncia y odontopediatria, Para prevenir la endocarditis bacteriana se recomendo la profilaxis antibiotica en cada cita, administrandole clindamicina (600 mg...

  14. Infección bacteriana severa en niños febriles: Parámetros predictivos

    Directory of Open Access Journals (Sweden)

    Alicia Álvarez Rodríguez

    1997-12-01

    Full Text Available Diferentes investigadores han realizado estudios sobre el manejo del niño febril y plantean que es un dilema al que se enfrenta a diario el médico que atiende niños. Motivados por este tema se efectuó un estudio descriptivo retrospectivo de los niños febriles, sin causa aparente en su valoración inicial, que asistieron al servicio de urgencias en un período de 9 meses, con el objetivo de identificar el diagnóstico definitivo al egreso y se precisó el tipo de infección bacteriana severa y relacionó la presencia de éstos con parámetros clínicos y de laboratorios. El mayor número de niños febriles valorados e ingresados mostraron edades desde 91 días hasta 36 meses. El menor porcenaje de ellos ingresaron y desarrollaron alguna infección bacteriana severa principalmente neumonía, y fue mayor el porcentaje de niños con esta patología a menos edad con predominio del aspecto tóxico y de la temperatura 39 EC. Resultó el manejo ambulatorio del niño febril mayor de 90 días y bajo riesgo de infección bacteriana severa un ahorro en vidas y dinero, por lo que se recomienda generalizar el flujograma propuesto para la evaluación y manejo del niño febril de 3 a 36 meses de edad.Different researches have performed studies on the management of the febrile infant and they point out that this is a dilemma faced by every physician who takes care of children. Motivated by this subject, a descriptive and retrospective study of febrile infants was conducted. The study was carried out to evaluate febrile infants without evident cause at the baseline evaluation who attended the emergency service during a period of 9 months with the objective of identifying the definite diagnosis at admission. The type of bacterial infection was accurately assessed and the presence of this was related to clinical and laboratory parameters. The greatest number of febrile infants evaluated and admitted to hospital were 91 days-36 months old. The lowest percentage

  15. Categorías de riesgo de meningitis bacteriana y tratamiento con antibióticos en neonatos con pleocitosis del líquido cefalorraquídeo

    Directory of Open Access Journals (Sweden)

    Manuel Díaz Álvarez

    Full Text Available Introducción: recientemente se desarrolló y validó el Modelo de Predicción de Meningitis Bacteriana Neonatal, lo cual provee de una herramienta efectiva en la toma de decisiones médicas para la indicación de tratamiento antibiótico ante un neonato con pleocitosis del líquido cefalorraquídeo. Objetivo: conocer cómo se procedió retrospectivamente con la indicación de tratamiento antibiótico en neonatos con pleocitosis del líquido cefalorraquídeo, antes de desarrollar el modelo mencionado, y fortalecer y fundamentar una estrategia del tratamiento antibiótico, basados en nuestro Modelo de Predicción de Meningitis Bacteriana Neonatal, ante un neonato con pleocitosis del líquido cefalorraquídeo. Métodos: estudio retrospectivo y aplicado, que incluyó 290 neonatos evaluados por probable infección, 44 con meningitis bacteriana y 246 con meningitis aséptica, ingresados en el Servicio de Neonatología del Hospital Pediátrico "Juan Manuel Márquez", entre febrero/1992 y diciembre/2009. Se verificó la efectividad del Modelo de Predicción de Meningitis Bacteriana Neonatal, lo que permitió clasificar los pacientes en alto o bajo riesgo de meningitis bacteriana. Se determinó retrospectivamente la indicación y los motivos de tratamiento antibiótico ante un neonato con pleocitosis del líquido cefalorraquídeo, así como análisis de asociación para distintas circunstancias clínicas, entre ellas, la clasificación de riesgo de infección bacteriana severa. Resultados: se precisó que el Modelo de Predicción de Meningitis Bacteriana Neonatal tuvo una sensibilidad y valor predictivo negativo de 100 % para meningitis bacteriana. Hubo concordancia estadísticamente significativa entre la predicción por el modelo y la clasificación de riesgo de infección bacteriana severa. Se comprobó un uso racional del tratamiento antibiótico, pues se utilizó de inmediato al diagnóstico de meningitis bacteriana en 100 % de los casos, y solo en

  16. Sensibilidade a cobre, estreptomicina e oxitetraciclina em Xanthomonas spp. associadas à mancha-bacteriana do tomate para processamento industrial

    Directory of Open Access Journals (Sweden)

