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Sample records for endocarditis infecciosa ecnei

  1. Endocarditis infecciosa activa: 152 casos

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    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.

  2. Endocarditis infecciosa de válvula pulmonar nativa

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    Franco Romaní R; Fernando Atencia M; José Cuadra A

    2007-01-01

    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 dr...

  3. Endocarditis infecciosa de válvula pulmonar nativa

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    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.

  4. Tratamiento quirúrgico de la endocarditis infecciosa Surgical treatment of infective endocarditis

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    Milvio Ramírez López

    2010-09-01

    Full Text Available La cirugía constituye un ataque vigoroso a la incompetencia valvular que ocasiona las graves complicaciones hemodinámicas que se observan en la endocarditis infecciosa. Se presenta una breve revisión de las diferentes técnicas quirúrgicas que se emplean para el tratamiento de la endocarditis infecciosa de la válvula mitral nativa, utilización de homoinjertos mitrales, tratamiento quirúrgico de la endocarditis infecciosa de la válvula aórtica y de la endocarditis infecciosa de prótesis valvular aórtica, homoinjertos criopreservados, prótesis sin soporte valvular y otros tipos de prótesis, así como de otras técnicas que se pueden emplear en caso de no contar con homoinjertos. Se revisan las técnicas que se utilizan en la endocarditis infecciosa de la válvula tricúspide y la conducta quirúrgica en la endocarditis por cables de marcapasos o desfibriladores automáticos implantables.Surgery is a strong attack to valvular incompetence causing the severe hemodynamic complications seen in infective endocarditis. This is a brief review of the different surgical techniques used in the treatment of infective endocarditis of native mitral valve, utilization of mitral homografts, surgical treatment of the infective endocarditis of the aortic valve and the infective endocarditis of the aortic valvular prosthesis, cryopreservation of the homografts, prosthesis without valvular support and other types of prostheses, as well as of other techniques that could be used if the homografts are not available. Techniques used in the infective endocarditis of tricuspid valve are reviewed and the surgical behavior in the endocarditis provoked by the pacemakers cables or implanted automated defibrillators.

  5. Complicaciones neurológicas de la endocarditis infecciosa: controversias

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    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.

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

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    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.

  7. Aspectos históricos da endocardite infecciosa Historical aspects of infective endocarditis

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    Max Grinberg

    2011-04-01

    Full Text Available A endocardite infecciosa era fatal até há três gerações. A evolução temporal do conhecimento da doença possibilitou avanços nas técnicas diagnósticas, especialmente na ecocardiografia, a possibilidade de se realizar a cirurgia cardíaca, mesmo com o processo infeccioso em atividade, e novas recomendações de profilaxia por antibióticos antes dos procedimentos de intervenção. Hoje a endocardite infecciosa é curável. Nesta revisão são abordados os aspectos históricos da endocardite, desde as observações de Osler, no século XIX, até a transformação de doença "clinicamente possível" em "clinicamente definida".Infective endocarditis was a fatal disease three generations ago. Temporal evolution of knowledge made possible important advances in diagnostic techniques, especially in echocardiography, the possibility of cardiac surgery during the active infectious process and new guidelines for antibiotic prophylaxis before interventional procedures. Nowadays, infective endocarditis is curable. In this review, we describe historical aspects of endocarditis, from Osler´s observations in the 19th century to the change from a "clinically possible" to a "clinically defined" disease.

  8. Endocarditis infecciosa, experiencia de diez años en un centro de referencia nacional

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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.

  9. Endocarditis infecciosa en válvula aórtica por Aggregatibacter aphrophilus

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    Ana Luísa Broa

    Full Text Available Resumen Hoy día, la endocarditis infecciosa continúa siendo una causa importante de mor-bimortalidad en todo el mundo y es preocupante el aumento del número de infecciones asociadas con agentes virulentos y procedimientos médicos. Presentamos el caso de un indigente con antecedentes médicos desconocidos, ingresado por dolor lumbar, que comenzó a sentirse confuso, hipotenso y taquicárdico. Poco después de su ingreso su estado evolucionó a septicemia grave. Los resultados de las pruebas iniciales también eran indicativos de infarto agudo de miocardio, pero el ecocardiograma transtorácico reveló una vegetación masiva en la válvula aórtica con absceso perivalvular condicionando regurgitación aórtica grave. El paciente murió, con el diagnóstico definitivo de endocarditis infecciosa. Más tarde, en los hemocultivos se identificó Aggregatibacter aphrophilus, un microorganismo del grupo HACEK. Este caso confirma que, a pesar de los resultados favorables en general, hay casos de infecciones graves, sobre todo si el diagnóstico y el tratamiento fueron tardíos.

  10. Evaluación preoperatoria del riesgo en la endocarditis infecciosa con el modelo EuroScore. Datos iniciales

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    Eduardo Bernabeu

    2007-01-01

    Conclusiones: Aunque la muestra puede ser pequeña, tanto el modelo aditivo como el logístico del EuroScore predicen adecuadamente el riesgoen la endocarditis infecciosa. Se necesita un volumen superior para confirmar estos resultados iniciales.

  11. Endocardite infecciosa: 12 anos de tratamento cirúrgico Infective endocarditis: 12 years of surgical treatment

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    Antoninho Sanfins ARNONI

    2000-12-01

    ,2%. CONCLUSÃO: Concluímos que o tratamento cirúrgico da endocardite infecciosa representa um desafio para o cirurgião, apesar de todo o progresso adicionado ao arsenal diagnóstico e terapêutico desta patologia.BACKGROUND: Infective endocarditis is a disease of difficult and multidisciplinar treatment that frequently needs the surgical participation. MATERIAL AND METHODS: Between January 1987 and January 1999, 159 patients were operated on in our Service for infective endocarditis. Male group represented 64.7%. The mean age was 39.2 yr. (2 to 78 yr. and the mean weight 57.1 kg. The aortic valve was affected most frequently (66 patients, the native valve was affected in 47 cases and the prostheses in 19 (11 bioprostheses and 8 mechanic valves. The mitral valve was affected in 53 patients, most commonly in prostheses (28 bioprostheses and 2 mechanical. Aortic and mitral valves were together affected in 28 cases. The other patients had congenital defects or definitive pacemaker. Surgical treatment was indicated in cases of heart failure, refractory to medical treatment, valvar or prosthesis dysfunction secondary to infection, leak or arrhythmia. RESULTS: Cultures revealed that Streptococcus viridans and Staphilococcus aureus were the most prevalent microorganisms. Valve repair was possible in 3 patients of mitral group and one of aortic group. For the others, prostheses were used (mechanical for aortic valve and bioprostetic for mitral valve in the majority of the cases. Reoperation was frequent. Ventricular septal defect was the most common congenital pathology (3 cases and 4 patients presented infective endocarditis in pacemaker wire. The global mortality was 16.3%. Abscess as a complication was presented in 18.2% of the patients. We used bovine pericardium for reconstruction with a surgical mortality of 17.2%. CONCLUSION: We concluded that the treatment for infective endocarditis represents a surgical challenge, in spite of the progress added to the diagnostic and

  12. Evolución y letalidad por endocarditis infecciosa en pacientes atendidos en el Hospital Nacional Dos de Mayo

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    Evelyn Sánchez

    2006-06-01

    Full Text Available Objetivo: Evaluar la evolución y letalidad de los pacientes portadores de endocarditis infecciosa, así como la presencia de complicaciones y la influencia de estas sobre la mortalidad. Diseño: Estudio longitudinal no concurrente. Lugar: Servicio de cardiología del Hospital 2 de Mayo, hospital universitario. Pacientes: Pacientes con diagnóstico de endocarditis infecciosa. Intervenciones: Se revisó las historias clínicas de los pacientes con diagnóstico de endocarditis infecciosa atendidos entre junio de 1999 y junio de 2005. Se evaluó los criterios clínicos, de laboratorio y ecocardiográficos (criterios de Duke empleados en el diagnóstico. Para el análisis estadístico, se realizó el análisis descriptivo y comparativo con el empleo de las pruebas de Fisher y t de Student y la comparación de las curvas de Kaplan Meier, para evaluar la supervivencia a través de la prueba de rango logarítmico. Principales medidas de resultados: Evaluación de supervivencia: Complicaciones y mortalidad en pacientes en endocarditis infecciosa. Resultados: Se estudió 75 pacientes, la edad promedio fue 42,1±20,4 años, 66,7% del sexo masculino. El 93,3% tenía cardiopatía de base. La presentación clínica incluyó insuficiencia cardiaca congestiva (73,3%, encefalopatía (17,3% y fenómenos embólicos (50,6%. Se evaluó la evolución de los parámetros de laboratorio, evidenciándose deterioro de la función renal. El ecocardiograma evidenció presencia de vegetaciones en 97,3% y complicaciones, como rotura valvar (8%, abscesos valvares (4%. Durante la evolución, se sometió a cirugía a 14,7%. La letalidad general fue 14,7%, la cual estuvo influenciada por el número de complicaciones, en particular las complicaciones sépticas y renales, que impactaron de igual manera en la probabilidad de supervivencia de estos pacientes. Conclusiones: Se registró una letalidad general de 14,7%. La probabilidad de supervivencia se vio afectada

  13. 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

  14. Endocarditis infecciosa: experiencia quirúrgica en el Cardiocentro de Santiago de Cuba Infectious endocarditis: surgical experience at the Cardiology Center of Santiago de Cuba

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    Frank Josué Perdomo García

    2011-06-01

    Full Text Available Se realizó un estudio epidemiológico, descriptivo y transversal, de 104 pacientes intervenidos en el Cardiocentro del Hospital Provincial Clinicoquirúrgico Docente "Saturnino Lora" de Santiago de Cuba, desde enero de 1988 hasta diciembre del 2008, por presentar endocarditis infecciosa. Entre los hallazgos sobresalió el predominio del grupo etario de 15-45 años, del sexo masculino, de la cardiopatía reumática como factor predisponerte, de la forma de presentación séptico-infecciosa, de los estafilococos como gérmenes y de los hemocultivos negativos. La disfunción valvular fue la principal indicación quirúrgica, seguida de la insuficiencia cardíaca. La mortalidad representó 16,3 %, atribuible fundamentalmente al fallo multiorgánico por sepsis y al bajo gasto cardiaco. Los resultados de estas operaciones son buenos en la mencionada institución.A descriptive cross-sectional and epidemiological study was carried out in 104 patients operated due to infectious endocarditis at the Cardiology Center of the "Saturnino Lora "Provincial Teaching Clinical Surgical Hospital in Santiago de Cuba from January 1988 to December 2008. Among the findings was the prevalence of the 15-45 year-old patients, male sex, rheumatic heart disease as predisposing factor, and septic and infectious presentation, staphylococci as pathogens and negative blood cultures. Valve disease was the main surgical indication followed by heart failure. The mortality was 16,3 % attributable mainly to multiorgan failure due to sepsis and to the low cardiac output. The results of these interventions are favorable in that institution.

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

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    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

  16. Determinación de la sensibilidad a amoxicilina y a clindamicina de staphylococcus spp aislado de cavidad oral de pacientes con alto riesgo de endocarditis infecciosa

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    Silvia Barrientos

    2011-01-01

    Full Text Available En la literatura existen pocos estudios acerca de la distribución de Staphylococcus spp en boca y los que hay sobre estos microorganismos como residentes de la cavidad oral son controversiales.El género Staphylococcus spp conforma un importante grupo de patógenos en el ser humano y origina distintas enfermedades, entre ellas, la Endocarditis Infecciosa; de igual forma, la literatura reporta tasas de resistencia a amoxicilina y clindamicina antibióticos usados comúnmente para la profilaxis en odontología. Objetivo: Conocer la sensibilidad de Staphylococcus spp a amoxicilina y la clindamicina aislados de cavidad oral de pacientes con alto riesgo de Endocarditis Infecciosa.

  17. Auto-administración de tratamiento antibiótico domiciliario endovenoso (A-TADE) en la endocarditis infecciosa : un modelo asistencial seguro y eficiente

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    Pajarón Guerrero, Marcos

    2016-01-01

    La endocarditis infecciosa (EI) es un proceso infeccioso de elevada gravedad, que habitualmente se maneja en el hospital. Las unidades de hospitalización a domicilio (HaD) ofrecen en su cartera de servicios el tratamiento antibiótico domiciliario endovenoso (TADE) para procesos infecciosos de diversa complejidad, siendo la EI uno de los que más reticencias ha suscitado hasta el momento. Dentro del modelo TADE, disponemos de una variante denominada auto-administración de tratamiento antimicrob...

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

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    Heraldo Guedis Lobo Filho

    2011-03-01

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

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

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    José Carena

    2004-06-01

    Full Text Available Se evaluaron 81 pacientes con endocarditis infecciosa con el objeto de establecer la significación clínica de la presencia de fiebre persistente (FP y/o fiebre recurrente (FR durante el tratamiento. Un total de 46 pacientes (56.8% (Grupo 1 tuvieron FP y/o FR durante el tratamiento: 35 FP y 16 FR, que se compararon con 35 sin FP/FR (Grupo 2. No hubo diferencias en la edad, sexo, permanencia hospitalaria, origen nosocomial, demora diagnóstica y comorbilidad asociada. El compromiso aórtico (47.8 vs 34.2% y tricuspídeo (21.7 vs 11.4% y la infección por Staphylococcus aureus (55.5 vs 28% fueron más frecuentes en el Grupo 1, aunque no significativamente. El S. aureus meticilino resistente (SAMR (22.2 vs 4%, las complicaciones (95.6 vs 65.7%, la disfunción renal (58.6 vs 31.4%, el embolismo mayor (60.8 vs 34%, los fenómenos microvasculares (43.4 vs 17.1% y la cirugía valvular (34.7 vs 11.4% ocurrieron significativamente en el Grupo 1 (pPatients with infective endocarditis (IE were studied to assess incidence, clinical features and mortality in a population with either persistent (PF or recurrent fever (RF during treatment. A sample of 81 patients was evaluated. Of these, 46 patients (56.8% had fever during treatment: 35 had PF and 16 had RF (Group 1. This group was compared with 35 patients with IE without fever (Group 2. Age, sex, in-hospital days, nosocomial acquisition, delay in diagnosis, and co-morbidities were similar among each group. The aortic and tricuspid valve compromise, and Staphylococcus aureus as etiologic agent were more frequent in Group 1 (although not significantly. However, the development of complications (95.6 vs. 65.7%, renal dysfunction (58.6 vs. 31.4%, major vessel embolization (60.8 vs. 34%, microvascular phenomena (43.4 vs. 17.1%, infections with MRSA (22.2 vs. 4% and valvular surgery (34.7 vs. 11.4% were significantly higher in Group 1(p<0.05. The most common causes of PF were microvascular phenomena (14

  20. Cirurgia conservadora de próteses aórtica e mitral na endocardite infecciosa Conservative surgery for aortic and mitral prosthesis in infective endocarditis

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    Kanim Kalil KASSAB

    2001-03-01

    Full Text Available A endocardite infecciosa (EI acometendo próteses valvares é uma complicação freqüente, sendo tratada geralmente com cirurgia, devido ao seu difícil controle clínico e má resposta à antibioticoterapia. Este relato descreve o caso de uma paciente com EI, acometendo simultaneamente as biopróteses aórtica (Ao e mitral (Mi após vinte e quatro meses de cirurgia de implantes valvares, submetida a tratamento cirúrgico conservador, e com resultado favorável. Discutem-se as vantagens deste procedimento em situações específicas.Infective endocarditis is a frequent complication for valvar prosthesis currently treated with surgery, orving to its difficult control and poor response to therapy with antibiotics. Although conservative surgery for infective endocarditis of prosthesis is not a procedure of choice, this report shows a case of infective endocarditis of aortic and mitral prosthesis, after 24 months of implantation, treated by conservative surgery with favorable outcome.

  1. Endocardite infecciosa valvar submetida a tratamento cirúrgico: análise de 64 casos Infective valve endocarditis treated by surgery: analysis of 64 cases

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    Demóstenes G. Lima Ribeiro

    2005-03-01

    Full Text Available OBJETIVO: Identificar aspectos clínico-laboratoriais da endocardite infecciosa valvar, tratada com cirurgia, no Hospital de Messejana, Fortaleza, CE, no período de 1988 a 2003. MÉTODO: Estudo observacional, retrospectivo, da fase hospitalar, de 64 pacientes portadores de endocardite infecciosa, submetidos à substituição valvar aórtica e/ou mitral, vegectomia e plastia da tricúspide e excisão da valva pulmonar, como parte do tratamento. Analisados o sexo, a idade, o tempo decorrido entre a internação e a cirurgia e entre a internação e a alta hospitalar, a valva acometida, o resultado da hemocultura, o procedimento cirúrgico efetuado e a mortalidade. RESULTADOS: A endocardite infecciosa valvar, tratada com cirurgia, preponderou na terceira década, 81,2% dos pacientes eram masculinos. O tempo decorrido entre a internamento e a cirurgia foi menor nos pacientes que faleceram. A valva aórtica, de modo isolado ou associado, foi acometida em 65% dos casos. Hemoculturas foram positivas em 42%; em 52,4% delas, isolou-se Estafilolococo aureus. Necessitaram de substituição valvar 93,7% dos pacientes. Houve mortalidade de 14,1%, não influenciada pela idade nem pelo resultado da hemocultura. CONCLUSÃO: Endocardite infecciosa valvar, submetida ao tratamento cirúrgico, foi mais freqüente em homens e na terceira década. Acometeu preferencialmente a valva aórtica. Estafilolococo aureus foi o patógeno mais comum. Na quase totalidade dos casos, procedeu-se substituição valvar e a mortalidade hospitalar foi de 14,1%.OBJECTIVE: To identify some aspects of the infective valve endocarditis treated by heart surgery, as well as antibiotic therapy, in a public hospital, in the city of Fortaleza, Ceará state, Brazil, from1988 to 2003. METHOD: A retrospective and observational study of 64 patients with Infective Valve Endocarditis who required aortic and/or mitral valve replacement, tricuspid vegectomy and repair or pulmonary valve valvulectomy

  2. Apuntes sobre la fisiopatología, etiología, diagnóstico, tratamiento y profilaxis de la endocarditis infecciosa

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    Hiram Tápanes Daumy

    Full Text Available La endocarditis infecciosa es una afección de difícil diagnóstico en Cardiología, con características clínicas muy variadas y una epidemiología cambiante en los últimos años. En la presente revisión se tratan aspectos novedosos sobre su clasificación, etiología y fisiopatología; además, se presentan las herramientas fundamentales para su diagnóstico, punto de partida para su tratamiento médico basado primordialmente en la terapia antimicrobiana, así como los criterios quirúrgicos y la conducta actual en la profilaxis antimicrobiana de esta compleja entidad.

  3. Surgical treatment for infective endocarditis and hospital mortality in a Brazilian single-center Tratamento cirúrgico para endocardite infecciosa e mortalidade hospitalar em centro único brasileiro

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    Maurício Nassau Machado

    2013-03-01

    Full Text Available OBJECTIVE: We evaluated patients underwent cardiac valve surgery in the presence of infective endocarditis in an attempt to identify independent predictors of 30-day mortality. METHODS: We evaluated 837 consecutive patients underwent cardiac valve surgery from January 2003 to May 2010 in a tertiary hospital in São José do Rio Preto, São Paulo (SP, Brazil. The study group comprised patients who underwent intervention in the presence of infective endocarditis and was compared to the control group (without infective endocarditis, evaluating perioperative clinical outcomes and 30-day all cause mortality. RESULTS: In our series, 64 patients (8% underwent cardiac valve surgery in the presence of infective endocarditis, and 37.5% of them had surgical intervention in multiple valves. The study group had prolonged ICU length of stay (16%, greater need for dialysis (9% and higher 30-day mortality (17% compared to the control group (7%, P=0.020; 2%, P=0.002 and 9%, P=0.038; respectively. In a Cox regression analysis, age (P = 0.007, acute kidney injury (P = 0.004, dialysis (P = 0.026, redo surgery (P = 0.026, re-exploration for bleeding (P = 0.013, tracheal reintubation (P OBJETIVO: Avaliamos pacientes submetidos à cirurgia valvar em vigência de endocardite infecciosa na tentativa de identificar preditores independentes de mortalidade intrahospitalar em 30 dias. MÉTODOS: Foram avaliados 837 pacientes consecutivamente submetidos à cirurgia valvar, no período de janeiro de 2003 a maio de 2010, em um hospital terciário de São José do Rio Preto, SP, Brasil. O Grupo de Estudo compreendeu indivíduos submetidos à intervenção em vigência de endocardite infecciosa e foi comparado ao Grupo Controle, considerando complicações clínicas perioperatórias e óbito por todas as causas em 30 dias. RESULTADOS: Em nossa casuística, 64 (8% pacientes foram submetidos à cirurgia valvar em vigência de endocardite infecciosa, sendo 37,5% deles com indica

  4. Endocarditis

    Science.gov (United States)

    ... lining of the heart. The most common type, bacterial endocarditis, occurs when germs enter your heart. These germs ... another part of your body, often your mouth. Bacterial endocarditis can damage your heart valves. If untreated, it ...

  5. Índice de risco de mortalidade por endocardite infecciosa: um modelo logístico multivariado Risk index for death by infective endocarditis: a multivariate logistic model

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    Mário Augusto Cray da Costa

    2007-06-01

    Full Text Available OBJETIVO: Os objetivos do presente trabalho foram identificar variáveis preditivas de mortalidade hospitalar em endocardite infecciosa e criar fórmula matemática para cálculo do risco de óbito e um escore de risco, comparando os dois métodos com a curva ROC. MÉTODO: Foram estudados, retrospectivamente, 186 casos consecutivos de endocardite infecciosa (EI confirmados, divididos em dois grupos: alta (137 e óbito hospitalar (49. A partir das razões das chances obtidas em análise multivariada, foram criados: uma fórmula para cálculo do risco de óbito e um escore de risco. RESULTADOS: Fatores preditivos de maior mortalidade (análise multivariada e o escore de risco com seus respectivos pesos foram: idade > 40 anos (RC = 4.16-95%I.C. [1.63,10.80] - 4 pontos, insuficiência cardíaca classe IV ou choque cardiovascular (RC = 4.93 - 95%I.C. [1.86,13.05] - 5 pontos, sepsis não-controlada (RC =5.97 - 95%I.C. [1.95,18.35] - 6 pontos, distúrbio de condução (RC = 5.07-95%I.C. [1.67,15.35] - 5 pontos, arritmia (RC = 8.17 - 95%I.C. [2.60,25.71] - 8 pontos, valva com grande destruição ou abscesso ou prótese (RC = 4.77-95%I.C. [1.44,15.76] - 5 pontos, e vegetação grande e móvel (RC = 4.36-95%I.C. [1.55,12.90] - 4 pontos. Pacientes com escore entre 0 e 10 tiveram 5,26% de MT e maior que 20: 78,9%. CONCLUSÕES: Quanto maior o escore, maior é a mortalidade, complemente-se, ainda, que a estimativa de mortalidade obtida por cálculo ou pelo escore é semelhante. É possível utilizar software para facilitar a aplicação do escore e calcular risco de mortalidade por endocardite infecciosa.OBJECTIVE: This study aimed at identifying predictive variables for in-hospital mortality, calculating the probability of death and creating a risk index for death by infective endocarditis by comparing two methods using a Receiver Operating Characteristic (ROC curve. METHODS: A retrospective study was conducted of 186 consecutive cases of confirmed infective

  6. Endocarditis infecciosa en edad pediátrica en el Hospital de la Misericordia de Bogotá

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    Susana Murcia de Onatra

    1996-07-01

    Full Text Available Clinical and pathological records of 21 pediatric patients with Infectious Endocarditis who were attended at the Hospital La Misericordia of Bogota, during 1986- 1993 were reviewed. Fifty two percent (52% of the cases had clinical manifestation related to cardiovascular system involvement: changing murmur and congestive heart failure with fever, whereas clinical signs described in adults were not found; therefore it's necessary for diagnosis a high clinical suspicion. The valvular structural defects congenital or acquired (reumatic disease, are the main predisposing factors. Nevertheless intravenous catheters, immunosupression owed to malnutrition and septic states are also important predisponing factors. Tricuspid valve was the most frecuently affected structure and the etiologic agents were Slaphilococcus au reus and gram negatives. The mortality was similar to that reported in other series.

  7. 263. Resultado de la cirugía cardíaca en los pacientes con cirrosis hepática y endocarditis infecciosa activa

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    E. Quintana

    2012-04-01

    Conclusiones: Los pacientes con endocarditis y cirrosis son los de más riesgo. EuroSCORE no fue útil para la estratificación del riesgo. En pacientes con cirrosis avanzada la cirugía debe ofrecerse sólo en casos seleccionados.

  8. 175. Implantación de Homoinjerto Por Endocarditis Infecciosa Precoz Sobre Prótesis Aórtica Complicada Con Absceso Aórtico Posterior

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    M.A. Tena Pajuelo

    2012-04-01

    Conclusiones: la endocarditis precoz, debido a su elevada mortalidad, se beneficia notoriamente de un tratamiento quirúrgico precoz, debiéndose individualizar el momento de la cirugía para evitar una insuficiencia cardíaca refractaria o la destrucción de tejidos perivalvulares. Se describen los detalles de esta intervención, siendo una alternativa eficaz en estos casos.

  9. Análisis de las complicaciones neurológicas en los pacientes diagnosticados de endocarditis infecciosa: 1985-2002

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    Tomasa Centella Hernández

    2007-07-01

    Conclusiones: Las complicaciones neurológicas son una causa frecuente de morbimortalidad en el paciente con EI. Hemos observado un incremento de los casos en las endocarditis sobre válvula na- tiva en los últimos años, sobre todo asociado al incremento de casos producidos por S. aureus. Frecuentemente la complicación neurológica es el evento que conduce al diagnóstico de EI.

  10. 112. Implantación de Homoinjerto Por Endocarditis Infecciosa Precoz Sobre Prótesis Aórtica Complicada Con Absceso Aórtico Posterior

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    M.A. Tena Pajuelo

    2012-04-01

    Conclusiones: la endocarditis precoz, debido a su elevada mortalidad, se beneficia notoriamente de un tratamiento quirúrgico precoz, debiéndose individualizar el momento de la cirugía para evitar una insuficiencia cardíaca refractaria o la destrucción de tejidos perivalvulares. Se describen los detalles de esta intervención, siendo una alternativa eficaz en estos casos.

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

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    Carla A.Z. Pereira

    2003-10-01

    Full Text Available OBJETIVO: Descrever os achados clínico-laboratoriais da endocardite infecciosa (EI em 28 crianças, em Vitória/ES. MÉTODO: Estudo retrospectivo dos prontuários de 28 crianças, com idade abaixo de 18 anos e diagnóstico de endocardite infecciosa, internadas no serviço de infectologia do Hospital Infantil Nossa Senhora da Glória, em Vitória - Espírito Santo, no período de janeiro de 1993 a dezembro de 2001. Os critérios para diagnóstico de endocardite infecciosa foram os do Duke Endocarditis Service (Duke University, Durham, North Carolina - USA: critérios maiores (hemoculturas e ecocardiograma positivos e critérios menores (febre, doença cardíaca prévia, sopro cardíaco recente, fenômenos vasculares e imunológicos. Através de protocolo específico, preenchido pelos médicos-residentes e acadêmicos do serviço de infectologia, e revisados pelos médicos da equipe, foram anotadas as idades, sexo, achados clínicos e laboratoriais, e os resultados da ecocardiografia transtorácica das 28 crianças que preenchiam os critérios clínicos e laboratoriais. Em todos os casos, as hemoculturas foram realizadas com coleta do sangue (três amostras, sob condições assépticas e com inoculação em meios aeróbicos e anaeróbicos, incubados a uma temperatura de 37ºC e testados com sistema automatizado Vitec System® (Biolab. RESULTADOS: Das 28 crianças, 16 eram do sexo masculino, com idade entre 3 e 180 meses (média 70,6±59,2 m, e a maioria (68% era procedente da região metropolitana de Vitória. Metade apresentava cardiopatia prévia. Os achados clínicos mais freqüentes que levaram à suspeita de EI foram: febre prolongada (100%, sopro cardíaco (67,9%, dispnéia (57,1%, hepatomegalia (57,1%, fenômenos vasculares (32,2%, esplenomegalia (28,6% e nódulos de Osler (7,1%. Foram colhidas hemoculturas dos 28 casos, sendo 16 (57,1% positivas. O S. aureus adquirido na comunidade foi o germe mais freqüentemente isolado (9

  12. Endocarditis de Libman-Sacks

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    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.

  13. Endocarditis - children

    Science.gov (United States)

    Valve infection - children; Staphylococcus aureus - endocarditis - children; Enterococcus - endocarditis- children; Streptococcus viridians - endocarditis - children; Candida - endocarditis - children; Bacterial endocarditis - children; Infective ...

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

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    Nádia Barreto Tenório Aoun

    1997-12-01

    Full Text Available OBJETIVO: Estudar os aspectos epidemiológicos, clínicos, terapêuticos e evolutivos da endocardite infecciosa (EI em grupo de pacientes com idade entre 12 e 20 (média de 15,5 anos. MÉTODOS: Foram estudados, retrospectivamente, 33 pacientes consecutivos (14 do sexo masculino e 19 do feminino, admitidos com diagnóstico de EI. RESULTADOS: A mortalidade da EI foi de 42%. A cardiopatia reumática predominou como condição predisponente (63% dos casos, seguida das cardiopatias congênitas (24% e próteses cardíacas (12%. A maioria dos pacientes (78% encontrava-se na admissão em CF III e IV e apresentava mortalidade significativamente maior do que os que se encontravam na CF I e II (p=0,01. Complicações embólicas foram detectadas em 51% e determinaram maior mortalidade (p=0,05. O agente etiológico mais isolado foi o Staphylococcus aureus (em 42% das hemoculturas positivas, seguido do Staphylococcus viridans (em 21%. A análise multivariada mostrou que a contagem global de leucócitos acima de 10.000/mm ³, e a CF referidos na admissão (p=0,01 e p=0,04, e a ocorrência de embolias (p=0,03 eram preditores independentes de mortalidade intra-hospitalar. CONCLUSÃO: A cardiopatia reumática permanece, semelhante à população adulta, como principal fator predisponente da EI nos adolescentes, tendo como principal agente etiológico o S.aureus, semelhante à população pediátrica. A mortalidade é elevada e representam preditores de mortalidade intra-hospitalar a CF na admissão, a ocorrência da fenômenos embólicos e a leucocitose.PURPOSE: To study the epidemiological, clinical, therapeutic and evolutive aspects of endocarditis in a group of patients aging 12 to 20 years-old ( mean 15.5. METHODS: Thirty-three consecutive patients (14 males, 19 females admitted with infective endocarditis were retrospectively studied. RESULTS: Infective endocarditismortality was 42%. Rheumatic heart disease was the predominant underlying condition in 63% of

  15. Infective Endocarditis

    Science.gov (United States)

    ... Center > Infective Endocarditis Menu Topics Topics FAQs Infective Endocarditis En español Infective endocarditis is an infection of ... time, congestive heart failure (CHF). What causes infective endocarditis? The infection that leads to endocarditis can be ...

  16. Endocarditis infecciosa por S. aureus en la Argentina: EIRA-2. Análisis comparativo luego de 10 años de los estudios EIRA 1 y 2

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    Ernesto R. Ferreirós

    2006-01-01

    Full Text Available Objetivo Comparar el perfil y la evolución de la endocarditis infecciosa (EI en nuestro país a lo largo de 10 años, a través de los registros EIRA-1 y EIRA-2. Determinar las características clínicas y epidemiológicas y la evolución hospitalaria de la EI por Staphylococcus aureus (EISA en la Argentina. Métodos El estudio EIRA-2 fue un registro prospectivo multicéntrico conducido en 82 hospitales de 16 provincias de la Argentina. En el presente análisis se incluyeron pacientes con EI definidas (clasificación de Duke relevados en un período de 18 meses. Resultados Se registraron 390 episodios de EI definidas (108 EISA y 282 no EISA; edad media 58,5 ± 17,3 años, sexo masculino 70%. No existieron diferencias estadísticamente significativas entre las 108 EISA y las 282 no EISA con respecto a edad, sexo, endocarditis de válvula protésica, enfermedad valvular degenerativa, presencia de insuficiencia cardíaca y frecuencia de tratamiento quirúrgico. La comparación de los registros EIRA-2 y EIRA-1 demostró cambios importantes en el perfil de la enfermedad en la última década, actualmente caracterizada por pacientes de mayor edad (58 versus 51 años, mayor prevalencia de cardiopatía subyacente 67% versus 55% (en particular prótesis valvulares 19,2% versus 8,5%, enfermedades valvulares degenerativas 12,4% versus 4,8% y cardiopatías congénitas 9,5% versus 4,2%, mayor frecuencia de infección causada por S. aureus (30% versus 26% y menor por Streptococcus viridans (30,8% versus 26,8%, con una reducción del tiempo hasta el diagnóstico definitivo (21,5 versus 33 días. No se encontraron modificaciones en la tasa de mortalidad de la enfermedad. Se observó una diferencia estadísticamente significativa (p < 0,01 de las EISA con respecto a las no EISA en la prevalencia de cardiopatía subyacente [58,3% versus 67,4% (OR 0,7 IC 95% 0,4-0,99]; la EISA presentó una prevalencia menor de enfermedad valvular reumática [0,9% versus 7,1% (OR

  17. [Consensus document for the treatment of bacteremia and endocarditis caused by methicillin-resistent Staphylococcus aureus. Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica].

    Science.gov (United States)

    Gudiol, Francisco; Aguado, José María; Pascual, Alvaro; Pujol, Miquel; Almirante, Benito; Miró, José María; Cercenado, Emilia; Domínguez, María de Los Angeles; Soriano, Alex; Rodríguez-Baño, Jesús; Vallés, Jordi; Palomar, Mercedes; Tornos, Pilar; Bouza, Emilio

    2009-02-01

    Bacteremia and endocarditis due to methicillin-resistant Staphylococcus aureus (MRSA) are prevalent and clinically important. The rise in MRSA bacteremia and endocarditis is related with the increasing use of venous catheters and other vascular procedures. Glycopeptides have been the reference drugs for treating these infections. Unfortunately their activity is not completely satisfactory, particularly against MRSA strains with MICs > 1 microg/mL. The development of new antibiotics, such as linezolid and daptomycin, and the promise of future compounds (dalvabancin, ceftobiprole and telavancin) may change the expectatives in this field.The principal aim of this consensus document was to formulate several recommendations to improve the outcome of MRSA bacteremia and endocarditis, based on the latest reported scientific evidence. This document specifically analyzes the approach for three clinical situations: venous catheter-related bacteremia, persistent bacteremia, and infective endocarditis due to MRSA.

  18. Infective Endocarditis

    Science.gov (United States)

    ... Venous Thromboembolism Aortic Aneurysm More Infective Endocarditis Updated:Mar 29,2018 View an illustration of endocarditis Infective ... procedure. Web Booklets on Congenital Heart Defects These online publications describe many defects and the procedures used ...

  19. Fungal Endocarditis.

    Science.gov (United States)

    Yuan, Shi-Min

    2016-01-01

    Fungal endocarditis is a rare and fatal condition. The Candida and Aspergillus species are the two most common etiologic fungi found responsible for fungal endocarditis. Fever and changing heart murmur are the most common clinical manifestations. Some patients may have a fever of unknown origin as the onset symptom. The diagnosis of fungal endocarditis is challenging, and diagnosis of prosthetic valve fungal endocarditis is extremely difficult. The optimum antifungal therapy still remains debatable. Treating Candida endocarditis can be difficult because the Candida species can form biofilms on native and prosthetic heart valves. Combined treatment appears superior to monotherapy. Combination of antifungal therapy and surgical debridement might bring about better prognosis.

  20. Tratamento cirúrgico da endocardite infecciosa na fase aguda: experiência de três anos Surgical treatment of infective endocarditis in the acute phase: a three-year experience

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    Iseu Affonso da Costa

    1987-08-01

    ápida resposta ao tratamento antibiótico.Surgical treatment is becoming accepted as the best means of dealing with acute bacterial endocarditis in many clinical settings. The continuing changes in diagnosis, bacteriology and clinical picture of this disease must be accounted for by the surgical teams. Definition of the rules for management of this severe condition has been a matter of concern for us in the last years. From November 1983 to November 1986, 6.7% of the valvar substitutions in our Service were due to active infection (32 of 477 patients. The site of infection was the mitral valve in six patients, aortic valve in 12 patients (one death mitral and aortic valves in six patients (two deaths, mitral prostheses in two patients (one death aortic prostheses (three deaths, mitral, aortic and tricuspid valves in one patient (one death and the wall of the left ventricle in one patient. Age varied from 10 to 56 years (m=29.2 years. Seven patients were females and 24 males. All patients were white. Analysis of the pathologic findings allowed us to define three subgroups: In subgroup A, 11 operations were done for simple valvar lesions. All patients left the hospital. Fifteen patients were in the subgroup of extensive valvar or perivalvar lesions, five of which died. Among the six prosthetic infections there were four deaths. The favorable outcome of the patients operated on for simple valvar lesions and the high risk of those who presented extensive tissue destruction or prosthetic infection makes us to prefer immediate surgical treatment if there is no clear response to antibiotics within 24 to 48 hours.

  1. 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

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    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

  2. Fístula aortoauricular izquierda secundaria a endocarditis infecciosa

    Directory of Open Access Journals (Sweden)

    Alberto Fernández Carmona

    2012-01-01

    Full Text Available Paciente de 74 años con antecedentes de hipertensión, diabetes mellitus e insuficiencia aórtica moderada. Ingresa en unidad de cuidados intensivos (UCI en situación de shock cardiogénico; en ecocardiografía transtorácica (Fig. 1 se aprecia masa globulosa en la base auricular de velo anterior mitral, insuficiencia aórtica grave e insuficiencia mitral con flujo de gran turbulencia tangencial a la válvula mitral. En ecocardiografía transesofágica (Fig. 2 se objetiva insuficiencia aórtica avanzada, fistulización raíz de aorta-aurícula izquierda con afectación de la continuidad mitroaórtica e insuficiencia mitral grave secundaria a la misma. El paciente evoluciona de forma desfavorable, falleciendo en menos de 36 h.

  3. Lyme Endocarditis.

    Science.gov (United States)

    Paim, Ana C; Baddour, Larry M; Pritt, Bobbi S; Schuetz, Audrey N; Wilson, John W

    2018-03-29

    We describe a case of Lyme endocarditis which, to our knowledge, is the first reported case confirmed by molecular diagnostics in the United States. Valvular involvement as a manifestation of Lyme carditis is rare 4 . The first case describing a possible association between Lyme disease and cardiac valvular disease in the United States was published in 1993 5 . Since that time, there have been 2 cases of Lyme endocarditis confirmed by Borrelia positive 16S rRNA polymerase chain reaction (PCR) and sequencing from valvular tissue 8,10 and reported from Europe. We present the case of a 68-year-old male with progressive dyspnea had mitral valve perforation with severe mitral valve insufficiency and perforation seen on transesophageal echocardiogram. Subsequently resected valve tissue had sings of acute inflammation without organisms seen. Although blood and valve tissue cultures were negative, 16S rRNA PCR and sequencing demonstrated Borrelia burgdorferi. Lyme endocarditis can be a challenging diagnosis to confirm, given the rarity of cases and the need for molecular tools of resected valve tissue. It should be included among diagnostic possibilities in patients with culture-negative endocarditis who have exposure to ticks in endemic and emerging areas of Lyme disease. Copyright © 2018. Published by Elsevier Inc.

  4. Infective endocarditis

    Directory of Open Access Journals (Sweden)

    Sénior, Juan Manuel

    2015-10-01

    Full Text Available Infective endocarditis is a disease caused by colonization and proliferation of infectious agents on the endothelial surface of the heart. Its clinical presentation is variable, depending upon conditions of the patient, such as immunosuppression, presence of prosthetic material, intravenous drug use, and the etiologic agent. Diagnosis is usually established through the addition of elements such as medical history, physical examination, results of blood cultures, echocardiography and other aids. We present the case of an adult male who came to the hospital with fever and symptoms and signs of acute heart failure. The presence of a systolic murmur was documented in the aortic area, and the echocardiogram revealed severe valve regurgitation and a vegetating lesion on the bicuspid aortic valve. He required valve replacement and completed antibiotic treatment based on the sensitivity of the Streptococcus mitis strain that was demonstrated in the blood cultures.

  5. INFECTIVE ENDOCARDITIS: MODERN COURSE

    Directory of Open Access Journals (Sweden)

    T. L. Vinogradova

    2014-07-01

    Full Text Available The paper presents the characteristic features of the modern course of infective endocarditis. Unresolved questions of classification of diseaseand drug therapy are discussed. Clearly defined indications for surgical treatment of endocarditis.

  6. 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 Enterococcus faecalis infective endocarditis treated in the years before and after endorsement of these new recommendations....

  7. What Is Infective Endocarditis?

    Science.gov (United States)

    ANSWERS by heart Cardiovascular Conditions What Is Infective Endocarditis? Infective (bacterial) endocarditis (IE) is an infection of either the heart’s inner lining (endocardium) or the heart valves. Infective endocarditis is a serious — and sometimes fatal — illness. Two ...

  8. Shewanella putrefaciens infective endocarditis

    Directory of Open Access Journals (Sweden)

    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.

  9. 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...... or ceftriaxone. E. faecalis infective endocarditis continues to be a very serious disease with considerable percentages of high-level gentamicin resistant strains and in-hospital mortality around 20%. Strategies to prevent E. faecalis IE, improve diagnostics, optimize treatment and reduce morbidity...

  10. Infective endocarditis, 1984 through 1993

    DEFF Research Database (Denmark)

    Benn, Marianne; Hagelskjaer, L H; Tvede, M

    1997-01-01

    To characterize the epidemiology and the clinical and microbiological spectrum of infective endocarditis in a Danish population.......To characterize the epidemiology and the clinical and microbiological spectrum of infective endocarditis in a Danish population....

  11. 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...

  12. 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.

  13. Infective Endocarditis and Cancer Risk

    Science.gov (United States)

    Sun, Li-Min; Wu, Jung-Nan; Lin, Cheng-Li; Day, Jen-Der; Liang, Ji-An; Liou, Li-Ren; Kao, Chia-Hung

    2016-01-01

    Abstract This study investigated the possible relationship between endocarditis and overall and individual cancer risk among study participants in Taiwan. We used data from the National Health Insurance program of Taiwan to conduct a population-based, observational, and retrospective cohort study. The case group consisted of 14,534 patients who were diagnosed with endocarditis between January 1, 2000 and December 31, 2010. For the control group, 4 patients without endocarditis were frequency matched to each endocarditis patient according to age, sex, and index year. Competing risks regression analysis was conducted to determine the effect of endocarditis on cancer risk. A large difference was noted in Charlson comorbidity index between endocarditis and nonendocarditis patients. In patients with endocarditis, the risk for developing overall cancer was significant and 119% higher than in patients without endocarditis (adjusted subhazard ratio = 2.19, 95% confidence interval = 1.98–2.42). Regarding individual cancers, in addition to head and neck, uterus, female breast and hematological malignancies, the risks of developing colorectal cancer, and some digestive tract cancers were significantly higher. Additional analyses determined that the association of cancer with endocarditis is stronger within the 1st 5 years after endocarditis diagnosis. This population-based cohort study found that patients with endocarditis are at a higher risk for colorectal cancer and other cancers in Taiwan. The risk was even higher within the 1st 5 years after endocarditis diagnosis. It suggested that endocarditis is an early marker of colorectal cancer and other cancers. The underlying mechanisms must still be explored and may account for a shared risk factor of infection in both endocarditis and malignancy. PMID:27015220

  14. 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.

  15. 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

    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

  16. 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

  17. 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

  18. ENDOCARDITIS WITH AN UNCOMMON GERM

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    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.

  19. Challenges in Infective Endocarditis.

    Science.gov (United States)

    Cahill, Thomas J; Baddour, Larry M; Habib, Gilbert; Hoen, Bruno; Salaun, Erwan; Pettersson, Gosta B; Schäfers, Hans Joachim; Prendergast, Bernard D

    2017-01-24

    Infective endocarditis is defined by a focus of infection within the heart and is a feared disease across the field of cardiology. It is frequently acquired in the health care setting, and more than one-half of cases now occur in patients without known heart disease. Despite optimal care, mortality approaches 30% at 1 year. The challenges posed by infective endocarditis are significant. It is heterogeneous in etiology, clinical manifestations, and course. Staphylococcus aureus, which has become the predominant causative organism in the developed world, leads to an aggressive form of the disease, often in vulnerable or elderly patient populations. There is a lack of research infrastructure and funding, with few randomized controlled trials to guide practice. Longstanding controversies such as the timing of surgery or the role of antibiotic prophylaxis have not been resolved. The present article reviews the challenges posed by infective endocarditis and outlines current and future strategies to limit its impact. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  20. Endocarditis Caused by Rhodotorula Infection

    OpenAIRE

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

    2014-01-01

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

  1. Endocarditis caused by Rhodotorula infection.

    Science.gov (United States)

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

    2014-01-01

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

  2. Zygomycotic infective endocarditis in pregnancy.

    Science.gov (United States)

    Vaideeswar, Pradeep; Shah, Rushabh

    Under the circumstances of cardiovascular adaptations and immunomodulation, an uncommon but disastrous complication of infective endocarditis (IE) can occur in pregnancy. Almost all the cases reported earlier were caused by bacteria. We report a fatal case of zygomycotic valvular and mural endocarditis in a young non-diabetic primigravida with a positive hepatitis B serology. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Serious complications after infective endocarditis

    DEFF Research Database (Denmark)

    Gill, Sabine

    2010-01-01

    The objective of the present study was to review all cases of infective endocarditis at our hospital between 2002 and 2006 concerning the bacteriological aetiology and outcomes.......The objective of the present study was to review all cases of infective endocarditis at our hospital between 2002 and 2006 concerning the bacteriological aetiology and outcomes....

  4. ENDOCARDITIS IN SYSTEMIC LUPUS ERYTHEMATOSUS

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    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

  5. Laboratory Diagnosis of Infective Endocarditis

    Science.gov (United States)

    Liesman, Rachael M.; Pritt, Bobbi S.; Maleszewski, Joseph J.

    2017-01-01

    ABSTRACT Infective endocarditis is life-threatening; identification of the underlying etiology informs optimized individual patient management. Changing epidemiology, advances in blood culture techniques, and new diagnostics guide the application of laboratory testing for diagnosis of endocarditis. Blood cultures remain the standard test for microbial diagnosis, with directed serological testing (i.e., Q fever serology, Bartonella serology) in culture-negative cases. Histopathology and molecular diagnostics (e.g., 16S rRNA gene PCR/sequencing, Tropheryma whipplei PCR) may be applied to resected valves to aid in diagnosis. Herein, we summarize recent knowledge in this area and propose a microbiologic and pathological algorithm for endocarditis diagnosis. PMID:28659319

  6. 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.

  7. Tricuspid valve endocarditis

    Science.gov (United States)

    Hussain, Syed T.; Witten, James; Shrestha, Nabin K.; Blackstone, Eugene H.

    2017-01-01

    Right-sided infective endocarditis (RSIE) is less common than left-sided infective endocarditis (IE), encompassing only 5–10% of cases of IE. Ninety percent of RSIE involves the tricuspid valve (TV). Given the relatively small numbers of TVIE cases operated on at most institutions, the purpose of this review is to highlight and discuss the current understanding of IE involving the TV. RSIE and TVIE are strongly associated with intravenous drug use (IVDU), although pacemaker leads, defibrillator leads and vascular access for dialysis are also major risk factors. Staphylococcus aureus is the predominant causative organism in TVIE. Most patients with TVIE are successfully treated with antibiotics, however, 5–16% of RSIE cases eventually require surgical intervention. Indications and timing for surgery are less clear than for left-sided IE; surgery is primarily considered for failed medical therapy, large vegetations and septic pulmonary embolism, and less often for TV regurgitation and heart failure. Most patients with an infected prosthetic TV will require surgery. Concomitant left-sided IE has its own surgical indications. Earlier surgical intervention may potentially prevent further destruction of leaflet tissue and increase the likelihood of TV repair. Fortunately, TV debridement and repair can be accomplished in most cases, even those with extensive valve destruction, using a variety of techniques. Valve repair is advocated over replacement, particularly in IVDUs patients who are young, non-compliant and have a higher risk of recurrent infection and reoperation with valve replacement. Excising the valve without replacing, it is not advocated; it has been reported previously, but these patients are likely to be symptomatic, particularly in cases with septic pulmonary embolism and increased pulmonary vascular resistance. Patients with concomitant left-sided involvement have worse prognosis than those with RSIE alone, due predominantly to greater likelihood of

  8. Histoplasma capsulatum Endocarditis

    Science.gov (United States)

    Riddell, James; Kauffman, Carol A.; Smith, Jeannina A.; Assi, Maha; Blue, Sky; Buitrago, Martha I.; Deresinski, Stan; Wright, Patty W.; Drevets, Douglas A.; Norris, Steven A.; Vikram, Holenarasipur R.; Carson, Paul J.; Vergidis, Paschalis; Carpenter, John; Seidenfeld, Steven M.; Wheat, L. Joseph

    2014-01-01

    Abstract Infective endocarditis is an uncommon manifestation of infection with Histoplasma capsulatum. The diagnosis is frequently missed, and outcomes historically have been poor. We present 14 cases of Histoplasma endocarditis seen in the last decade at medical centers throughout the United States. All patients were men, and 10 of the 14 had an infected prosthetic aortic valve. One patient had an infected left atrial myxoma. Symptoms were present a median of 7 weeks before the diagnosis was established. Blood cultures yielded H. capsulatum in only 6 (43%) patients. Histoplasma antigen was present in urine and/or serum in all but 3 of the patients and provided the first clue to the diagnosis of histoplasmosis for several patients. Antibody testing was positive for H. capsulatum in 6 of 8 patients in whom the test was performed. Eleven patients underwent surgery for valve replacement or myxoma removal. Large, friable vegetations were noted at surgery in most patients, confirming the preoperative transesophageal echocardiography findings. Histopathologic examination of valve tissue and the myxoma revealed granulomatous inflammation and large numbers of organisms in most specimens. Four of the excised valves and the atrial myxoma showed a mixture of both yeast and hyphal forms on histopathology. A lipid formulation of amphotericin B, administered for a median of 29 days, was the initial therapy in 11 of the 14 patients. This was followed by oral itraconazole therapy, in all but 2 patients. The length of itraconazole suppressive therapy ranged from 11 months to lifelong administration. Three patients (21%) died within 3 months of the date of diagnosis. All 3 deaths were in patients who had received either no or minimal (1 day and 1 week) amphotericin B. PMID:25181311

  9. Bacterial Clearance and Endocarditis in American Opossums

    Science.gov (United States)

    Musher, Daniel M.; Richie, Yvonne

    1974-01-01

    The American opossum is the only experimental animal that regularly develops bacterial endocarditis spontaneously. There was no relation between the ability of opossums to clear bacteria from the bloodstream and the subsequent development of endocarditis. PMID:4208530

  10. Nuclear medicine imaging in endocarditis

    International Nuclear Information System (INIS)

    Ivancevic, V.; Munz, D.L.

    1999-01-01

    Infective endocarditis is a serious disease which requires early diagnosis and adequate therapy. Echocardiography plays a key role in diagnosis and follow-up. Subacute infective endocarditis, however, is often difficult to prove echocardiographically due to its more subtle morphological changes. Also, echocardiography cannot reliably differentiate florid vegetations from residual structural changes of the affected valves in cured patients. Therefor, scintigraphy of infection and inflammation has been investigated as a complementary tool in diagnosis and follow-up of infective endocarditis. Immunoscintigraphy with the 99m Tc labelled anti granulocyte antibody in SPECT technique is complementary to echocardiography and seems to assess the floridity of the underlying inflammatory process. The combined use of both imaging modalities allows detection of virtually all cases of subacute infective endocarditis. SPECT immunoscintigraphy with the anti granulocyte antibody seems useful in doubtful cases of infective endocarditis, especially, if echocardiography is non-diagnostic and valve pathology pre-existing. the method may be used for follow-up and monitoring antibiotic therapy

  11. Nuclear medicine imaging in endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Ivancevic, V.; Munz, D.L. (Univ. Hospital Charite' , Humboldt Univ., Berlin (Germany). Clinic for Nuclear Medicine)

    1999-03-01

    Infective endocarditis is a serious disease which requires early diagnosis and adequate therapy. Echocardiography plays a key role in diagnosis and follow-up. Subacute infective endocarditis, however, is often difficult to prove echocardiographically due to its more subtle morphological changes. Also, echocardiography cannot reliably differentiate florid vegetations from residual structural changes of the affected valves in cured patients. Therefor, scintigraphy of infection and inflammation has been investigated as a complementary tool in diagnosis and follow-up of infective endocarditis. Immunoscintigraphy with the [sup 99m]Tc labelled anti granulocyte antibody in SPECT technique is complementary to echocardiography and seems to assess the floridity of the underlying inflammatory process. The combined use of both imaging modalities allows detection of virtually all cases of subacute infective endocarditis. SPECT immunoscintigraphy with the anti granulocyte antibody seems useful in doubtful cases of infective endocarditis, especially, if echocardiography is non-diagnostic and valve pathology pre-existing. the method may be used for follow-up and monitoring antibiotic therapy.

  12. Fungal Endocarditis: Update on Diagnosis and Management.

    Science.gov (United States)

    Pasha, Ahmed Khurshid; Lee, Justin Z; Low, See-Wei; Desai, Hem; Lee, Kwan S; Al Mohajer, Mayar

    2016-10-01

    Fungal endocarditis is an extremely debilitating disease associated with high morbidity and mortality. Candida spp. are the most common isolated organisms in fungal endocarditis. It is most prevalent in patients who are immunosuppressed and intravenous drug users. Most patients present with constitutional symptoms, which are indistinguishable from bacterial endocarditis, hence a high index of suspicion is required for pursuing diagnosis. Diagnosis of fungal endocarditis can be very challenging: most of the time, blood cultures are negative or take a long time to yield growth. Fungal endocarditis mandates an aggressive treatment strategy. A medical and surgical combined approach is the cornerstone of therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Infective Endocarditis during Pregnancy

    International Nuclear Information System (INIS)

    Yuan, S.

    2015-01-01

    Objective: Infective Endocarditis (IE) during pregnancy is a rare but grave condition. The diagnosis and management can be challenging, especially when the pregnant patient warrants a cardiac operation under cardiopulmonary bypass. The present article describes IE during pregnancy based on a series of published case reports in the literature. IE during pregnancy often causes embolic events and mycotic aneurysms. Two-thirds of IE in the pregnant patients requires timely or urgent cardiac surgery to alleviate patients deterioration. At least a 3-week antibiotic therapy is mandatory before cardiac surgery aiming at improving the patients. Conditions. During cardiac surgery, fetal heart rates may temporarily be slowed down but may gradually recover to normal after the operation. The fetal and maternal mortalities were 16.7% and 3.3%, respectively. The fetal deaths were apparently associated with a cardiac surgery during early pregnancy. Cardiopulmonary bypass, hypothermia and rewarming can adversely affect both the mother and the fetus by triggering placental deficits, fetal hypoxia and uterine contraction. Avoidance of cardiac operations before 24th gestation week and preferably deferred until after 28th gestation week have been a plausible argument as per the possible fetal deaths related to immaturity. (author)

  14. Bacterial Endocarditis and Cerebrovascular Disease.

    Science.gov (United States)

    Silver, Brian; Behrouz, Réza; Silliman, Scott

    2016-12-01

    Cerebrovascular complications of endocarditis occur in 25-70% of patients with infective endocarditis. The cornerstone of treatment is early initiation of antibiotic treatment, which significantly reduces the risk of embolization after 1 week of treatment. In general, thrombolysis and anticoagulation of these patients should be avoided, while antiplatelet therapy may be considered in those with other indications. Endovascular treatment of acute septic emboli is uncertain, but a few case reports have demonstrated benefit. Other complications of infective endocarditis include intracerebral hemorrhage, which may be predicted by the presence of two or more cerebral microbleeds on gradient echo sequences. Intracranial mycotic aneurysms can often be managed with serial imaging and coiled if there is evidence of failure to reduce in size, or enlargement.

  15. Musculoskeletal manifestations of bacterial endocarditis

    Directory of Open Access Journals (Sweden)

    Érika Bevilaqua Rangel

    2000-09-01

    Full Text Available CONTEXT: The incidence of staphylococcal infection has been increasing during the last 20 years. OBJECTIVE: Report a case of staphylococcal endocarditis preceded by musculoskeletal manifestations, which is a rare form of clinical presentation. DESIGN: Case report. CASE REPORT: A 45-year-old-man, without addictions and without known previous cardiopathy, was diagnosed as having definitive acute bacterial endocarditis due to Staphylococcus aureus. Its etiology was community-acquired, arising from a non-apparent primary focus. In addition, the musculoskeletal symptoms preceded the infective endocarditis (IE by about 1 month, which occurred together with other symptoms, e.g. mycotic aneurysms and petechiae. Later, the patient showed perforation of the mitral valve and moderate mitral insufficiency with clinical control.

  16. 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.

  17. Cardiac imaging in infectious endocarditis

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...... 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...

  18. Nosocomial infective endocarditis in Hemodialysis

    International Nuclear Information System (INIS)

    Bhat, A.W.; Solangi, S.; Murtada, O.

    2002-01-01

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

  19. Partial oral treatment of endocarditis

    DEFF Research Database (Denmark)

    Iversen, Kasper; Høst, Nis Baun; 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...

  20. Infective endocarditis associated with Bartonella henselae: A case series

    Directory of Open Access Journals (Sweden)

    Akio Nakasu

    Full Text Available Organisms in the genus Bartonella are cause of blood culture-negative endocarditis. Bartonella infective endocarditis is being increasingly reported worldwide; however, reports from Japan are limited. Here, we report five cases of infective endocarditis associated with Bartonella henselae. All patients had a history of contact with cats or fleas; this information helped achieve an appropriate diagnosis. Keywords: Infective endocarditis, Blood culture-negative endocarditis, Bartonella henselae, Infection, Bartonella, Endocarditis

  1. 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

  2. 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

  3. 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...

  4. Nonbacterial thrombotic endocarditis presenting as intracerebral hemorrhage.

    Science.gov (United States)

    Wigger, Olivier; Windecker, Stephan; Bloechlinger, Stefan

    2016-12-01

    Nonbacterial thrombotic endocarditis is a rare cause of valvular heart disease, most commonly associated with advanced malignancy. The morbidity of this kind of endocarditis lies in its tendency to embolize, while the valve function is usually preserved. The central nervous system is the most common site of embolization, leading to ischemic stroke. We report a case of nonbacterial thrombotic endocarditis complicated by intracerebral hemorrhage as the first manifestation of adenocarcinoma of the lung. The endocarditis led to severe aortic regurgitation. In view of the advanced stage of lung cancer, the patient refused further therapy. He passed away 3 weeks after first diagnosis of the adenocarcinoma.

  5. Neurological complications of infective endocarditis

    International Nuclear Information System (INIS)

    Khan, Sonia A.A.; Yaqub, Basim A.; Al-Deeb, Saleh M.

    1996-01-01

    We reviewed the files of 80 successive patients with native and prosthetic valve endocarditis admitted to Riyadh Armed Forces Hospital. Neurolological complications (NC) occurred in 28 (35%) patients. The valves involved were mitral in 12 (43%), aortic in eight (29%), combined mitral and aortic lesions in six (21%) and others in two (7%). The common causative organisms were Streptococci in 12 (43%), Staphylococcus aureus and Staphylococcus epidermides, both occurring in four (14%). Compared to the 52 infective endocarditis patients with no neurological complications (NNC), the NC occurred more frequently in male patients, those with aortic valve lesion, those with atrial fibrillation, those with delayed therapy and those with causative organisms being Streptococci or Staphylococci. Eleven patients died (39%), 12 (43%) recovered with motor sequelae, six (21%) had seizure disorder and five (18%) had full recovery. The frequency of neurological complications and mortality is comparable to those reported in the literature: however, the frequency was higher in our patients. (author)

  6. Caries temprana de infancia: ¿enfermedad infecciosa?

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    F. Sandra Rojas, Dra.

    2014-05-01

    Full Text Available La caries dental es una de las enfermedades más comunes en la infancia y las personas continúan siendo susceptible a través de la vida. Aunque actualmente puede ser detenida y potencialmente revertida en etapas tempranas, no es autolimitada, progresa en forma crónica si no existe un cuidado y control de los factores que la producen, llegando a la destrucción de dientes, dolor, alteraciones funcionales, sistémicas y consecuencias en la calidad de vida de las personas. La caries temprana de infancia, de inicio precoz en niños, es causada en forma frecuente por hábitos alimenticios inapropiados y la adquisición temprana de microorganismos como Streptococcus mutans. Se ha sugerido una transmisión vertical de madre a hijo como la vía principal de adquisición de Streptococcus mutans, y también se ha demostrado en la literatura, que existiría una transmisión horizontal entre niños y sus cuidadores, compañeros de jardín infantil y colegios. Por esta razón durante muchos años se ha definido la enfermedad caries como infecciosa y transmisible. Nuevos avances en técnicas moleculares han dado evidencia acerca de la microflora autóctona y cómo la placa dental o biofilm funciona como un sistema ecológico dinámico y complejo. Existe evidencia que la caries dental no es una enfermedad infecciosa clásica, como se creía hace unos años, por el contrario, esta enfermedad es el resultado de un cambio ecológico en la biopelícula adquirida en la superficie dental. Además la transmisión de Streptococcus mutans de la madre hacia el hijo no implica que la enfermedad se desarrolle, por el contrario, la caries dental hoy se describe como una enfermedad común, compleja y multifactorial, donde interactúan varios factores de riesgo, entre los más destacados conductuales, ambientales y genéticos.

  7. Efeito terapêutico do crosslinking corneal na ceratite infecciosa

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    Ana Cecília de Souza Leão Escarião

    2013-12-01

    Full Text Available OBJETIVO: Avaliar o efeito do crosslinking (CXL no tratamento de ceratite infecciosa, resistente ao tratamento clínico, e investigar a relação com o agente etiológico. MÉTODOS: Foram incluídos 11 pacientes com diagnóstico de ceratite infecciosa de etiologia bacteriana (sete olhos e fúngica (quatro olhos na Fundação Altino Ventura (FAV no período de outubro de 2011 a maio de 2012. Os pacientes incluídos estavam em uso de colírios há pelo menos sete dias e não apresentavam melhora da infecção. Estes foram avaliados antes da realização do CXL e no período pós-operatório até cicatrização da úlcera. Para realização do CXL foram instiladas gotas de riboflavina a 0,1% e dextrano a 20%, a cada cinco minutos em um período de 30 minutos antes do procedimento, e durante a aplicação da luz ultravioleta A (UVA. A córnea foi exposta à UVA com comprimento de onda de 370ηm ± 5ηm e uma irradiância de 3mW/cm². RESULTADOS: Os pacientes com infecção bacteriana obtiveram cura do processo infeccioso após o CXL e nenhum paciente com ceratite fúngica apresentou cicatrização. Observou-se associação significante (p = 0,003 entre o agente etiológico e a cicatrização. CONCLUSÃO: O CXL mostrou-se eficaz no tratamento da ceratite bacteriana resistente ao tratamento clínico, evitando a realização de transplante tectônico. Em relação à ceratite fúngica, este procedimento não influenciou na melhora do processo infeccioso.

  8. Las Enfermedades Infecciosas emergentes y la Salud Pública

    Directory of Open Access Journals (Sweden)

    Fabio Aurelio Rivas Muñoz

    1997-06-01

    Full Text Available

    El optimismo de hace unos años con respecto al control definitivo de las enfermedades infecciosas ha venido diluyéndose poco a poco. Hoy en día, estas entidades nos atacan por múltiples frentes y, en conjunto, representan la principal causa de muerte a escala mundial. En 1995 17 millones de personas, incluidos 9 millones de niños, murieron por infecciones prevenibles como diarreas y neumonías. Los antibióticos, considerados hasta hace poco tiempo la solución al problema de las infecciones, son cada vez menos eficaces en la medida en que se incrementa el número de cepas resistentes y la velocidad con que éstas desarrollan dicha resistencia.

    Si a este hecho agregamos el evidente deterioro de las condiciones de vida de la población y el que ha sufrido la salud pública en particular, a consecuencia del desigual impulso a la más rentable atención de la enfermedad individual, la facilidad y rapidez con que se viaja de uno a otro continente o de una a otra región dentro de un país, la urbanización desordenada e incontrolada de las ciudades, la crisis económica mundial, los daños al ambiente, etc., todas condiciones que, en general, favorecen la aparición de “”nuevas” infecciones, puede entonces comprenderse la magnitud del desafío.

    Algunas de las enfermedades infecciosas emergentes, esto es, aquellas cuya incidencia en el Ser Humano ha aumentado durante los dos últimos decenios o amenaza con aumentar en el futuro próximo, han surgido a consecuencia de la evolución de microorganismos ya existentes como la tuberculosis o el cólera. Otras, quizás las menos, son ocasionadas por agentes hasta hace poco desconocidos (nuevos, varios de gran patogenecidad, como el virus de Ebola o Hantavirus que llevan a severas neumonías con letalidad del 50%.

    En las Américas, entre 1991 y 1995 se notificaron más de 1 millón de casos de cólera y 9 mil muertes. La OPS estima en 10 años y en más de 200.000 millones de

  9. Endocarditis : Improving the chain of care

    NARCIS (Netherlands)

    Gomes, Anna

    2018-01-01

    Infectieuze endocarditis is een levensbedreigende ziekte dat een agressief diagnostisch en therapeutisch beleid vereist. Aangezien dit in de huidige praktijk nog niet optimaal geïmplementeerd is, is er behoefte aan verbetering van de zorg voor patiënten met (een verdenking op) endocarditis. Wegens

  10. Lymphangiogenesis is increased in heart valve endocarditis.

    Science.gov (United States)

    Niinimäki, Eetu; Mennander, Ari A; Paavonen, Timo; Kholová, Ivana

    2016-09-15

    Inflammation-associated lymphangiogenesis (IAL) has been identified as part of several acute and chronic inflammation. Sparse data exist on lymphatics during endocarditis. Fifty-two patients with surgically resected valves were included. Endocarditis was present in 18 aortic and 10 mitral valves. Controls consisted of 15 degenerative aortic and 9 degenerative mitral valves. There were 22 males with endocarditis and 17 males in controls. The mean age was 58 (SD 15) years with endocarditis vs. 62 (SD 13) years for controls. Lymphatics were detected by podoplanin antibody immunohistochemistry and morphometrical analysis was performed. The lymphatic density in endocarditis was 833 (SD 529) vessels/mm(2) (range 0-1707) as compared with 39 (SD 60) vessels/mm(2) (range 0-250) in controls (p=0.000). In endocarditis, the mean lymphatic size was 153 (SD 372) μm(2) ranging from 1 to 2034μm(2), whereas it was 30 (SD 29) μm(2), with maximum 90μm(2) and minimum 2μm(2) in controls (p=0.000). IAL is increased in valves with endocarditis as compared with controls. Lymphatics in heart valves may provide a novel means for treatment strategies against endocarditis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Infective endocarditis in children: an update.

    Science.gov (United States)

    Dixon, Garth; Christov, Georgi

    2017-06-01

    Infective endocarditis in children remains a clinical challenge. Here, we review the impact of the updated 2015 American Heart Association and European Society of Cardiology guidelines on management as well as the significance of the new predisposing factors, diagnostic and treatment options, and the impact of the 2007-2008 change in prophylaxis recommendations. The new 2015 infective endocarditis guidelines introduced the endocarditis team, added the new imaging modalities of computer tomography and PET-computer tomography into the diagnostic criteria and endorsed the concept of safety of relatively early surgical treatment. The impact of the restriction of infective endocarditis prophylaxis since the 2007-2008 American Heart Association and National Institute for Health and Care Excellence recommendations is uncertain, with some studies showing no change and other more recent studies showing increased incidence. The difficulties in adjusting for varying confounding factors are discussed. The relative proportion of the device-related infective endocarditis is increasing. Special attention is paid to relatively high incidence of percutaneous pulmonary valve implantation-related infective endocarditis with low proportion of positive echo signs, disproportionate shift in causative agents, and unusual complication of acute obstruction. The significance of incomplete neoendothelialization on the risk of infective endocarditis on intracardiac devices is also discussed. The impact of changes in the infective endocarditis prophylaxis recommendations in pediatric patients is still uncertain. The device-related infective endocarditis has increasing importance, with the incidence on transcatheter implanted bovine jugular vein pulmonary valves being relatively high. The use of novel imaging, laboratory diagnostic techniques, and relatively early surgery in particular circumstances is important for management of paediatric infective endocarditis.

  12. Aerococcus christensenii native aortic valve subacute bacterial endocarditis (SBE) presenting as culture negative endocarditis (CNE) mimicking marantic endocarditis.

    Science.gov (United States)

    Jose, Anita; Cunha, Burke A; Klein, Natalie C; Schoch, Paul E

    2014-01-01

    This is a case report of an adult who presented with apparent culture negative endocarditis (CNE) thought to be marantic endocarditis due to a B-cell lymphoproliferative disorder. This was a most perplexing case and was eventually diagnosed as subacute bacterial endocarditis (SBE) due to a rare slow growing organism. Against the diagnosis of SBE was the lack of fever, hepatomegaly, peripheral manifestations and microscopic hematuria. Also, against a diagnosis of SBE was another explanation for the patient's abnormal findings, e.g., elevated ferritin levels, elevated α1/α2 globulins on SPEP, an elevated alkaline phosphatase, flow cytometry showing B-lymphocytes expressing CD5, and a bone lesion in the right iliac. Findings compatible with both SBE and marantic endocarditis due to a B-cell lymphoproliferative disorder included an elevated ESR, and splenomegaly. Blood cultures eventually became positive during hospitalization. We report a case of native aortic valve (AV) subacute bacterial endocarditis (SBE) due to Aerococcus christensenii mimicking marantic endocarditis due to a B-cell lymphoproliferative disorder. To the best of our knowledge, this is the first reported case of native AV SBE due to A. christensenii presenting as marantic endocarditis. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Peritonite infecciosa felina: 13 casos Feline infectious peritonitis: 13 cases

    Directory of Open Access Journals (Sweden)

    Fabiano Nunes de Oliveira

    2003-10-01

    Full Text Available Numa pesquisa realizada em tecidos de 638 gatos necropsiados, foram encontrados 13 casos (2,03% de peritonite infecciosa felina. Oito desses casos (61,53% eram da forma efusiva ou úmida, e 5 apresentavam a forma seca ou não-efusiva da doença. A idade dos gatos afetados variou de 2 meses a 3 anos. Doze gatos (92,30% eram de raças puras, cinco deles (38,47% eram oriundos de ambientes onde havia mais de um gato e três eram provenientes de um mesmo gatil. A duração da doença clínica foi de 7 a 45 dias e os sinais clínicos incluíram emagrecimento, anorexia, diarréia, icterícia, vômito, linfadenopatia e distúrbios neurológicos. Os achados de necropsia na forma úmida incluíam excesso de líquido viscoso (50ml a 1 litro, translúcido ou levemente opaco na cavidade peritoneal e, em um caso, na cavidade torácica. Exsudato fibrinoso cobria as superfícies serosas dos órgãos abdominais dando-lhes aspecto granular e brancacento. Na forma seca, havia múltiplos focos granulomatosos sob a superfície serosa e para o interior do parênquima de órgãos abdominais; esses achados eram particularmente proeminentes nos rins. Opacidade de córnea foi observada em um gato. Histologicamente, havia graus variáveis de vasculite e perivasculite piogranulomatosa, particularmente em arteríolas. Meningite ou meningoencefalite piogranulomatosa foram observadas em três gatos com a forma seca de peritonite infecciosa felina.In a survey carried out in tissue specimens from 638 necropsied cats, 13 cases (2.03% of feline infectious peritonitis were found. Eight of those (61.53% were of the effusive or wet form and five had the dry non-effusive form of the disease. Ages of affected cats varied from 2-months to 3 yeas. Twelve affected cats (92.30% were purebreds, five of these cats (38.47% came from households with more than one cat and three of them came from the same comercial cat raising facility. The duration of clinical courses were 7-45 days and

  14. 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...

  15. Endocarditis in adults with bacterial meningitis.

    Science.gov (United States)

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

    2013-05-21

    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 community-acquired bacterial meningitis in the Netherlands from 2006 to 2012. Endocarditis was identified in 24 of 1025 episodes (2%) of bacterial meningitis. Cultures yielded Streptococcus pneumoniae in 13 patients, Staphylococcus aureus in 8 patients, and Streptococcus agalactiae, Streptococcus pyogenes, and Streptococcus salivarius in 1 patient each. Clues leading to the diagnosis of endocarditis were cardiac murmurs, persistent or recurrent fever, a history of heart valve disease, and S aureus as the causative pathogen of bacterial meningitis. Treatment consisted of prolonged antibiotic therapy in all patients and surgical valve replacement in 10 patients (42%). Two patients were treated with oral anticoagulants, and both developed life-threatening intracerebral hemorrhage. Systemic (70%) and neurological (54%) complications occurred frequently, leading to a high proportion of patients with unfavorable outcome (63%). Seven of 24 patients (29%) with meningitis and endocarditis died. Endocarditis is an uncommon coexisting condition in bacterial meningitis but is associated with a high rate of unfavorable outcome.

  16. Classic Peripheral Signs of Subacute Bacterial Endocarditis

    Directory of Open Access Journals (Sweden)

    Yooyoung Chong

    2016-10-01

    Full Text Available A 50-year-old female patient with visual disturbances was referred for further evaluation of a heart murmur. Fundoscopy revealed a Roth spot in both eyes. A physical examination showed peripheral signs of infective endocarditis, including Osler nodes, Janeway lesions, and splinter hemorrhages. Our preoperative diagnosis was subacute bacterial endocarditis with severe aortic regurgitation. The patient underwent aortic valve replacement and was treated with intravenous antibiotics for 6 weeks postoperatively. The patient made a remarkable recovery and was discharged without complications. We report this case of subacute endocarditis with all 4 classic peripheral signs in a patient who presented with visual disturbance.

  17. Classic Peripheral Signs of Subacute Bacterial Endocarditis

    Science.gov (United States)

    Chong, Yooyoung; Han, Sung Joon; Rhee, Youn Ju; Kang, Shin Kwang; Yu, Jae Hyeon; Na, Myung Hoon

    2016-01-01

    A 50-year-old female patient with visual disturbances was referred for further evaluation of a heart murmur. Fundoscopy revealed a Roth spot in both eyes. A physical examination showed peripheral signs of infective endocarditis, including Osler nodes, Janeway lesions, and splinter hemorrhages. Our preoperative diagnosis was subacute bacterial endocarditis with severe aortic regurgitation. The patient underwent aortic valve replacement and was treated with intravenous antibiotics for 6 weeks postoperatively. The patient made a remarkable recovery and was discharged without complications. We report this case of subacute endocarditis with all 4 classic peripheral signs in a patient who presented with visual disturbance. PMID:27734006

  18. Primary Mural Endocarditis Without Valvular Involvement.

    Science.gov (United States)

    Tahara, Mai; Nagai, Tomoo; Takase, Yoshiyuki; Takiguchi, Shunichi; Tanaka, Yoshiaki; Kunihara, Takashi; Arakawa, Junko; Nakaya, Kazuhiro; Hamabe, Akira; Gatate, Youdou; Kujiraoka, Takehiko; Tabata, Hirotsugu; Katsushika, Shuichi

    2017-03-01

    Primary mural endocarditis is an extremely rare infection in which nonvalvular endocardial involvement is seen without any cardiac structural abnormalities such as ventricular septal defects. The rapid and precise diagnosis of this disease remains challenging. We present 2 cases (67- and 47-year-old male patients) of pathologically confirmed primary mural endocarditis that could have been detected by initial transthoracic echocardiography in the emergency department. Transthoracic echocardiography and transesophageal echocardiography play critical roles in the early recognition and confirmation of primary mural endocarditis. © 2017 by the American Institute of Ultrasound in Medicine.

  19. Endocarditis due to Micrococcus sedentarius incertae sedis.

    Science.gov (United States)

    Old, D C; McNeill, G P

    1979-01-01

    The clinical and bacteriological features of a case of endocarditis are described in which a Gram-positive coccus, presently designated Micrococcus sedentarius incertae sedis, was repeatedly isolated. PMID:512056

  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

    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.

  2. 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.

  3. Diagnostic value of echocardiography in infective endocarditis

    International Nuclear Information System (INIS)

    Luo Yinli; Ni Xianda; Hu Yuanping; Liu Jingyun; Yang Weiyu

    2010-01-01

    Objective: To investigate the feature and value of echocardiography for diagnosing infective endocarditis. Methods: The shape, size, echogenicity, distribution of vegetations and valvular injury of the heart were observed in 30 patients with infective endocarditis. Results: The vegetations were located in the aortic valves (10 cases), bicuspid valves (5), tricuspid valve (1), pulmonary valve (2), main pulmonary artery with patent ductus arteriosus (2), and right ventricle with ventricular septal defect (2). The size of vegetation ranged from 2 to 27 mm and the echogenicity of vegetations was low to high. The location, size, shape and amount of vegetations observed on echocardiography correlated well with the operative findings. Echocardiography also demonstrated underlying heart disease and abnormal hemodynamics induced by infective endocarditis. Conclusion: Echocardiography can determine the location, size, shape, amount of vegetation and concomitant cardiac disease in patients with infective endocarditis. It play an important role in treatment and prognosis. (authors)

  4. Mortalidad prematura por enfermedades infecciosas en España, 1908-1995

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    Mirón Canelo José Antonio

    2002-01-01

    Full Text Available Objetivos. Las enfermedades infecciosas han sido tradicionalmente una de las principales causas de muerte en los países desarrollados. Los objetivos del presente trabajo consistieron en cuantificar la importancia de las enfermedades infecciosas como causa de muerte prematura en España entre 1908 y 1995, y conocer la frecuencia y distribución de las enfermedades infecciosas con mayor impacto sobre la mortalidad prematura. Métodos. El estudio se realizó a partir de los datos de mortalidad por causas infecciosas publicados por el Instituto Nacional de Estadística en el Movimiento Natural de la Población para el período en estudio. Se utilizan como indicadores de mortalidad prematura los años de vida potencial perdidos (AVPP, la tasa bruta de AVPP por 1 000 habitantes y el porcentaje y la media de AVPP. Resultados. Entre 1908 y 1995, el número y la tasa de AVPP por causas infecciosas experimentaron una evolución claramente descendente. El descenso fue más acusado a partir de los años 50 y se observó en todos los grupos de edad. La tuberculosis fue la primera causa de muerte prematura desde principios de siglo hasta los años 70. A partir de esta fecha toman el relevo las neumonías y el sida. Conclusiones. El impacto de las enfermedades infecciosas como determinantes de muerte prematura en España ha descendido a lo largo del siglo XX, sobre todo a partir de los años 70.

  5. Brucella Endocarditis Caused By Brucella Melitensis

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    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

    2016-01-01

    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. 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 and 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. 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. 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.

  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. Membranous glomerulonephritis associated with enterococcal endocarditis.

    Science.gov (United States)

    Iida, H; Mizumura, Y; Uraoka, T; Takata, M; Sugimoto, T; Miwa, A; Yamagishi, T

    1985-01-01

    An autopsy case of membranous glomerulonephritis associated with enterococcal endocarditis was reported. Although enterococcal antigen was not identified in glomerular deposits, the eluate from the patient's renal tissue was shown to specifically recombine with cells of the enterococcus isolated from his own ante mortem blood. Hypocomplementemia, circulating immune complexes and antienterococcal antibodies were also observed. These findings suggest that enterococcus-related immune complexes played a role in the pathogenesis of glomerulonephritis associated with enterococcal endocarditis in this patient.

  9. Aspectos determinantes en la presentación de la enfermedad infecciosa de la bursa

    OpenAIRE

    Jaimes-Olaya, Javier Andrés; Álvarez Espejo, Diana Claudia; Correa, Jairo Jaime; Vera Alfonso, Víctor Julio

    2009-01-01

    La enfermedad infecciosa de la bursa, o enfermedad de Gumboro, es una patología inmunosupresiva de las aves de gran importancia en la industria avícola, debido a las grandes pérdidas económicas que produce no sólo por su efecto directo, sino por la predisposición a infecciones secundarias y a la interferencia con las vacunas comerciales, disminuyendo la eficacia de éstas. Es producida por el virus de la enfermedad infecciosa de la bursa (IBDV), el cual es un birnavirus de genoma RNA, con alta...

  10. Complicated infective endocarditis: a case series.

    Science.gov (United States)

    Kim, Joo Seop; Kang, Min-Kyung; Cho, A Jin; Seo, Yu Bin; Kim, Kun Il

    2017-05-08

    Infective endocarditis is associated with not only cardiac complications but also neurologic, renal, musculoskeletal, and systemic complications related to the infection, such as embolization, metastatic infection, and mycotic aneurysm. We report three cases (the first patient is Chinese and the other two are Koreans) of complicated infective endocarditis; two of the cases were associated with a mycotic aneurysm, and one case was associated with a splenic abscess. One case of a patient with prosthetic valve endocarditis was complicated by intracerebral hemorrhage caused by mycotic aneurysm rupture. A second case of a patient with right-sided valve endocarditis associated with a central catheter was complicated by an abdominal aortic mycotic aneurysm. The third patient had a splenic infarction and abscess associated with infected cardiac thrombi. Complicated infective endocarditis is rare and is associated with cardiac, neurologic, renal, musculoskeletal, and systemic complications related to infection, such as embolization, metastatic infection, and mycotic aneurysm. Infective endocarditis caused by Staphylococcus aureus is more frequently associated with complications. Because the mortality rate increases when complications develop, aggressive antibiotic therapy and surgery, combined with specific treatments for the complications, are necessary.

  11. 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

  12. Endocarditis caused by anaerobic bacteria.

    Science.gov (United States)

    Kestler, M; Muñoz, P; Marín, M; Goenaga, M A; Idígoras Viedma, P; de Alarcón, A; Lepe, J A; Sousa Regueiro, D; Bravo-Ferrer, J M; Pajarón, M; Costas, C; García-López, M V; Hidalgo-Tenorio, C; Moreno, M; Bouza, E

    2017-10-01

    Infective endocarditis (IE) caused by anaerobic bacteria is a rare and poorly characterized disease. Most data reported in the literature are from case reports [1-3]. Therefore, we assessed the situation of anaerobic IE (AIE) in Spain using the database of the Spanish Collaboration on Endocarditis (GAMES). We performed a prospective study from 2008 to 2016 in 26 Spanish centers. We included 2491 consecutive cases of definite IE (Duke criteria). Anaerobic bacteria caused 22 cases (0.9%) of definite IE. Median age was 66 years (IQR, 56-73), and 19 (86.4%) patients were men. Most patients (14 [63.6%]) had prosthetic valve IE and all episodes were left-sided: aortic valves, 12 (54.5%); and mitral valves, 8 (36.4%). The most common pathogens were Propionibacterium acnes (14 [63.6%]), Lactobacillus spp (3 [13.63%]), and Clostridium spp. (2 [9.0%]), and the infection was mainly odontogenic. Fifteen of the 22 patients (68.2%) underwent cardiac surgery. Mortality was 18.2% during admission and 5.5% after 1 year of follow-up. When patients with AIE were compared with the rest of the cohort, we found that although those with AIE had a similar age and Charlson comorbidity index, they were more likely to have community-acquired IE (86.4% vs. 60.9%, p = 0.01), have undergone cardiac surgery (68.2% vs 48.7% p = 0.06), and have had lower mortality rates during admission (18.2% vs. 27.3%). IE due to anaerobic bacteria is an uncommon disease that affects mainly prosthetic valves and frequently requires surgery. Otherwise, there are no major differences between AIE and IE caused by other microorganisms. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. ENFERMEDADES INFECCIOSAS EMERGENTES: EL TURNO DEL VIRUS DEL ZIKA

    Directory of Open Access Journals (Sweden)

    Carlos Arturo Álvarez Moreno

    2016-04-01

    ó y continúa siendo una causa frecuente de epidemias. En Suramérica, incluyendo Colombia, el último brote fue introducido en 1991.