    Quezado-Duval Alice Maria

    2003-01-01

    Full Text Available Apesar de amplamente empregados em lavouras de tomate para processamento industrial no Brasil, fungicidas cúpricos e antibióticos registrados para uso agrícola nem sempre resultam em controle eficiente das bacterioses que afetam a cultura. O aparecimento de estirpes resistentes é uma das causas dessa baixa eficiência. Avaliou-se, in vitro, a sensibilidade a cobre, estreptomicina e oxitetraciclina de 389 isolados de Xanthomonas spp. associadas à mancha-bacteriana do tomateiro, sendo 92 de X. axonopodis pv. vesicatoria (60 do grupo "A"/raça T1 e 32 do "C"/raça T3, 93 de X. vesicatoria (grupo "B"/raça T2 e 204 de X. gardneri (grupo "D"/raça T2. Os isolados foram obtidos de plantas doentes em campos comerciais de tomate para processamento industrial nos estados de Goiás, Minas Gerais, Pernambuco e Bahia, nos anos de 1995 a 1998 e em 2000. Alíquotas de 5 ml de suspensões bacterianas foram depositadas em meio Nutriente-Ágar suplementado com sulfato de cobre, nas concentrações de 50 e 200 µg/ml; sulfato de estreptomicina, a 25 e 200 µg/ml e cloridrato de oxitetraciclina, a 25 µg/ml. Nenhum isolado foi resistente a oxitetraciclina, como também nenhum foi resistente ao cobre na concentração de 200 µg/ml do sulfato de cobre. No entanto, houve diferença entre isolados quanto à sensibilidade ao sulfato de cobre na concentração de 50 µg/ml e ao sulfato de estreptomicina nas duas concentrações empregadas. As freqüências de isolados de X. gardneri, X. axonopodis pv. vesicatoria (grupos "A" e "C" e X. vesicatoria resistentes à estreptomicina (25 µg/ml do produto usado foram, respectivamente, 98%, 38% e 2%, ao passo que, ao cobre, foram, respectivamente, 48%, 4% e 74%. Todos os isolados do grupo "C" foram sensíveis à estreptomicina e 97% sensíveis ao cobre.

  17. Streptococcus agalactiae endocarditis presenting as acalculous cholecystitis in a previously well woman.

    LENUS (Irish Health Repository)

    Brewer, Linda

    2013-01-01

    This case report describes the unusual presentation of a previously very well woman with Streptococcus agalactiae endocarditis in the emergency department. History, examination and preliminary laboratory and radiological investigations supported a diagnosis of acalculous cholecystitis, for which she was given intravenous broad spectrum antimicrobial therapy. One day following admission, the patient deteriorated and became unresponsive. Subsequent MRI of the brain revealed multiple bihemispheric cerebral emboli and a large, mobile mitral valve thrombus was visualised on her transoesophageal echocardiogram. S agalactiae was cultured from venous blood samples and her antimicrobial cover was adjusted accordingly. Despite her presumed guarded prognosis, this patient made a remarkable recovery. To our knowledge, the association of S agalactiae endocarditis with acalculous cholecystitis has not been previously described.

  18. The bacteremia of dental origin and its implications in the appearance of bacterial endocarditis

    Science.gov (United States)

    Mang-de la Rosa, María R.; Castellanos-Cosano, Lizett; Romero-Perez, María J.

    2014-01-01

    Numerous systemic diseases may affect the oral cavity and vice versa,in particular severe diseases that involve the heart valve. In these cases, additional measures or a modification to our dental treatment need to be taken. We are aware of various diseases that can cause the emergence of bacterial endocarditis (BE), such as; rheumatic fever, valve lesions due to intravenous drug use, Kawasaki disease and valve surgery, among others. Due to its severity when it is not taken into account in dental treatment, we intend to show the evolution of the antimicrobial prophylaxis towards this condition. Furthermore, we intend to publish the current guidelines of institutions and societies which increasingly encourage rational antimicrobial use. In addition, we intend to examine the evidence of the possible origins of this disease during dental treatment and at the same time describe the necessary considerations that need to be taken during dental treatment. Key words:Endocarditis, antibiotic profilaxis, dental treatment. PMID:24121925

  19. Contribution of the Enterococcal Surface Protein Esp to pathogenesis of Enterococcus faecium endocarditis

    Science.gov (United States)

    Heikens, Esther; Singh, Kavindra V.; Jacques-Palaz, Karen D.; van Luit-Asbroek, Miranda; Oostdijk, Evelien A. N.; Bonten, Marc J. M.; Murray, Barbara E.; Willems, Rob J. L.

    2011-01-01

    The enterococcal surface protein Esp, specifically linked to nosocomial Enterococcus faecium, is involved in biofilm formation. To assess the role of Esp in endocarditis, a biofilm-associated infection, an Esp-expressing E. faecium strain (E1162) or its Esp-deficient mutant (E1162Δesp) were inoculated through a catheter into the left ventricle of rats. After 24 hours, less E1162Δesp than E1162 were recovered from heart valve vegetations. In addition, anti-Esp antibodies were detected in Esp-positive E. faecium bacteremia and endocarditis patient sera. In conclusion, Esp contributes to colonization of E. faecium at the heart valves. Furthermore, systemic infection elicits an Esp-specific antibody response in humans. PMID:21911077

  20. Complicated Community-Acquired Staphylococcus Endocarditis and Multiple Lung Abscesses: Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Musa A. Garbati

    2011-01-01

    Full Text Available Background. Isolated tricuspid valve endocarditis in the absence of risk factors in the community setting is very rare and can be easily missed in patients with hitherto normal valves. Case Presentation. We present a case of a 49 year old gentleman who presented with generalized body aches, fever, and jaundice and was initial diagnosed as hepatitis. He subsequently developed recurrent episodes of panic attacks and shortness of breath and later multiple skin abscesses. Further investigations excluded pulmonary embolism but revealed multiple abscesses in the body including the lungs. Blood cultures and culture from abscesses grew S. aureus. An initial transthoracic echocardiogram was normal. A transesophageal echocardiogram subsequently confirmed endocarditis on a normal natural tricuspid valve and multiple lung abscesses. He was successfully treated with appropriate antibiotics. Conclusion. We discuss the pathogenesis of this patient's presentation highlight the need for assessment and proper evaluation of patients with unexplained bacteremia.