    Más cerca, en 1918, la pandemia de la influenza (gripa española produjo solo en Estados Unidos 500.000 muertes y mucho más cerca, la pandemia de influenza por la A(H1N1 causó solo en el 2009 cerca de 500.000 muertes y aún sigue circulando, generando muertes adicionales (1. Si a esto le sumamos los casos de otras enfermedades emergentes como síndrome respiratorio agudo severo causados por coronavirus (SARS en el 2003 o MERS actualmente o el brote de fiebre amarilla (enfermedad reemergente ocurrido en el 2003-2004 en nuestro país, se puede decir que las enfermedades infecciosas, tanto las emergentes como las reemergentes, lejos de estar controladas, cada vez son un problema creciente de salud pública.

    1 Miembro Correspondiente. Academia Nacional de Medicina. Profesor Titular, Facultad de Medicina. Universidad Nacional de
    Colombia. Director General, Clínica Universitaria Colombia, Clínicas COLSANITAS S.A...

  14. Endocarditis

    Science.gov (United States)

    ... and may even be fatal. Complications in Other Organs IE also can affect other organs in the ... to attach and multiply on damaged, malformed, or artificial (man-made) heart valves and implanted medical devices. ...

  15. Aggregatibacter aphrophilus pacemaker endocarditis: a case report.

    Science.gov (United States)

    Patel, Sahil R; Patel, Nishi H; Borah, Amit; Saltzman, Heath

    2014-12-08

    Aggregatibacter bacteria are a rare cause of endocarditis in adults. They are part of a group of organisms known as HACEK--Haemophilus, Aggregatibacter, Cardiobacter, Eikenella, and Kingella. Among these organisms, several Haemophilus species have been reclassified under the genus Aggregatibacter. Very few cases of Aggregatibacter endocarditis in patients with pacemaker devices have been reported. We present here what we believe to be the first case of Aggregatibacter aphrophilus pacemaker endocarditis. A 62-year-old African American male with a medical history significant for dual-chamber pacemaker placement in 1996 for complete heart block with subsequent lead manipulation in 2007, presented to his primary care doctor with fever, chills, night sweats, fatigue, and ten-pound weight loss over a four-month period. Physical examination revealed a new murmur and jugular venous distension which prompted initiation of antibiotics for suspicion of endocarditis. Both sets of initial blood cultures were positive for A. aphrophilus. Transesophageal echocardiogram revealed vegetations on the tricuspid valve and the right ventricular pacemaker lead (Figure 1). This case highlights the importance of identifying rare causes of endocarditis and recognizing that treatment may not differ from the standard treatment for typical presentations. The patient received intravenous ceftriaxone for his endocarditis for a total of six weeks. Upon device removal, temporary jugular venous pacing wires were placed. After two weeks of antibiotic treatment and no clinical deterioration, a new permanent pacemaker was placed and the patient was discharged home. This is the first case of A. aphrophilus endocarditis in a patient with a permanent pacemaker. Our patient had no obvious risk factors other than poor dentition and a history of repeated pacemaker lead manipulation. This suggests that valvulopathies secondary to repeated lead manipulation can be clinically significant factors in morbidity

  16. Clinical and microbiological findings of infective endocarditis.

    Science.gov (United States)

    Cancan Gursul, Nur; Vardar, Ilknur; Demirdal, Tuna; Gursul, Erdal; Ural, Serap; Yesil, Murat

    2016-05-31

    Infective endocarditis (IE) is an infection that develops on the endothelial surface of the heart. Endocarditis is a major problem for the clinicians despite of the developments in diagnostic, surgical, and medical treatment methods. In this study, we aimed to evaluate symptoms, laboratory findings, treatment options, and clinical endpoint of the patients who were diagnosed with IE in a tertiary healthcare organization according to the literature data. Between January 2006 and March 2013, 80 IE patients who were diagnosed and treated in accordance with modified Duke criteria were enrolled in the study. Demographic features, symptoms, and laboratory and echocardiographic findings were recorded after reviewing the patient files. The mean age of the patients was 51.3 ± 16.0, and IE was more common in men (n = 56; 70%). Of 41 patients who had positive blood cultures, 20 patients had Staphylococcus spp. (48.7%) and 8 patients had Streptococcus spp. (19.5%). Brucella spp. was isolated from 5 patients (12.2%). While 48.7% (n = 39) of the patients had cardiac complications, 22 patients (27.5%) had embolic complication. Hospital mortality was observed in 20 patients (15%). In our patients, endocarditis was seen at a young age, and staphylococci were the most frequently isolated microorganism from blood culture. There were more patients with Brucella endocarditis compared to the general population. Complications are frequently seen in the course of endocarditis, and they cause problems for the clinicians during follow ups due to the high mortality rate of IE.

  17. Hepatite infecciosa canina: 62 casos Infectious canine hepatitis: 62 cases

    Directory of Open Access Journals (Sweden)

    Maria A. Inkelmann

    2007-08-01

    Full Text Available Os protocolos de necropsias realizadas em 5.361 cães durante um período de 43 anos (1964-2006 foram revisados em busca de casos de hepatite infecciosa canina (HIC e sessenta e dois (1,2% casos foram encontrados. A maioria dos 62 cães afetados tinha dois anos de idade ou menos (91,9%. Os sinais clínicos foram anotados nos protocolos de necropsia de 45 cães afetados por HIC e incluíam anorexia (55,6%, apatia (35,6%, diarréia (35,6%, freqüentemente com sangue (43,8% dos casos de diarréia, distúrbios neurológicos (33,3%, vômito (26,7%, petéquias e equimoses nas membranas mucosas e/ou pele (24,4%, hipotermia (20,0%, dor abdominal (15,6%, icterícia (13,3%, aumento de volume e congestão das tonsilas (11,1%, febre (11,1% e ascite (6,7%. A duração do curso clínico variou de poucas horas a 15 dias. Os principais achados de necropsia incluíram alterações hepáticas (87,1%, linfonodos edematosos, congestos e hemorrágicos (51,6%, líquido sanguinolento, líquido claro ou sangue na cavidade abdominal (35,5%, víbices, sufusões e petéquias sobre a pleura visceral (27,4% e superfície serosa das vísceras gastrintestinais (24,2%. Em 12,9% dos casos a serosa do intestino tinha aspecto granular. Hemorragias cerebrais nas leptomeninges e na substância do encéfalo foram observadas em 9,7% dos casos. As alterações hepáticas macroscópicas incluíam fígados moderadamente aumentados de volume, mais friáveis, com acentuação do padrão lobular, congestos e com múltiplos focos de necrose pálidos ou hemorrágicos. Películas e filamentos de fibrina cobriam a superfície hepática em 20,4% dos casos e em 27,8% dos casos a parede da vesícula biliar estava espessada por edema. Necrose hepática zonal ou aleatória (93,5% dos casos associada a corpúsculos de inclusão intranucleares foi a lesão histológica mais regularmente encontrada. Os corpúsculos de inclusão intranucleares ocorreram no fígado em todos os casos e esse foi o crit

  18. Acute bacterial endocarditis. Optimizing surgical results.

    Science.gov (United States)

    Larbalestier, R I; Kinchla, N M; Aranki, S F; Couper, G S; Collins, J J; Cohn, L H

    1992-11-01

    Acute bacterial endocarditis continues to be a condition with high morbidity. Although the majority of patients are treated by high-dose antibiotics, a high-risk patient group requires surgical intervention, which is the subject of this article. From 1972 to 1991, 3,820 patients underwent heart valve replacement at the Brigham and Women's Hospital, Boston. Of this group, 158 patients underwent surgery for acute bacterial endocarditis: 109 had native valve endocarditis (NVE), and 49 had prosthetic valve endocarditis (PVE). There were 108 men and 50 women with a mean age of 49 years (range, 16-79 years); 64% were New York Heart Association functional class IV before surgery, and 12% of the group had a history of intravenous drug abuse. In both NVE and PVE groups, Streptococcus was the predominant infecting agent. Uncontrolled sepsis, progressive congestive failure, peripheral emboli, and echocardiographically demonstrated vegetations were the most common indications for surgery. Eighty-five percent of patients had a single-valve procedure, 15% had a multivalve procedure, and 34 patients had other associated major cardiac procedures. The operative mortality was 6% in NVE and 22% in PVE. Long-term survival at 10 years was 66% for NVE and 29% for PVE. Freedom from recurrent endocarditis at 10 years was 85% for NVE and 82% for PVE. The main factors associated with decreased survival overall were PVE and nonstreptococcal infection. The morbidity and mortality after surgical treatment of acute endocarditis depend on the site, the severity, and the subject infected. Early aggressive surgical intervention is indicated to optimize surgical results, especially in patients with nonstreptococcal infection or PVE.

  19. 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

    streptococcal isolates from the oral cavities of periodontal patients without endocarditis. Subsequently, surface hydrophobicity was assessed by hydrophobic interaction chromatography, production of extracellular dextran was determined by precipitation, and non-specific proteolytic activity was evaluated......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...... and non-endocarditis isolates. CONCLUSIONS: The present study showed that infective endocarditis may be caused by a variety of oral streptococcal species. The possible virulence factors investigated were found in the same proportions in endocarditis and non-endocarditis isolates, and thus did not seem...

  20. 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 may...... be atypical causing a delay in the diagnosis and treatment. The management is also complicated by their comorbidities, and surgical treatment may not be feasible leading to a significant morbidity and mortality. We describe a case of an 85-year-old man with TAVI prosthetic valve endocarditis successfully...

  1. 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...

  2. 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

    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...... with PE, 67% needed acute valve replacement and the mortality rate was 33%. CONCLUSIONS: The high incidence rate, clinical characteristics and grave prognosis of PE are consistent with another study of an Inuit population in Alaska....

  3. O conceito de espaço na epidemiologia das doenças infecciosas

    Directory of Open Access Journals (Sweden)

    Silva Luiz Jacintho da

    1997-01-01

    Full Text Available Análise teórica da utilização do conceito de espaço na epidemiologia das doenças infecciosas. Faz-se uma breve retrospectiva do uso de diferentes conceituações de espaço e de suas implicações. Ênfase é dada à teoria dos focos naturais de Pavlovsky e às interações entre a epidemiologia e a geografia. O problema atual das infecções emergentes é visto como determinante da necessidade de se intensificarem as discussões sobre este conceito na epidemiologia das doenças infecciosas.

  4. O conceito de espaço na epidemiologia das doenças infecciosas

    Directory of Open Access Journals (Sweden)

    Luiz Jacintho da Silva

    Full Text Available Análise teórica da utilização do conceito de espaço na epidemiologia das doenças infecciosas. Faz-se uma breve retrospectiva do uso de diferentes conceituações de espaço e de suas implicações. Ênfase é dada à teoria dos focos naturais de Pavlovsky e às interações entre a epidemiologia e a geografia. O problema atual das infecções emergentes é visto como determinante da necessidade de se intensificarem as discussões sobre este conceito na epidemiologia das doenças infecciosas.

  5. Endocarditis in left ventricular assist device

    Science.gov (United States)

    Thyagarajan, Braghadheeswar; Kumar, Monisha Priyadarshini; Sikachi, Rutuja R; Agrawal, Abhinav

    2016-01-01

    Summary Heart failure is one of the leading causes of death in developed nations. End stage heart failure often requires cardiac transplantation for survival. The left ventricular assist device (LVAD) has been one of the biggest evolvements in heart failure management often serving as bridge to transplant or destination therapy in advanced heart failure. Like any other medical device, LVAD is associated with complications with infections being reported in many patients. Endocarditis developing secondary to the placement of LVAD is not a frequent, serious and difficult to treat condition with high morbidity and mortality. Currently, there are few retrospective studies and case reports reporting the same. In our review, we found the most common cause of endocarditis in LVAD was due to bacteria. Both bacterial and fungal endocarditis were associated with high morbidity and mortality. In this review we will be discussing the risk factors, organisms involved, diagnostic tests, management strategies, complications, and outcomes in patients who developed endocarditis secondary to LVAD placement. PMID:27672540

  6. 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 structure...

  7. 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...

  8. 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...

  9. 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

  10. Endocarditis associated with intracardiac devices

    International Nuclear Information System (INIS)

    Tourn, J.; Rocha, A.; Jubany, L.; Figueroa, S.; Sasso, D.; Dalto, L.; Ferreiro, A.; Fernandez, P.; Kuster, F.

    2013-01-01

    Full text: Background: Infective endocarditis (I E) associated with intracardiac devices (DIC) (pacemakers and CDAI) is a serious condition associated with high mortality (10-20%). Its incidence is variable according different studies but round 1.9 / 1000 devices year. The Eco and blood cultures are the pillars diagnosis of this disease. Early treatment reduces morbidity and mortality and is the extraction of entire system accompanied prolonged antibiotic therapy. Objective: To analyze the epidemiological, clinical, pathological and disease progression in patients EI carriers with DIC. Method: 3,110 DIC placed in the institution between April 2000 and February 2012 were identified by analysis of medical records EI 26 patients with DIC carriers. For diagnosis they were included EI definite cases according to the criteria Duke. They were classified into early EI (<12 months) or late (> 12 months) from the date of the last implant. Descriptive statistical analysis was performed. Result: The incidence was 8.3 / 1,000 DIC (n = 26). The mean age was 70 ± 10 years, 19 men, 9 diabetic and 16 patients had implemented a Ddd device. In 17 patients underwent more than one replacement device; 10 patients required temporary pacemaker (MPT) prior to placement permanent pacemaker. The average time since the last implant DIC at diagnosis was 710 days. The DIC extraction was early in 8 patients and late in 18. Topography of vegetation: 10 cases over the cable, six tricuspid valve, valve and four over six patient cable and vegetation not found. 15 patients blood cultures were positive; the most frequently found germ was staphylococcus aureus (S A) in nine, being this methicillin-resistant in five of them. The fever accompanied impact elements General was present in 24 cases. The most frequent medical complications were anemia in eight patients and acute renal failure in four patients. Two patients died during hospitalization (7.6%; 95% CI: 0-17.5%). The extraction system was

  11. Aspergillus niger endocarditis in an immunocompetent patient: an unusual course

    Science.gov (United States)

    Kreiss, Y.; Vered, Z.; Keller, N.; Kochva, I.; Sidi, Y.; Gur, H.

    2000-01-01

    Aspergillus is an opportunistic nosocomial fungus generally associated with a high mortality rate. A niger has been rarely associated with infection, and most cases have occurred in patients who have recently undergone heart surgery or in immunocompromised patients. We present a case of an immunocompetent patient with A niger endocarditis which illustrates the difficulties in diagnosis and the possible insidious course of fungal endocarditis.


Keywords: endocarditis; Aspergillus niger; transoesophageal echocardiography PMID:10644391

  12. 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.

  13. [Mitral valve endocarditis after Turkish "Festival of Sacrifice"].

    Science.gov (United States)

    Blaich, A; Fasel, D; Kaech, C; Frei, R

    2011-09-01

    Erysipelothrix rhusiopathiae is the causative agent of swine erysipelas. Systemic infections caused by E. rhusiopathiae are rare, but often (90%) associated with endocarditis. In about 60% of cases endocarditis develops on normal heart valves, and despite appropriate antibiotic therapy about one-third of the patients requires valve replacement. We report the case of a housewife, who developed a mitral valve endocarditis due to E. rhusiopathiae after preparing meat for the Turkish "Festival of Sacrifice".

  14. Dentigenous infectious foci ? a risk factor of infective endocarditis

    OpenAIRE

    Wisniewska-Spychala, Beata; Sokalski, Jerzy; Grajek, Stefan; Jemielity, Marek; Trojnarska, Olga; Choroszy-Kr?l, Irena; S?jka, 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 hear...

  15. Autoimmune Disease with Cardiac Valves Involvement: Libman-Sacks Endocarditis.

    Science.gov (United States)

    Ginanjar, Eka; Yulianto, Yulianto

    2017-04-01

    This case study aim to evaluate the response of steroid treatment for autoimmune endocarditis. Valvular heart disease is relatively rising in both congenital and acquired cases, but the autoimmune endocarditis remains rare. In this case, a 34 year old woman with clinical manifestation resembling systemic lupus erythematosus (SLE) is diagnosed with Libman-sacks Endocarditis. After six months of steroid treatment, her clinical manifestations and heart structure improved.

  16. Enterococcal Infective Endocarditis following Periodontal Disease in Dogs

    OpenAIRE

    Semedo-Lemsaddek, Teresa; Tavares, Marta; S?o Braz, Berta; Tavares, Lu?s; Oliveira, Manuela

    2016-01-01

    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...

  17. Acute myocardial infarction in infectious endocarditis. Report of one case

    International Nuclear Information System (INIS)

    Parietti, G; Artucio, C.; Fernandez, A; Areco, D.; Mallo, D; Lluberas, R.

    2012-01-01

    The acute myocardial infarction is a rare complication in the course of an acute endocarditis. It takes place in the first weeks infection. Although is not associated with any particular microorganism it has been associated with virulent microorganism and is common in aortic valve endocarditis insufficiency. This report is a case of a patient who suffered a myocardial infarction during a acute endocarditis of native valve

  18. Aortic root abscess resulting from endocarditis: spectrum of angiographic findings

    International Nuclear Information System (INIS)

    Miller, S.W.; Dinsmore, R.E.

    1984-01-01

    Abscesses in the aortic root are a serious complication of infective endocarditis and require accurate diagnosis for antibiotic and surgical management. Nineteen cases of endocarditis of a native valve or prosthetic valve and adjacent abscess cavities were identified with angiography. Of 6 patients with endocarditis of a native valve, 5 had bicuspid aortic valves and all had severe aortic regurgitation. Of 13 patients with endocarditis of a prosthetic aortic valve, all had paravalvular regurgitation. Fistulas were detected into the mitral anulus in 8 patients, and into the right ventricle in 3 patients. No complications from the catheterization were recorded during the 48-hour follow-up

  19. 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.

  20. Successful Management of Prosthetic Valve Brucella Endocarditis with Antibiotherapy Alone

    Directory of Open Access Journals (Sweden)

    José Pedro Fonseca

    2018-01-01

    Full Text Available Objectives: To report a case of mechanical aortic prosthesis Brucella endocarditis successfully treated with antibiotics alone. Materials and methods: We describe a clinical case and present a review of the literature. Results: A 60-year-old female farmer with a mechanical aortic prosthetic valve presented with low back pain and fever. She was diagnosed with prosthetic valve Brucella mellitensis endocarditis and was cured with antibiotic therapy alone. Few cases of successfully treated prosthetic valve Brucella endocarditis without surgery have been reported. Conclusion: Prosthetic valve Brucella endocarditis usually requires surgical valve replacement. However, selected patients may be successfully treated with antibiotic therapy alone.

  1. [Severe infective endocarditis through the history].

    Science.gov (United States)

    Rouzé, S; Leguerrier, A; Verhoye, J P; Flécher, E

    2017-02-01

    The history of infective endocarditis (IE) is a good example of medical progress. Initially incurable, endocarditis, when diagnosed, was synonym of death. After significant diagnostic progress, thanks to Osler's contribution especially, the first surgeries and antibacterial drugs obtained very few successful cures. We had to wait until Flamming's discovery to observe frequent cures thanks to antibiotics. Surgery manages to push possibilities of cure a bit further. However, paravalvular extensions, described since the first surgical case of IE, was a real technical matter. Thus, the second half of 20th century was devoted to overcoming this surgical challenge. In this historical review, we describe the story of severe IE, especially with paravalvular involvement, by highlighting major progress - clinical and surgical, that allows its current management. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  2. 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...

  3. Triple valve infective endocarditis - a late diagnosis

    Directory of Open Access Journals (Sweden)

    Edme R. Mustafa

    2018-04-01

    Full Text Available Behcet's disease is a systemic vasculitis of unknown aetiology with cardiac involvement as well as damage to other organs. Whether the sterile valvular inflammation which occurs in this autoimmune disease predisposes to bacterial adhesion and infective endocarditis is not yet established. We present the case of a patient with Behcet disease in which transthoracic echocardiography showed mobile masses on the aortic, tricuspid, and mitral valves, leading to multivalvular infective endocarditis diagnosis, possibly in the context of valvular inflammation. The case presented in this article confirms observation of other studies, namely that ultrasonography plays an important role in the diagnosis and evaluation of rheumatic diseases and permits optimal management in daily practice.

  4. Efficacy of imipenem/cilastatin in endocarditis.

    Science.gov (United States)

    Dickinson, G; Rodriguez, K; Arcey, S; Alea, A; Greenman, R

    1985-06-07

    Imipenem, a potent new beta-lactam antibiotic, which is bactericidal against most pathogenic bacteria, and cilastatin, a dehydropeptidase inhibitor combined with imipenem to prevent the metabolism of imipenem in the kidney, were evaluated in the treatment of bacterial endocarditis. Seventeen patients, including 14 who used intravenous drugs, were treated with imipenem/cilastatin in a dose of 500 mg each infused over 30 minutes every six hours. The mean duration of treatment was 29 days with a range of 21 to 56 days. Causative bacteria were Staphylococcus aureus in 10 patients, S. aureus plus group B Streptococcus in one, viridans group Streptococcus in two, Neisseria subflava, Eikenella corrodens, and group G Streptococcus in one patient, and Staphylococcus epidermidis, Hemophilus aphrophilus, and Enterobacter aerogenes in one patient each. The minimal bactericidal concentration of imipenem against 16 of 18 isolates tested was 0.04 micrograms/ml, 1 microgram/ml against H. aphrophilus, and 0.4 micrograms/ml against E. aerogenes. The site of infection was the right side of the heart in 11 patients, the left side in five, and both sides in one. The mean number of days to defervescence was 9.7. All patients were cured, and none required cardiac surgery. Adverse effects were few and interrupted treatment occurred in only one patient who had acute dyspnea during an infusion on Day 26 of therapy. Imipenem/cilastatin appears to be a relatively safe and highly effective treatment of staphylococcal endocarditis in intravenous drug users; too few patients with endocarditis caused by other bacteria were treated to allow a firm statement about efficacy in non-staphylococcal endocarditis.

  5. Bilateral Nongranulomatous Uveitis with Infective Endocarditis

    OpenAIRE

    Ha, Sang Won; Shin, Jae Pil; Kim, Si Yeol; Park, Dong Ho

    2012-01-01

    A 32-year-old male who had infective endocarditis complained of photophobia and blurred vision in both eyes. Biomicroscopic examination and fundus examination revealed anterior chamber reaction, vitritis, optic disc swelling, and Roth spots. He was diagnosed with bilateral nongranulomatous uveitis and treated with topical steroid eye drops and posterior sub-Tenon injection of triamcinolone. His visual symptoms were resolved within 1 week, and inflammation resolved within 4 weeks after treatment.

  6. Bilateral nongranulomatous uveitis with infective endocarditis.

    Science.gov (United States)

    Ha, Sang Won; Shin, Jae Pil; Kim, Si Yeol; Park, Dong Ho

    2013-02-01

    A 32-year-old male who had infective endocarditis complained of photophobia and blurred vision in both eyes. Biomicroscopic examination and fundus examination revealed anterior chamber reaction, vitritis, optic disc swelling, and Roth spots. He was diagnosed with bilateral nongranulomatous uveitis and treated with topical steroid eye drops and posterior sub-Tenon injection of triamcinolone. His visual symptoms were resolved within 1 week, and inflammation resolved within 4 weeks after treatment.

  7. Infective endocarditis with spondylodiscitis after prostate biopsy

    Directory of Open Access Journals (Sweden)

    Fernando Pivatto Júnior

    2014-04-01

    Full Text Available Transrectal ultrasonography-guided prostate needle biopsy is the ideal method to obtain prostate specimens for histological analysis and is therefore frequently used in clinical practice. In the majority of the studies, prostate biopsy is considered a safe procedure with few major complications. In the present report, we describe a case of endocarditis with spondylodiscitis, two very rare complications of prostate biopsy.

  8. 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.

  9. A influência do laboratório no tratamento da ceratite infecciosa

    Directory of Open Access Journals (Sweden)

    Flávia Pelinsari Lana

    2011-06-01

    Full Text Available OBJETIVO: Avaliar a resposta terapêutica das ceratites infecciosas e sua correlação com o resultado laboratorial. MÉTODOS: Foram estudados 62 casos retrospectivamente de ceratite infecciosa de moderada à grave, atendidos no Hospitaldo Servidor Público Estadual de São Paulo no período de janeiro de 2000 a dezembro de 2006. Foi avaliada a resposta ao tratamento tópico com colírios antibióticos (Cefalotina 50mg/ml e Gentamicina 14mg/ml ou Ciprofloxacino 0,3%, verificando-se a necessidade de modificação da terapêutica inicial de acordo com a evolução clínica e correlação com os testes microbiológicos pré-tratamento. RESULTADOS: Observou-se que 21 culturas (33,9% foram positivas e 41 (66,1% foram negativas. Houve crescimento de fungo em uma amostra (1,6%. Em apenas dois casos (3,5% houve correlação do exame bacterioscópico com o da cultura. Em 5 casos (8,1% houve necessidade de modificação da medicação devido à piora clínica e 91,9% dos pacientes cursaram com cura do processo infeccioso com o tratamento inicial instituído. CONCLUSÃO: O uso tópico de antibióticos fortificados ou quinolonas foi eficaz no tratamento das ceratites de provável etiologia infecciosa com culturas positivas e negativas.

  10. Meningite e endocardite infecciosa causada por Rhodotorula mucilaginosa em paciente imunocompetente

    Directory of Open Access Journals (Sweden)

    Sergio Henrique Loss

    2011-12-01

    Full Text Available Os autores relatam o caso de um homem imunocompetente admitido com comprometimento agudo do sistema nervoso, crise hipertensiva e insuficiência renal, vindo a receber diagnóstico de meningite e endocardite infecciosa por Rhodotorula mucilaginosa. Até onde sabemos, esta é a primeira descrição de infecção simultânea das meninges e do endotélio causada por Rhodotorula em um paciente sem comprometimento imunológico.

  11. Endocarditis infecciosa en pacientes diagnosticados de cirrosis hepática. ¿Está indicado el tratamiento quirúrgico?

    Directory of Open Access Journals (Sweden)

    Javier Miguelena

    2016-05-01

    Conclusiones: La cirrosis hepática empeora claramente el pronóstico de la EI, aumentando la mortalidad global del 19,2% al 37%. Además se asocia a una tasa de complicaciones mayores muy elevada. Aunque los pacientes en estadio A intervenidos quirúrgicamente presentaron una mortalidad inferior a quienes siguieron tratamiento médico exclusivamente, la elevada mortalidad en estadios más avanzados obliga a establecer la indicación quirúrgica de manera individualizada y procurar un cuidadoso manejo perioperatorio en estos pacientes.

  12. Endocarditis due to nutritionally deficient streptococci: therapeutic dilemma

    Directory of Open Access Journals (Sweden)

    Erica Escarcega

    2017-07-01

    Full Text Available Subacute endocarditis often presents with an indolent course. A potentially lethal form generated by infection with Abiotrophia defectiva may be easily overlooked early in its presentation. This report discusses the case of an 18-year-old male discovered to have severe endocarditis after presenting to the emergency department with the chief complaint of foot pain.

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

    African Journals Online (AJOL)

    spectrum antimicrobial agents, pre-existing valvular heart disease and. HIV infection. A catheter-related portal of entry has been reported in. 80% of cases of C. parapsilosis endocarditis in one series of Candida endocarditis cases.[5] Other described risk factors include abdominal surgery, IV drug use and prosthetic heart ...

  14. Francisella tularensis endocarditis: two case reports and a literature review.

    Science.gov (United States)

    Gaci, Rostane; Alauzet, Corentine; Selton-Suty, Christine; Lozniewski, Alain; Pulcini, Céline; May, Thierry; Goehringer, François

    2017-02-01

    We report the first two cases of infective endocarditis caused by Francisella tularensis in Europe (two cases have previously been reported outside Europe). We suggest clinicians should consider tularemia as a possible diagnosis in endemic regions in cases of culture-negative endocarditis.

  15. 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.

  16. [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.

  17. Virulence Factors Associated with Enterococcus Faecalis Infective Endocarditis

    DEFF Research Database (Denmark)

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

    2017-01-01

    INTRODUCTION: The enterococci are accountable for up to 20% of all cases of infective endocarditis, with Enterococcus faecalis being the primary causative isolate. Infective endocarditis is a life-threatening infection of the endocardium that results in the formation of vegetations. Based...... on a literature review, this paper provides an overview of the virulence factors associated with E. faecalis infective endocarditis. Furthermore, it reports the effects of active or passive immunization against some of these involved factors. INDIVIDUAL VIRULENCE FACTORS: Nine virulence factors have in particular...... 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...

  18. Las enfermedades infecciosas y su importancia en el sector avícola

    Directory of Open Access Journals (Sweden)

    Javier Andrés Jaimes Olaya

    2010-12-01

    Full Text Available Dentro del contexto de un país cuyas mejores capacidades se encuentran en el sector agropecuario, la industria avícola se ha convertido en uno de los sectores más promisorios y de mayor crecimiento en Colombia. Por esta razón, actualmente se vienen implementando programas para el mejoramiento de la calidad de los productos avícolas, con el objetivo no solo de mantener el crecimiento de la industria,sino de poder expandir las fronteras de exportación. Sin embargo, la avicultura enfrenta un gran reto encuanto a su producción, debido a que las enfermedades infecciosas que afectan a las aves continúan siendo una problemática importante del sector, aun por encima de la alimentación y la genética. En este artículo se presentan elementos de relevancia referentes a la industria avícola, así como en relación con las enfermedades de control oficial y algunas de las enfermedades infecciosas que más la aquejan, enfatizando en la importancia de la intervención en el manejo y control de dichas enfermedades.

  19. Clinical Risk Factors for Infective Endocarditis in Staphylococcus aureus Bacteremia.

    Science.gov (United States)

    Salvador, Vincent Bryan D; Chapagain, Bikash; Joshi, Astha; Brennessel, Debra J

    2017-02-01

    Crucial to the management of staphylococcal bacteremia is an accurate evaluation of associated endocarditis, which has both therapeutic and prognostic implications. Because the clinical presentation of endocarditis can be nonspecific, the judicious use of echocardiography is important in distinguishing patients at high risk of developing endocarditis. In the presence of high-risk clinical features, an early transesophageal echocardiogram is warranted without prior transthoracic echocardiography. The purpose of this study was to investigate the clinical risk factors for staphylococcal infective endocarditis that might warrant earlier transesophageal echocardiography and to describe the incidence of endocarditis in cases of methicillin-resistant and methicillin-sensitive Staphylococcus aureus bacteremia. A retrospective case-control study was conducted by means of chart review of 91 patients consecutively admitted to a community hospital from January 2009 through January 2013. Clinical risk factors of patients with staphylococcal bacteremia were compared with risk factors of patients who had definite diagnoses of infective endocarditis. There were 69 patients with bacteremia alone (76%) and 22 patients with endocarditis (24%), as verified by echocardiography. Univariate analysis showed that diabetes mellitus ( P =0.024), the presence of an automatic implantable cardioverter-defibrillator/pacemaker ( P =0.006) or a prosthetic heart valve ( P =0.003), and recent hospitalization ( P =0.048) were significantly associated with developing infective endocarditis in patients with S. aureus bacteremia. The incidence of methicillin-resistant and methicillin-sensitive S. aureus bacteremia was similar in the bacteremia and infective-endocarditis groups ( P =0.437). In conclusion, identified high-risk clinical factors in the presence of bacteremia can suggest infective endocarditis. Early evaluation with transesophageal echocardiography might well be warranted.

  20. La actuación de enfermería ante las enfermedades infecciosas en la urgencias hospitalarias

    OpenAIRE

    Suárez Domínguez, Sara

    2017-01-01

    [EN] Una enfermedad infecciosa se define como aquella enfermedad producida por microorganismos patógenos como bacterias, hongos, virus o parásitos, la cual puede contagiarse por contacto con animales, insectos o de una persona a otra. A lo largo de este trabajo estudiaremos las Enfermedades Infecciosas Hospitalarias, concretamente en la enfermedad por virus Ébola y en las diferentes actuaciones de enfermería ante la misma. Para ello, se realizará un repaso en la historia y el desarrollo de...

  1. Minimal access surgery for mitral valve endocarditis.

    Science.gov (United States)

    Barbero, Cristina; Marchetto, Giovanni; Ricci, Davide; Mancuso, Samuel; Boffini, Massimo; Cecchi, Enrico; De Rosa, Francesco Giuseppe; Rinaldi, Mauro

    2017-08-01

    Minimal access mitral valve surgery (MVS) has already proved to be feasible and effective with low perioperative mortality and excellent long-term outcomes. However, experience in more complex valve diseases such as infective endocarditis (IE) still remains limited. The aim of this retrospective study was to evaluate early and long-term results of minimal access MVS for IE. Data were entered into a dedicated database. Analysis was performed retrospectively for the 8-year period between January 2007 and April 2015. During the study period, 35 consecutive patients underwent minimal access MVS for IE at our department. Twenty-four had diagnosis of native MV endocarditis (68.6%) and 11 of mitral prosthesis endocarditis (31.4%).Thirty patients underwent early MVS (85.7%), and 5 patients were operated after the completion of antibiotic treatment (14.3%). Seven patients underwent MV repair (20%), 17 patients underwent MV replacement (48.6%), and 11 patients underwent mitral prosthesis replacement (31.4%). Thirty-day mortality was 11.4% (4 patients). No neurological or vascular complications were reported. One patient underwent reoperation for prosthesis IE relapse after 37 days. Overall actuarial survival rate at 1 and 5 years was 83%; freedom from MV reoperation and/or recurrence of IE at 1 and 5 years was 97%. Minimally invasive MVS for IE is feasible and associated with good early and long-term results. Preoperative accurate patient selection and transoesophageal echocardiography evaluation is mandatory for surgical planning. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  2. The Changing Epidemiology of Pediatric Endocarditis.

    Science.gov (United States)

    Elder, Robert W; Baltimore, Robert S

    2015-09-01

    The epidemiology of infective endocarditis (IE) appears to be related to changes in the management of children with congenital heart disease (CHD) and the virtual disappearance of rheumatic heart disease. To better understand these changes, we divide the history into: I. The pre-surgical era, II. The early years of CHD surgical intervention, correlated with introduction of antibiotics, III. The modern era of cardiac interventions. Microbiologic changes include an early predominance of viridans streptococci and an overtaking by staphylococci. Additionally, there have been advances in imaging that allow earlier detection of IE and a reduction in IE-related mortality. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Infective endocarditis in patients on haemodialysis - possible strategies for prevention.

    Science.gov (United States)

    Oun, Hadi A; Price, Andrew J; Traynor, Jamie P

    2016-05-01

    Infective endocarditis is an important cause of morbidity and mortality in patients receiving haemodialysis for established renal failure. We carried out a prospective audit of patients developing infective endocarditis in a single renal unit. From 1 January 2000 to 31 December 2013, we collected data on all cases of endocarditis occurring in patients receiving haemodialysis at Monklands Hospital, Airdrie. Twenty-nine patients developed endocarditis during our audit period. Twenty-three (79.3%) of the patients had pre-existing cardiac valve abnormalities such as regurgitation or calcification. Staphylococcus aureus was the most common microorganism cultured from the blood of 22 patients (75.9%). MRSA bacteraemia was identified in eight of these patients and all eight patients died during that first presentation. Different strategies were introduced within the unit during the audit period aiming to reduce the rate of bacteraemia. Since 2011, a successful strategy has been introduced under the auspices of the Scottish Patient Safety Programme. This led to our Staph aureus bacteraemia rate related to non-tunnelled venous catheters going from an average of 15 days between episodes to having had no episodes between 2 December 2011 and the end of the study period (760 days). This also appears to have had a positive impact on reducing the rate of endocarditis. Infective endocarditis remains a devastating consequence of bacteraemia in patients receiving haemodialysis. An effective strategy aimed at reducing the rate of bacteraemia appears to have a similar effect on the rate of endocarditis. © The Author(s) 2016.

  4. Complicaciones infecciosas de la diálisis peritoneal ambulatoria en niños

    Directory of Open Access Journals (Sweden)

    Diana Patricia Durán Casal

    Full Text Available Introducción: la diálisis peritoneal es la mejor alternativa terapéutica para los niños con enfermedad renal crónica terminal, y en las modalidades de diálisis peritoneal ambulatoria ha permitido el tratamiento fuera del hospital, lo que proporciona un mejor estilo y calidad de vida. No es un método exento de riesgos. Las complicaciones infecciosas relacionadas a la diálisis peritoneal son la causa más importante de morbilidad y es la peritonitis su principal complicación. Objetivo: determinar retrospectivamente la frecuencia y las características de complicaciones infecciosas relacionadas al proceder dialítico. Métodos: nuestro hospital es referente como unidad de diálisis pediátrica del país, así que recibe la mayoría de los niños con enfermedad renal crónica terminal de Cuba. Se revisaron los expedientes clínicos de niños con enfermedad renal crónica terminal en programa de diálisis peritoneal ambulatoria en el Hospital Pediátrico de Centro Habana durante el período 2008-2011. Resultados: se estudiaron 12 pacientes con un promedio de edad de 11 años, 58 % del sexo femenino. Se documentaron 24 episodios infecciosos. Las complicaciones encontradas fueron infección del sitio de salida del catéter, con 62,5 %, peritonitis 33,3 % e infección del túnel submucoso 4,2 %. Predominaron cultivos positivos a bacterias grampositivas (66,7 %. Las bacterias más comunes fueron: Staphylococcus coagulasa positivo (48 % y Staphylococcus coagulasa negativo (22 %. Otros gérmenes identificados fueron E. coli, Enterobacter spp. y Candida spp., con 8,3 % respectivamente. Conclusiones: la infección del sitio de salida del catéter fue la complicación infecciosa más frecuente en nuestra serie. Las bacterias grampositivas son los gérmenes más comunes que causan infección del sitio de salida y peritonitis en pacientes en diálisis peritoneal ambulatoria.

  5. Bronquiolite obliterante pós-infecciosa em crianças

    Directory of Open Access Journals (Sweden)

    Natália da Silva Champs

    2011-06-01

    Full Text Available OBJETIVOS: Revisar os trabalhos publicados sobre os principais aspectos da bronquiolite obliterante pós-infecciosa, relacionados com sua história, etiologia, epidemiologia, fatores de risco, patogenia, alterações histológicas, manifestações clínicas, exames complementares, critérios diagnósticos, diagnóstico diferencial, tratamento e prognóstico. FONTES DOS DADOS: Realizou-se uma revisão não sistemática nas bases de dados MEDLINE e LILACS, selecionando-se 66 referências mais relevantes. SÍNTESE DOS DADOS: Na bronquiolite obliterante pós-infecciosa ocorre lesão do epitélio respiratório, e a gravidade clínica está relacionada aos diferentes graus de lesão e ao processo inflamatório. O diagnóstico baseia-se no quadro clínico, na exclusão dos principais diagnósticos diferenciais e no auxílio dos exames complementares. A tomografia computadorizada de alta resolução, principalmente com imagens em inspiração e expiração, possibilta a avaliação das pequenas vias aéreas. As provas de função pulmonar caracterizam-se por padrão obstrutivo fixo com redução acentuada do FEF25-75%. O tratamento não está bem estabelecido, e o uso de corticoides tem sido preconizado em forma de pulsoterapia ou por via inalatória em elevadas doses, no entanto, os dados da literatura a respeito de sua eficácia ainda são escassos. O prognóstico a longo prazo é variável, podendo haver melhora clínica ou evolução para insuficiência respiratória crônica e óbito. CONCLUSÃO: A bronquiolite obliterante pós-infecciosa é uma doença que cursa com elevada morbidade e deve ser abordada por equipe multidisciplinar com acompanhamento em longo prazo.

  6. Detection of endocarditis bacteria in tonsillar mucosa of Afghan population.

    Science.gov (United States)

    Ruggiero, F; Carbone, D; Mugavero, R; Palmieri, A; Lauritano, D; Baggi, L; Nardone, M; Carinci, F; Martinelli, M

    2018-01-01

    Endocarditis is a cardiovascular disease caused by the inflammation of the inner tissues of the heart, the endocardium, usually of the valves. Bacteraemia is essential in the development of endocarditis, and there are some findings that the main pathogens of endocarditis are viridans group streptococci: Streptococcus oralis, Streptococcus sanguinis, and Enterococcus faecalis. There is strong evidence that endocarditis bacteria are present in the tonsillar microbiota, so that tonsillar infection is associated with an increased risk of endocarditis. The aim of this manuscript is to investigate the presence of the main pathogens of endocarditis in tonsillar microbiota of an Afghan population group. A sample of 80 tonsil swabs were analyzed by quantitative real time PCR to detect endocarditis pathogens and an estimation of the total bacterial load. The median bacterial load in PCR reaction was 1.4x106 (interquartile range 4,7x105 - 2,9x106). Three species, S. Oralis, S. Sanguinis, and E. Faecalis were found in large amounts in all specimens. On the other hand, S. Mitis was never detected. The S. Aureus was found in 3 samples with a prevalence of 0.04 (C.I. 0.01-0.10). The S. Mutans was found in 33 samples with a prevalence of 0.41 (C.I. 0.31-0.52). Endocarditis bacteria has been found into the tonsillar microbiota, so there is sufficient evidence to justify that the oral cavity is a reservoir of endocarditis bacteria that can have a significant impact on the cardiovascular function.

  7. Brucella endocarditis – A series of five case reports

    Directory of Open Access Journals (Sweden)

    I. Tammi Raju

    2013-01-01

    Full Text Available Endocarditis due to brucellosis is considered a rare occurrence involving native, congenital and prosthetic valves. The diagnosis needs high degree of suspicion in culture negative endocarditis especially in those with history of exposure to farm animals. A positive culture in a susceptible patient confirms the diagnosis with 91% sensitivity. An early diagnosis and prompt treatment with appropriate antibiotics can restore the valve structural integrity with minimal damage. Here we present a series of five cases of culture proven Brucella endocarditis (four native valves, one prosthetic valve and this report discusses the diagnostic and management issues involved.

  8. 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.

  9. 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...... endocarditis after TAVR. DESIGN, SETTING, AND PARTICIPANTS: 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. EXPOSURE: Transcatheter...... aortic valve replacement for incidence of infective endocarditis and infective endocarditis for in-hospital mortality. MAIN OUTCOMES AND MEASURES: Infective endocarditis and in-hospital mortality after infective endocarditis. RESULTS: A total of 250 cases of infective endocarditis occurred in 20...

  10. Antibiotics for the prophylaxis of bacterial endocarditis in dentistry.

    Science.gov (United States)

    Glenny, Anne-Marie; Oliver, Richard; Roberts, Graham J; Hooper, Lee; Worthington, Helen V

    2013-10-09

    Infective endocarditis is a severe infection arising in the lining of the chambers of the heart with a high mortality rate.Many dental procedures cause bacteraemia and it was believed that this may lead to bacterial endocarditis (BE) in a few people. Guidelines in many countries have recommended that prior to invasive dental procedures antibiotics are administered to people at high risk of endocarditis. However, recent guidance by the National Institute for Health and Care Excellence (NICE) in England and Wales has recommended that antibiotics are not required. To determine whether prophylactic antibiotic administration, compared to no such administration or placebo, before invasive dental procedures in people at risk or at high risk of bacterial endocarditis influences mortality, serious illness or the incidence of endocarditis. The following electronic databases were searched: the Cochrane Oral Health Group's Trials Register (to 21 January 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 12), MEDLINE via OVID (1946 to 21 January 2013) and EMBASE via OVID (1980 to 21 January 2013). We searched for ongoing trials in the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the metaRegister of Controlled Trials (http://www.controlled-trials.com/mrct/). No restrictions were placed on the language or date of publication when searching the electronic databases. Due to the low incidence of BE it was anticipated that few if any trials would be located. For this reason, cohort and case-control studies were included where suitably matched control or comparison groups had been studied. The intervention was the administration of antibiotic, compared to no such administration, before a dental procedure in people with an increased risk of BE. Cohort studies would need to follow those individuals at increased risk and assess outcomes following any invasive dental procedures, grouping by whether

  11. PREVALENCIA DE BACTERIAS ASOCIADAS A LA INFERTILIDAD INFECCIOSA EN BOVINOS DE MONTERÍA, COLOMBIA

    Directory of Open Access Journals (Sweden)

    Marco González T

    2007-12-01

    Full Text Available Objetivo. Establecer la prevalencia de algunos gérmenes asociados con infertilidad infecciosa de bovinos del municipio de Montería. Materiales y métodos. Se recolectaron 384 muestras sanguíneas e igual número de hisopados cervicales de hembras que cumplieron con alguno de los siguientes criterios de inclusión: más de tres servicios sin concepción, vaginitis, cervicitis, metritis, endometritis, útero con contenido, momificación fetal, natimortos, reabsorciones embrionarias, antecedentes de abortos y/o hembras positivas a brucelosis. Las muestras cervicales se sembraron en agar Mc conkey, agar sangre, agar brucella y agar campylobacter. A las colonias sospechosas se le realizaron pruebas bioquímicas y la confirmación se llevó a cabo con pruebas serológicas. Para el serodiagnóstico de Brucella, los sueros fueron analizados por Rosa de Bengala y los positivos fueron confirmados con ELISA indirecta. Resultados. De las 384 muestras procesadas, hubo crecimiento en 281 (73,2%, las bacterias prevalentes fueron Escherichia coli, Bacilos Gram Negativos Oxidantes, Klepsiella spp y Pseudomonas spp, que correspondieron a 194 (69.1% aislamientos y cinco muestras equivalentes al 1.8% resultaron positivas para Campylobacter spp. Las pruebas serológicas para Brucella arrojaron como resultado 22 muestras positivas por ELISA (6.3%. Conclusiones. Los resultados de este trabajo describen de forma preliminar la posible asociación bacteriana en la infertilidad infecciosa en hembras vacunas, demostrando la presencia de una gran variedad de microorganismos.

  12. World Health Day 1997: emerging infectious diseases Día Mundial de la Salud 1997: enfermedades infecciosas emergentes

    Directory of Open Access Journals (Sweden)

    1997-05-01

    Full Text Available Para el Día Mundial de la Salud de 1997, la Organización Mundial de la Salud (OMS ha elegido el tema "Enfermedades infecciosas emergentes; alerta mundial, respuesta mundial" con el fin de llamar la atención hacia la amenaza que representan algunas enfermedades infecciosas recientemente reconocidas en seres humanos y otras que han vuelto a aparecer. En la emergencia y reemergencia de enfermedades infecciosas intervienen factores como el deterioro de la infraestructura de salud pública, la creciente resistencia microbiana a los antibióticos y los cambios sociales y ecológicos asociados con el crecimiento de la población humana. La OMS ha hecho hincapié en la necesidad de que se compromentan a entrar juntos en acción tanto países como organizaciones internacionales, organizaciones no gubernamentales e individuos, con objeto de mejorar la vigilancia de las enfermedades y la capacidad de controlarlas para prevenir y refrenar las epidemias. Por su parte, la OMS está reforzando su sistema de vigilancia mundial tripartito, que consta de los centros de colaboración de la OMS en el área de enfermedades infecciosas, las redes de monitoreo de resistencia antimicrobiana y el Reglamento Sanitario Internacional. Para hacer frente adecuadamente al problema de las enfermedades infecciosas durante el siglo próximo, se necesitarán programas de vigilancia y control; redes mundiales de monitoreo y notificación; rápido intercambio de información por vía electrónica (incluida la World Wide Web; y un estado de preparación efectivo con la capacidad para responder rápidamente a las epidemias y contenerlas.

  13. Infective Endocarditis in Children — New Approach in Antimicrobial Prophylaxis

    Directory of Open Access Journals (Sweden)

    Togănel Rodica

    2016-06-01

    Full Text Available Infective endocarditis (IE is an infection of the endocardium and/or heart valves with the formation of a thrombus and secondary damage of the involved tissue, with significant mortality and severe complications. The prevention of bacterial endocarditis is of great controversy. Antimicrobial prophylaxis is usable in the prevention of endocarditis by killing bacteria before or after their extension to the damaged endocardium. No human studies offer strong evidence to support the efficacy of antibiotic prophylaxis so far, thus it could be potentially dangerous. Therefore, the European Society of Cardiology (ESC may need to reconsider and update the previous guidelines with the proposal of reducing the prophylactic approach of IE. The 2015 Task Force recommends prophylaxis for highest risk patients undergoing highest risk procedures, focused on prevention rather than prophylaxis of IE, especially in nosocomial endocarditis.

  14. Experimental Bacterial Endocarditis in the Opossum (Didelphis virginiana)

    Science.gov (United States)

    Sherwood, B. F.; Rowlands, D. T.; Vakilzadeh, J.; LeMay, J. C.

    1971-01-01

    It was possible to induce bacterial endocarditis in opossums with single intravenous injections of Streptococcus viridans or Staphylococcus aureus. Fiftyeight percent of those animals given Streptococcus viridans developed bacterial endocarditis in which most of the lesions were on the left side of the heart. The experimentally induced streptococcal disease was similar to that which may occur spontaneously in opossums, both with respect to the distribution and structure of the vegetations. Single injections of Staphylococcus aureus resulted in endocarditis in 100% of the test animals. These lesions differed from those due to streptococci by having a relatively high frequency of right- as well as left-sided valvular disease and by being somewhat smaller than those due to streptococci.Endocarditis could not be successfully induced with injection of three different fungi. PMID:5133514

  15. 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

  16. 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

  17. Sinus of Valsalva Pseudoaneurysm as a Sequela to Infective Endocarditis.

    Science.gov (United States)

    Lee, Chin C; Siegel, Robert J

    2016-02-01

    Pseudoaneurysm is an uncommon sequela of infective endocarditis. We treated a 44-year-old man who had an active case of group B streptococcal infective endocarditis of the aortic valve despite no evidence of valvular dysfunction or vegetation on his initial transesophageal echocardiogram. After completing 6 weeks of intravenous antibiotic therapy, the patient developed a sinus of Valsalva pseudoaneurysm and severe aortic regurgitation caused by partial detachment of the left coronary cusp. We used a pericardial patch to close the pseudoaneurysm and repair the coronary cusp. This case shows the importance of routine clinical follow-up evaluation in infective endocarditis, even after completion of antibiotic therapy. Late sequelae associated with infective endocarditis or its therapy include recurrent infection, heart failure caused by valvular dysfunction (albeit delayed), and antibiotic toxicity such as aminoglycoside-induced nephropathy and vestibular toxicity.

  18. Epidemiology of bacterial endocarditis in The Netherlands. I. Patient characteristics

    NARCIS (Netherlands)

    van der Meer, J. T.; Thompson, J.; Valkenburg, H. A.; Michel, M. F.

    1992-01-01

    BACKGROUND: Studies of the epidemiology of bacterial endocarditis are usually based on a retrospective review of medical records from referral centers serving diverse patient populations. These studies are therefore likely to suffer from selection bias. We conducted a nationwide prospective

  19. [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.

  20. Lactococcus garvieae Endocarditis on a Prosthetic Biological Aortic Valve.

    Science.gov (United States)

    Tsur, A; Slutzki, T; Flusser, D

    2015-09-01

    Lactococcus garvieae (LG) endocarditis is a rare disease in humans. There are only about 16 reported cases in the world. We report a 76-year-old male patient with LG endocarditis. In depth interview with the patient revealed that 2 weeks prior to admission, he had eaten sushi containing raw fish. Unlike many of the other infections reported, which were on a native mitral valve, our patient's vegetation was on a prosthetic aortic valve. © 2014 Blackwell Verlag GmbH.

  1. 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...... variables and (2) to describe a methodology for assessing quality in an observational cohort containing site-interpreted data. IE reproducibility was assessed on a subset of echocardiograms from subjects enrolled in the International Collaboration on Endocarditis registry. Specific echocardiographic case...

  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. 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.

  4. [Rare diagnostics of infective endocarditis after kidney transplantation].

    Science.gov (United States)

    Dedinská, Ivana; Skalová, Petra; Mokáň, Michal; Martiaková, Katarína; Osinová, Denisa; Pindura, Miroslav; Palkoci, Blažej; Vojtko, Marián; Hubová, Janka; Kadlecová, Denisa; Lendová, Ivona; Zacharovský, Radovan; Pekar, Filip; Kaliská, Lucia

    2016-01-01

    Infective endocarditis in a patient after kidney transplantation is a serious infective complication which increases the risk of loss of the graft and also the mortality of patients. The most important predisposing factor is the immunosuppressive therapy - mainly induction immunosuppression.Material and case description: 250 patients underwent kidney transplantation throughout the period of 12 years in the Transplant Center Martin. This set of patients included 5 patients (2 %) after heart valve replacement. We present the case of a patient after kidney transplantation with development of endocarditis of the bioprosthesis of the aortic valve one month after successful kidney transplantation. Diagnostics of endocarditis by standard procedures (examination by transthoracic echocardiogram, transesophageal echocardiography, hemocultures) was unsuccessful. We rarely diagnosed endocarditis only by PET-CT examination with a consequent change of the antibiotic treatment and successful managing of this post-transplant complication. Endocarditis after kidney transplantation is a serious complication which significantly worsens the mortality of patients. The risk of development of infective endocarditis after transplantation is also increased by induction, mainly by antithymocyte globulin. Diagnostics only by PET-CT examination is rare; however, in this case it fundamentally changed the approach to the patient and led to a successful treatment.

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

    International Nuclear Information System (INIS)

    Ch'ng, Julie; Chan, William; Lee, Paul; Joshi, Subodh; Grigg, Leanne E.; Ajani, Andrew E.

    2003-01-01

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

  6. Time interval between infective endocarditis first symptoms and diagnosis: relationship to infective endocarditis characteristics, microorganisms and prognosis.

    Science.gov (United States)

    N'Guyen, Yohan; Duval, Xavier; Revest, Matthieu; Saada, Matthieu; Erpelding, Marie-Line; Selton-Suty, Christine; Bouchiat, Coralie; Delahaye, François; Chirouze, Catherine; Alla, François; Strady, Christophe; Hoen, Bruno

    2017-03-01

    To analyze the characteristics and outcome of infective endocarditis (IE) according to the time interval between IE first symptoms and diagnosis. Among the IE cases of a French population-based epidemiological survey, patients having early-diagnosed IE (diagnosis of IE within 1 month of first symptoms) were compared with those having late-diagnosed IE (diagnosis of IE more than 1 month after first symptoms). Among the 486 definite-IE, 124 (25%) had late-diagnosed IE whereas others had early-diagnosed IE. Early-diagnosed IE were independently associated with female gender (OR = 1.8; 95% CI [1.0-3.0]), prosthetic valve (OR= 2.6; 95% CI [1.4-5.0]) and staphylococci as causative pathogen (OR = 3.7; 95% CI [2.2-6.2]). Cardiac surgery theoretical indication rates were not different between early and late-diagnosed IE (56.3% vs 58.9%), whereas valve surgery performance was lower in early-diagnosed IE (41% vs 53%; p = .03). In-hospital mortality rates were higher in early-diagnosed IE than in late-diagnosed IE (25.1% vs 16.1%; p endocarditis, which time interval between first symptoms and diagnosis was less than one month, were mainly due to Staphylococcus aureus in France. Staphylococcus aureus infective endocarditis were associated with septic shock, transient ischemic attack or stroke and higher mortality rates than infective endocarditis due to other bacteria or infective endocarditis, which time interval between first symptoms and diagnosis was more than one month. Infective endocarditis, which time interval between first symptoms and diagnosis was more than one month, were accounting for one quarter of all infective endocarditis in our study and were associated with vertebral osteomyelitis and a higher rate of cardiac surgery performed for hemodynamic indication than other infective endocarditis.

  7. Surgery in current therapy for infective endocarditis

    Science.gov (United States)

    Head, Stuart J; Mokhles, M Mostafa; Osnabrugge, Ruben LJ; Bogers, Ad JJC; Kappetein, A Pieter

    2011-01-01

    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. PMID:21603594

  8. Ecologia e Doenças Infecciosas: Um Perfil Nacional dos Grupos de Pesquisa do CNPQ

    Directory of Open Access Journals (Sweden)

    Rafaela Rodrigues Ramos

    2013-12-01

    Full Text Available Procurando entender se incorporação da abordagem ecológica em pesquisas sobre meio ambiente-animal-doença-saúde vem ocorrendo na construção do conhecimento no campo da saúde ambiental, voltado para a investigação sobre doenças resultantes das relações e inter-relações entre seres humanos, animais, ecossistemas e ações antrópicas, o presente artigo traz uma discussão acerca da ecologia das doenças infecciosas, apresentando, em seguida, um quadro nacional da pesquisa voltada para esta temática, construído a partir de um levantamento realizado no Diretório de Grupos de Pesquisa do CNPQ. Por meio deste procuramos descrever e analisar o perfil  dos grupos de pesquisa que trabalham com doenças resultantes das relações e inter-relações entre seres humanos, animais, ecossistemas e ações antrópicas, de modo a visualizar como tem se dado a participação da ciência ecológica nesta área. Pouco sabemos sobre a cultura epistêmica de construção do conhecimento no campo da saúde ambiental, voltado para a investigação sobre doenças resultantes das relações e inter-relações entre seres humanos, animais, ecossistemas e ações antrópicas. Dado o nível de complexidade desta realidade, entendemos que tal cultura de produção do conhecimento deva ser permeada por uma mentalidade de cooperação acadêmico–científico, tomando a ciência ecológica como parceira categórica. Como podemos observar na analise dos dados, ainda é baixa a participação da ciência ecológica em pesquisas empreendidas no campo da saúde ambiental, voltadas para doenças infecciosas, ao mesmo tempo em que se verifica uma concentração espacial desta produção, não se observando uma relação direta desta e as necessidades socioambientais territorialmente estabelecidas no país.

  9. A Case Series and Review of Bacillus Cereus Endocarditis from India.

    Science.gov (United States)

    Gopinathan, Anusha; Kumar, Anil; Sen, Amitabh C; Sudha, Srisruthy; Varma, Praveen; Gs, Sunil; Eapen, Malini; Dinesh, Kavitha R

    2018-01-01

    Bacillus cereus is a gram positive bacilli found commonly in the soil and environment. It is a bacteria rarely associated with endocarditis. Intravenous drug abuse, presence of valvular defects, pacemakers, immunodeficiency are some of the known risk factors for B.cereus endocarditis. We present here a case series of two patients with B.cereus endocarditis along with a review of the literature. This is the first report of B.cereus endocarditis from India to the best of our knowledge.

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

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    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.

  11. 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.

  12. 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....

  13. Complicações infecciosas da ventrículo-auriculostomia

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    Gilberto M. Almeida

    1966-09-01

    Full Text Available De 184 pacientes submetidos à ventrículo-auriculostomia com a válvula de Holter, 39 apresentaram complicações infecciosas. Em 18 casos ficou demonstrada a existência de ependimite e/ou meningite e em 21 instalou-se o quadro da bacteremia. Apesar das complicações, a ventrículo-auriculostomia continua a ser a técnica cirúrgica mais usada no tratamento da hidrocefalia. Com melhor seleção dos casos, excluindo-se doentes com meningite recente ou com fistula liquórica, os resultados poderão ser melhores. Ainda não se conseguiu método seguro para abolir a contaminação operatória. Nos casos em que existe ependimite deve-se iniciar tratamento antibiótico intensivo, seguido de retirada do sistema de drenagem. Nos doentes com bacteremia apenas, a remoção da válvula e cateteres dependerá da gravidade do caso e da resposta ao tratamento com antibióticos e corticosteróides, podendo ser adiada por algum tempo. Quando a infecção é causada por germe reconhecidamente patogênico há maior gravidade, devendo-se retirar precocemente o sistema de drenagem.

  14. Saúde nas metrópoles - Doenças infecciosas

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    Aluisio Cotrim Segurado

    2016-04-01

    Full Text Available A urbanização é um processo irreversível em escala mundial e estima-se que o número de pessoas que vivem em cidades deverá atingir 67% da população do planeta até 2050. Os países de baixa ou média renda, por sua vez, possuem 30% a 40% da população urbana vivendo atualmente em favelas, em situação de risco para diversos agravos de saúde. No Brasil, embora 84,3% da população residissem em áreas urbanas já em 2010, não se verificam no momento ações consistentes voltadas ao enfrentamento das questões de saúde urbana. Neste artigo discute-se a situação epidemiológica de agravos infecciosos de interesse para a saúde pública (dengue, infecção por HIV/aids, leptospirose, hanseníase e tuberculose a partir do ano 2000 nas 17 metrópoles do país, de modo a esclarecer o papel atual das doenças infecciosas no contexto da saúde urbana brasileira.

  15. CAMBIOS CLIMÁTICOS Y ENFERMEDADES INFECCIOSAS: NUEVOS RETOS EPIDEMIOLÓGICOS

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    Liliana Sánchez L, M.Sc

    2009-12-01

    Full Text Available El Niño / Oscilación Sur (ENSO es el fenómeno mejor conocido que influye en la variabilidad del clima mundial en escalas de tiempo inter anuales. El término El Niño se refiere al fenómeno climático vinculado a un calentamiento periódico de las temperaturas superficiales del mar en la zona central y oriental del Pacífico ecuatorial central (aproximadamente entre la línea internacional y 120 grados de longitud oeste, y se refiere a veces como un episodio cálido del Pacífico. Lo contrario de lo que es La Niña, la fase fría del fenómeno ENSO. Debido al gran tamaño del Océano Pacífico, los cambios en los patrones de temperatura superficial del mar tienen gran influencia en la circulación atmosférica con efectos pronunciados en la precipitación tropical mundial y los patrones de temperatura. Se ha relacionado el ENSO con las anomalías climáticas y el incremento de las enfermedades infecciosas, especialmente las transmitidas por insectos, por lo que su conocimiento puede permitir ofrecer mejores predicciones a largo plazo de epidemias o epizootia.

  16. SEROEPIDEMIOLOGÍA DE LA RINOTRAQUEITIS INFECCIOSA BOVINA EN EL MUNICIPIO DE MONTERÍA, COLOMBIA

    Directory of Open Access Journals (Sweden)

    César Betancur H

    2006-12-01

    Full Text Available Objetivo. Estudiar la sero prevalencia de IBR en ganado bovino con antecedentes de infertilidad.Materiales y métodos. Se recolectaron 150 muestras de sangre de hembras con antecedentes deinfertilidad y sin historia de vacunación contra IBR, pertenecientes a 32 fincas distribuidas en elmunicipio de Montería. Adicionalmente, se obtuvieron muestras al azar de 20 toros pertenecientesa las mismas fincas. Se analizaron anticuerpos contra IBR mediante la prueba de ELISA. Resultados.Los resultados mostraron una seroprevalencia de 74.7% para rinotraqueitis infecciosa bovina. Seencontraron diferencias significativas en cuanto a prevalencía para las variables sexo y edad de losanimales (p0.05. Conclusión. La alta prevalencia de lainfección por IBR en vacas podrían correlacionarse con la infección en toros, lo cual tiene unsignificado relevante, ya que la infección es de transmisión venérea. Estos resultados deben alertara las autoridades sanitarias para que implementen estrategias de prevención y control.

  17. Moraxella bovoculi em casos de ceratoconjuntivite infecciosa bovina no Rio Grande do Sul

    Directory of Open Access Journals (Sweden)

    Felipe Libardoni

    2012-08-01

    Full Text Available A ceratoconjuntivite infecciosa (CI, embora raramente fatal, resulta em perdas econômicas significativas para os rebanhos bovinos e ovinos. Os principais agentes causadores dessa enfermidade são Moraxella bovis e Moraxella ovis. Em 2007 foi descrita uma nova espécie também responsável pela CI e denominada Moraxella bovoculi, que até o presente momento, não havia sido relatada no Brasil. Assim, objetivou-se com este trabalho caracterizar e distinguir 54 isolados de Moraxella spp. de amostras clínicas oriundas de 34 bovinos e 17 ovinos, encaminhadas ao Laboratório de Bacteriologia da Universidade Federal de Santa Maria no período de 1990 a 2011, visando a identificação de M. bovoculi. A distinção dos isolados foi fundamentada nas características genotípicas, pela amplificação parcial da região intergênica 16S-23S e clivagem dos produtos da amplificação com enzima RsaI. Como resultados, 25 (46% isolados foram caracterizados como M. bovis, 17 (32% como M. ovis e 12 (22% como M. bovoculi. Logo, conclui-se que M. bovoculi encontra-se presente no rebanho bovino do Rio Grande do Sul e, portanto, no Brasil.

  18. Porcine models of non-bacterial thrombotic endocarditis (NBTE) and infective endocarditis (IE) caused by Staphylococcus aureus: a preliminary study.

    Science.gov (United States)

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

    2013-05-01

    Non-bacterial thrombotic endocarditis (NBTE) and, in particular, infective endocarditis (IE), are serious and potentially life-threatening diseases. An increasingly important agent of human IE is Staphylococcus aureus, which typically causes an acute endocarditis with high mortality. The study aim was to evaluate the pig as a model for non-bacterial as well as S. aureus-associated endocarditis, as these models would have several advantages compared to other laboratory animal models. Fourteen animals underwent surgery with placement of a plastic catheter in the left side of the heart. Six of the pigs did not receive a bacterial inoculation and were used to study the development of NBTE. The remaining eight pigs were inoculated intravenously once or twice with S. aureus, 10(5)-10(7) cfu/kg body weight. Two bacterial strains were used: S54F9 (porcine) and NCTC8325-4 (human). Clinical examination, echocardiography and bacterial blood cultures were used to diagnose and monitor the development of endocarditis. Animals were euthanized at between two and 15 days after catheter placement, and tissue samples were collected for bacteriology and histopathology. Pigs inoculated with 10(7) cfu/kg of S. aureus strain S54F9 developed clinical, echocardiographic and pathologic signs of IE. All other pigs, except one, developed NBTE. Serial blood cultures withdrawn after inoculation were positive in animals with IE, and negative in all other animals. S. aureus endocarditis was successfully induced in pigs with an indwelling cardiac catheter after intravenous inoculation of 10(7) cfu/kg of S. aureus strain S54F9. The model simulates typical pathological, clinical and diagnostic features seen in the human disease. Furthermore, NBTE was induced in all but one of the pigs without IE. Thus, the pig model can be used in future studies of the pathogenesis, diagnosis and therapy of NBTE and S. aureus endocarditis.

  19. 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.

  20. Fungal prosthetic valve endocarditis with mycotic aneurysm: Case report.

    Science.gov (United States)

    Brandão, Mariana; Almeida, Jorge; Ferraz, Rita; Santos, Lurdes; Pinho, Paulo; Casanova, Jorge

    2016-09-01

    Fungal prosthetic valve endocarditis is an extremely severe form of infective endocarditis, with poor prognosis and high mortality despite treatment. Candida albicans is the most common etiological agent for this rare but increasingly frequent condition. We present a case of fungal prosthetic valve endocarditis due to C. albicans following aortic and pulmonary valve replacement in a 38-year-old woman with a history of surgically corrected tetralogy of Fallot, prior infective endocarditis and acute renal failure with need for catheter-based hemodialysis. Antifungal therapy with liposomal amphotericin B was initiated prior to cardiac surgery, in which the bioprostheses were replaced by homografts, providing greater resistance to recurrent infection. During hospitalization, a mycotic aneurysm was diagnosed following an episode of acute arterial ischemia, requiring two vascular surgical interventions. Despite the complications, the patient's outcome was good and she was discharged on suppressive antifungal therapy with oral fluconazole for at least a year. The reported case illustrates multiple risk factors for fungal endocarditis, as well as complications and predictors of poor prognosis, demonstrating its complexity. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Garenoxacin treatment of experimental endocarditis caused by viridans group streptococci.

    Science.gov (United States)

    Anguita-Alonso, Paloma; Rouse, Mark S; Piper, Kerryl E; Steckelberg, James M; Patel, Robin

    2006-04-01

    The activity of garenoxacin was compared to that of levofloxacin or penicillin in a rabbit model of Streptococcus mitis group (penicillin MIC, 0.125 microg/ml) and Streptococcus sanguinis group (penicillin MIC, 0.25 microg/ml) endocarditis. Garenoxacin and levofloxacin had MICs of 0.125 and 0.5 microg/ml, respectively, for both study isolates. Rabbits with catheter-induced aortic valve endocarditis were given no treatment, penicillin at 1.2x10(6) IU/8 h intramuscularly, garenoxacin at 20 mg/kg of body weight/12 h intravenously, or levofloxacin at 40 mg/kg/12 h intravenously. For both isolates tested, garenoxacin area under the curve (AUC)/MIC and maximum concentration of drug in serum (Cmax)/MIC ratios were 368 and 91, respectively. Rabbits were sacrificed after 3 days of treatment; cardiac valve vegetations were aseptically removed and quantitatively cultured. For S. mitis group experimental endocarditis, all studied antimicrobial agents were more active than no treatment (PS. sanguinis group endocarditis, no studied antimicrobial agents were more active than no treatment. We conclude that AUC/MIC and Cmax/MIC ratios may not predict activity of some quinolones in experimental viridans group endocarditis and that garenoxacin and levofloxacin may not be ideal choices for serious infections caused by some quinolone-susceptible viridans group streptococci.

  2. 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.

  3. Brain magnetic resonance findings in infective endocarditis with neurological complications

    International Nuclear Information System (INIS)

    Azuma, Asako; O'uchi, Toshihiro; Toyoda, Keiko

    2009-01-01

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

  4. Common diagnostic flowcharts in infective endocarditis

    International Nuclear Information System (INIS)

    Iung, B.; Erba, P. A.; Lazzeri, E.; Petrosillo, N.

    2014-01-01

    The presentation of infective endocarditis (IE) has changed over time and its diagnosis remains difficult since it relies on the conjunction of a number of criteria which have their own limitations. The Duke classification allows for a standardized approach and is now recognized as the reference method for the diagnosis of IE. The diagnostic value of the different criteria of the Duke classification can be improved by the use of transoesophageal echocardiography for the detection of endocardial involvement and the use of non-cardiac imaging for the detection of embolic events. The number of cases of IE without identified causative microorganism can be reduced due to serological analyses and broad-range polymerase chain reaction on explanted valves. Radionuclide imaging techniques are useful when the diagnosis of IE remains uncertain. [18F]FDG PET/CT can be used for the diagnosis of cardiac infection and for the detection of embolic events or metastatic infection, keeping in mind the possibility of false positive diagnosis due to its high sensitivity. Radiolabelled-leukocytes scintigraphy is more specific than [18F]FDG PET/CT and can differentiate between septic and sterile vegetations. Diagnostic flowcharts are proposed to combine the Duke classification and recent imaging techniques for the diagnostic workup of IE.

  5. 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.

  6. Extracardiac manifestations of infective endocarditis and their historical descriptions.

    Science.gov (United States)

    Silverman, Mark E; Upshaw, Charles B

    2007-12-15

    In his landmark "Gulstonian Lectures on Malignant Endocarditis," published in 1885, William Osler commented, "Few diseases present greater difficulties in the way of diagnosis than malignant endocarditis, difficulties which in many cases are practically insurmountable." At that time, the fields of microbiology and blood cultures were in their infancy, and the diagnosis was made premortem in just half the patients with the condition. After Osler's report, extracardiac physical findings became essential clues to earlier diagnosis. Today, infective endocarditis is most commonly suggested from the history and often clinched by an echocardiogram and blood cultures. Although prized physical manifestations are much less frequent now, they still do occur and may be an invaluable clue that leads to earlier, more effective treatment. The investigators review these extracardiac findings along with their historical descriptions: splinter hemorrhages, emboli, Osler's nodes, Janeway and Bowman lesions of the eye, Roth spots, petechiae, and clubbing.

  7. [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.

  8. 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.

  9. [Clinical Characteristics and Evolution of Recurrent Infectious Endocarditis in non Drug Addicts].

    Science.gov (United States)

    Rodríguez, M; Anguita, M; Castillo, J M; Torres, F; Siles, J R; Mesa, D; Franco, M; García-Alegría, J; Concha, M; Vallés, F

    2001-09-01

    Recurrence of infection is observed in a high proportion of patients who have had infective endocarditis in the past. The aim of our study was to evaluate the possible differences between the first and the recurrent episodes of endocarditis, as well as to assess the outcome and prognosis of patients with recurrent endocarditis. We reviewed a series of 13 episodes of recurrent endocarditis from among 196 cases of infective endocarditis involving non-drug-addict patients in two hospitals from 1987 to 2000. There were no differences between recurrent and first episodes of endocarditis according to age, sex, heart valve involved or causal microorganisms. Prosthetic valve endocarditis was more common in patients with recurrent endocarditis (86% versus 27%; p < 0.001). Although there were no differences in the rate of complications or early surgery, overall mortality was significantly higher in patients with recurrent endocarditis (53% versus 27%: p < 0.05). When early and late mortality were analysed separately, the differences did not achieve significance. Recurrent endocarditis was frequent in our series (7% of all cases). The features were similar to those of the first episode except for a higher rate of prosthetic valve endocarditis and a higher overall mortality.

  10. Epidemiology of infective endocarditis in a large Belgian non-referral hospital.

    Science.gov (United States)

    Poesen, K; Pottel, H; Colaert, J; De Niel, C

    2014-06-01

    Guidelines for diagnosis of infective endocarditis are largely based upon epidemiological studies in referral hospitals. Referral bias, however, might impair the validity of guidelines in non-referral hospitals. Recent studies in non-referral care centres on infective endocarditis are sparse. We conducted a retrospective epidemiological study on infective endocarditis in a large non-referral hospital in a Belgian city (Kortrijk). The medical record system was searched for all cases tagged with a putative diagnosis of infective endocarditis in the period 2003-2010. The cases that fulfilled the modified Duke criteria for probable or definite infective endocarditis were included. Compared to referral centres, an older population with infective endocarditis, and fewer predisposing cardiac factors and catheter-related infective endocarditis is seen in our population. Our patients have fewer prosthetic valve endocarditis as well as fewer staphylococcal endocarditis. Our patients undergo less surgery, although mortality rate seems to be highly comparable with referral centres, with nosocomial infective endocarditis as an independent predictor of mortality. The present study suggests that characteristics of infective endocarditis as well as associative factors might differ among non-referral hospitals and referral hospitals.

  11. Infective Endocarditis With Paravalvular Extension: 35-Year Experience.

    Science.gov (United States)

    Rouzé, Simon; Flécher, Erwan; Revest, Matthieu; Anselmi, Amedeo; Aymami, Marie; Roisné, Antoine; Guihaire, Julien; Verhoye, Jean Philippe

    2016-08-01

    We investigated our surgical strategy and clinical results in patients from active infective endocarditis (AIE) complicated by paravalvular involvement to determine the risk factors of early and late death and reoperation. From October 1979 to December 2014, 955 patients underwent operations for AIE; among them 207 had AIE with paravalvular extension. The patients were a mean age of 59.9 ± 15.4 years, and 162 (78%) were male. Of these patients, 137 (66%) had isolated aortic valve endocarditis, and 138 (67%) had native valve endocarditis. Follow-up was 99% complete. The operative mortality of the cohort was 16% (n = 34). Abnormal communication, mechanical valve implantation, and renal failure were independent predictors of 30-day death. Survival at 1, 5, 10, and 15 years was 90.3% ± 2.3%, 62.4% ± 3.7%, 49.3% ± 4.1%, and 37.9% ± 4.4%, respectively. Streptococcus endocarditis (all species), complex annular repair, and preoperative heart failure were independent predictors of long-term death. A reoperation was required in 29 patients (14%). Streptococcus pneumoniae endocarditis was the only independent predictor of early reoperation (within 30 days after the operation or during the same hospitalization). Freedom from reoperation at 1, 5, 10, and 15 years was 91.9% ± 2.2%, 89.6% ± 2.6%, 89.6% ± 2.6%, and 87.0% ± 3.5%, respectively. Independent predictors of late reoperation were urgent/emergency operation, prosthetic valve endocarditis, and complex annular repair. AIE complicated by paravalvular involvement remains a surgical challenge. Valve replacement (particularly using bioprosthesis) associated with ad hoc reconstruction seems to be a reliable option and showed very encouraging results in this context. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Péptidos antimicrobianos en la inmunidad innata de enfermedades infecciosas

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    Rivas-Santiago Bruno

    2006-01-01

    Full Text Available Los péptidos antimicrobianos son moléculas efectoras clave en la inmunidad innata. Generalmente contienen de 15 a 45 residuos de aminoácidos y en su gran mayoría poseen carga positiva, además de que tienen la propiedad de ser anfipáticos. Estos péptidos son secretados por células epiteliales y leucocitos, como es el caso de los macrófagos y neutrófilos. En la actualidad, con base en la traducción de secuencias en programas computacionales se han descrito más de 800 tipos de péptidos antimicrobianos distribuidos en los reinos animal y vegetal. Estos péptidos pueden ser clasificados de acuerdo con su conformación estructural y la ubicación de sus puentes disulfuro. Las defensinas constituyen uno de los tipos de péptidos antimicrobianos más estudiados, y se dividen en dos familias de acuerdo con la ubicación de sus puentes disulfuro: alfa-defensinas y beta-defensinas. Algunas de estas defensinas pueden ser inducidas por citocinas proinflamatorias, así como por moléculas propias de patógenos, y se ha observado que están relacionadas con la inmunopatogenia de varias enfermedades. El papel principal de los péptidos antimicrobianos es la lisis directa de microorganismos; sin embargo, a la fecha también se han descrito propiedades quimiotácticas, que le permiten modular el sistema inmune y de esta forma constituir un puente entre la inmunidad innata y la inmunidad adaptativa. Actualmente se han iniciado estudios con la posibilidad de utilizar esta clase de moléculas como nuevos fármacos en diferentes tipos de enfermedades infecciosas.

  13. Efectividad comunitaria de las vacunas frente a la Parotiditis Infecciosa. Estudio de casos

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    Limón Mora Juan

    1999-01-01

    Full Text Available FUNDAMENTO: En nuestro país existen dos tipos de vacunas disponibles frente a la parotiditis infecciosa. En los últimos tiempos se han planteado dudas sobre la eficacia global de estas vacunas y de la eficacia comparada entre ambas (cepa Rubini y cepa Jeryl Lynn. En el distrito sanitario de A.P. "Sevilla Este" se registraron 256 casos durante 1997 (90,1 casos por 100.000 habitantes. Con este estudio se pretende aprovechar la aparición de casos de parotiditis para evaluar poblaciones afectadas e incidencia comparada según tipo de vacuna recibida durante la infancia. MÉTODOS: Análisis descriptivo de los casos (edad, distribución territorial, antecedentes vacunales,... y análisis evolutivo (tasas de incidencia anuales en el distrito sanitario y su entorno. Se evalúa la efectividad global de las vacunas frente a la parotiditis. Igualmente se estiman las tasas de incidencia de casos entre los vacunados con cepa Rubini y Jeryl Lynn. RESULTADOS: Se observan las tasas de incidencias más elevadas en niños entre 1 y 4 años. Se han estimado niveles de efectividad global para estas vacunas. Además se observa una incidencia de casos significativamente más elevada entre los niños vacunados con cepa Rubini que en los que lo hicieron con Jeryl Lynn (riesgo relativo de 6,5 con Intervalo de confianza 95% 3,6-11,8. CONCLUSIONES: La efectividad que se desprende de este estudio no parece ser tan buena como la eficacia teórica preconizada para las vacunas frente a la parotiditis. Se plantea la conveniencia de realizar otros estudios de casos según tipos de vacunas utilizadas. Igualmente son de gran interés los datos a suministrar por estudios seroepidemiológicos.

  14. Salmonella enterica Serovar Typhi: An Unusual Cause of Infective Endocarditis

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    Christopher Robson

    2018-03-01

    Full Text Available While typhoid fever is a common infection, Salmonella enterica serovar Typhi is a rare cause of endocarditis. We describe the case of a 20-year-old male who was treated for a primary episode of microbiologically-confirmed typhoid fever. He presented six weeks post-discharge with fever and lethargy. S. Typhi was again identified in blood cultures, and echocardiography identified a mitral valve lesion. Our case suggests that a relapse of typhoid should prompt further investigation for a deep-seated infection, including consideration of echocardiographic evaluation to rule out infective endocarditis.

  15. 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.

  16. Gallium-67 myocardial imaging for the detection of bacterial endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Wiseman, J.; Rouleau, J.; Rigo, P.; Strauss, H.W.; Pitt, B.

    1976-07-01

    Eleven patients with a clinical diagnosis of bacterial endocarditis underwent scintillation scanning of the precordial region 2--7 days after the intravenous administration of 3 mCi of gallium-67 citrate. Seven had positive scans, 3 of which were confirmed by postmortem imaging at autopsy. Serial images revealed the scans to be frequently negative at 48 hours and positive from 3 to 8 days following injection. Uptake was not seen in the region of the myocardium 48 hours or longer after the injection of 15 patients without endocarditis used as controls.

  17. Bioprosthetic Aortic Valve Endocarditis in Association with Enterococcus durans.

    Science.gov (United States)

    Fallavollita, Luca; Di Gioacchino, Lorena; Balestrini, Fabrizio

    2016-04-01

    Enterococci are common organisms associated with endocarditis, but infection by Enterococcus durans is very rare. To our knowledge, only 3 cases have been reported in the medical literature, and all 3 have involved native valves. Here we publish the first reported case (to our knowledge) of E. durans endocarditis in association with a bioprosthetic aortic valve. After the organism and its antibiotic susceptibility were identified, the 74-year-old male patient was treated successfully with teicoplanin and gentamicin, over a course of 6 weeks.

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

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    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.

  19. 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,......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...

  20. 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......%) were treated conservatively and 1 with surgery. Four patients (22%) died from endocarditis or complications to treatment, 2 of those (11%) during initial hospitalization for PVE. An increased risk of TAVI-PVE was seen in patients with low implanted valve position (hazard ratio, 2.8 [1.1-7.2]), moderate...

  1. Gallium-67 myocardial imaging for the detection of bacterial endocarditis

    International Nuclear Information System (INIS)

    Wiseman, J.; Rouleau, J.; Rigo, P.; Strauss, H.W.; Pitt, B.

    1976-01-01

    Eleven patients with a clinical diagnosis of bacterial endocarditis underwent scintillation scanning of the precordial region 2--7 days after the intravenous administration of 3 mCi of gallium-67 citrate. Seven had positive scans, 3 of which were confirmed by postmortem imaging at autopsy. Serial images revealed the scans to be frequently negative at 48 hours and positive from 3 to 8 days following injection. Uptake was not seen in the region of the myocardium 48 hours or longer after the injection of 15 patients without endocarditis used as controls

  2. 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.

  3. 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....

  4. Infective Endocarditis and Cancer Risk: A Population-Based Cohort Study.

    Science.gov (United States)

    Sun, Li-Min; Wu, Jung-Nan; Lin, Cheng-Li; Day, Jen-Der; Liang, Ji-An; Liou, Li-Ren; Kao, Chia-Hung

    2016-03-01

    This study investigated the possible relationship between endocarditis and overall and individual cancer risk among study participants in Taiwan.We used data from the National Health Insurance program of Taiwan to conduct a population-based, observational, and retrospective cohort study. The case group consisted of 14,534 patients who were diagnosed with endocarditis between January 1, 2000 and December 31, 2010. For the control group, 4 patients without endocarditis were frequency matched to each endocarditis patient according to age, sex, and index year. Competing risks regression analysis was conducted to determine the effect of endocarditis on cancer risk.A large difference was noted in Charlson comorbidity index between endocarditis and nonendocarditis patients. In patients with endocarditis, the risk for developing overall cancer was significant and 119% higher than in patients without endocarditis (adjusted subhazard ratio = 2.19, 95% confidence interval = 1.98-2.42). Regarding individual cancers, in addition to head and neck, uterus, female breast and hematological malignancies, the risks of developing colorectal cancer, and some digestive tract cancers were significantly higher. Additional analyses determined that the association of cancer with endocarditis is stronger within the 1st 5 years after endocarditis diagnosis.This population-based cohort study found that patients with endocarditis are at a higher risk for colorectal cancer and other cancers in Taiwan. The risk was even higher within the 1st 5 years after endocarditis diagnosis. It suggested that endocarditis is an early marker of colorectal cancer and other cancers. The underlying mechanisms must still be explored and may account for a shared risk factor of infection in both endocarditis and malignancy.

  5. Staphylococcus caprae native mitral valve infective endocarditis.

    Science.gov (United States)

    Kwok, T'ng Choong; Poyner, Jennifer; Olson, Ewan; Henriksen, Peter; Koch, Oliver

    2016-10-01

    Staphylococcus caprae is a rare cause of infective endocarditis. Here, we report a case involving the native mitral valve in the absence of an implantable cardiac electronic device. A 76-year-old man presented with a 2 week history of confusion and pyrexia. His past medical history included an open reduction and internal fixation of a humeral fracture 17 years previously, which remained non-united despite further revision 4 years later. There was no history of immunocompromise or farm-animal contact. Two sets of blood culture bottles, more than 12 h apart, were positive for S. caprae . Trans-thoracic echocardiography revealed a 1×1.2 cm vegetation on the mitral valve, with moderate mitral regurgitation. Due to ongoing confusion, he had a magnetic resonance imaging brain scan, which showed a subacute small vessel infarct consistent with a thromboembolic source. A humeral SPECT-CT (single-photon emission computerized tomography-computerized tomography) scan showed no clear evidence of acute osteomyelitis. Surgical vegetectomy and mitral-valve repair were considered to reduce the risk of further systemic embolism and progressive valve infection. However, the potential risks of surgery to this patient led to a decision to pursue a cure with antibiotic therapy alone. He remained well 3 months after discharge, with repeat echocardiography demonstrating a reduction in the size of the vegetation (0.9 cm). Management of this infection was challenging due to its rarity and its unclear progression, complicated by the dilemma surrounding surgical intervention in a patient with a complex medical background.

  6. Antineutrophil Cytoplasmic Antibodies Associated With Infective Endocarditis

    Science.gov (United States)

    Langlois, Vincent; Lesourd, Anais; Girszyn, Nicolas; Ménard, Jean-Francois; Levesque, Hervé; Caron, Francois; Marie, Isabelle

    2016-01-01

    Abstract To determine the prevalence of antineutrophil cytoplasmic antibodies (ANCA) in patients with infective endocarditis (IE) in internal medicine; and to compare clinical and biochemical features and outcome between patients exhibiting IE with and without ANCA. Fifty consecutive patients with IE underwent ANCA testing. The medical records of these patients were reviewed. Of the 50 patients with IE, 12 exhibited ANCA (24%). ANCA-positive patients with IE exhibited: longer duration between the onset of first symptoms and IE diagnosis (P = 0.02); and more frequently: weight loss (P = 0.017) and renal impairment (P = 0.08), lower levels of C-reactive protein (P = 0.0009) and serum albumin (P = 0.0032), involvement of both aortic and mitral valves (P = 0.009), and longer hospital stay (P = 0.016). Under multivariate analysis, significant factors for ANCA-associated IE were: longer hospital stay (P = 0.004), lower level of serum albumin (P = 0.02), and multiple valve involvement (P = 0.04). Mortality rate was 25% in ANCA patients; death was because of IE complications in all these patients. Our study identifies a high prevalence of ANCA in unselected patients with IE in internal medicine (24%). Our findings further underscore that ANCA may be associated with a subacute form of IE leading to multiple valve involvement and more frequent renal impairment. Because death was due to IE complications in all patients, our data suggest that aggressive therapy may be required to improve such patients’ outcome. PMID:26817911

  7. Posible papel de Bacteroides fragilis enterotoxigénico en la etiología de la vaginitis infecciosa

    OpenAIRE

    Polanco, Nina; Manzi, Lorna; Carmona, Oswaldo

    2012-01-01

    La vaginitis es un trastorno ginecológico frecuente producido por distintas causas, algunas de las cuales permanecen desconocidas. Bacteroides fragilis es el anaerobio más importante en bacteriología clínica. Algunas cepas son enterotoxigénicas y se asocian con síndromes intestinales y extraintestinales. Recientemente han sido aisladas de pacientes con vaginitis. En este trabajo se planteó investigar la posible asociación de B. fragilis enterotoxigénico con la vaginitis infecciosa. Fueron pro...

  8. Early prosthetic valve endocarditis caused by Corynebacterium kroppenstedtii.

    Science.gov (United States)

    Hagemann, Jürgen Benjamin; Essig, Andreas; Herrmann, Manuel; Liebold, Andreas; Quader, Mohamed Abo

    2015-12-01

    Corynebacterium (C.) kroppenstedtii is a rarely detected agent of bacterial infections in humans. Here, we describe the first case of prosthetic valve endocarditis caused by C. kroppenstedtii. Application of molecular methods using surgically excised valve tissue was a cornerstone for the establishment of the microbiological diagnosis, which is crucial for targeted antimicrobial treatment. Copyright © 2015 Elsevier GmbH. All rights reserved.

  9. ANTIMICROBIAL TREATMENT BEFORE DENTAL PROCEDURES IN PATIENTS WITH BACTERIAL ENDOCARDITIS

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    Adriana Krasteva

    2010-12-01

    Full Text Available Infective endocarditis is a rare condition with significant morbidity and mortality. It may arise following bacteraemia in a patient with a predisposing cardiac lesion. In an attempt to prevent this disease, over the past 50 years, at-risk patients have been given antibiotic prophylaxis before dental procedures.

  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. Enterococcal Infective Endocarditis following Periodontal Disease in Dogs.

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    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.

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

    OpenAIRE

    Sibel Serin; Kevser Kutlu Tatar; Tayyibe Saler

    2014-01-01

    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...

  13. Acute Q fever and the risk of developing endocarditis.

    Science.gov (United States)

    Martín-Aspas, A; Collado-Pérez, C; Vela-Manzano, L; Fernández-Gutiérrez Del Álamo, C; Tinoco-Racero, I; Girón-González, J A

    2015-01-01

    Assess clinical and serological data as parameters indicative of a possible evolution to endocarditis after an episode of acute Q fever. Retrospective cohort study of evolution to endocarditis after an acute Q fever episode, analyzing the clinical and serological evolution and the antibiotic treatment administered. Eighty patients were recruited, 20% of whom had phase i IgG antibody levels ≥ 1:1024 in the first 3 months. Only 44% of the patients underwent antibiotherapy in the acute phase; only 2 patients underwent extended antibiotherapy. Fifteen percent of the patients underwent an echocardiogram. None of the patients had symptoms suggestive of chronic infection or progressed to endocarditis after a median follow-up of 100 months, regardless of the early increase in phase i IgG antibodies. The early increase in phase i IgG antibodies in asymptomatic patients is not associated with progression to endocarditis despite not undergoing prolonged antibiotic treatment. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  14. 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.

  15. Triple valve endocarditis by mycobacterium tuberculosis. A case report

    Directory of Open Access Journals (Sweden)

    Shaikh Quratulain

    2012-09-01

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

  16. Rarity of invasiveness in right-sided infective endocarditis

    DEFF Research Database (Denmark)

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

    2018-01-01

    OBJECTIVE: 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. PATIENTS AND METHODS: From January 2002 to January 20...

  17. Infective endocarditis following urinary tract infection caused by Globicatella sanguinis

    OpenAIRE

    Takahashi, Saeko; Xu, Chieko; Sakai, Tetsuya; Fujii, Kotaro; Nakamura, Morio

    2017-01-01

    We report the first case of infective endocarditis following urinary tract infection (UTI) caused by Globicatella sanguinis in an 87-year-old Japanese woman with recurrent episodes of UTI. We identified the pathogen using the Rapid ID32 Strep system. Accurate identification of this infection is important and essential for the effective antimicrobial coverage to this pathogen.

  18. 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

  19. Enterococcal Infective Endocarditis following Periodontal Disease in Dogs.

    Science.gov (United States)

    Semedo-Lemsaddek, Teresa; Tavares, Marta; São Braz, Berta; Tavares, Luís; Oliveira, Manuela

    2016-01-01

    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.

  20. 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.

  1. 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...

  2. 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...

  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. A 27-year experience with infective endocarditis in Lebanon.

    Science.gov (United States)

    El-Chakhtoura, Nadim; Yasmin, Mohamad; Kanj, Souha S; Baban, Tania; Sfeir, Jad; Kanafani, Zeina A

    Although rare, infective endocarditis (IE) continues to cause significant morbidity and mortality. Previous data from the American University of Beirut Medical Center (AUBMC) had shown predominance of streptococcal infection. As worldwide studies in developed countries show increasing trends in Staphylococcus aureus endocarditis, it becomes vital to continually inspect local data for epidemiological variations. We reviewed all IE cases between 2001 and 2014, and we performed a comparison to a historical cohort of 86 IE cases from 1987 to 2001. A total of 80 patients were diagnosed with IE between 2001 and 2014. The mean age was 61 years. The most commonly isolated organisms were streptococci (37%), compared to 51% in the previous cohort. S. aureus accounted for 11%. Only one S. aureus isolate was methicillin-resistant. In the historical cohort, 26% of cases were caused by S. aureus. Enterococci ranked behind staphylococci with 22% of total cases, while in the previous cohort, enterococcal IE was only 4%. Compared to previous data from AUBMC, the rates of streptococcal and staphylococcal endocarditis have decreased while enterococcal endocarditis has increased. This study reconfirms that in Lebanon, a developing country, we continue to have a low predominance of staphylococci as etiologic agents in IE. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Early detection of infantile endocarditis by gallium-67 scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Hardoff, R; Luder, A S; Lorber, A; Dembo, L

    1989-04-01

    An infant with suspected soft tissue infection of the knee was studied by /sup 67/Ga-scintigraphy. In addition to knee and hip joint increased activity, heart uptake was also demonstrated prior to the development of clinical signs of endocarditis. The early detection and treatment resulted in satisfactory clinical resolution.

  6. Early detection of infantile endocarditis by gallium-67 scintigraphy

    International Nuclear Information System (INIS)

    Hardoff, R.; Luder, A.S.; Lorber, A.; Dembo, L.; Technion-Israel Inst. of Tech., Haifa. Faculty of Medicine)

    1989-01-01

    An infant with suspected soft tissue infection of the knee was studied by 67 Ga-scintigraphy. In addition to knee and hip joint increased activity, heart uptake was also demonstrated prior to the development of clinical signs of endocarditis. The early detection and treatment resulted in satisfactory clinical resolution. (orig.)

  7. 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.

  8. Recent Surgical Results for Active Endocarditis Complicated With Perivalvular Abscess.

    Science.gov (United States)

    Yoshioka, Daisuke; Toda, Koichi; Yokoyama, Jun-Ya; Matsuura, Ryohei; Miyagawa, Shigeru; Shirakawa, Yukitoshi; Takahashi, Toshiki; Sakaguchi, Taichi; Fukuda, Hirotsugu; Sawa, Yoshiki

    2017-10-25

    Surgical treatment for endocarditis patients with a perivalvular abscess is still challenging.Methods and Results:From 2009 to 2016, 470 patients underwent surgery for active endocarditis at 11 hospitals. Of these, 226 patients underwent aortic valve surgery. We compared the clinical results of 162 patients without a perivalvular abscess, 37 patients who required patch reconstruction of the aortic annulus (PR group) and 27 who underwent aortic root replacement (ARR group). Patients with a perivalvular abscess had a greater number ofStaphylococcusspecies and prosthetic valve endocarditis, a greater level of inflammation at diagnosis and symptomatic heart failure before surgery, especially in the ARR group. Nevertheless, the duration between diagnosis and surgery was similar, because of a high prevalence of intracranial hemorrhage in the ARR group. Hospital death occurred in 13 (9%) patients without a perivalvular abscess, in 4 (12%) in the PR and in 7 (32%) in the ARR group. Postoperative inflammation and end-organ function were similar between the groups. Overall survival of patients without a perivalvular abscess and that of the PR group was similar, but was significantly worse in the ARR group (P=0.050, 0.026). Freedom from endocarditis recurrence was similar among all patients. Patients treated with patch reconstruction showed favorable clinical results. Early surgical intervention is necessary when a refractory invasive infection is suspected.

  9. Gallium67 scintigraphy in fibrinous pericarditis associated with bacterial endocarditis

    International Nuclear Information System (INIS)

    Martin, P.; Verhas, M.; Devriendt, J.; Goffin, Y.

    1982-01-01

    An 80-year-old man presented with pyrexia, progressive cardiac failure and inflammation. A diagnosis of pericarditisd associated with bacterial endocarditis was suggested from Gallium 67 scintigraphy and confirmed at autpsy. This case of fibrinous pericarditis without effusion could not be diagnosed by echography or routine cardiopulmonary scintigraphy. (orig.)

  10. Incidence of infective endocarditis among patients considered at high risk

    DEFF Research Database (Denmark)

    Østergaard, Lauge; Valeur, Nana; Ihlemann, Nikolaj

    2018-01-01

    Aims: Patients with prior infective endocarditis (IE), a prosthetic heart valve, or a cyanotic congenital heart disease (CHD) are considered to be at high risk of IE by guidelines. However, knowledge is sparse on the relative risk of IE between these three groups and compared controls. Methods...

  11. Technetium-99m stannous pyrophosphate imaging of experimental infective endocarditis

    International Nuclear Information System (INIS)

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

    1978-01-01

    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

  12. 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...

  13. 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...

  14. Native valve endocarditis due to Corynebacterium group JK.

    Science.gov (United States)

    Moffie, B G; Veenendaal, R A; Thompson, J

    1990-12-01

    We report a case of a 32-yr-old woman on chronic intermittent haemodialysis, who developed endocarditis due to a Corynebacterium group JK, involving both the native aortic and mitral valves. Despite a four-week treatment with vancomycin, an aortic root abscess developed. The diagnosis was confirmed on autopsy.

  15. 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.

  16. Infective endocarditis prophylaxis: current practice trend among paediatric cardiologists: are we following the 2007 guidelines?

    Science.gov (United States)

    Naik, Ronak J; Patel, Neil R; Wang, Ming; Shah, Nishant C

    2016-08-01

    In 2007, the American Heart Association modified the infective endocarditis prophylaxis guidelines by limiting the use of antibiotics in patients with cardiac conditions associated with the highest risk of adverse outcomes after infective endocarditis. Our objective was to evaluate current practice for infective endocarditis prophylaxis among paediatric cardiologists. A web-based survey focussing on current practice, describing the use of antibiotics for infective endocarditis prophylaxis in various congenital and acquired heart diseases, was distributed via e-mail to paediatric cardiologists. The survey was kept anonymous and was distributed twice. Data from 253 participants were analysed. Most paediatric cardiologists discontinued infective endocarditis prophylaxis in patients with simple lesions such as small ventricular septal defect, patent ductus arteriosus, and bicuspid aortic valve without stenosis or regurgitation; however, significant disagreement persists in prescribing infective endocarditis prophylaxis in certain conditions such as rheumatic heart disease, Fontan palliation without fenestration, and the Ross procedure. Use of antibiotic prophylaxis in certain selected conditions for which infective endocarditis prophylaxis has been indicated as per the current guidelines varies from 44 to 83%. Only 44% follow the current guidelines exclusively, and 34% regularly discuss the importance of oral hygiene with their patients at risk for infective endocarditis. Significant heterogeneity still persists in recommending infective endocarditis prophylaxis for several cardiac lesions among paediatric cardiologists. More than half of the participants (56%) do not follow the current guidelines exclusively in their practice. Counselling for optimal oral health in patients at risk for infective endocarditis needs to be optimised in the current practice.

  17. ASOCIACIÓN SEROLÓGICA DE LA RINONEUMONITIS VIRAL EQUINA Y LA ANEMIA INFECCIOSA EQUINA

    Directory of Open Access Journals (Sweden)

    Albeiro López-Herrera

    2008-04-01

    Full Text Available Objetivo. Determinar el nivel de asociación serológica entre los herpesvirus equinos tipos 1 y 4 (HVE-1 y HVE-4 causantes de la rinoneumonitis equina y el virus de la anemia infecciosa equina (VAIE en caballos de trabajo provenientes de 5 municipios del Meta. Materiales y métodos. Se realizó una encuesta serológica transversal en 68 equinos provenientes de los municipios de San Martín, Guamal, Restrepo, Cumaral y Paratebueno. Para la evaluación de los anticuerpos contra los HVE-1 y HVE-4, se utilizó un ELISA indirecto para detectar la presencia de anticuerpos dirigidos contra la glicoproteína G del HVE-1 y HVE-4 (Svanovir ™ EHV1/EHV4-Ab ELISA; para el diagnóstico de anticuerpos contra el VAIE se utilizó la prueba de inmunodifusión en agar de gel de Coggins. Resultados. No se encontraron reactores al HVE-1; sin embargo, el porcentaje de seropositividad fue de 94.12% (64/68 y 13.2%(9/68 para HVE-4 y VAIE respectivamente. El porcentaje de animales coinfectados HVE-4 y AIE fue 13.23% (9/68. Cuando se discriminaron los resultados por Municipio se encontró un 27.9% (19/68 de reactividad en el municipio de Restrepo, 26.5% (18/68 en Cumaral, 14.7% (10/68 en Paratebueno, 14.7% (10/68 en Guamal, y 10.3% (7/68 en San Martin. El porcentaje de reactores por municipio al VAIE fue Cumaral 5.88% (4/68, Restrepo 4.4% (3/68, Guamal 1.47%(1/68 y San Martín 1.47% (1/68. Conclusión. El alto porcentaje de coinfección entre HVE-4 y VAIE sugiere un efecto importante en la interacción, pues el efecto inmunosupresor del VAIE podría facilitar la reactivación del estado latente del HVE-4.

  18. 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

    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

  19. Superantigens Are Critical for Staphylococcus aureus Infective Endocarditis, Sepsis, and Acute Kidney Injury

    Science.gov (United States)

    Salgado-Pabón, Wilmara; Breshears, Laura; Spaulding, Adam R.; Merriman, Joseph A.; Stach, Christopher S.; Horswill, Alexander R.; Peterson, Marnie L.; Schlievert, Patrick M.

    2013-01-01

    ABSTRACT Infective endocarditis and kidney infections are serious complications of Staphylococcus aureus sepsis. We investigated the role of superantigens (SAgs) in the development of lethal sepsis, infective endocarditis, and kidney infections. SAgs cause toxic shock syndrome, but it is unclear if SAgs contribute to infective endocarditis and kidney infections secondary to sepsis. We show in the methicillin-resistant S. aureus strain MW2 that lethal sepsis, infective endocarditis, and kidney infections in rabbits are critically dependent on high-level SAgs. In contrast, the isogenic strain lacking staphylococcal enterotoxin C (SEC), the major SAg in this strain, is attenuated in virulence, while complementation restores disease production. SAgs’ role in infective endocarditis appears to be both superantigenicity and direct endothelial cell stimulation. Maintenance of elevated blood pressure by fluid therapy significantly protects from infective endocarditis, possibly through preventing bacterial accumulation on valves and increased SAg elimination. These data should facilitate better methods to manage these serious illnesses. PMID:23963178

  20. Purulent Meningitis as an Unusual Presentation of Staphylococcus aureus Endocarditis: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Giancarlo Ceccarelli

    2011-01-01

    Full Text Available On presentation of Staphylococcus aureus endocarditis, unusual manifestations may represent the main clinical features of the disease. Isolated bacterial meningitis as the first manifestation of endocarditis is considered to be an unusual neurological complication. Here, we describe a case S. aureus endocarditis presenting as isolated meningitis and mimicking meningococcal septicaemia. Because of the high mortality rate of the disease, the prompt recognition of this infectious syndrome is of crucial importance for the correct management of patients.

  1. 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...

  2. Complete Atrioventricular Block Complicating Mitral Infective Endocarditis Caused by Streptococcus Agalactiae

    OpenAIRE

    Arai, Masaru; Nagashima, Koichi; Kato, Mahoto; Akutsu, Naotaka; Hayase, Misa; Ogura, Kanako; Iwasawa, Yukino; Aizawa, Yoshihiro; Saito, Yuki; Okumura, Yasuo; Nishimaki, Haruna; Masuda, Shinobu; Hirayama, Atsushi

    2016-01-01

    Patient: Male, 74 Final Diagnosis: Infective endocarditis Symptoms: Apetite loss ? fever Medication: ? Clinical Procedure: Transesophageal echocardiography Specialty: Cardiology Objective: Rare co-existance of disease or pathology Background: Infective endocarditis (IE) involving the mitral valve can but rarely lead to complete atrioventricular block (CAVB). Case Report: A 74-year-old man with a history of infective endocarditis caused by Streptococcus gordonii (S. gordonii) presented to our ...

  3. 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....

  4. Cardiopulmonary manifestations of isolated pulmonary valve infective endocarditis demonstrated with cardiac CT.

    Science.gov (United States)

    Passen, Edward; Feng, Zekun

    2015-01-01

    Right-sided infective endocarditis involving the pulmonary valve is rare. This pictorial essay discusses the use and findings of cardiac CT combined with delayed chest CT and noncontrast chest CT of pulmonary valve endocarditis. Cardiac CT is able to show the full spectrum of right-sided endocarditis cardiopulmonary features including manifestations that cannot be demonstrated by echocardiography. Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  5. Pulmonary valve endocarditis associated to a septal interventricular defect and infundibular and pulmonary valve Stenosis

    International Nuclear Information System (INIS)

    Echeverri, Juan G; Diaz, Alejandro; Jaramillo, Nicolas; Gonzalez, Sergio

    2004-01-01

    Ventricular septal defects generate 10% of all adult congenital cardiopathies. 4% to 8% of patients to whom the defect has not been corrected are in risk of developing endocarditis. Pulmonary valve endocarditis is a rare event (1.5% to 2% of all endocarditis cases) and its mean etiology is intravenous drug abuse. The most frequently isolated microorganism in these cases is staphylococcus aurous. We report a case of pulmonary valve endocarditis associated with ventricular septal defect and valvular and infundibular pulmonary stenosis caused by streptococcus sp. in a patient without past medical history of drug abuse, alcoholism or previous invasive procedures

  6. Usefulness of three-dimensional echocardiography in the assessment of valvular involvement in Loeffler endocarditis.

    Science.gov (United States)

    Hernandez, Carlos M; Arisha, Mohammed J; Ahmad, Amier; Oates, Ethan; Nanda, Navin C; Nanda, Anil; Wasan, Anita; Caleti, Beda E; Bernal, Cinthia L P; Gallardo, Sergio M

    2017-07-01

    Loeffler endocarditis is a complication of hypereosinophilic syndrome resulting from eosinophilic infiltration of heart tissue. We report a case of Loeffler endocarditis in which three-dimensional transthoracic and transesophageal echocardiography provided additional information to what was found by two-dimensional transthoracic echocardiography alone. Our case illustrates the usefulness of combined two- and three-dimensional echocardiography in the assessment of Loeffler endocarditis. In addition, a summary of the features of hypereosinophilic syndrome and Loeffler endocarditis is provided in tabular form. © 2017, Wiley Periodicals, Inc.

  7. 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.

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

    DEFF Research Database (Denmark)

    Chen, Ming; Kemp, Michael; Bruun, Niels E

    2011-01-01

    Cardiobacterium valvarum is a newly recognized human pathogen related to infective endocarditis. Cardiobacterium species are, however, only rarely the aetiology of infective endocarditis. An infective endocarditis case is presented and, additionally, phenotypic and phylogenetic comparison...... of a further 10 collection strains, representing the two species within the genus, was performed. C. valvarum was isolated from the blood and DNA was present in valvular tissue (partial 16S rRNA gene analysis) from a 64-year-old man with infective endocarditis of the mitral valve, rupture of chordae...

  9. 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

  10. Granulomatosis with polyangiitis mimicking infective endocarditis in an adolescent male.

    Science.gov (United States)

    Varnier, Giulia Camilla; Sebire, Neil; Christov, Georgi; Eleftheriou, Despina; Brogan, Paul A

    2016-09-01

    Granulomatosis with polyangiitis (GPA) is a rare but serious small vessel vasculitis with heterogeneous clinical presentation ranging from mainly localised disease with a chronic course, to a florid, acute small vessel vasculitic form characterised by severe pulmonary haemorrhage and/or rapidly progressive vasculitis or other severe systemic vasculitic manifestations. Cardiac involvement is, however, uncommon in the paediatric population. We report a case of a 16-year-old male who presented with peripheral gangrene and vegetation with unusual location on the supporting apparatus of the tricuspid valve, initially considered to have infective endocarditis but ultimately diagnosed with GPA. We provide an overview of the limited literature relating to cardiac involvement in GPA, and the diagnostic challenge relating to infective endocarditis in this context, especially focusing on the interpretation of the antineutrophil cytoplasmic antibody (ANCA) and the characteristic clinical features to identify in order to promptly recognise GPA, since timely diagnosis and treatment are essential for this potentially life-threatening condition.

  11. Molecular Characterization of Endocarditis-Associated Staphylococcus aureus

    OpenAIRE

    Nethercott, Cara; Mabbett, Amanda N.; Totsika, Makrina; Peters, Paul; Ortiz, Juan C.; Nimmo, Graeme R.; Coombs, Geoffrey W.; Walker, Mark J.; Schembri, Mark A.

    2013-01-01

    Infective endocarditis (IE) is a life-threatening infection of the heart endothelium and valves. Staphylococcus aureus is a predominant cause of severe IE and is frequently associated with infections in health care settings and device-related infections. Multilocus sequence typing (MLST), spa typing, and virulence gene microarrays are frequently used to classify S. aureus clinical isolates. This study examined the utility of these typing tools to investigate S. aureus epidemiology associated ...

  12. Streptobacillus moniliformis endocarditis: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    M. Madhubashini

    2013-07-01

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

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

    OpenAIRE

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

    2017-01-01

    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 classic...

  14. Rochalimaea elizabethae sp. nov. isolated from a patient with endocarditis.

    OpenAIRE

    Daly, J S; Worthington, M G; Brenner, D J; Moss, C W; Hollis, D G; Weyant, R S; Steigerwalt, A G; Weaver, R E; Daneshvar, M I; O'Connor, S P

    1993-01-01

    A Rochalimaea-like organism (strain F9251) was isolated from a patient with endocarditis after blood drawn for culture before antimicrobial therapy was subcultured onto blood and chocolate agars and incubated for 2 weeks in 5% CO2. The strain was phenotypically similar to known Rochalimaea species. The cellular fatty acid composition of strain F9251 was close to but distinct from those of the three known Rochalimaea species and was most similar to that of R. vinsonii. Labeled DNA from strain ...

  15. 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.

  16. Late bacterial endocarditis of an Amplatzer atrial septal device

    Directory of Open Access Journals (Sweden)

    Bhavith Aruni

    2013-07-01

    Full Text Available A 59-year-old male with an secundum atrial septal defect status post repair with an Amplatzer occluder in 2001 was admitted with sepsis and MRSA bacteremia. Transesophageal Echocardiography (TEE showed presence of an overlying mobile echogenic structure on the left atrial surface of the device suggestive of a vegetation/infected thrombus. This is only the 3rd case description of late endocarditis involving the Amplatzer ASD closure device in an adult.

  17. 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.

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Severe Rhabdomyolysis Associated with Staphylococcus aureus Acute Endocarditis Requiring Surgery.

    Science.gov (United States)

    Ravry, Céline; Fedou, Anne-Laure; Dubos, Maria; Denes, Éric; Etchecopar, Caroline; Barraud, Olivier; Vignon, Philippe; François, Bruno

    2015-12-01

    Rhabdomyolysis has multiple etiologies with unclear mechanisms; however, rhabdomyolysis caused by Staphylococcus aureus infection is rare. A case report of severe rhabdomyolysis in a patient who presented with endocarditis caused by methicillin-susceptible S. aureus and review of relevant literature. The patient had a history of cardiac surgery for tetralogy of Fallot. He was admitted to the hospital because of fever and digestive symptoms. Respiratory and hemodynamic status deteriorated rapidly, leading to admission to the intensive care unit (ICU) for mechanical ventilation and vasopressor support. Laboratory tests disclosed severe rhabdomyolysis with a serum concentration of creatine kinase that peaked at 49,068 IU/L; all blood cultures grew methicillin-susceptible S. aureus. Antibiotic therapy was amoxicillin-clavulanic acid, ciprofloxacin, and gentamicin initially and was changed subsequently to oxacillin, clindamycin, and gentamicin. Transesophageal echocardiography showed vegetation on the pulmonary valve, thus confirming the diagnosis of acute endocarditis. Viral testing and computed tomography (CT) scan ruled out any obvious alternative etiology for rhabdomyolysis. Bacterial analysis did not reveal any specificity of the staphylococcal strain. The patient improved with antibiotics and was discharged from the ICU on day 26. He underwent redux surgery for valve replacement on day 53. Staphylococcal endocarditis should be suspected in cases of severe unexplained rhabdomyolysis with acute infectious symptoms.

  1. Bilateral foveal cysts secondary to Streptococcus constellatus endocarditis.

    Science.gov (United States)

    Shah, Anish N; Shah, Benoy N; Glover, Sarah; Herbert, Luke

    2013-06-01

    Infective endocarditis can be acute or subacute, depending on the virulence of the causative organism. It can also cause loss of vision by a variety of mechanisms, ranging from embolic retinal artery occlusion to endogenous endophthalmitis. We illustrate the first report of foveal cyst formation secondary to infective endocarditis. A 53-year-old man presented to his general practitioner with a variety of constitutional symptoms, but initial laboratory and imaging investigations revealed only mild normocytic anaemia, and he was discharged from further medical care. Four weeks later he developed bilateral visual loss associated with whitish lesions of the superficial retina at both foveae. These later developed into foveal cysts with disruption of the photoreceptor inner segment-outer segment junction and persistent poor visual acuity of 6/60 OU. No retinal haemorrhages or Roth spots were noted. Only after he presented with visual loss did further investigations reveal the underlying diagnosis of streptococcal endocarditis. Ophthalmologists assessing retinal pathology which presents in association with undiagnosed constitutional symptoms are advised to refer such patients promptly for thorough medical investigation, including blood culture and echocardiography where appropriate.

  2. Reconstructive valve surgery within 10 days of stroke in endocarditis.

    Science.gov (United States)

    Raman, Jai; Ballal, Apoorva; Hota, Bala; Mirza, Sara; Lai, David; Bleck, Thomas; Lateef, Omar

    2016-07-01

    The optimal timing of surgical treatment for infective endocarditis complicated by cerebrovascular events is controversial, largely due to the perceived risk of perioperative intracranial bleeding. Current guidelines suggest waiting 2 weeks between the diagnosis of stroke and surgery. The aim of this study was to investigate the clinical and neurological outcomes of early surgery following a stroke. This was a single-center retrospective analysis of 12 consecutive patients requiring surgery for infective endocarditis between 2011 and 2014 at Rush University Medical Center, with either ischemic (n = 6) and/or hemorrhagic (n = 6) cerebrovascular complications. All underwent computed tomographic angiography prior to early valve reconstructive surgery to identify potentially actionable neurological findings. Early valve surgery was performed for ongoing sepsis or persistent emboli. Neurologic risk and outcome were assessed pre- and postoperatively using the National Institutes of Health Stroke Scale and the Glasgow Outcome Scale, respectively. All 12 patients underwent surgical treatment within 10 days of the diagnosis of stroke. Mortality in the immediate postoperative period was 8%. Eleven of the 12 patients exhibited good neurological recovery in the immediate postoperative period, with a Glasgow Outcome Scale score ≥ 3. There was no correlation between duration of cardiopulmonary bypass and neurological outcomes. Early cardiac surgery in patients with infective endocarditis and stroke maybe lifesaving with a low neurological risk. Comprehensive neurovascular imaging may help in identifying patient-related risk factors. © The Author(s) 2016.

  3. Echocardiography in Infective Endocarditis: State of the Art.

    Science.gov (United States)

    Afonso, Luis; Kottam, Anupama; Reddy, Vivek; Penumetcha, Anirudh

    2017-10-25

    In this review, we examine the central role of echocardiography in the diagnosis, prognosis, and management of infective endocarditis (IE). 2D transthoracic echocardiography (TTE) and transesophageal echocardiography TEE have complementary roles and are unequivocally the mainstay of diagnostic imaging in IE. The advent of 3D and multiplanar imaging have greatly enhanced the ability of the imager to evaluate cardiac structure and function. Technologic advances in 3D imaging allow for the reconstruction of realistic anatomic images that in turn have positively impacted IE-related surgical planning and intervention. CT and metabolic imaging appear to be emerging as promising ancillary diagnostic tools that could be deployed in select scenarios to circumvent some of the limitations of echocardiography. Our review summarizes the indispensable and central role of various echocardiographic modalities in the management of infective endocarditis. The complementary role of 2D TTE and TEE are discussed and areas where 3D TEE offers incremental value highlighted. An algorithm summarizing a contemporary approach to the workup of endocarditis is provided and major societal guidelines for timing of surgery are reviewed.

  4. Doenças infecciosas e parasitárias no Brasil: uma década de transição

    Directory of Open Access Journals (Sweden)

    Neir Antunes Paes

    1999-08-01

    Full Text Available Em pleno período de transição epidemiológica e demográfica, também marcado pela melhoria na qualidade dos registros de óbitos no Brasil, é crucial entender o comportamento recente da mortalidade por doenças infecciosas e parasitárias neste país. Este trabalho apresenta as mudanças nos padrões de mortalidade por causas infecciosas e parasitárias para o Brasil e seus estados durante a década de 1980. Foram utilizados para tanto os dados de mortalidade provenientes do Sistema de Informações sobre Mortalidade do Ministério da Saúde, classificados de acordo com a Classificação Internacional de Doenças (nona revisão. O resultado desta análise revela mudanças nos padrões de mortalidade com acentuadas quedas nas taxas de mortalidade por doenças infecciosas e parasitárias para o Brasil (variação de 41% para homens e 44% para mulheres, em particular para os estados das regiões Norte e Nordeste. No entanto, estes estados ainda são detentores das mais elevadas taxas de mortalidade do país. Em termos de distribuição etária, as variações atingiram com maior intensidade os extremos de idade, especialmente o grupo de menores de 1 ano. Dentre as doenças infecciosas e parasitárias, o estudo observou ainda o comportamento da mortalidade por doenças infecciosas intestinais (na sua maioria classificadas como mal definidas, tuberculose e septicemia. As taxas de mortalidade por doenças infecciosas intestinais e tuberculose apresentaram uma expressiva queda; o risco de morte por septicemia, por sua vez, apresentou um aumento real durante a década. Apesar do decréscimo global das taxas de mortalidade e da diminuição da mortalidade proporcional por doenças infecciosas e parasitárias, a mortalidade por esta causa ainda permanece elevada no Brasil, e exige atenção prioritária por parte dos setores competentes.

  5. USO DE PRODUTOS NATURAIS PARA O TRATAMENTO DE DOENÇAS INFECCIOSAS: PROSPECÇÃO TECNOLÓGICA

    Directory of Open Access Journals (Sweden)

    Keylla Conceição Machado

    2014-03-01

    Full Text Available O uso de produtos naturais demonstram uma grande dimensão e conscientização através da aplicação empírica da fitoterapia entre a população. Esses produtos estão frequentemente em testes para comprovar sua eficácia em diversas patologias, dentre elas, as doenças infecciosas que representam graves problemas de saúde pública. O presente estudo objetivou realizar uma busca de anterioridade e apresentar uma visão geral do estado atual do desenvolvimento tecnológico relacionado ao uso de produtos naturais para o tratamento de doenças infecciosas. A prospecção foi realizada tendo como base os pedidos de patente depositados em 4 bancos de dados analisados, sendo eles, Instituto Nacional de Propriedade Industrial (INPI do Brasil, no European Patent Office (EPO, United States Patent and Trademark Office (USPTO e World Intellectual Property Organization (WIPO. Após a pesquisa foi constatado apenas 20 patentes, demostrando que em 2008 foi observado o maior número de depósito e que os Estados Unidos se apresentam como o maior depositário, e demostrando a classificação internacional mais abundante foi A61K, que trata de preparações para finalidades médicas, odontológicas e/ou higiênicas. Contudo, foi observado que ainda existe um pequeno número de patentes, sendo necessário um interesse maior no uso de produtos naturais nessas doenças, que vem se manifestando cada vez mais.

  6. Esclerite infecciosa espontânea por Nocardia asteroides: relato de caso Spontaneus nocardial scleritis: case report

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    Andréia Peltier Urbano

    2003-01-01

    Full Text Available OBJETIVO: Relato de caso raro de esclerite infecciosa por Nocardia asteroides, em paciente sem fatores de risco para esclerite. MÉTODOS: Paciente feminina, de 38 anos, apresentando olho vermelho e dor durante 1 mês, com esclerite nodular no olho direito. Sem história prévia de trauma ou cirurgia ocular. Exames laboratoriais normais, sem doenças sistêmicas ou imunodepressão. Foi submetida à biópsia diagnóstica, com ressecção conjuntival da área acometida, cuja cultura evidenciou Nocardia asteroides. Fez tratamento sistêmico com sulfametoxazol-trimetropima e tópico com colírio de amicacina. Após dois meses de tratamento apresentou remissão total do processo infeccioso e acuidade visual final corrigida 20/20. CONCLUSÃO: O diagnóstico e tratamento precoces na esclerite infecciosa por Nocardia asteroides podem permitir prognóstico visual satisfatório.PURPOSE: To report a case of Nocardia asteroides scleritis in a patient without risk factors for infeccious scleritis. METHODS: A 38-year old woman was initially examined for pain, discharge, photophobia of 1 month duration in her right eye. Her medical and ophthalmological history were unremarkable. The results of laboratory tests were normal. Surgical debridement of necrotic tissue was performed and material was sent for biopsy and culture confirmed as Nocardia asteroides. Treatment consisted of amikacin eyedrops, and systemic trimethropim-sulfamethoxazole. The infection resolved leaving scleral thinning and a subconjunctival fibrovascular scar. Best corrected visual acuity two months after referral had improved to LE, 20/20. CONCLUSION: Prompt evaluation and treatment is essential for successful management of Nocardia asteroides infectious scleritis.

  7. Disminución de enfermedades infecciosas intestinales relacionada al acceso a servicios de agua y desagüe en el Perú, 2002-2009

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    Fernando Arenas-Significación

    2011-12-01

    Full Text Available Introducción: En el Perú, las enfermedades infecciosas intestinales ocupan el tercer lugar en causas de morbilidad registradas en consulta externa. Por otro lado, el acceso a agua y desagüe existió en 74,7% y 62,8%, respectivamente. Objetivos: Determinar la correlación del acceso de agua potable y desagüe con las consultas por enfermedades infecciosas intestinales. Diseño: Estudio ecológico de series de tiempo. Institución: Facultad de Medicina de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Perú. Material: Registros del Ministerio de Salud y del Instituto Nacional de Estadística e Informática, Lima, Perú. Métodos: A partir de los registros del Ministerio de Salud (MINSA de las causas de morbilidad en consulta externa y datos del Instituto Nacional de Estadística e Informática (INEI, se realizó un estudio ecológico de serie de tiempo, del periodo 2002 al 2009. Se analizó los resultados con el coeficiente rho de Spearman. Principales medidas de resultados: Coeficientes de correlación. Resultados: Se obtuvo un rho = -0,810 y p = 0,015 para la relación entre acceso a agua potable y enfermedades infecciosas intestinales. Se obtuvo un rho = -0,714 y p = 0,047 para la relación entre el acceso a desagüe y enfermedades infecciosas intestinales. Interpretación: Se encontró correlación entre el porcentaje de acceso de agua potable y desagüe y el porcentaje de consultas externas por enfermedades infecciosas intestinales, en el periodo del 2002 al 2009, en el Perú.

  8. Morbilidad y mortalidad por enfermedades infecciosas intestinales (001-009: Cuba, 1980-1999

    Directory of Open Access Journals (Sweden)

    Raúl L. Riverón Corteguera

    2000-06-01

    Full Text Available En los últimos 20 años la mortalidad por enfermedades infecciosas intestinales en menores de 5 años en el mundo se ha reducido de manera significativa; sin embargo, en 1998 se registraron en el nivel mundial 2,2 millones de defunciones en los menores de 5 años. En la actualidad todavía la mortalidad seconsidera un problema de salud muy serio, sobre todo en los países subdesarrollados. En Cuba, la mortalidad por estas enfermedades en los menores de 5 años se ha reducido de manera notable, aunque la morbilidad constituye un problema importante de salud en ciertos meses del año por las alzas estacionales de la enfermedad. Este artículo muestra los resultados del trabajo desplegado a partir de 1980 en el cual se puso en ejecución el Programa Mundial de Control de las Enfermedades Diarreicas por la Organización Mundial de la Salud, que en Cuba es una continuación del Programa Nacional de Lucha contra la Gastroenteritis que se inició en 1962. Los datos de morbilidad se ofrecen desde 1985 según diferentes grupos de edades. Las reducciones en la morbilidad han sido discretas; en los menores de 1 año fue del 30,8 %; en el grupo de 1 a 4 años, 8,0 %; en los menores de 5 años del 20,1 %; en los de 5 a 14 años del 3,5 % y en los menores de 15 años del 15,8 %. Las tasas de mortalidad disminuyeron en el período de 1980 a 1999 en el 91,0 % en los menores de un año; el 50,0 % en los niños de 1 a 4 años; 85,7 % en menores de 5 años; en 66,7 % en el grupo de 5 a 14 años, y en 81,1 % en los menores de 15 años. Los elementos fundamentales que han contribuido a esta disminución en la mortalidad por enfermedades diarreas han sido, en primer lugar el uso de las sales de rehidratación oral, en la prevención y tratamiento de la deshidratación, el uso racional de antimicrobianos, el incremento de la lactancia materna exclusiva, la capacitación de los recursos humanos, el tratamiento intensivo por parte de nuestros profesionales de la salud

  9. Candida endocarditis: systematic literature review from 1997 to 2014 and analysis of 29 cases from the Italian Study of Endocarditis.

    Science.gov (United States)

    Giuliano, Simone; Guastalegname, Maurizio; Russo, Alessandro; Falcone, Marco; Ravasio, Veronica; Rizzi, Marco; Bassetti, Matteo; Viale, Pierluigi; Pasticci, Maria Bruna; Durante-Mangoni, Emanuele; Venditti, Mario

    2017-09-01

    Candida Endocarditis (CE) is a deadly disease. It is of paramount importance to assess risk factors for acquisition of both Candida native (NVE) and prosthetic (PVE) valve endocarditis and relate clinical features and treatment strategies with the outcome of the disease. Areas covered: We searched the literature using the Pubmed database. Cases of CE from the Italian Study on Endocarditis (SEI) were also included. Overall, 140 cases of CE were analyzed. Patients with a history of abdominal surgery and antibiotic exposure had higher probability of developing NVE than PVE. In the PVE group, time to onset of CE was significantly lower for biological prosthesis compared to mechanical prosthesis. In the whole population, greater age and longer time to diagnosis were associated with increased likelihood of death. Patients with effective anti-biofilm treatment, patients who underwent cardiac surgery and patients who were administered chronic suppressive antifungal treatment showed increased survival. For PVE, moderate active anti-biofilm and highly active anti-biofilm treatment were associated with lower mortality. Expert commentary: Both NVE and PVE could be considered biofilm-related diseases, pathogenetically characterized by Candida intestinal translocation and initial transient candidemia. Cardiac surgery, EAB treatment and chronic suppressive therapy might be crucial in increasing patient survival.

  10. Efficacy of antibiotic prophylaxis for prevention of native-valve endocarditis

    NARCIS (Netherlands)

    van der Meer, J. T.; van Wijk, W.; Thompson, J.; Vandenbroucke, J. P.; Valkenburg, H. A.; Michel, M. F.

    1992-01-01

    Whether antibiotic prophylaxis can prevent bacterial endocarditis is hotly debated. In an attempt to settle this issue, we have assessed the efficacy of prophylaxis for bacterial endocarditis on native valves in a nationwide, case-control study in the Netherlands. Cases were patients with known

  11. Infective endocarditis caused by Stenotrophomonas maltophilia: A report of two cases and review of literature

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    Shaik Subhani

    2016-09-01

    Full Text Available Stenotrophomonas maltophilia is known for nosocomial habitat. Infective endocarditis due to this organism is rare and challenging because of resistance to multiple broad-spectrum antibiotic regimens. Early detection and appropriate antibiotic based on culture sensitivity reports are the key to its management. We report the diagnosis, treatment, and outcome of two cases of infective endocarditis caused by S. maltophilia.

  12. Exophiala (Wangiella dermatitidis Prosthetic Aortic Valve Endocarditis and Prosthetic Graft Infection in an Immune Competent Patient

    Directory of Open Access Journals (Sweden)

    Jay S. Berger

    2017-01-01

    Full Text Available Exophiala (Wangiella dermatitidis is an emerging dematiaceous fungus associated with high mortality rates and is a rare cause of endocarditis. We describe the first case of E. dermatitidis endocarditis of a prosthetic aortic valve and aortic graft in an immune competent patient with no clear risk factors of hematological acquisition.

  13. Gemella sanguinis endocarditis: First case report in Taiwan and review of the literature

    OpenAIRE

    Ching-Huei Yang; Kuei-Ton Tsai

    2014-01-01

    We describe a case of infective endocarditis of the native aortic valve due to Gemella sanguinis in a 67-year-old Taiwanese man who had pre-existent valvular heart disease. He was successfully treated with aortic valve replacement accompanying a 6-week intravenous antibiotic treatment. To the best of our knowledge, this is the first report of G sanguinis endocarditis in Taiwan.

  14. Infective Endocarditis of the Aortic Valve with Anterior Mitral Valve Leaflet Aneurysm

    NARCIS (Netherlands)

    Tomsic, Anton; Li, Wilson W. L.; van Paridon, Marieke; Bindraban, Navin R.; de Mol, Bas A. J. M.

    2016-01-01

    Mitral valve leaflet aneurysm is a rare and potentially devastating complication of aortic valve endocarditis. We report the case of a 48-year-old man who had endocarditis of the native aortic valve and a concomitant aneurysm of the anterior mitral valve leaflet. Severe mitral regurgitation occurred

  15. ANCA positivity in a patient with infective endocarditis-associated glomerulonephritis: a diagnostic dilemma.

    Science.gov (United States)

    Ghosh, Gopal Chandra; Sharma, Brijesh; Katageri, Bhimarey; Bhardwaj, Minakshi

    2014-09-01

    Glomerulonephritis (GN) is an immunological phenomenon in bacterial endocarditis. These may be pauci-immune/vasculitic GN, post-infective GN, and sub-endothelial membranoproliferative glomerulonephritis. Each type of glomerulonephritis usually occurs in isolation. We report a case of infective endocarditis with dual existence of pauci-immune/vasculitic GN and post infective type of GN at the same time.

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

    International Nuclear Information System (INIS)

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

    1989-01-01

    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 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

  17. 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.

  18. 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...... such as endocarditis, which in this case probably occurred as metastatic sepsis from endograft infection....

  19. 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.

  20. Three-dimensional transesophageal echocardiography in the evaluation of aortic valve destruction by endocarditis

    NARCIS (Netherlands)

    Nemes, Attila; Lagrand, Wim K.; McGhie, Jackie S.; ten Cate, Folkert J.

    2006-01-01

    Infective endocarditis remains a serious and complex disease with significant morbidity and mortality. The aim of this study was to demonstrate the clinical usefulness of 3-dimensional transesophageal echocardiography for the spatial assessment of aortic valve endocarditis. This case showed severe

  1. Epidemiology of bacterial endocarditis in The Netherlands. II. Antecedent procedures and use of prophylaxis

    NARCIS (Netherlands)

    van der Meer, J. T.; Thompson, J.; Valkenburg, H. A.; Michel, M. F.

    1992-01-01

    BACKGROUND: The reported frequency with which endocarditis is ascribed to an antecedent dental or medical procedure varies from 3% to 62%. METHODS: We performed a nationwide prospective study of the epidemiology of bacterial endocarditis in the Netherlands. During a 2-year period, all consecutively

  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. 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 endocarditis increased (from 12.0% to 13.8%; APC, 1.3%; 95% CI, 0.8% to 1.7%; P endocarditis increased (from 1.3% to 4.1%; APC, 8.8%; 95% CI, 7.8% to 9.9%; P endocarditis decreased (from 17.7% to 15.3%; APC, -1.0%; 95% CI, -1.4% to -0.7%; P endocarditis increased (from 32.1% to 35.9%; APC, 0.8%; 95% CI, 0.5% to 1.1%; P endocarditis did not increase (unadjusted: APC, -0.1%; 95% CI, -0.8% to 0.6%; P = .77; adjusted: APC, -1.3%; 95% CI, -1.8% to -0.7%; P endocarditis was stable from 1998 through 2013, with changes in patient characteristics and etiology over this time.

  4. 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.

  5. 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.

  6. Risk of Infective Endocarditis in Patients with End Stage Renal 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 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. Sensitivity, specificity and predictive value of blood cultures from cattle clinically suspected of bacterial endocarditis

    DEFF Research Database (Denmark)

    Houe, Hans; Eriksen, L.; Jungersen, Gregers

    1993-01-01

    This study investigated the number of blood culture-positive cattle among 215 animals clinically suspected of having bacterial endocarditis. For animals that were necropsied, the sensitivity, specificity and predictive value of the diagnosis of endocarditis were calculated on the basis...... of the isolation of the causative bacteria from blood. Furthermore, it was investigated whether the glutaraldehyde coagulation time, total leucocyte count, per cent neutrophil granulocytes, pulse rate and duration of disease could help to discriminate endocarditis from other diseases. Among 138 animals necropsied...... the sensitivity, specificity and predictive value of blood cultivation were 70.7 per cent, 93.8 per cent and 89.1 per cent, respectively. None of the other measurements could be used to discriminate between endocarditis and non-endocarditis cases....

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

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    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.

  9. Endocarditis due to Rhodotorula mucilaginosa in a kidney transplanted patient: case report and review of medical literature

    Science.gov (United States)

    Cabral, Andrea Maria; da Siveira Rioja, Suzimar; Brito-Santos, Fabio; Peres da Silva, Juliana Ribeiro; MacDowell, Maria Luíza; Melhem, Marcia S. C.; Mattos-Guaraldi, Ana Luíza; Hirata Junior, Raphael

    2017-01-01

    Introduction. Endocarditis caused by yeasts is currently an emerging cause of infective endocarditis and, when accompanied byfever of unknown origin, is more severe since interferes with proper diagnosis and endocarditis treatment. Case presentation. The Rio de Janeiro Infective Endocarditis Study Group reports a case of infectious endocarditis (IE) with negative blood cultures in a 45-year-old white female resident in Rio de Janeiro, Brazil, previously submitted to kidney transplantation. After diagnosis and intervention, the valve culture revealed Rhodotorula mucilaginosa. The clinical aspects and overview of endocarditis caused by Rhodotorula spp. demonstrated that R. muscilaginosa have been isolated from the last IE cases from kidney transplanted patients. Conclusion. Though most of the patients (in literature) recovered well from endocarditis caused by Rhodotorula spp., physicians must be aware for diagnosis of fungemia and fungal treatment in kidney transplanted patients suffering of fever of unknown origin in the modern immunosuppressive treatment. PMID:29255609

  10. Kocuria kristinae endocarditis related to diabetic foot infection.

    Science.gov (United States)

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

    2013-06-01

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

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

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    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.

  12. 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.

  13. Recurrent infective endocarditis causing heart valve failure: A case report

    Directory of Open Access Journals (Sweden)

    Victoria McIntyre, BASc Chemical Engineering (2018 candidate

    2017-11-01

    Full Text Available Infective endocarditis (IE is an infection that does not usually respond rapidly to treatment, often because its early symptoms are non-specific. The diseased valves (native or bioprosthetic may be calcified and the thrombotic vegetations on them typically friable and embolize easily. Left untreated IE leads to damage to the infected valve and to congestive heart failure (CHF. Its treatment usually requires heart valve replacement. Our 69-year-old patient had IE, and underwent aortic valve replacement (AVR with a bioprosthesis. This case stresses the complications of IE and its tendency to recur in patients with bioprosthetic heart valves (BHV who previously had IE.

  14. Aortic valve replacement for Libman-Sacks endocarditis.

    Science.gov (United States)

    Keenan, Jack B; Janardhanan, Rajesh; Larsen, Brandon T; Khalpey, Zain

    2016-10-04

    A 24-year-old man with systemic lupus erythematosus and antiphospholipid syndrome complicated by lupus nephritis presented with acute limb ischaemia secondary to an embolus. Following embolectomy, the patient underwent a transthoracic echocardiogram which revealed a large vegetation on all three cusps of the aortic valve. The patient was taken for an urgent aortic valve replacement with a mechanical valve. Cultures of one cusp remained sterile. Histopathological examination of the remaining two cusps revealed sterile fibrin-rich thrombotic vegetations characteristic of non-bacterial thrombotic endocarditis. 2016 BMJ Publishing Group Ltd.

  15. 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.

  16. 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.

  17. Patient with congenital heart malformation and infective endocarditis

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    Ramírez Ortiz, Zoraida

    2014-10-01

    Full Text Available We present the case of a 17 year-old-man, with no remarkable past medical history, who had a one month history of worsening functional class, fatigability and dyspnea, in addition to fever and systemic inflammatory response syndrome (SIRS; a de-novo congenital heart malformation, situs inversus type, with levocardia and a ventricular septal defect (VSD associated with transposition of great vessels were documented. During hospitalization he received several antibiotic treatments without microbiological isolation or identification of the cause of hemodynamic decompensation. An Aspergillus endocarditis with emboli to different organs was identified in the post-mortem examination.

  18. Surgical treatment of infective endocarditis in active intravenous drug users: a justified procedure?

    Science.gov (United States)

    Weymann, Alexander; Borst, Tobias; Popov, Aron-Frederik; Sabashnikov, Anton; Bowles, Christopher; Schmack, Bastian; Veres, Gabor; Chaimow, Nicole; Simon, Andre Rüdiger; Karck, Matthias; Szabo, Gábor

    2014-03-24

    Infective endocarditis is a life threatening complication of intravenous drug abuse, which continues to be a major burden with inadequately characterised long-term outcomes. We reviewed our institutional experience of surgical treatment of infective endocarditis in active intravenous drug abusers with the aim of identifying the determinants long-term outcome of this distinct subgroup of infective endocarditis patients. A total of 451 patients underwent surgery for infective endocarditis between January 1993 and July 2013 at the University Hospital of Heidelberg. Of these patients, 20 (7 female, mean age 35 ± 7.7 years) underwent surgery for infective endocarditis with a history of active intravenous drug abuse. Mean follow-up was 2504 ± 1842 days. Staphylococcus aureus was the most common pathogen detected in preoperative blood cultures. Two patients (10%) died before postoperative day 30. Survival at 1, 5 and 10 years was 90%, 85% and 85%, respectively. Freedom from reoperation was 100%. Higher NYHA functional class, higher EuroSCORE II, HIV infection, longer operating time, postoperative fever and higher requirement for red blood cell transfusion were associated with 90-day mortality. In active intravenous drug abusers, surgical treatment for infective endocarditis should be performed as extensively as possible and be followed by an aggressive postoperative antibiotic therapy to avoid high mortality. Early surgical intervention is advisable in patients with precipitous cardiac deterioration and under conditions of staphylococcal endocarditis. However, larger studies are necessary to confirm our preliminary results.

  19. Association of periodontal disease, oral procedures, and other clinical findings with bacterial endocarditis in dogs.

    Science.gov (United States)

    Peddle, Gordon D; Drobatz, Kenneth J; Harvey, Colin E; Adams, Allison; Sleeper, Meg M

    2009-01-01

    To identify risk factors potentially associated with the development of bacterial endocarditis in dogs and determine whether periodontal disease and surgical procedures (oral and nonoral) were associated with bacterial endocarditis. Retrospective case-control study. 76 dogs with (cases) and 80 dogs without (controls) bacterial endocarditis. Medical records were reviewed for information on signalment, physical examination findings, recent medical history, and results of echocardiography, clinicopathologic testing, and necropsy. None of the dogs with endocarditis had a history of undergoing any dental or oral procedure in the 3 months prior to the diagnosis of endocarditis, and no significant difference was found between groups with regard to the prevalence of oral infection. Dogs with endocarditis were significantly more likely to have undergone a nonoral surgical procedure that required general anesthesia in the preceding 3 months or to have developed a new heart murmur or a change in intensity of an existing heart murmur. Preexisting cardiac dis-ease (congenital or acquired) was not found to be a risk factor. Results did not provide any evidence of an association between bacterial endocarditis in dogs and either dental or oral surgical procedures or oral infection. Findings suggested that the routine use of prophylactic antimicrobial administration in dogs undergoing oral procedures needs to be reevaluated.

  20. 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.

  1. The Changing “Face” of Endocarditis in Kentucky: A Rise in Tricuspid Cases

    Science.gov (United States)

    Seratnahaei, Arash; Leung, Steve W.; Charnigo, Richard J.; Cummings, Matthew S.; Sorrell, Vincent L.; Smith, Mikel D.

    2015-01-01

    Background Advancements in medical technology and increased life expectancy have been described as contributing to the evolution of endocarditis. We sought to determine whether there has been a change in the incidence, demographics, microbiology, complications, and outcomes of infective endocarditis over a ten-year time span. Methods We screened 28,420 transthoracic and transesophageal echocardiogram reports performed at our center for the following indications: fever, masses, emboli (including stroke), sepsis, bacteremia, and endocarditis in two time periods: 1999 through 2000 and 2009 through 2010. Data were collected from diagnosed endocarditis cases. Results Overall, 143 cases of infective endocarditis were analyzed (48 in 1999-2000 and 95 in 2009-2010). The endocarditis incidence per number of admissions remained nearly constant at 0.113% for 1999-2000 and 0.148% for 2009-2010 (p = 0.153). However, tricuspid valve involvement increased markedly from 6% to 36% (p endocarditis at our center has not changed and mortality remains high, but the “face of endocarditis” in Kentucky has evolved with an increased incidence of tricuspid valve involvement, valvular complications, and embolic events. PMID:24769025

  2. Corneal specular microscopy in infectious and noninfectious uveitis Microscopia especular de córnea em pacientes com uveítes infecciosas e não-infecciosas

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    Filipe de Oliveira

    2009-08-01

    Full Text Available PURPOSE: Involvement of the cornea endothelium during uveitis has not been extensively studied even though it might participate in or constitute a target of ocular inflammation. Formation of keratic precipitates (KP is a characteristic finding in several forms of uveitis. The aim of this prospective study was to examine the vicinity of keratic precipitates in infectious and noninfectious uveitis by specular microscopy. METHODS: Patients with infectious and noninfectious uveitis in any activity level and presence of keratic precipitates were enrolled. The mean age was 40.5 years (± 14.2 years. A Topcon SP-2000P noncontact specular microscope was used to capture endothelial images in the vicinity of keratic precipitates. Automated morphometric analysis was done for cell size, cell density and cells coefficient of variation. Statistical comparisons were made between the infectious and noninfectious groups. RESULTS: From the 25 patients enrolled in this study, 16 (44% eyes presented infectious uveitis, 19 (53% noninfectious uveitis and 1 (3% eye was excluded due to the impossibility to obtain a specular image. The mean cell density estimated was 2,628 ± 204 cells/mm² in infectious group and 2,622 ± 357 cells/mm² in noninfectious group. The mean cellular area in infectious and noninfectious group was respectively 385 ± 31 µm² and 390 ± 60 µm². The coefficient of variation (% of the cellular area in the vicinity of keratic precipitates was 26.36 ±3.44 in infectious and 27.69 ± 4.61 in noninfectious group. The differences between the groups were not statistically significant (POBJETIVO: Avaliar o endotélio corneano na presença de precipitados ceráticos em pacientes portadores de uveítes infecciosas e não-infecciosas com emprego da microscopia especular de não-contato. MÉTODOS: Prospectivamente foram incluídos 25 pacientes com média de idade de 40,5 (±14,2 anos. Os pacientes foram divididos em dois grupos de acordo com a etiologia

  3. Novel Tissue Level Effects of the Staphylococcus aureus Enterotoxin Gene Cluster Are Essential for Infective Endocarditis.

    Science.gov (United States)

    Stach, Christopher S; Vu, Bao G; Merriman, Joseph A; Herrera, Alfa; Cahill, Michael P; Schlievert, Patrick M; Salgado-Pabón, Wilmara

    2016-01-01

    Superantigens are indispensable virulence factors for Staphylococcus aureus in disease causation. Superantigens stimulate massive immune cell activation, leading to toxic shock syndrome (TSS) and contributing to other illnesses. However, superantigens differ in their capacities to induce body-wide effects. For many, their production, at least as tested in vitro, is not high enough to reach the circulation, or the proteins are not efficient in crossing epithelial and endothelial barriers, thus remaining within tissues or localized on mucosal surfaces where they exert only local effects. In this study, we address the role of TSS toxin-1 (TSST-1) and most importantly the enterotoxin gene cluster (egc) in infective endocarditis and sepsis, gaining insights into the body-wide versus local effects of superantigens. We examined S. aureus TSST-1 gene (tstH) and egc deletion strains in the rabbit model of infective endocarditis and sepsis. Importantly, we also assessed the ability of commercial human intravenous immunoglobulin (IVIG) plus vancomycin to alter the course of infective endocarditis and sepsis. TSST-1 contributed to infective endocarditis vegetations and lethal sepsis, while superantigens of the egc, a cluster with uncharacterized functions in S. aureus infections, promoted vegetation formation in infective endocarditis. IVIG plus vancomycin prevented lethality and stroke development in infective endocarditis and sepsis. Our studies support the local tissue effects of egc superantigens for establishment and progression of infective endocarditis providing evidence for their role in life-threatening illnesses. In contrast, TSST-1 contributes to both infective endocarditis and lethal sepsis. IVIG may be a useful adjunct therapy for infective endocarditis and sepsis.

  4. Infective endocarditis following Melody valve implantation: comparison with a surgical cohort.

    Science.gov (United States)

    O'Donnell, Clare; Holloway, Rhonda; Tilton, Elizabeth; Stirling, John; Finucane, Kirsten; Wilson, Nigel

    2017-03-01

    Infective endocarditis has been reported post Melody percutaneous pulmonary valve implant; the incidence and risk factors, however, remain poorly defined. We identified four cases of endocarditis from our first 25 Melody implants. Our aim was to examine these cases in the context of postulated risk factors and directly compare endocarditis rates with local surgical valves. We conducted a retrospective review of patients post Melody percutaneous pulmonary valve implant in New Zealand (October, 2009-May, 2015) and also reviewed the incidence of endocarditis in New Zealand among patients who have undergone surgical pulmonary valve implants. In total, 25 patients underwent Melody implantation at a median age of 18 years. At a median follow-up of 2.9 years, most were well with low valve gradient (median 27 mmHg) and only mild regurgitation. Two patients presented with life-threatening endocarditis and obstructive vegetations at 14 and 26 months post implant, respectively. Two additional patients presented with subacute endocarditis at 5.5 years post implant. From 2009 to May, 2015, 178 surgical pulmonic bioprostheses, largely Hancock valves and homografts, were used at our institution. At a median follow-up of 2.9 years, four patients (2%) had developed endocarditis in this group compared with 4/25 (16%) in the Melody group (p=0.0089). Three surgical valves have been replaced. The Melody valve offers a good alternative to surgical conduit replacement in selected patients. Many patients have excellent outcomes in the medium term. Endocarditis, however, can occur and if associated with obstruction can be life threatening. The risk for endocarditis in the Melody group was higher in comparison with that in a contemporaneous surgical pulmonary implant cohort.

  5. 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

  6. [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

  7. Erysipelothrix endocarditis with previous cutaneous lesion: report of a case and review of the literature

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    Marion P. Rocha

    1989-08-01

    Full Text Available This report describes the first documented case of Erysipelothrix rhusiopathiae endocarditis in Latin America. The patient was a 51-years-old male, moderate alcoholic, with a previous history of aortic failure. He was used to fishing and cooking as a hobby and had his left hand wounded by a fish-bone. The disease began with erysipeloid form and developed to septicemia and endocarditis. He was treated with antibiotics and surgery for aortic valve replacement. There are only 46 cases of E. rhusiopathiae endocarditis reported to date. The authors wonder if several other cases might go unreported for lack of microbiological laboratorial diagnosis.

  8. 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.

  9. Streptococcus anginosus endocarditis and multiple liver abscesses in a splenectomised patient.

    Science.gov (United States)

    Finn, Talya; Schattner, Ami; Dubin, Ina; Cohen, Regev

    2018-04-27

    An unusual case of infective endocarditis and concurrent multiple liver abscesses both caused by Streptococcus anginosus in a splenectomised patient is reported. The microorganism is a very rare cause of endocarditis and its presentation with multiple liver abscesses is highly unusual. It was initially misdiagnosed as Streptococcus sanguinis and issues relating to the different clinical presentations of S. anginosus including the rare cases of endocarditis, the role of the patient's splenectomy and problems that may contribute to its potential laboratory misidentifications are discussed. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

    Science.gov (United States)

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

    2015-04-01

    We report the case of using a long-term combination of meropenem and amikacin to treat infective endocarditis caused by Enterobacter cloacae resistant to third- and fourth-generation cephalosporins. Multi-drug resistant Gram-negative bacilli, such as the E. cloacae in our study, may become possible pathogens of infective endocarditis. Our experience with this case indicates that long-term use of a combination of β-lactam and aminoglycosides might represent a suitable management option for future infective endocarditis cases due to non-Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella spp. (HACEK group) Gram-negative bacilli such as ours. Copyright © 2012. Published by Elsevier B.V.

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

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    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.

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

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    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.

  13. A case of native valve endocarditis caused by Burkholderia cepacia without predisposing factors

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    Han Seong

    2011-05-01

    Full Text Available Abstract Background Infective endocarditis is rarely caused by Burkholderia cepacia. This infection is known to occur particularly in immunocompromised hosts, intravenous heroin users, and in patients with prosthetic valve replacement. Most patients with Burkholderia cepacia endocarditis usually need surgical treatment in addition to antimicrobial treatment. Case Presentation Here, we report the case of a patient who developed Burkholderia cepacia-induced native valve endocarditis with consequent cerebral involvement without any predisposing factors; she was successfully treated by antimicrobial agents only. Conclusion In this report, we also present literature review of relevant cases.

  14. 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

  15. [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.

  16. Clinical and microbiological features of infective endocarditis caused by aerococci.

    Science.gov (United States)

    Sunnerhagen, Torgny; Nilson, Bo; Olaison, Lars; Rasmussen, Magnus

    2016-04-01

    To define the clinical presentation of aerococcal infective endocarditis (IE) and the prevalence of synergy between penicillin and gentamicin on aerococcal isolates. Cases of aerococcal IE between 2002 and 2014 were identified in the Swedish Registry of Infective Endocarditis (SRIE). MALDI-TOF MS was used to confirm species determination. The medical records were analysed and compared to cases reported to the SRIE caused by other pathogens. Sixteen cases of aerococcal IE, fourteen with Aerococcus urinae and two with Aerococcus sanguinicola, were confirmed. Etest-based methods and time-kill experiments suggested synergy between penicillin and gentamicin towards seven of fifteen isolates. The patients with aerococcal IE were significantly older than those with streptococci or Staphylococcus aureus IE. Most of the patients had underlying urinary tract diseases or symptoms suggesting a urinary tract focus of the infection. Seven patients with aerococcal IE presented with severe sepsis but ICU treatment was needed only in one patient and there was no fatality. Valve exchange surgery was needed in four patients and embolization was seen in three patients. This report is the largest on aerococcal IE and suggests that the prognosis is relatively favourable despite the fact that the patients are old and have significant comorbidities.

  17. 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.

  18. 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.

  19. 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

  20. [Methods for evaluating diagnostic tests in Enfermedades Infecciosas y Microbiología Clínica].

    Science.gov (United States)

    Ramos, J M; Hernández, I

    1998-04-01

    In the field of infectious diseases and clinical microbiology, the evaluation of diagnostic tests (DT) is an important research area. The specific difficulties of this type of research has motivated that have not caught the severity methodological of others areas of clinical research. This article try to asses and characterize the methodology of articles about DT published in Enfermedades Infecciosas y Microbiología Clínica (EIMC) journal. Forty-five articles was selected in the EIMC journal during the 1990-1996 period, because of determinate the sensitivity and specificity of different DT. Methodological standards, extensively accepted was used. In all of articles, except one (98%) the gold standard was specified yours use, however in 4 studies (9%) include the DT in the gold standard (incorporation bias). The correct description of DT was reported in 75% of cases, but only in 11% cases the reproducibility of test was evaluated. The description of source of reference population, standard of inclusion and spectrum of composition was described in 58, 33 and 40% of articles, respectively. In 33% of studies presented workup bias, only 6% commented blind-analysis of results, and 11% presented indeterminate test results. Half of the studies reported test indexes for clinical subgroups, only one article (2%) provided numerical precision for test indexes, and only 7% reported receiver operating characteristics curves. The methodological quality of DT research in the EIMC journal may improve in different aspects of design and presentation of results.

  1. Freqüência de anemia infecciosa em eqüinos no Acre, 1986 a 1996

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    Santos R.M.L.

    2001-01-01

    Full Text Available Foram analisadas as fichas de 9.963 eqüídeos do Acre, submetidos ao teste de imunodifusão em gel de ágar (IDGA para anemia infecciosa eqüina (AIE, no período de 1986 a 1996. As regiões sócio-ecológicas da Bacia do Alto Juruá, Alto Acre e Alta Bacia do Purus apresentaram os maiores índices da doença, o que caracteriza a associação entre região e positividade. Essas áreas são fronteiriças com o Peru, Bolívia e o Estado do Amazonas, são distantes de Rio Branco, capital do Estado, onde muitas vezes é difícil o acesso pelas estradas, revelando serem áreas de risco. As regiões Oriental e Rio Branco apresentaram baixos índices de positividade. Não se observou diferença estatística entre animais positivos e negativos quanto à espécie, sexo, raça e idade.

  2. Etiología y manejo de la gastroenteritis aguda infecciosa en niños y adultos

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    A. Yalda Lucero, DRA

    2014-05-01

    Full Text Available La Gastroenteritis Aguda (GEA infecciosa es una patología frecuente y de alto impacto, especialmente en niños menores de cinco años y adultos mayores. En nuestro medio, la causa más frecuente es viral (rotavirus y norovirus seguido de Salmonella, Shigella, E.coli diarreogénicas y Campylobacter. Habitualmente son cuadros autolimitados que no requieren estudio de laboratorio específico y cuyo manejo debe centrarse en la reposición hidro-electrolítica de acuerdo al grado de deshidratación. Existe evidencia sobre beneficio sintomático del uso de probióticos (Lactobacillus GG y S.boulardii; racecadotrilo en cuanto a la diarrea; y ondasetrón para los vómitos. En caso de sospecha de agente invasor (bacteria o parásito debe realizarse un estudio etiológico e iniciar terapia antimicrobiana de acuerdo al microorganismo identificado. La prevención de contagio mediante medidas de saneamiento y adecuada manipulación de agua y alimentos es fundamental. Actualmente se dispone de vacunas efectivas contra algunos de los agentes involucrados (ej. rotavirus, que deben recomendarse en grupos de riesgo.

  3. Prevalencia de anemia infecciosa equina en caballos de tracción en el municipio de Florencia (Caquetá

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    Beatriz Elena Patiño-Quiroz

    2016-11-01

    Full Text Available En el estudio se evaluó la prevalecía de anemia infecciosa equina (AIE en los caballos de tracción en el municipio de Florencia, buscando relación por sexo, edad, condición corporal y distribución por comunas. Para ello se recolectaron 128 muestras de sangre de equinos (103 machos y 25 hembras que asistieron a 4 brigadas de salud animal realizadas por el semillero de investigación en equinos “SIEQUUS”, de la Universidad de la Amazonia, durante el periodo comprendido entre mayo de 2014 y diciembre de 2015. Las muestras fueron analizadas en laboratorio con la prueba de inmunodifusión en agar gel. Se realizó análisis estadístico descriptivo y una prueba Chí cuadrado (P10 fue del 14.29 %, y en los animales entre 5 y 10 años fue considerablemente mayor, el 33.33 %. Las condiciones ambientales y socioeconómicas facilitan la transmisión del virus entre los caballos del mismo gremio y con cualquier sistema de manejo y producción equina de la zona, lo que generaría pérdidas económicas y de semovientes de importancia para el sector equino.

  4. Splinter haemorrhages, Osler's nodes, Janeway lesions and Roth spots: the peripheral stigmata of endocarditis.

    Science.gov (United States)

    Sethi, Karishma; Buckley, Jim; de Wolff, Jacob

    2013-09-01

    Infective endocarditis is a serious endo-vascular infection, potentially affecting not only native heart valves, but also intra-vascularly implanted foreign materials such as valvular prostheses and pacemaker electrodes (Westphal et al, 2009).

  5. Prosthetic valve endocarditis 7 months after transcatheter aortic valve implantation diagnosed with 3D TEE

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    Cenk Sarı

    2016-03-01

    Full Text Available Transcatheter aortic valve implantation (TAVI was introduced as an alternative treatment for patients with severe symptomatic aortic stenosis for whom surgery would be high-risk. Prosthetic aortic valve endocarditis is a serious complication of surgical AVR (SAVR with high morbidity and mortality. According to recent cases, post-TAVI prosthetic valve endocarditis (PVE seems to occur very rarely. We present the case of a 75-year-old woman who underwent TAVI (Edwards Saphien XT with an uneventful postoperative stay. She was diagnosed with endocarditis using three dimensional (3D echocardiography on the TAVI device 7 months later and she subsequently underwent surgical aortic valve replacement. Little experience of the interpretation of transoesophageal echocardiography (TEE and the clinical course and effectiveness of treatment strategies in post-TAVI endocarditis exists. We report a case of PVE in a TAVI patient which was diagnosed with three-dimensional transoesophageal echocardiography (3DTEE.

  6. Culture-Negative Neonatal Meningitis and Endocarditis Caused by Streptococcus agalactiae

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    Nègre, Valérie Lefranc; Colin-Gorski, Anne-Marie; Magnier, Suzel; Maisonneuve, Lydia; Aujard, Yannick; Bingen, Edouard; Bonacorsi, Stéphane

    2004-01-01

    We describe a case of culture-negative meningitis and endocarditis caused by Streptococcus agalactiae in a 27-day-old boy. S. agalactiae was detected in cerebrospinal fluid and serum by broad-spectrum PCR amplification.

  7. Severe infective endocarditis in a healthy adult due to Streptococcus agalactiae.

    Science.gov (United States)

    Fujita, Hiroaki; Nakamura, Itaru; Tsukimori, Ayaka; Sato, Akihiro; Ohkusu, Kiyofumi; Matsumoto, Tetsuya

    2015-09-01

    A case of severe endocarditis, with complications of multiple infarction, meningitis, and ruptured mitral chordae tendineae, caused by Streptococcus agalactiae in a healthy man, is reported. Emergency cardiovascular surgery was performed on the day of admission. Infective endocarditis caused by S. agalactiae is very rare, particularly in a healthy adult. In addition, microbiological analysis revealed that S. agalactiae of sequence type (ST) 19, which belongs to serotype III, was present in the patient's vegetation, mitral valve, and blood culture. It was therefore concluded that the endocarditis was caused by ST19, which has been reported as a non-invasive type of S. agalactiae. This was an extremely rare case in which S. agalactiae of ST19 caused very severe endocarditis in an adult patient with no underlying disease. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Infective endocarditis and risk of death after cardiac implantable electronic device implantation

    DEFF Research Database (Denmark)

    Özcan, Cengiz; Raunsø, Jakob; Lamberts, Morten

    2017-01-01

    AIMS: To determine the incidence, risk factors, and mortality of infective endocarditis (IE) following implantation of a first-time, permanent, cardiac implantable electronic device (CIED). METHODS AND RESULTS: From Danish nationwide administrative registers (beginning in 1996), we identified all...

  9. The diagnostic ability of echocardiography for infective endocarditis and its associated complications.

    Science.gov (United States)

    Vilacosta, Isidre; Olmos, Carmen; de Agustín, Alberto; López, Javier; Islas, Fabián; Sarriá, Cristina; Ferrera, Carlos; Ortiz-Bautista, Carlos; Sánchez-Enrique, Cristina; Vivas, David; San Román, Alberto

    2015-11-01

    Echocardiography, transthoracic and transoesophageal, plays a key role in the diagnosis and prognosis assessment of patients with infective endocarditis. It constitutes a major Duke criterion and is pivotal in treatment guiding. Seven echocardiographic findings are major criteria in the diagnosis of infective endocarditis (IE) (vegetation, abscess, pseudoaneurysm, fistulae, new dehiscence of a prosthetic valve, perforation and valve aneurysm). Echocardiography must be performed as soon as endocarditis is suspected. Transoesophageal echocardiography should be done in most cases of left-sided endocarditis to better define the anatomic lesions and to rule out local complications. Transoesophageal echocardiography is not necessary in isolated right-sided native valve IE with good quality transthoracic examination and unequivocal echocardiographic findings. Echocardiography is a very useful tool to assess the prognosis of patients with IE at any time during the course of the disease. Echocardiographic predictors of poor outcome include presence of periannular complications, prosthetic dysfunction, low left ventricular ejection fraction, pulmonary hypertension and very large vegetations.

  10. 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.

  11. 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.

  12. 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.

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

    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...

  14. Fungal Endocarditis Due to Aspergillus oryzae: The First Case Reported in the Literature.

    Science.gov (United States)

    Mazza, Andrea; Luciani, Nicola; Luciani, Marco; Cammertoni, Federico; Giaquinto, Alessia; Pavone, Natalia; Bruno, Piergiorgio; Massetti, Massimo

    2017-03-01

    Infective endocarditis (IE) is a severe disease with high mortality and morbidity. Prosthetic valve endocarditis is a life-threatening complication which can occur in less than 10% of patients with valve prosthesis. A fungal etiology of IE is rare and accounts for only 2-4% of all case of endocarditis, but is associated with a higher mortality and morbidity. Herein is reported the first case of fungal endocarditis of aortic valve prosthesis due to Aspergillus oryzae in a 67-year-old caucasian man who nine years previously underwent mitral and aortic valve replacement with mechanical prostheses, and tricuspid annuloplasty for acute IE due to Enterococcus spp. Seven months previously, the patient also underwent a redo cardiac procedure to replace a mitral valve prosthesis with a new mechanical device due to a leakage. Aspergillus oryzae showed impressive growth with strong and unexpected virulence in both local and systemic settings.

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

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    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.

  16. Bacterial Endocarditis Caused by Lactobacillus acidophilus Leading to Rupture of Sinus of Valsalva Aneurysm.

    Science.gov (United States)

    Encarnacion, Carlos Omar; Loranger, Austin Mitchell; Bharatkumar, A G; Almassi, G Hossein

    2016-04-01

    Lactobacillus acidophilus rarely causes bacterial endocarditis, because it usually resides in the mucosa of the vagina, gastrointestinal tract, and oropharynx. Moreover, sinus of Valsalva aneurysms are rare cardiac anomalies, either acquired or congenital. We present the case of a middle-aged man whose bacterial endocarditis, caused by Lactobacillus acidophilus, led to an aneurysmal rupture of the sinus of Valsalva into the right ventricular outflow tract. The patient underwent successful surgical repair, despite numerous complications and sequelae.

  17. Infective endocarditis caused by Stenotrophomonas maltophilia: A report of two cases and review of literature.

    Science.gov (United States)

    Subhani, Shaik; Patnaik, Amar N; Barik, Ramachandra; Nemani, Lalita

    2016-09-01

    Stenotrophomonas maltophilia is known for nosocomial habitat. Infective endocarditis due to this organism is rare and challenging because of resistance to multiple broad-spectrum antibiotic regimens. Early detection and appropriate antibiotic based on culture sensitivity reports are the key to its management. We report the diagnosis, treatment, and outcome of two cases of infective endocarditis caused by S. maltophilia. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  18. 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.)

  19. Healthcare-Associated Infective Endocarditis: a Case Series in a Referral Hospital from 2006 to 2011

    OpenAIRE

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

    2014-01-01

    Background: Healthcare-associated infective endocarditis (HCA-IE), a severe complication of medical care, shows a growing incidence in literature. Objective: To evaluate epidemiology, etiology, risk factors for acquisition, complications, surgical treatment, and outcome of HCA-IE. Methods: Observational prospective case series study (2006-2011) in a public hospital in Rio de Janeiro. Results: Fifty-three patients with HCA-IE from a total of 151 cases of infective endocarditis (IE) were ...

  20. Levofloxacin-resistant-Streptococcus mitis endophthalmitis: a unique presentation of bacterial endocarditis.

    Science.gov (United States)

    Dinani, Amreen; Ktaich, Nessrine; Urban, Carl; Rubin, David

    2009-10-01

    Endogenous endophthalmitis is a rare complication of infective endocarditis and has been decreasing due to the availability of effective antibiotics. We highlight a case of endogenous endophthalmitis due to levofloxacin-resistant Streptococcus mitis presenting as infective endocarditis. Endogenous endophthalmitis should be considered as a manifestation of an underlying systemic disease, especially in patients who present with non-specific signs and symptoms with no obvious source of precipitating infection.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    2014-01-01

    Background 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. Discussion 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. Summary 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

  3. 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

  4. Demonstration of infective endocarditis by cardiac CT and transoesophageal echocardiography: comparison with intra-operative findings.

    Science.gov (United States)

    Koo, Hyun Jung; Yang, Dong Hyun; Kang, Joon-Won; Lee, Joo Yeon; Kim, Dae-Hee; Song, Jong-Min; Kang, Duk-Hyun; Song, Jae-Kwan; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae-Won; Lim, Tae-Hwan

    2018-02-01

    We aimed to compare imaging findings of infective endocarditis between computed tomography (CT) and transoesophageal echocardiography (TEE) using surgical inspection as a reference standard. Forty-nine patients (aged 54 ± 17 years, 69% men) who underwent pre-operative CT and TEE for infective endocarditis were included. Twelve of these patients had prosthetic valve endocarditis. Imaging findings of infective endocarditis were classified as vegetation, leaflet perforation, abscess/pseudoaneurysm, and paravalvular leakage. Diagnostic performances of CT and TEE were evaluated using surgical inspection as a reference standard. Interobserver agreements for CT findings were obtained using Cohen's κ test. The detection rates of infective endocarditis per patient with CT and TEE were 93.9% (46/49) and 95.9% (47/49), respectively. In per-imaging analysis, the sensitivities of CT and TEE were not significantly different for both native and prosthetic valve infective endocarditis (sensitivity: vegetation, 100% in TEE and 90.9% in CT; leaflet perforation, 87.5% in TEE and 50.0% in CT; abscess/pseudoaneurysm, 40.0% in TEE and 60.0% in CT; paravalvular leakage, 100% in TEE and 50.0% in CT). Interobserver agreements for CT findings were substantial or excellent (0.79-0.88). Cardiac CT can accurately demonstrate infective endocarditis in pre-operative patients with a similar diagnostic accuracy to TEE. The interobserver agreements for the CT findings of infective endocarditis were excellent. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  5. Anesthetic implications of emergent Cesarean section in a parturient with Noonan syndrome and bacterial endocarditis.

    Science.gov (United States)

    Chase, Charles J; Holak, Elena J; Pagel, Paul S

    2013-08-01

    Noonan syndrome is a relatively common genetically transmitted disorder characterized by facial, cardiac, and musculoskeletal abnormalities. The management of a 27 year old woman with Noonan syndrome at 23 weeks' gestation, presenting with premature labor, who required an emergent Cesarean section for placental abruption, is discussed. In addition to Noonan syndrome, this patient had bacterial endocarditis involving the mitral and aortic valves. The anesthetic implications of Noonan syndrome and endocarditis during pregnancy are presented. © 2013 Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2013-01-01

    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. (orig.)

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

    Directory of Open Access Journals (Sweden)

    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.

  8. sup 99m Tc-labelled anti NCA-95 antibodies in prosthetic heart valve endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Bair, H J; Becker, W; Wolf, F [Dept. of Nuclear Medicine, Univ. Erlangen-Nuernberg, Erlangen (Germany); Volkholz, H J [Dept. of Internal Medicine 1, Univ. of Erlangen-Nuernberg, Erlangen (Germany)

    1991-08-01

    A 54-y old women with earlier replacement of the mitral and aortic valves and clinical signs of localized endocarditis was studied with {sup 99m}Tc-labelled anti NCA-95 antibody. Whereas echocardiographic findings were negative, increased radionuclide uptake was observed left parasternal over the mitral valve as a sign of prosthetic valve endocarditis. This result could be confirmed by a similar study with leukocytes labelled in vitro with {sup 111}In-oxine. (orig.).

  9. Análise da qualidade de vida de portadores de uveítes de causas infecciosas e não infecciosas pelo questionário NEI-VFQ-25 Analysis of the life quality of infectious and non-infectious patients with uveitis using the NEI-VFQ-25 questionnaire

    Directory of Open Access Journals (Sweden)

    Paula Resende Aquino de Assis Pereira Mello

    2008-12-01

    Full Text Available OBJETIVO: Avaliar a qualidade de vida dos pacientes portadores de uveítes infecciosas e não infecciosas avaliados no setor de uveíte do serviço de oftalmologia do Hospital Universitário Clementino Fraga Filho - UFRJ, por meio da aplicação do questionário NEI-VFQ-25, de modo a esclarecer melhor a importância do diagnóstico e tratamento das uveítes, assim como suas conseqüências na função visual e social dos pacientes. MÉTODOS: Estudo prospectivo composto de 30 pacientes com uveítes que foram divididos em dois grupos conforme a etiologia, infecciosa e não infecciosa, tendo sido aplicado duas vezes em cada paciente o questionário NEI-VFQ-25 que avalia a qualidade de vida relacionada à saúde geral e visual. RESULTADOS: A toxoplasmose foi a principal causa de uveíte infecciosa, enquanto a não infecciosa foi a síndrome de Vogt-Koyanagi-Harada. Quanto à qualidade de vida, a saúde geral é melhor no grupo de causa infecciosa, sendo que a saúde ocular é regular nos dois grupos. Apesar do déficit visual não provocar grandes distúrbios e restrições sociais, ambos os grupos apresentam comprometimento emocional importante, sendo que no grupo de causa não infecciosa, esse comprometimento gera grau maior de dependência para a realização de tarefas do cotidiano. CONCLUSÃO: A maior dependência social e na realização de atividades do dia-a-dia no grupo de uveítes de causa não infecciosas, se explica pelo modo crônico e recidivante dessas afecções, o que leva à qualidade de vida inferior se comparada ao outro grupo.PURPOSE: To evaluate the life quality of patients with infectious and non-infectious uveitis evaluated at the uveitis service of the Hospital Universitário Clementino Fraga Filho-UFRJ, using the NEI-VFQ-25 questionnaire in order to clarify the importance of uveitis diagnosis and treatment as well as its consequences to visual and social functions of the patients. METHODS: Prospective study of 30 patients

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

    Science.gov (United States)

    Gabus, Vincent; Grenak-Degoumois, Zita; Jeanneret, Severin; Rakotoarimanana, Riana; Greub, Gilbert; Genné, Daniel

    2010-08-04

    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. 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. 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).

  11. Anti-fibrin antibody binding in valvular vegetations and kidney lesions during experimental endocarditis.

    Science.gov (United States)

    Yokota, M; Basi, D L; Herzberg, M C; Meyer, M W

    2001-01-01

    In Streptococcus sanguinis (sanguis) induced experimental endocarditis, we sought evidence that the development of aortic valvular vegetation depends on the availability of fibrin. Endocarditis was induced in New Zealand white rabbits by catheter placement into the left ventricle and inoculation of the bacteria. Fibrin was localized in the developing vegetation with 99mTechnetium (Tc)-labeled anti-fibrin antibody one or three days later. When rabbit anti-fibrin antibody was given intravenously on day 1, the mass of aortic valvular vegetation was significantly reduced at day 3; infusion of non-specific rabbit IgG showed no effect. The 99mTc-labeled anti-fibrin antibody also labeled kidneys that showed macroscopic subcapsular hemorrhage. To learn if the deposition of fibrin in the kidneys was a consequence of endocarditis required a comparison of farm-bred and specific pathogen-free rabbits before and after the induction of endocarditis. Before induction, the kidneys of farm-bred rabbits were labeled, but specific pathogen-free rabbits were free of labeling and signs of macroscopic hemorrhage. After 3 days of endocarditis, kidneys of 10 of 14 specific pathogen-free rabbits labeled with 99mTc-labeled anti-fibrin antibody and showed hemorrhage. Kidney lesions were suggested to be a frequent sequellae of S. sanguinis infective endocarditis. For the first time, fibrin was shown to be required for the continued development of aortic valvular vegetations.

  12. 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.

  13. Role of Negative Trans-Thoracic Echocardiography in the Diagnosis of Infective Endocarditis.

    Science.gov (United States)

    Leitman, Marina; Peleg, Eli; Shmueli, Ruthie; Vered, Zvi

    2016-07-01

    The search for the presence of vegetations in patients with suspected infective endocarditis is a major indication for trans-esophageal echocardiographic (TEE) examinations. Advances in harmonic imaging and ongoing improvement in modern echocardiographic systems allow adequate quality of diagnostic images in most patients. To investigate whether TEE examinations are always necessary for the assessment of patients with suspected infective endocarditis. During 2012-2014 230 trans-thoracic echo (TTE) exams in patients with suspected infective endocarditis were performed at our center. Demographic, epidemiological, clinical and echocardiographic data were collected and analyzed, and the final clinical diagnosis and outcome were determined. Of 230 patients, 24 had definite infective endocarditis by clinical assessment. TEE examination was undertaken in 76 of the 230 patients based on the clinical decision of the attending physician. All TTE exams were classified as: (i) positive, i.e., vegetations present; (ii) clearly negative; or (iii) non-conclusive. Of the 92 with clearly negative TTE exams, 20 underwent TEE and all were negative. All clearly negative patients had native valves, adequate quality images, and in all 92 the final diagnosis was not infective endocarditis. Thus, the negative predictive value of a clearly negative TTE examination was 100%. In patients with native cardiac valves referred for evaluation for infective endocarditis, an adequate quality TTE with clearly negative examination may be sufficient for the diagnosis.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. 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......: Consecutive patients with LNVIE, enrolled between January 2000 and September 2006, in the International Collaboration on Endocarditis were identified. Subjects without S aureus IE were matched to those with S aureus IE by the propensity of having S aureus. Survival differences were determined using log...

  16. Doença hepática aguda e edema palpebral persistente associados à mononucleose infecciosa

    Directory of Open Access Journals (Sweden)

    Mônica Ayres de A. Scattolin

    2007-05-01

    Full Text Available Este trabalho tem como objetivo relatar e discutir o caso clínico de um paciente portador de mononucleose infecciosa, tendo como manifestação inicial edema palpebral seguido de hepatopatia aguda e icterícia. Descrição - J.F.G.F., masculino, cinco anos, com histórico de sete dias de edema bipalpebral, conjuntivas hiperemiadas, cansaço, anorexia, febre moderada, vômitos e dor abdominal em hipocôndrio direito. Há um dia passou a apresentar icterícia, urina escura, exantema urticariforme, febre de 39,5ºC e diarréia, tendo sido internado para rehidratação e investigação diagnóstica. Ao exame físico de entrada, apresentava-se abatido, estado geral comprometido, FC: 96, FR: 30, febril, PA: 110x 60 mmHg, descorado +/4+, desidratado de 2º grau, eupnéico e ictérico ++, infartamento ganglionar assimétrico generalizado, mais acentuado em região cervical posterior. Sem alterações ao exame cardíaco e pulmonar. Abdômen distendido, doloroso à palpação, fígado a 4 cm e baço a 2,5 cm. A avaliação laboratorial revelou Hb: 10,1 g/dL, leucocitose moderada com acentuada linfocitose e atipia linfocitária evidente, ALT: 179 U/L, AST: 232 U/L, LDH: 2.103 U/L e bilirrubinas: total 6,7 mg/Dl (direta 4,9 mg/dL, urina tipo I com bilirrubinas ++ e ultra-som de abdômen com hepatoesplenomegalia inespecífica. As sorologias para toxoplasmose citomegalovírus, hepatite foram negativas e para o vírus Epstein-Barr (EBV reagente: IgG: 108 UA/mL, e IgM 28 UA/mL. Após hidratação parenteral e antitérmico, o paciente evoluiu com a melhora dos parâmetros clínicos e laboratoriais. Discussão - Estima-se, atualmente, que 50% das crianças menores de cinco anos já apresentaram infecção pelo EBV. Vários agentes causam lesão hepática aguda. Entre os vírus ressalta-se os das hepatites, entretanto, pode ocorrer hepatopatia aguda por outras causas virais, entre elas, mononucleose e citomegalia. Sabe-se que a hepatomegalia ocorre em 10% a 20

  17. [Gender analysis among articles published in Enfermedades Infecciosas y Microbiología Clínica (2001-2005)].

    Science.gov (United States)

    Aleixandre-Benavent, Rafael; González-Alcaide, Gregorio; Alonso-Arroyo, Adolfo; Castellano-Gómez, Miguel; Valderrama-Zurián, Juan Carlos

    2007-12-01

    There is growing concern for promoting equality between sexes and full integration of women in research activities. The purpose of this study is to identify the bibliometric characteristics of articles published during the 2001-2005 period in Enfermedades Infecciosas y Microbiología Clínica (EIMC) from the perspective of gender. EIMC records for 2001-2005 were obtained from the Science Citation Index database and differences according to sex were calculated for the following indicators: year of publication, type of document, number and order of author signatures, number of collaborators, and the signature/article index at the institutional and geographical level. A total of 2,163 authors were identified, 1,220 (56.4%) men and 943 (43.6%) women. The greatest of contribution from women was in original articles (42.32% of signatures). Excluding the Centro Nacional de Microbiología (Spanish National Center for Microbiology), the participation of women was lower than men in the most productive institutions. There were significant differences regarding the number of papers published and the number of collaborators; with greater productivity for men and a higher rate of collaboration for women. Studies on scientific activity according to gender provide essential information to establish the basis for a policy of equality in this regard. A yearly increase of almost 1% was seen in the number of female authors contributing articles to the EIMC, which, if the trend continues, will result in parity in coming years. Nevertheless, the presence of women in positions of high productivity remains low. The causes of this difference should be identified and corrected.

  18. Enfermedades infecciosas desatendidas: un permanente reto para la salud pública y la equidad en el Perú

    Directory of Open Access Journals (Sweden)

    César Cabezas-Sánchez

    Full Text Available Las enfermedades infecciosas desatendidas (EID afectan a más de mil millones de personas en el mundo, y están asociadas con la pobreza, el aislamiento geográfico de las poblaciones, la estigmatización social, la escasez de datos sobre estimaciones de la carga de enfermedad local y mundial (subregistro de la enfermedad, insuficientes recursos políticos y financieros para su control, falta de grupos de presión de parte de la población más vulnerable, escasos fármacos y métodos de diagnóstico. En este artículo se describe la relación entre las EID la pobreza e inequidad, se propone un nuevo concepto de enfermedad en el trópico, la ampliación de la lista de enfermedades en el contexto del Perú que comparten las características de las EID, la escasa disponibilidad de medicamentos y pruebas de diagnóstico para enfrentar adecuadamente estas enfermedades, los aportes que viene haciendo el Instituto Nacional de Salud del Ministerio de Salud del Perú en este contexto, y como consideraciones finales se menciona que la solución para la prevención y control de las EID debe ser integral, con un abordaje desde las determinantes sociales de la salud y en el contexto de la lucha contra la pobreza y la inequidad

  19. 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

  20. Combined computed tomography and fluorodeoxyglucose positron emission tomography in the diagnosis of prosthetic valve endocarditis: a case series.

    Science.gov (United States)

    Bartoletti, Michele; Tumietto, Fabio; Fasulo, Giovanni; Giannella, Maddalena; Cristini, Francesco; Bonfiglioli, Rachele; Raumer, Luigi; Nanni, Cristina; Sanfilippo, Silvia; Di Eusanio, Marco; Scotton, Pier Giorgio; Graziosi, Maddalena; Rapezzi, Claudio; Fanti, Stefano; Viale, Pierluigi

    2014-01-13

    The diagnosis of prosthetic valve endocarditis is challenging. The gold standard for prosthetic valve endocarditis diagnosis is trans-esophageal echocardiography. However, trans-esophageal echocardiography may result in negative findings or yield images difficult to differentiate from thrombus in patients with prosthetic valve endocarditis. Combined computed tomography and fluorodeoxyglucose positron emission tomography is a potentially promising diagnostic tool for several infectious conditions and it has also been employed in patients with prosthetic valve endocarditis but data are still scant. We reviewed the charts of 6 patients with prosthetic aortic valves evaluated for suspicion of prosthetic valve endocarditis, at two different hospital, over a 3-year period. We found 3 patients with early-onset PVE cases and blood cultures yielding Pseudomonas aeruginosa, Staphylococcus epidermidis and Staphylococcus lugdunensis, respectively; and 3 late-onset cases in the remaining 3 patients with isolation in the blood of Streptococcus bovis, Candida albicans and P. aeruginosa, respectively. Initial trans-esophageal echocardiography was negative in all the patients, while fluorodeoxyglucose positron emission tomography showed images suspicious for prosthetic valve endocarditis. In 4 out of 6 patients valve replacement was done with histology confirming the prosthetic valve endocarditis diagnosis. After an adequate course of antibiotic therapy fluorodeoxyglucose positron emission tomography showed resolution of prosthetic valve endocarditis in all the patients. Our experience confirms the potential role of fluoroseoxyglucose positron emission tomography in the diagnosis and follow-up of prosthetic valve endocarditis.

  1. Subacute Bacterial Endocarditis Caused by Cardiobacterium hominis: A Case Report

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    Davie Wong

    2015-01-01

    Full Text Available Cardiobacterium hominis, a member of the HACEK group of organisms, is an uncommon but important cause of subacute bacterial endocarditis. First-line therapy is a third-generation cephalosporin due to rare beta-lactamase production. The authors report a case involving endovascular infection due to C hominis that initially tested resistant to third-generation cephalosporins using an antibiotic gradient strip susceptibility method (nitrocephin negative, but later proved to be susceptible using broth microdilution reference methods (a ‘major’ error. There are limited studies to guide susceptibility testing and interpretive breakpoints for C hominis in the medical literature, and the present case illustrates some of the issues that may arise when performing susceptibility testing for fastidious organisms in the clinical microbiology laboratory.

  2. An Uncommon Cause of Stroke: Non-bacterial Thrombotic Endocarditis.

    Science.gov (United States)

    Gundersen, Hilde; Moynihan, Barry

    2016-10-01

    Our objective is to present the case of an uncommon but probably under-recognized cause of stroke: Non-bacterial thrombotic endocarditis (NBTE). A 59-year-old man presented to our hospital with multiple bihemispheric infarcts despite taking rivaroxaban for pulmonary emboli diagnosed 2 weeks earlier. The patient's symptoms progressed quickly and he died within a week of his initial presentation despite attempts at neuroradiologically guided clot retrieval and early recognition and treatment of disseminated intravascular coagulation. On postmortem examination it was discovered that he had an undiagnosed squamous cell adenocarcinoma of the lung and NBTE. NBTE is difficult to diagnose and difficult to treat. It is associated with a mortality rate and is often not diagnosed until autopsy. However there are case reports in the literature where NBTE has been successfully treated. Early recognition and prompt treatment of the underlying disease process is the essential first step. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Radiologic manifestations of extra-cardiac complications of infective endocarditis

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    Colen, Teran W.; Gunn, Martin; Cook, Erin; Dubinsky, Theodore [University of Washington Medical Center, Department of Radiology, 1959 NE Pacific Ave, Box 357115, Seattle, WA (United States)

    2008-11-15

    Infective endocarditis (IE) is a disease with high morbidity and a mortality rate of 9-30%, even with appropriate diagnosis and therapy. Septic emboli, caused by IE, can affect any organ or tissue in the body with an arterial supply and occur in 12-40% of IE cases. The most common extra-cardiac organ system involved in IE is the central nervous system. Other organs frequently involved are the lungs (especially in right-sided IE), spleen, kidneys, liver, and the musculoskeletal system. In addition, the arterial system itself is susceptible to the development of potentially fatal mycotic aneurysms. As extra-cardiac complications often antedate the clinical diagnosis of IE, it is important that the diagnosis is suggested when characteristic findings are encountered during imaging. In addition, imaging is often used to monitor the extent of complications in patients with a known diagnosis of IE. (orig.)

  4. Right-sided infective endocarditis: recent epidemiologic changes

    Science.gov (United States)

    Yuan, Shi-Min

    2014-01-01

    Background: Infective endocarditis (IE) has been increasingly reported, however, little is available regarding recent development of right-sided IE. Methods: Right-sided IE was comprehensively analyzed based on recent 5⅓-year literature. Results: Portal of entry, implanted foreign material, and repaired congenital heart defects were the main predisposing risk factors. Vegetation size on the right-sided valves was much smaller than those beyond the valves. Multiple logistic regression analysis revealed that predisposing risk factors, and vegetation size and locations were independent predictive risks of patients’ survival. Conclusions: Changes of right-sided IE in the past 5⅓ years included younger patient age, and increased vegetation size, but still prominent Staphylococcus aureus infections. Complication spectrum has changed into more valve insufficiency, more embolic events, reduced abscess formation, and considerably decreased valve perforations. With effective antibiotic regimens, prognoses of the patients seemed to be better than before. PMID:24482708

  5. Infective Endocarditis with Uveitis: A Rare Case Report

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    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.

  6. Infective endocarditis detection through SPECT/CT images digital processing

    Science.gov (United States)

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

    2014-03-01

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

  7. Radiologic manifestations of extra-cardiac complications of infective endocarditis

    International Nuclear Information System (INIS)

    Colen, Teran W.; Gunn, Martin; Cook, Erin; Dubinsky, Theodore

    2008-01-01

    Infective endocarditis (IE) is a disease with high morbidity and a mortality rate of 9-30%, even with appropriate diagnosis and therapy. Septic emboli, caused by IE, can affect any organ or tissue in the body with an arterial supply and occur in 12-40% of IE cases. The most common extra-cardiac organ system involved in IE is the central nervous system. Other organs frequently involved are the lungs (especially in right-sided IE), spleen, kidneys, liver, and the musculoskeletal system. In addition, the arterial system itself is susceptible to the development of potentially fatal mycotic aneurysms. As extra-cardiac complications often antedate the clinical diagnosis of IE, it is important that the diagnosis is suggested when characteristic findings are encountered during imaging. In addition, imaging is often used to monitor the extent of complications in patients with a known diagnosis of IE. (orig.)

  8. Multiple systemic embolism in infective endocarditis underlying in Barlow's disease.

    Science.gov (United States)

    Yu, Ziqing; Fan, Bing; Wu, Hongyi; Wang, Xiangfei; Li, Chenguang; Xu, Rende; Su, Yangang; Ge, Junbo

    2016-08-11

    Systemic embolism, especially septic embolism, is a severe complication of infective endocarditis (IE). However, concurrent embolism to the brain, coronary arteries, and spleen is very rare. Because of the risk of hemorrhage or visceral rupture, anticoagulants are recommended only if an indication is present, e.g. prosthetic valve. Antiplatelet therapy in IE is controversial, but theoretically, this therapy has the potential to prevent and treat thrombosis and embolism in IE. Unfortunately, clinical trial results have been inconclusive. We describe a previously healthy 50-year-old man who presented with dysarthria secondary to bacterial endocarditis with multiple cerebral, coronary, splenic, and peripheral emboli; antibiotic therapy contributed to the multiple emboli. Emergency splenectomy was performed, with subsequent mitral valve repair. Pathological examination confirmed mucoid degeneration and mitral valve prolapse (Barlow's disease) as the underlying etiology of the endocardial lesion. Continuous antibiotics were prescribed, postoperatively. Transthoracic echocardiography at 1.5, 3, and 6 months after the onset of his illness showed no severe regurgitation, and there was no respiratory distress, fever, or lethargy during follow-up. Although antibiotic use in IE carries a risk of septic embolism, these drugs have bactericidal and antithrombotic benefits. It is important to consider that negative blood culture and symptom resolution do not confirm complete elimination of bacteria. However, vegetation size and Staphylococcus aureus infection accurately predict embolization. It is also important to consider that bacteria can be segregated from the microbicide when embedded in platelets and fibrin. Therefore, antimicrobial therapy with concurrent antiplatelet therapy should be considered carefully.

  9. Superantigens are critical for Staphylococcus aureus Infective endocarditis, sepsis, and acute kidney injury.

    Science.gov (United States)

    Salgado-Pabón, Wilmara; Breshears, Laura; Spaulding, Adam R; Merriman, Joseph A; Stach, Christopher S; Horswill, Alexander R; Peterson, Marnie L; Schlievert, Patrick M

    2013-08-20

    Infective endocarditis and kidney infections are serious complications of Staphylococcus aureus sepsis. We investigated the role of superantigens (SAgs) in the development of lethal sepsis, infective endocarditis, and kidney infections. SAgs cause toxic shock syndrome, but it is unclear if SAgs contribute to infective endocarditis and kidney infections secondary to sepsis. We show in the methicillin-resistant S. aureus strain MW2 that lethal sepsis, infective endocarditis, and kidney infections in rabbits are critically dependent on high-level SAgs. In contrast, the isogenic strain lacking staphylococcal enterotoxin C (SEC), the major SAg in this strain, is attenuated in virulence, while complementation restores disease production. SAgs' role in infective endocarditis appears to be both superantigenicity and direct endothelial cell stimulation. Maintenance of elevated blood pressure by fluid therapy significantly protects from infective endocarditis, possibly through preventing bacterial accumulation on valves and increased SAg elimination. These data should facilitate better methods to manage these serious illnesses. The Centers for Disease Control and Prevention reported in 2007 that Staphylococcus aureus is the most significant cause of serious infectious diseases in the United States (R. M. Klevens, M. A. Morrison, J. Nadle, S. Petit, K. Gershman, et al., JAMA 298:1763-1771, 2007). Among these infections are sepsis, infective endocarditis, and acute kidney injury. Infective endocarditis occurs in 30 to 60% of patients with S. aureus bacteremia and carries a mortality rate of 40 to 50%. Over the past decades, infective endocarditis outcomes have not improved, and infection rates are steadily increasing (D. H. Bor, S. Woolhandler, R. Nardin, J. Brusch, D. U. Himmelstein, PLoS One 8:e60033, 2013). There is little understanding of the S. aureus virulence factors that are key for infective endocarditis development and kidney abscess formation. We demonstrate that

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

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    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

  11. Complicações pulmonares não infecciosas após transplante de células-tronco hematopoiéticas

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    Eliane Viana Mancuzo

    2010-09-01

    Full Text Available Resumo: As complicações pulmonares constituem importante causa de morbidade e mortalidade após o transplante de células-tronco hematopoiéticas (TCTH ocorrendo em cerca de 30 a 60% dos receptores. O avanço na profilaxia e tratamento de complicações infecciosas tem aumentado de forma significativa a parcela de complicações pulmonares não infecciosas. O diagnóstico e o tratamento precoce destas complicações podem mudar o prognóstico dos receptores de transplante de células-tronco hematopoéticas. O objectivo deste estudo é rever as principais complicações não infecciosas associadas ao TCTH desde a realização do primeiro transplante de medula óssea em 1957.Foi realizada uma revisão sistemática da literatura utilizando-se a estratégia PICO para a construção das perguntas. Os descritores transplante de células-tronco hematopoiéticas, complicações pulmonares não infecciosas, revisão sistemática, em português e seus correspondentes em inglês, foram utilizados para acesso às seguintes bases de dados: MEDLINE, EBM, EMBASE, COCRANE LIBRARY, LILACS e SciELO. Nesta revisão foram identificados 263 trabalhos. Destes, 30 foram seleccionados para serem analisados na íntegra. As complicações pulmonares não infecciosas mais frequentemente descritas foram: bronquiolite obliterante, bronquiolite obliterante com pneumonia em organização, edema pulmonar, síndroma da pneumonia idiopática, síndroma da toxicidade pulmonar por droga, hemorragia alveolar difusa, síndroma do enxerto e trombo citolítico pulmonar.Rev Port Pneumol 2010; XVI (5: 815-828 Abstract: Pulmonary complications are important cause of mortality and morbidity after hematopoietic stem cell transplantation, in 30% to 60% of the patients. Improvements in prophylaxis and treatment of infectious complications have been increasing the rate of non-infectious complications. Early diagnosis and treatment of those complications can significantly change the

  12. Percepción del riesgo al cambio climático y sus efectos sobre la salud y enfermedades infecciosas en estudiantes universitarios, 2011 Santa Marta - Colombia

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    Alexander Salazar Ceballos

    2014-06-01

    Full Text Available Introducción: La Organización Mundial de la Salud (OMS ha denominado que el cambio climático es una amenaza para la salud pública, por lo tanto es necesario conocer la percepción del riesgo al cambio climático específicamente en los futuros profesionales de la salud. Materiales y Métodos: Se realizó una investigación de tipo cuantitativo descriptiva con muestreo aleatorio estratificado. Se realizaron análisis de Chi2 y regresión logística para identificar los factores asociados a la percepción del riesgo al cambio climático y al aumento de enfermedades infecciosas sensibles al cambio climático en estudiantes universitarios de las ciencias de la salud en la Universidad del Magdalena. Resultados: Por Chi2 se encontró que cerca del 69% de los estudiantes perciben el cambio climático como dañino y entre 50 y 59% de ellos perciben que las enfermedades infecciosas aumentarán como consecuencia del cambio climático. Por regresión logística se observó significancia estadística que los estudiantes que pertenecen al sexto semestre de estudios o semestres superiores tienen 60% más probabilidad de reconocer que pueden enfermarse por el cambio climático, 63% más probabilidad de percibir el cambio climático como dañino, relacionaron 2,2 veces más el aumento de la temperatura global con el aumento de enfermos con fiebre amarilla y dengue, también tienen 58% más posibilidad de relacionar el aumento de los casos. Discusión: Los estudiantes de los diferentes programas de salud que pertenecen al sexto semestre de estudios o superiores percibieron el cambio climático como una amenaza sobre la salud pública y lo asociaron con el aumento de enfermedades infecciosas, de esta manera, se puede considerar que los estudiantes de salud conforme avanzan en los semestres académicos perciben un mayor riesgo del cambio climático como una amenaza sobre la salud pública y un aumento de los enfermos por enfermedades infecciosas

  13. Twenty-Year Experience in the Diagnosis and Treatment of Infective Endocarditis.

    Science.gov (United States)

    Abramczuk, Elżbieta; Stępińska, Janina; Hryniewiecki, Tomasz

    2015-01-01

    The aim of this study was to compare the etiology, clinical course, selected diagnostic methods and efficacy of the treatment used in patients with infective endocarditis (IE) in the nineteen eighties and nineties. The study group comprised 300 patients with infective endocarditis hospitalized in the Institute of Cardiology in Warsaw in the following years: from 1982 to 1987 (150 patients: 75 successive patients with IE on the prosthetic valve and 75 successive patients with IE on the native valve), as well as from 1990 to 2003 (150 patients: 75 successive patients with IE on the prosthetic valve and 75 successive patients with IE on the native valve). In the nineties, immunological symptoms, embolism formation and progressive heart failure were diagnosed decidedly more frequently. Early prosthetic valve endocarditis (PVE) (up to 60 days after operation) occurred significantly more frequently in the eighties. The quantity of negative blood cultures in PVE has not decreased, it is still observed in over 20% of cases. For 20 years the etiology of PVE has remained the same, the dominant pathogen remains Staphylococcus. The frequency of PVE caused by Streptococci has markedly reduced. In both the decades analyzed the etiology of native valve endocarditis (NVE) was similar. In the eighties Streptococcus was predominant. In successive years the number of infections caused by Staphylococci was the same as that caused by Streptococci. The incidence of early PVE decreased in the nineties. More patients were treated surgically with lesser peri-operative mortality. A lower incidence of infective endocarditis on prosthetic valves caused by streptococci may signify better prophylaxis against infective endocarditis. Infective endocarditis with sterile blood cultures continues to occur frequently.

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

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    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.

  15. Twenty-Year Experience in the Diagnosis and Treatment of Infective Endocarditis

    Science.gov (United States)

    2015-01-01

    Aims The aim of this study was to compare the etiology, clinical course, selected diagnostic methods and efficacy of the treatment used in patients with infective endocarditis (IE) in the nineteen eighties and nineties. Material and Methods The study group comprised 300 patients with infective endocarditis hospitalized in the Institute of Cardiology in Warsaw in the following years: from 1982 to 1987 (150 patients: 75 successive patients with IE on the prosthetic valve and 75 successive patients with IE on the native valve), as well as from 1990 to 2003 (150 patients: 75 successive patients with IE on the prosthetic valve and 75 successive patients with IE on the native valve). Results In the nineties, immunological symptoms, embolism formation and progressive heart failure were diagnosed decidedly more frequently. Early prosthetic valve endocarditis (PVE) (up to 60 days after operation) occurred significantly more frequently in the eighties. The quantity of negative blood cultures in PVE has not decreased, it is still observed in over 20% of cases. For 20 years the etiology of PVE has remained the same, the dominant pathogen remains Staphylococcus. The frequency of PVE caused by Streptococci has markedly reduced. In both the decades analyzed the etiology of native valve endocarditis (NVE) was similar. In the eighties Streptococcus was predominant. In successive years the number of infections caused by Staphylococci was the same as that caused by Streptococci. Conclusions The incidence of early PVE decreased in the nineties. More patients were treated surgically with lesser peri-operative mortality. A lower incidence of infective endocarditis on prosthetic valves caused by streptococci may signify better prophylaxis against infective endocarditis. Infective endocarditis with sterile blood cultures continues to occur frequently. PMID:26230402

  16. Impact of serology and molecular methods on improving the microbiologic diagnosis of infective endocarditis in Egypt.

    Science.gov (United States)

    El-Kholy, Amany Aly; El-Rachidi, Nevine Gamal El-din; El-Enany, Mervat Gaber; AbdulRahman, Eiman Mohammed; Mohamed, Reem Mostafa; Rizk, Hussien Hasan

    2015-10-01

    Conventional diagnosis of infective endocarditis (IE) is based mainly on culture-dependent methods that may fail because of antibiotic therapy or fastidious microorganisms. We aimed to evaluate the added values of serological and molecular methods for diagnosis of infective endocarditis. One hundred and fifty-six cases of suspected endocarditis were enrolled in the study. For each patient, three sets of blood culture were withdrawn and serum sample was collected for Brucella, Bartonella and Coxiella burnetii antibody testing. Galactomannan antigen was added if fungal endocarditis was suspected. Broad range PCR targeting bacterial and fungal pathogens were done on blood culture bottles followed by sequencing. Culture and molecular studies were done on excised valve tissue when available. One hundred and thirty-two cases were diagnosed as definite IE. Causative organisms were detected by blood cultures in 40 (30.3 %) of cases. Blood culture-negative endocarditis (BCNE) represented 69.7 %. Of these cases, PCR followed by sequencing on blood and valvular tissue could diagnose five cases of Aspergillus flavus. Eleven patients with BCNE (8.3 %) were diagnosed as zoonotic endocarditis by serology and PCR including five cases of Brucella spp, four cases of Bartonella spp and two cases of Coxiella burnetii. PCR detected three cases of Brucella spp and two cases of Bartonella spp, while cases of Coxiella burnetii were PCR negative. The results of all diagnostic tools decreased the percentage of non-identified cases of BCNE from 69.7 to 49.2 %. Our data underline the role of serologic and molecular tools for the diagnosis of blood culture-negative endocarditis.

  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. Suboptimal Addiction Interventions for Patients Hospitalized with Injection Drug Use-Associated Infective Endocarditis.

    Science.gov (United States)

    Rosenthal, Elana S; Karchmer, Adolf W; Theisen-Toupal, Jesse; Castillo, Roger Araujo; Rowley, Chris F

    2016-05-01

    Infective endocarditis is a serious infection, often resulting from injection drug use. Inpatient treatment regularly focuses on management of infection without attention to the underlying addiction. We aimed to determine the addiction interventions done in patients hospitalized with injection drug use-associated infective endocarditis. This is a retrospective review of patients hospitalized with injection drug use-associated infective endocarditis from January, 2004 through August, 2014 at a large academic tertiary care center in Boston, Massachusetts. For the initial and subsequent admissions, data were collected regarding addiction interventions, including consultation by social work, addiction clinical nurse and psychiatry, documentation of addiction in the discharge summary plan, plan for medication-assisted treatment and naloxone provision. There were 102 patients admitted with injection drug use-associated infective endocarditis, 50 patients (49.0%) were readmitted and 28 (27.5%) patients had ongoing injection drug use at readmission. At initial admission, 86.4% of patients had social work consultation, 23.7% had addiction consultation, and 24.0% had psychiatry consultation. Addiction was mentioned in 55.9% of discharge summary plans, 7.8% of patients had a plan for medication-assisted treatment, and naloxone was never prescribed. Of 102 patients, 26 (25.5%) are deceased. The median age at death was 40.9 years (interquartile range 28.7-48.7). We found that patients hospitalized with injection drug use-associated infective endocarditis had high rates of readmission, recurrent infective endocarditis and death. Despite this, addiction interventions were suboptimal. Improved addiction interventions are imperative in the treatment of injection drug use-associated infective endocarditis. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. 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.

  20. Peritonitis infecciosa felina, gastroenteritis y colangiohepatitis parasitaria (platinosomiasis) con colangiocarcinoma hepático: estudio clínico y anatomopatológico de tres casos

    OpenAIRE

    Vale Echeto, Oswaldo E.; Madrigal, Karina; Admadé, María; Vale Oviedo, Oswaldo R.; Moreno, Alejandro; Simoes, David

    2009-01-01

    La Peritonitis Infecciosa Felina (PIF) es una enfermedad viral sistémica producida por un coronavirus (ARN) que ocurre con frecuencia en los felinos domésticos. Este proceso patológico ha sido referido en el felino doméstico y relacionado concurrentemente con otras enfermedades virales tales como la panleucopenia felina, leucemia felina y enteritis por coronavirus. En el presente trabajo se reportan los hallazgos clínicos y anatomopatológicos de tres casos de PIF, asociados a gastroenteritis ...

  1. 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

  2. Pharmacokinetic modeling of gentamicin in treatment of infective endocarditis: Model development and validation of existing models

    Science.gov (United States)

    van der Wijk, Lars; Proost, Johannes H.; Sinha, Bhanu; Touw, Daan J.

    2017-01-01

    Gentamicin shows large variations in half-life and volume of distribution (Vd) within and between individuals. Thus, monitoring and accurately predicting serum levels are required to optimize effectiveness and minimize toxicity. Currently, two population pharmacokinetic models are applied for predicting gentamicin doses in adults. For endocarditis patients the optimal model is unknown. We aimed at: 1) creating an optimal model for endocarditis patients; and 2) assessing whether the endocarditis and existing models can accurately predict serum levels. We performed a retrospective observational two-cohort study: one cohort to parameterize the endocarditis model by iterative two-stage Bayesian analysis, and a second cohort to validate and compare all three models. The Akaike Information Criterion and the weighted sum of squares of the residuals divided by the degrees of freedom were used to select the endocarditis model. Median Prediction Error (MDPE) and Median Absolute Prediction Error (MDAPE) were used to test all models with the validation dataset. We built the endocarditis model based on data from the modeling cohort (65 patients) with a fixed 0.277 L/h/70kg metabolic clearance, 0.698 (±0.358) renal clearance as fraction of creatinine clearance, and Vd 0.312 (±0.076) L/kg corrected lean body mass. External validation with data from 14 validation cohort patients showed a similar predictive power of the endocarditis model (MDPE -1.77%, MDAPE 4.68%) as compared to the intensive-care (MDPE -1.33%, MDAPE 4.37%) and standard (MDPE -0.90%, MDAPE 4.82%) models. All models acceptably predicted pharmacokinetic parameters for gentamicin in endocarditis patients. However, these patients appear to have an increased Vd, similar to intensive care patients. Vd mainly determines the height of peak serum levels, which in turn correlate with bactericidal activity. In order to maintain simplicity, we advise to use the existing intensive-care model in clinical practice to avoid

  3. Pharmacokinetic modeling of gentamicin in treatment of infective endocarditis: Model development and validation of existing models.

    Directory of Open Access Journals (Sweden)

    Anna Gomes

    Full Text Available Gentamicin shows large variations in half-life and volume of distribution (Vd within and between individuals. Thus, monitoring and accurately predicting serum levels are required to optimize effectiveness and minimize toxicity. Currently, two population pharmacokinetic models are applied for predicting gentamicin doses in adults. For endocarditis patients the optimal model is unknown. We aimed at: 1 creating an optimal model for endocarditis patients; and 2 assessing whether the endocarditis and existing models can accurately predict serum levels. We performed a retrospective observational two-cohort study: one cohort to parameterize the endocarditis model by iterative two-stage Bayesian analysis, and a second cohort to validate and compare all three models. The Akaike Information Criterion and the weighted sum of squares of the residuals divided by the degrees of freedom were used to select the endocarditis model. Median Prediction Error (MDPE and Median Absolute Prediction Error (MDAPE were used to test all models with the validation dataset. We built the endocarditis model based on data from the modeling cohort (65 patients with a fixed 0.277 L/h/70kg metabolic clearance, 0.698 (±0.358 renal clearance as fraction of creatinine clearance, and Vd 0.312 (±0.076 L/kg corrected lean body mass. External validation with data from 14 validation cohort patients showed a similar predictive power of the endocarditis model (MDPE -1.77%, MDAPE 4.68% as compared to the intensive-care (MDPE -1.33%, MDAPE 4.37% and standard (MDPE -0.90%, MDAPE 4.82% models. All models acceptably predicted pharmacokinetic parameters for gentamicin in endocarditis patients. However, these patients appear to have an increased Vd, similar to intensive care patients. Vd mainly determines the height of peak serum levels, which in turn correlate with bactericidal activity. In order to maintain simplicity, we advise to use the existing intensive-care model in clinical practice to

  4. Distribution, antibiotic susceptibility and tolerance of bacterial isolates in culture-positive cases of endocarditis in The Netherlands

    NARCIS (Netherlands)

    van der Meer, J. T.; van Vianen, W.; Hu, E.; van Leeuwen, W. B.; Valkenburg, H. A.; Thompson, J.; Michel, M. F.

    1991-01-01

    During a two-year period data were collected nationwide in The Netherlands on 438 episodes of bacterial endocarditis (BE) in 432 patients. Of the strains isolated in these patients 419 were available for analysis. Of these, 326 were isolated in native valve endocarditis (NVE) and 93 in prosthetic

  5. Antimicrobial treatment of infective endocarditis caused by viridans streptococci highly susceptible to penicillin: historic overview and future considerations

    NARCIS (Netherlands)

    Verhagen, D. W. M.; Vedder, A. C.; Speelman, P.; van der Meer, J. T. M.

    2006-01-01

    In this article we present the path that led to current concepts regarding antimicrobial treatment of endocarditis caused by viridans streptococci highly susceptible to penicillin. Early treatment trials indicate that some patients with subacute endocarditis can be cured with shorter treatment

  6. 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....

  7. 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 endocarditis in systemic 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.

  8. 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.

  9. [Primary Aspergillus endocarditis. Apropos of a case and review of the international literature].

    Science.gov (United States)

    Roux, J P; Koussa, A; Cajot, M A; Marquette, F; Goullard, L; Gosselin, B; Pol, A; Warembourg, H; Soots, G

    1992-01-01

    The authors report a case of primary aspergillus endocarditis with endophthalmitis and vertebral osteomyelitis. No underlying disease and no predisposing factors were found. Valve replacement plus combined antifungal chemotherapy proved to be effective as the patient is asymptomatic 18 months after the first symptoms. 48 cases of aspergillus endocarditis, without prior cardiac surgery have been reported in the literature. Aspergillus endocarditis was valvular or mural. Extracardiac dissemination was common but endophthalmitis and osteomyelitis were infrequent. In 11 cases, the diagnosis was made by histologic examination of embolectomy or ocular, skin biopsy tissue. All patients were febrile. Blood cultures showed no Aspergillus species. Clinical manifestations of endocarditis were described in less than fifty per cent of cases. Echocardiographic visualization of vegetations was obtained in 5 cases. Many patients experienced embolic phenomena. Mortality from Aspergillus endocarditis is extremely high (96%). Surgery is the main treatment, consisting of valve replacement. Antifungal chemotherapy should be combined. The proper duration and dosage and the combination of antifungal drugs have not been clearly defined.

  10. 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.

  11. Antifungal activity of caspofungin in experimental infective endocarditis caused by Candida albicans.

    Science.gov (United States)

    Victorio, Gerardo Becerra; Bourdon, Lorena Michele Brennan; Benavides, Leonel García; Huerta-Olvera, Selene G; Plascencia, Arturo; Villanueva, José; Martinez-Lopez, Erika; Hernández-Cañaveral, Iván Isidro

    2017-05-01

    Infective endocarditis is a disease characterised by heart valve lesions, which exhibit extracellular matrix proteins that act as a physical barrier to prevent the passage of antimicrobial agents. The genus Candida has acquired clinical importance given that it is increasingly being isolated from cases of nosocomial infections. To evaluate the activity of caspofungin compared to that of liposomal amphotericin B against Candida albicans in experimental infective endocarditis. Wistar rats underwent surgical intervention and infection with strains of C. albicans to develop infective endocarditis. Three groups were formed: the first group was treated with caspofungin, the second with liposomal amphotericin B, and the third received a placebo. In vitro sensitivity was first determined to further evaluate the effect of these treatments on a rat experimental model of endocarditis by semiquantitative culture of fibrinous vegetations and histological analysis. Our semiquantitative culture of growing vegetation showed massive C. albicans colonisation in rats without treatment, whereas rats treated with caspofungin showed significantly reduced colonisation, which was similar to the results obtained with liposomal amphotericin B. The antifungal activity of caspofungin is similar to that of liposomal amphotericin B in an experimental model of infective endocarditis caused by C. albicans.

  12. Positive predictive value of infective endocarditis in the Danish National Patient Registry: a validation study.

    Science.gov (United States)

    Østergaard, Lauge; Adelborg, Kasper; Sundbøll, Jens; Pedersen, Lars; Loldrup Fosbøl, Emil; Schmidt, Morten

    2018-05-30

    The positive predictive value of an infective endocarditis diagnosis is approximately 80% in the Danish National Patient Registry. However, since infective endocarditis is a heterogeneous disease implying long-term intravenous treatment, we hypothesiszed that the positive predictive value varies by length of hospital stay. A total of 100 patients with first-time infective endocarditis in the Danish National Patient Registry were identified from January 2010 - December 2012 at the University hospital of Aarhus and regional hospitals of Herning and Randers. Medical records were reviewed. We calculated the positive predictive value according to admission length, and separately for patients with a cardiac implantable electronic device and a prosthetic heart valve using the Wilson score method. Among the 92 medical records available for review, the majority of the patients had admission length ⩾2 weeks. The positive predictive value increased with length of admission. In patients with admission length value was 65% while it was 90% for admission length ⩾2 weeks. The positive predictive value was 81% for patients with a cardiac implantable electronic device and 87% for patients with a prosthetic valve. The positive predictive value of the infective endocarditis diagnosis in the Danish National Patient Registry is high for patients with admission length ⩾2 weeks. Using this algorithm, the Danish National Patient Registry provides a valid source for identifying infective endocarditis for research.

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

    International Nuclear Information System (INIS)

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

    1982-01-01

    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

  14. Bartonella, a Common Cause of Endocarditis: a Report on 106 Cases and Review

    Science.gov (United States)

    Edouard, Sophie; Nabet, Cecile; Lepidi, Hubert; Fournier, Pierre-Edouard

    2014-01-01

    Bartonella spp. are fastidious bacteria that cause blood culture-negative endocarditis and have been increasingly reported. In this study, we included all patients retrospectively and prospectively diagnosed with Bartonella endocarditis in our French reference center between 2005 and 2013. Our diagnosis was based on the modified Duke criteria and microbiological findings, including serological and PCR results. To review the published literature, we searched all human Bartonella endocarditis cases published in the PubMed database between January 2005 and October 2013. We report here a large series of 106 cases, which include 59 cases that had not previously been reported or mentioned. Indirect immunofluorescence assays, Western blotting, and real-time PCR from total blood, serum, and valve tissue exhibited sensitivities of 58%, 100%, 33%, 36%, and 91%, respectively. The number of cases reported in the literature between 2005 and 2013 increased to reach a cumulative number of 196 cases. The number of cases reported in the literature by other centers is increasing more rapidly than that reported by our French reference center (P endocarditis. We suggest that a positive PCR result from a cardiac valve or blood specimen, an IgG titer of ≥800 using an immunofluorescence assay, or a positive Western blot assay be considered major Duke criteria for Bartonella endocarditis. There is no real increase in the incidence of these infections but rather a better understanding and interest in the disease resulting from the improvement of diagnostic tools. PMID:25540398

  15. Bartonella Species, an Emerging Cause of Blood-Culture-Negative Endocarditis.

    Science.gov (United States)

    Okaro, Udoka; Addisu, Anteneh; Casanas, Beata; Anderson, Burt

    2017-07-01

    Since the reclassification of the genus Bartonella in 1993, the number of species has grown from 1 to 45 currently designated members. Likewise, the association of different Bartonella species with human disease continues to grow, as does the range of clinical presentations associated with these bacteria. Among these, blood-culture-negative endocarditis stands out as a common, often undiagnosed, clinical presentation of infection with several different Bartonella species. The limitations of laboratory tests resulting in this underdiagnosis of Bartonella endocarditis are discussed. The varied clinical picture of Bartonella infection and a review of clinical aspects of endocarditis caused by Bartonella are presented. We also summarize the current knowledge of the molecular basis of Bartonella pathogenesis, focusing on surface adhesins in the two Bartonella species that most commonly cause endocarditis, B. henselae and B. quintana . We discuss evidence that surface adhesins are important factors for autoaggregation and biofilm formation by Bartonella species. Finally, we propose that biofilm formation is a critical step in the formation of vegetative masses during Bartonella -mediated endocarditis and represents a potential reservoir for persistence by these bacteria. Copyright © 2017 American Society for Microbiology.

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

    International Nuclear Information System (INIS)

    Ellmann, A.; Rubow, S.M.; Erlank, P.; Reuter, H.

    2002-01-01

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

  17. 18F-FDG-PET/CT Angiography for the Diagnosis of Infective Endocarditis.

    Science.gov (United States)

    Roque, A; Pizzi, M N; Cuéllar-Calàbria, H; Aguadé-Bruix, S

    2017-02-01

    This article reviews the current imaging role of 18 F-fluordeoxyglucose positron emission computed tomography ( 18 F-FDG-PET/CT) combined with cardiac CT angiography (CTA) in infective endocarditis and discusses the strengths and limitations of this technique. The diagnosis of infective endocarditis affecting prosthetic valves and intracardiac devices is challenging because echocardiography and, therefore, the modified Duke criteria have well-recognized limitations in this clinical scenario. The high sensitivity of 18 F-FDG-PET/CT for the detection of infection associated with the accurate definition of structural damage by gated cardiac CTA in a combined technique (PET/CTA) has provided a significant increase in diagnostic sensitivity for the detection of IE. PET/CTA has proven to be a useful diagnostic tool in patients with suspected infective endocarditis. The additional information provided by this technique improves diagnostic performance in prosthetic valve endocarditis when it is used in combination with the Duke criteria. The findings obtained in PET/CTA studies have been included as a major criterion in the recently updated diagnostic algorithm in infective endocarditis guidelines.

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

    International Nuclear Information System (INIS)

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

    1979-01-01

    The capability of radionuclide imaging to detect experimental aortic valve infective endocarditis was assessed with indium-111 ( 111 In)-labeled blood cells. Sequential cardiac imaging and tissue distribution studies were obtained in 17 rabbits with infective endocarditis after administration of 111 In-platelets and in five after 111 In-polymorphonuclear leukocytes. Forty-eight to 72 hours after platelet administration, in vivo imaging demonstrated abnormal 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. 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, 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 111 In-platelet scintigraphs nor abnormal cardiac tissue uptake. Likewise, noncellular 111 In was not concentrated to any significant extent in three animals with infective endocarditis. This study demonstrates that 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. 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.

  20. [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

  1. O PAPEL IMUNOLÓGICO E SOCIAL DO LEITE MATERNO NA PREVENÇÃO DE DOENÇAS INFECCIOSAS E ALÉRGICAS NA INFÂNCIA

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    MÁRCIO FLÁVIO MOURA DE ARAÚJO

    2006-01-01

    Full Text Available Estudio reflexivo que tuvo como objetivo analizar la contribución inmunológica y social de la leche materna en la prevención de enfermidades infecciosas y alérgicas . El proceso de amamantamiento repercute de forma biopsicosocial en el desarrollo del niño, especialmente, en la prevención de enfermedades como las diarreas, las IRAs y las alergias que son asociadas como causa de morbimortalidad pediátrica. Esa inmunidad es conferida por los anticuerpos maternos transmitidos durante la lactancia materna, principalmente, por la IgA( principal anticuerpo de la leche que irán a habitar el trato digestivo del niño, impidiendo así que microorganismos patógenos colonicen el trato enterogástrico infantil, produciendo enfermedades. El enfermero teñie tido realce en lo aconsejamento de gestantes y puerperas para asegurar lo amamantamiento hasta lo período de seis meses. Se señala que el amamantamiento maternal debido a sus características inmunológicas y sociales que previenen varias enfermedades infecciosas y alérgicas se constituye en una acción de promoción de la salud.

  2. [Scientific productivity, collaboration and research areas in Enfermedades Infecciosas y Microbiología Clínica (2003-2007)].

    Science.gov (United States)

    González-Alcaide, Gregorio; Valderrama-Zurián, Juan Carlos; Ramos-Rincón, José Manuel

    2010-10-01

    Collaboration is essential for biomedical research. The Carlos III Health Institute (the Spanish national public organization responsible for promoting biomedical research) has encouraged scientific collaboration by promoting Thematic Networks and Cooperative Research Centres. Scientific collaboration in Enfermedades Infecciosas y Microbiología Clinica journal is investigated. Papers published in Enfermedades Infecciosas y Microbiología Clinica in the period 2002-2007 have been identified. Bibliometrics and Social Network Analysis methods have been carried out in order to quantify and characterise scientific collaboration and research areas. A total of 805 papers generated by 2,289 authors and 326 institutions have been analysed. There were 36 research groups involving 138 authors identified. The Collaboration Index for articles was 5.5. Institutional collaboration was determined in 75% of articles. The collaboration between departments or units of the same institution prevails (43%), followed by intra-regional domestic collaboration (41%) and inter-regional domestic collaboration (14%). Hospital centres were the main institutional sector responsible of research (88% of papers), with 68% of articles cited. Sida/VIH (AIDS/HIV) is the main research area (n=114), followed by Staphylococcal Infections (n=33). Notable collaboration and citation rates have been observed. Research is focused on diseases with the highest mortality rates caused by infectious diseases in Spain. Copyright © 2009 Elsevier España, S.L. All rights reserved.

  3. Avaliação ética de projetos de pesquisa de enfermagem no contexto das doenças infecciosas

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    Marli Teresinha Gimeniz Galvão

    2005-01-01

    Full Text Available Frente al creciente aumento de nuevas nosologías, la necesidad y el aspecto ético de las investigaciones que envuelven a los seres humanos se há ampliado, asi como, también, la inserción del enfermero en el contexto científico. En este trabajo, nuestro objetivo fue presentar la demanda de las investigaciones en enfermería sometidas a un Comité de Ética en la Investigación de una determinada institución pública con referencia en la atención de enfermedades infecciosas de la región Nor-este del Brasil entre el período del 2000 al 2004. Según un estudio retrospectivo para la evaluación de los proyectos éticos desarrollados durante el segundo trimestre del 2004. Los resultados indicaron que los protocolos de enfermería corresponden al 35,4% de todos los proyectos recibidos durante este período y abarcan particularmente los temas del SIDA (54,9% y el trabajo de enfermería en el contexto de las enfermedades infecciosas (17,7%. Se concluye que hubo una demanda expresiva de los protocolos de investigación en enfermería en los temas prioritarios en el Brasil que involucran la evaluación ética.

  4. O conceito de espaço na epidemiologia das doenças infecciosas The concept of space in infectious disease epidemiology

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    Luiz Jacintho da Silva

    1997-10-01

    Full Text Available Análise teórica da utilização do conceito de espaço na epidemiologia das doenças infecciosas. Faz-se uma breve retrospectiva do uso de diferentes conceituações de espaço e de suas implicações. Ênfase é dada à teoria dos focos naturais de Pavlovsky e às interações entre a epidemiologia e a geografia. O problema atual das infecções emergentes é visto como determinante da necessidade de se intensificarem as discussões sobre este conceito na epidemiologia das doenças infecciosas.This article analyzes how space is employed in infectious disease epidemiology, with a brief retrospective of the various definitions of space and its implications. Emphasis is given to the theory of natural foci of infectious diseases formulated by Pavlovsky and the interactions of epidemiology and geography.The current problem posed by emerging infections is seen as a determinant of the need for further discussion on the concept of space in infectious disease epidemiology.

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

    Science.gov (United States)

    Ceglowska, Karolina; Nowomiejska, Katarzyna; Kiszka, Agnieszka; Koss, Michael J; Maciejewski, Ryszard; Rejdak, Robert

    2015-01-01

    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.

  6. Dental Procedures and the Risk of Infective Endocarditis

    Science.gov (United States)

    Chen, Pei-Chun; Tung, Ying-Chang; Wu, Patricia W.; Wu, Lung-Sheng; Lin, Yu-Sheng; Chang, Chee-Jen; Kung, Suefang; Chu, Pao-Hsien

    2015-01-01

    Abstract Infective endocarditis (IE) is an uncommon but potentially devastating disease. Recently published data have revealed a significant increase in the incidence of IE following the restriction on indications for antibiotic prophylaxis as recommended by the revised guidelines. This study aims to reexamine the basic assumption behind the rationale of prophylaxis that dental procedures increase the risk of IE. Using the Longitudinal Health Insurance Database of Taiwan, we retrospectively analyzed a total of 739 patients hospitalized for IE between 1999 and 2012. A case-crossover design was conducted to compare the odds of exposure to dental procedures within 3 months preceding hospitalization with that during matched control periods when no IE developed. In the unadjusted model, the odds ratio (OR) was 0.93 for tooth extraction (95% confidence interval [CI] 0.54–1.59), 1.64 for surgery (95% CI 0.61–4.42), 0.92 for dental scaling (95% CI 0.59–1.42), 1.69 for periodontal treatment (95% CI 0.88–3.21), and 1.29 for endodontic treatment (95% CI 0.72–2.31). The association between dental procedures and the risk of IE remained insignificant after adjustment for antibiotic use, indicating that dental procedures did not increase the risk of IE. Therefore, this result may argue against the conventional assumption on which the recommended prophylaxis for IE is based. PMID:26512586

  7. A rare case of renal infarction caused by infective endocarditis.

    Science.gov (United States)

    Zakaria, Rasheed; Forsyth, Vhari; Rosenbaum, Tomas

    2009-10-01

    A 29-year-old man presented to the emergency department of a general hospital complaining of sudden onset left loin pain, radiating to the groin, which had started 48 h previously. He described no urological symptoms and had no medical history of note. Physical examination, electrocardiography, dipstick testing of urine, radiography of the chest and abdomen, blood tests (white blood cell count and serum urea, creatinine, sodium, potassium and C-reactive protein levels), CT of the renal tract, blood and urine cultures, renal angiography, thromboembolic blood panel, urine and blood tests for illicit drugs, transthoracic echocardiography, transesophageal echocardiography, renal ultrasonography. Infective endocarditis resulting in thromboembolic unilateral renal infarction. The patient was started on anticoagulation therapy with low-molecular-weight heparin and treated with intravenous gentamicin and benzylpenicillin for 4 weeks. He was seen in an outpatient clinic 4 weeks after discharge, at which time serum urea and creatinine levels and repeat ultrasonography of the renal tract confirmed normal renal function. He will be followed up regularly by cardiologists and urologists, at 6 weeks initially, and every 6 months to 1 year thereafter by his family physician.

  8. A rare cause of native tricuspid valve endocarditis: Abortus

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    M.Sıddık Evsen

    2011-03-01

    Full Text Available A 28-year-old female patient, who at her 7 weeks ofpregnancy, admitted to hospital with abdominal painand vaginal bleeding. She had been hospitalized in anothercenter with the diagnosis of spontaneous completeabortion. After discharge, her clinical process, deteriorateddue to fever, chills and fatigue therefore she hadbeen admitted to emergency unit of that hospital onceagain, and received non-specific antibiotics. She was referredto our clinic because of persistant complaints.Transthoracic echocardiography showed vegetations onthe tricuspid valve leading to diagnosis of infective endocarditis,so treatment was started at our clinic. No microorganismisolated in blood cultures. Following 15-days antibiotic therapy no reduction was seen in the diameterof the vegetation, therefore surgical operationwas planned and a bioprosthetic tricuspid valve was putinto place. In this article we aimed to report the developmentof spontaneous abortus at 7 weeks of pregnancy,in order to emphasize that tricuspid valve endocarditiscan be developed secondary to very rare causes.J Clin Exp Invest 2011; 2(1: 102-105

  9. Imaging of the neurological complications of infective endocarditis

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    Kim, S.J.; Lee, J.Y.; Kim, T.H.; Kim, S.C.; Choi, Y.H. [Department of Radiology, Dankook University College of Medicine, Chungnam (Korea, Republic of); Pai, H. [Department of Internal Medicine, Dankook University College of Medicine, Chungnam (Korea, Republic of); Choi, W.S. [Department of Radiology, Kyung Hee University College of Medicine, Seoul (Korea, Republic of)

    1998-02-01

    We describe the findings on CT or MRI in five patients with neurological symptoms and underlying infective endocarditis (IE). We noted the size, number, and distribution of lesions, the presence or absence of haemorrhage, and contrast enhancement patterns. The number of lesions ranged from 4 to more than 10 in each patient. Their size varied from punctate to 6 cm; they were distributed throughout the brain. The lesions could be categorized into four patterns based on imaging features. A cortical infarct pattern was seen in all patients. Patchy lesions, which did not enhance, were found in the white matter or basal ganglia in three. Isolated, tiny, nodular or ring-enhancing white matter lesions were seen in three patients, and parenchymal haemorrhages in four. In addition to the occurrence of multiple lesions with various patterns in the same patient, isolated, tiny, enhancing lesions in the white matter seemed to be valuable features which could help to differentiate the neurological complications of IE from other thromboembolic infarcts. (orig.) With 4 figs., 2 tabs., 11 refs.

  10. 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.

  11. 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.

  12. 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.

  13. [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.

  14. Imaging of the neurological complications of infective endocarditis

    International Nuclear Information System (INIS)

    Kim, S.J.; Lee, J.Y.; Kim, T.H.; Kim, S.C.; Choi, Y.H.; Pai, H.; Choi, W.S.

    1998-01-01

    We describe the findings on CT or MRI in five patients with neurological symptoms and underlying infective endocarditis (IE). We noted the size, number, and distribution of lesions, the presence or absence of haemorrhage, and contrast enhancement patterns. The number of lesions ranged from 4 to more than 10 in each patient. Their size varied from punctate to 6 cm; they were distributed throughout the brain. The lesions could be categorized into four patterns based on imaging features. A cortical infarct pattern was seen in all patients. Patchy lesions, which did not enhance, were found in the white matter or basal ganglia in three. Isolated, tiny, nodular or ring-enhancing white matter lesions were seen in three patients, and parenchymal haemorrhages in four. In addition to the occurrence of multiple lesions with various patterns in the same patient, isolated, tiny, enhancing lesions in the white matter seemed to be valuable features which could help to differentiate the neurological complications of IE from other thromboembolic infarcts. (orig.)

  15. Analysis of clinical features and risk factors for infective endocarditis

    International Nuclear Information System (INIS)

    Wang Li; Zhao Liangping; Xu Weiting; Chen Jianchang; Tong Guangming; Hong Xiaosu

    2012-01-01

    Objective: To analyze the clinical features of infective endocarditis (IE) and explore the risk factors for it's prognosis. Methods: Clinical data of 65 patients with IE were acquired retrospectively, and its causes, clinical characteristics, pathogenic microorganism, clinical outcomes were analyzed. Results: The major occurring heart diseases for IE in all patients were rheumatic heart disease, congenital heart disease, and there was no any previously known heart disease. The major clinical manifestations included fever and anemia. The major pathogenic bacteria is streptococcus, but percentage of other bacteria increased gradually. Thirteen patients were refractory, in hospital. Haematoglobin and seralbumin were significantly lower, and leucocyte, hsCRP, erythrocyte sedimentation were significantly higher in refractory group. Anaemia, lower seralbumin, higher hsCRP were independent predictors for bad prognosis. Conclusion: The proportion of rheumatic heart disease is decreasing as one of the risk factors for IE in recent years. Streptococcus is major pathogen of IE, and the mortality of IE is still very high. Anaemia, lower seralbumin, higher hsCRP are independent predictors for bad prognosis. (authors)

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

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    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.

  17. A rare localization in right-sided endocarditis diagnosed by echocardiography: A case report

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    Beaufils Philippe

    2003-08-01

    Full Text Available Abstract Background Right-sided endocarditis occurs predominantly in intravenous drug users, patients with pacemakers or central venous lines and with congenital heart diseases. The vast majority of cases involve the tricuspid valve. Case presentation A case of a 31-year-old woman with intravenous drug abuse who had a right-sided vegetation attached to the muscular bundle of the right ventricle is presented. Transthoracic echocardiography revealed a vegetation in the right ventricular outflow tract. Transesophageal echocardiography clearly showed that the 1.8 cm vegetation was not adherent to the pulmonary valve but attached to a muscular bundle. Conclusions Our case points to an unusual location of right-sided endocarditis in intravenous drug users. It confirms that TTE remains an easy and highly sensitive first-line examination for the diagnosis of right-sided endocarditis.

  18. [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.

  19. Infective Endocarditis of the Left Main to Right Atrial Coronary Cameral Fistula

    Science.gov (United States)

    Mishra, Ramesh Chandra; Barik, Ramachandra; Patnaik, Amar Narayana

    2016-01-01

    A 7-year-old female child presented with pyrexia of unknown origin. She had received an empirical regimen of antibiotic for possible endocarditis. Evaluation included multiple imaging supports and blood culture. She had left main coronary artery to right atrium coronary cameral fistula, restricted patent ductus arteriosus, vegetation at the right atrial exit of fistula and negative blood culture. Ongoing fever more than 2 weeks, oscillating vegetation in the echo and histopathological evidence of healing vegetation suggested definite diagnosis of infective endocarditis. She was treated successfully by surgical closure of fistula from the right atrial approach. Device closure in this case would have resulted in a large residual cul-de-sac with or without tiny residual high-velocity jets, either being a threat for future enlargement, rupture of the residual aneurysmal sac, thromboembolism, prolonged anticoagulation, and infective endocarditis. PMID:28465978

  20. Iris abscess as an unusual presentation of endogenous endophthalmitis in a patient with bacterial endocarditis.

    Science.gov (United States)

    Ramonas, Krista M; Freilich, Benjamin D

    2003-02-01

    To report the clinical findings and management of a case of endogenous endophthalmitis in a patient with bacterial endocarditis presenting with a septic metastasis to the iris. Observational case report. Review of clinical findings and treatment. A 37-year-old intravenous drug user hospitalized with bacterial endocarditis secondary to methicillin-sensitive Staphylococcus aureus bacteremia presented with a painful red left eye, hypopyon, and iris abscess. Roth spots were noted in the fundus of the right eye. Aqueous culture was positive for methicillin-sensitive S aureus. The patient was treated with intravitreal, topical, and intravenous antibiotics. The hypopyon and iris abscess resolved within 2 weeks, and the patient achieved a final visual acuity of 20/25 in the left eye. Septic metastasis to the iris is a rare occurrence. To our knowledge this is the first reported case of an iris abscess secondary to bacterial endocarditis.

  1. Effectiveness of Thrombolytic Therapy in Acute Embolic Stroke due to Infective Endocarditis

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    Siva P. Sontineni

    2010-01-01

    Full Text Available Objective. To identify the role of thrombolytic therapy in acute embolic stroke due to infective endocarditis. Design. Case report. Setting. University hospital. Patient. A 70-year-old male presented with acute onset aphasia and hemiparesis due to infective endocarditis. His head computerized tomographic scan revealed left parietal sulcal effacement. He was given intravenous tissue plasminogen activator with significant resolution of the neurologic deficits without complications. Main Outcome Measures. Physical examination, National Institute of Health Stroke Scale, radiologic examination results. Conclusions. Thrombolytic therapy in selected cases of stroke due to infective endocarditis manifesting as major neurologic deficits can be considered as an option after careful consideration of risks and benefits. The basis for such favorable response rests in the presence of fibrin as a major constituent of the vegetation. The risk of precipitating hemorrhage with thrombolytic therapy especially with large infarcts and mycotic aneurysms should be weighed against the benefits of averting a major neurologic deficit.

  2. Infective endocarditis caused by Neisseria elongata on a native tricuspid valve and confirmed by DNA sequencing.

    Science.gov (United States)

    Yoo, Yeon Pyo; Kang, Ki-Woon; Yoon, Hyeon Soo; Yoo, Seungmin; Lee, Myung-Shin

    2014-04-01

    Neisseria elongata, a common oral bacterium, has been recognized as a cause of infections such as infective endocarditis, septicemia, and osteomyelitis. Neisseria-induced infective endocarditis, although infrequently reported, typically arises after dental procedures. Without antibiotic therapy, its complications can be severe. We report the case of a 27-year-old man who presented with fever, severe dyspnea, and a leg abscess from cellulitis. An echocardiogram showed a vegetation-like echogenic structure on the septal leaflet of the patient's native tricuspid valve, and an insignificant Gerbode defect. Three blood cultures grew gram-negative, antibiotic-susceptible coccobacilli that were confirmed to be N. elongata. Subsequent DNA sequencing conclusively isolated N. elongata subsp nitroreducens as the organism responsible for the infective endocarditis. The patient recovered after 21 days of antibiotic therapy. In addition to the patient's unusual case, we discuss the nature and isolation of N. elongata and its subspecies.

  3. Lupus-Negative Libman-Sacks Endocarditis Complicated by Catastrophic Antiphospholipid Syndrome.

    Science.gov (United States)

    Murtaza, Ghulam; Iskandar, Joy; Humphrey, Tara; Adhikari, Sujeen; Kuruvilla, Aneesh

    2017-04-01

    Libman-Sacks endocarditis is characterized by sterile and verrucous lesions that predominantly affect the aortic and mitral valves. In most cases, patients do not have significant valvular dysfunction. However, patients with significant valvular dysfunction may present with serious complications such as cardiac failure, arrhythmias, and thromboembolic events. Recently, association of Libman-Sacks endocarditis with antiphospholipid antibody syndrome (APS) has been made. APS is most commonly defined by venous and arterial thrombosis, recurrent pregnancy loss, and thrombocytopenia. While the syndrome can be a primary syndrome, it is usually secondary to systemic lupus erythematosus. Catastrophic antiphospholipid syndrome (CAPS) can be a life-threatening presentation of APS and can occur in 1% of patients with antiphospholipid syndrome. We present a very rare case of a young female patient with lupus-negative Libman-Sacks endocarditis complicated by CAPS.

  4. New Onset Murmur and Hemodynamic Deterioration in a Patient with Infective Endocarditis

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    Zekeriya Arslan

    2014-03-01

    Full Text Available Despite the use of new wide spectrum antibiotics, infective endocarditis may lead to a paravalvular abscess or an aorta-cavitary fistula formation. Although the latest developments in surgical techniques give some advantages to perform an appropriate surgery in more complex operations in patients with complicated infective endocarditis, the mortality rates are still high. We hereby report a case of infective endocarditis caused a fatal complication that was aorta-cavitary fistula caused hemodynamic deterioration. The case underwent a successful surgical procedure in which fistula was repaired using a pericardial patch and mechanic valve prosthesis was implanted in aortic position. The case was discharged without any complication after finishing the antibiotic regime on the postoperative 28th day. We would like to discuss the treatment strategy of this case and current literature related management options will be presented.

  5. Whole-genome sequencing of bloodstream Staphylococcus aureus isolates does not distinguish bacteraemia from endocarditis

    DEFF Research Database (Denmark)

    Lilje, Berit; Rasmussen, Rasmus Vedby; Dahl, Anders

    2017-01-01

    Most Staphylococcus aureus isolates can cause invasive disease given the right circumstances, but it is unknown if some isolates are more likely to cause severe infections than others. S. aureus bloodstream isolates from 120 patients with definite infective endocarditis and 121 with S. aureus...... bacteraemia without infective endocarditis underwent whole-genome sequencing. Genome-wide association analysis was performed using a variety of bioinformatics approaches including SNP analysis, accessory genome analysis and k-mer based analysis. Core and accessory genome analyses found no association...... with either of the two clinical groups. In this study, the genome sequences of S. aureus bloodstream isolates did not discriminate between bacteraemia and infective endocarditis. Based on our study and the current literature, it is not convincing that a specific S. aureus genotype is clearly associated...

  6. 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≥30years 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=43.2years). Over a median follow-up of 15.9years, 13,181 individuals...

  7. 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...... 10 cases of endocarditis due to S. suis and E. rhusiopathiae were disclosed. Within lesions, streptococci predominated (53%) followed by E. rhusiopathiae (30%). Distinct features of both the lesions and the shape and localization of bacterial colonies were related to streptococci and E. rhusiopathiae....... 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...

  8. Prolonged fever and involuntary weight loss as manifestations of bacterial endocarditis: A case report

    Science.gov (United States)

    Sukmawati, N. M. D. D.; Merati, T. P.; Somia, A.; Utama, S.; Gayatri, Y.

    2018-03-01

    We reported an unusual presentation of prolonged fever and involuntary weight loss in older adult as a manifestation of infective bacterial endocarditis. The patient had pre-existing compensated asymptomatic valvular heart disease without treatment. A positive fecal occult blood test is prompting an investigation of malignancy of gastrointestinal as one of other possible cause of prolonged fever with wasting, evaluation of HIV serostatus shows seronegative. The case fulfilled criteria for definitive infective endocarditis: one major criterion of positive blood culture for Streptococcus mitis, which was one of viridans group streptococci and three minor criteria of fever at least 38°Celsius, immunologic phenomena in the form of glomerulonephritis, and a predisposing heart condition. One course of third-generation cephalosporin successfully cleared the Streptococcus mitis infection proven by culture. Infective endocarditis should be considered as one of the causes of prolonged fever with wasting, especially in cases with the previous history of heart disease.

  9. 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...

  10. Capnocytophaga canimorsus: a rare case of conservatively treated prosthetic valve endocarditis.

    Science.gov (United States)

    Jalava-Karvinen, Päivi; Grönroos, Juha O; Tuunanen, Helena; Kemppainen, Jukka; Oksi, Jarmo; Hohenthal, Ulla

    2018-05-01

    We describe a rare case of prosthetic valve endocarditis caused by the canine bacterium Capnocytophaga canimorsus in a male aged 73 years. The diagnosis of infective endocarditis was unequivocal, as it blood cultures were positive for C. canimorsus and vegetations were detected on transesophageal echocardiography; the modified Duke criteria were fulfilled. PET-CT showed intense 18 F-FDG uptake of the prosthetic valve area. The patient was treated with antibiotics alone (no surgery), and is now on life-long suppressive antibiotic therapy. To our knowledge, this is the third reported case of prosthetic valve endocarditis caused by C. canimorsus and the first one to have been treated conservatively. © 2018 APMIS. Published by John Wiley & Sons Ltd.

  11. Candida infective endocarditis: an observational cohort study with a focus on therapy.

    Science.gov (United States)

    Arnold, Christopher J; Johnson, Melissa; Bayer, Arnold S; Bradley, Suzanne; Giannitsioti, Efthymia; Miró, José M; Tornos, Pilar; Tattevin, Pierre; Strahilevitz, Jacob; Spelman, Denis; Athan, Eugene; Nacinovich, Francisco; Fortes, Claudio Q; Lamas, Cristiane; Barsic, Bruno; Fernández-Hidalgo, Nuria; Muñoz, Patricia; Chu, Vivian H

    2015-04-01

    Candida infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for Candida infective endocarditis. This prospective cohort study was based on 70 cases of Candida infective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, Candida infective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  12. Asymptomatic and symptomatic embolic events in infective endocarditis: associated factors and clinical impact.

    Science.gov (United States)

    Monteiro, Thaíssa S; Correia, Marcelo G; Golebiovski, Wilma F; Barbosa, Giovanna Ianini F; Weksler, Clara; Lamas, Cristiane C

    Embolic complications of infective endocarditis are common. The impact of asymptomatic embolism is uncertain. To determine the frequency of emboli due to IE and to identify events associated with embolism. Retrospective analysis of an endocarditis database, prospectively implemented, with a post hoc study driven by analysis of data on embolic events. Data was obtained from the International Collaboration Endocarditis case report forms and additional information on embolic events and imaging reports were obtained from the medical records. Variables associated with embolism were analyzed by the statistical software R version 3.1.0. In the study period, 2006-2011, 136 episodes of definite infective endocarditis were included. The most common complication was heart failure (55.1%), followed by embolism (50%). Among the 100 medical records analyzed for emboli in left-sided infective endocarditis, 36 (36%) were found to have had asymptomatic events, 11 (11%) to the central nervous system and 28 (28%) to the spleen. Cardiac surgery was performed in 98/136 (72%). In the multivariate analysis, splenomegaly was the only associated factor for embolism to any site (pinfective endocarditis of the mitral valve (p<0.05, OR 3.5, 95% CI 1.23-10) and male gender (p<0.05, OR 3.2, 95% CI 1.04-10). Splenectomy and cardiac surgery did not impact on in-hospital mortality. Asymptomatic embolism to the central nervous system and to the spleen were frequent. Splenomegaly was consistently associated with embolic events. Copyright © 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

  13. Candida Infective Endocarditis: an Observational Cohort Study with a Focus on Therapy

    Science.gov (United States)

    Johnson, Melissa; Bayer, Arnold S.; Bradley, Suzanne; Giannitsioti, Efthymia; Miró, José M.; Tornos, Pilar; Tattevin, Pierre; Strahilevitz, Jacob; Spelman, Denis; Athan, Eugene; Nacinovich, Francisco; Fortes, Claudio Q.; Lamas, Cristiane; Barsic, Bruno; Fernández-Hidalgo, Nuria; Muñoz, Patricia; Chu, Vivian H.

    2015-01-01

    Candida infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens for Candida infective endocarditis. This prospective cohort study was based on 70 cases of Candida infective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion, Candida infective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis. PMID:25645855

  14. Association Between Valvular Surgery and Mortality Among Patients With Infective Endocarditis Complicated by Heart Failure

    Science.gov (United States)

    Kiefer, Todd; Park, Lawrence; Tribouilloy, Christophe; Cortes, Claudia; Casillo, Roberta; Chu, Vivian; Delahaye, Francois; Durante-Mangoni, Emanuele; Edathodu, Jameela; Falces, Carlos; Logar, Mateja; Miró, José M.; Naber, Christophe; Tripodi, Marie Françoise; Murdoch, David R.; Moreillon, Philippe; Utili, Riccardo; Wang, Andrew

    2016-01-01

    Context Heart failure (HF) is the most common complication of infective endocarditis. However, clinical characteristics of HF in patients with infective endocarditis, use of surgical therapy, and their associations with patient outcome are not well described. Objectives To determine the clinical, echocardiographic, and microbiological variables associated with HF in patients with definite infective endocarditis and to examine variables independently associated with in-hospital and 1-year mortality for patients with infective endocarditis and HF, including the use and association of surgery with outcome. Design, Setting, and Patients The International Collaboration on Endocarditis–Prospective Cohort Study, a prospective, multicenter study enrolling 4166 patients with definite native- or prosthetic-valve infective endocarditis from 61 centers in 28 countries between June 2000 and December 2006. Main Outcome Measures In-hospital and 1-year mortality. Results Of 4075 patients with infective endocarditis and known HF status enrolled, 1359 (33.4% [95% CI, 31.9%–34.8%]) had HF, and 906 (66.7% [95% CI, 64.2%–69.2%]) were classified as having New York Heart Association class III or IV symptom status. Within the subset with HF, 839 (61.7% [95% CI, 59.2%–64.3%]) underwent valvular surgery during the index hospitalization. In-hospital mortality was 29.7% (95% CI, 27.2%–32.1%) for the entire HF cohort, with lower mortality observed in patients undergoing valvular surgery compared with medical therapy alone (20.6% [95% CI, 17.9%–23.4%] vs 44.8% [95% CI, 40.4%–49.0%], respectively; Pendocarditis complicated by HF, severity of HF was strongly associated with surgical therapy and subsequent mortality, whereas valvular surgery was associated with lower in-hospital and 1-year mortality. PMID:22110106

  15. Fungal endocarditis in paediatrics: a review of 192 cases (1971-2016).

    Science.gov (United States)

    Ganesan, Vithiya; Ponnusamy, Shunmuga Sundaram; Sundaramurthy, Raja

    2017-10-01

    The aims of this article were to review the published literature on fungal endocarditis in children and to discuss the aetiology and diagnosis, with emphasis on non-invasive methods and various treatment regimes. We systematically reviewed published cases and case series of fungal endocarditis in children. We searched the literature, including PubMed and individual references for publications of original articles, single cases, or case series of paediatric fungal endocarditis, with the following keywords: "fungal endocarditis", "neonates", "infants", "child", and "cardiac vegetation". There have been 192 documented cases of fungal endocarditis in paediatrics. The highest number of cases was reported in infants (93/192, 48%) including 60 in neonates. Of the neonatal cases, 57 were premature with a median gestational age of 27 weeks and median birth weight of 860 g. Overall, 120 yeast - fungus that grows as a single cell - infections and 43 mould - fungus that grows in multicellular filaments, hyphae - infections were reported. With increasing age, there was an increased infection rate with moulds. All the yeast infections were detected by blood culture. In cases with mould infection, diagnosis was mainly established by culture or histology of emboli or infected valves after invasive surgical procedures. There have been a few recent cases of successful early diagnosis by non-invasive methods such as blood polymerase chain reaction (PCR) for moulds. The overall mortality for paediatric fungal endocarditis was 56.25%. The most important cause of death was cardiac complications due to heart failure. Among the various treatment regimens used, none of them was significantly associated with better outcome. Non-invasive methods such as PCR tests can be used to improve the chances of detecting and identifying the aetiological agent in a timely manner. Delays in the diagnosis of these infections may result in high mortality and morbidity. No significant difference was noted

  16. Péptidos antimicrobianos en la inmunidad innata de enfermedades infecciosas Antimicrobial peptides in the innate immunity of infectious diseases

    Directory of Open Access Journals (Sweden)

    Bruno Rivas-Santiago

    2006-02-01

    Full Text Available Los péptidos antimicrobianos son moléculas efectoras clave en la inmunidad innata. Generalmente contienen de 15 a 45 residuos de aminoácidos y en su gran mayoría poseen carga positiva, además de que tienen la propiedad de ser anfipáticos. Estos péptidos son secretados por células epiteliales y leucocitos, como es el caso de los macrófagos y neutrófilos. En la actualidad, con base en la traducción de secuencias en programas computacionales se han descrito más de 800 tipos de péptidos antimicrobianos distribuidos en los reinos animal y vegetal. Estos péptidos pueden ser clasificados de acuerdo con su conformación estructural y la ubicación de sus puentes disulfuro. Las defensinas constituyen uno de los tipos de péptidos antimicrobianos más estudiados, y se dividen en dos familias de acuerdo con la ubicación de sus puentes disulfuro: alfa-defensinas y beta-defensinas. Algunas de estas defensinas pueden ser inducidas por citocinas proinflamatorias, así como por moléculas propias de patógenos, y se ha observado que están relacionadas con la inmunopatogenia de varias enfermedades. El papel principal de los péptidos antimicrobianos es la lisis directa de microorganismos; sin embargo, a la fecha también se han descrito propiedades quimiotácticas, que le permiten modular el sistema inmune y de esta forma constituir un puente entre la inmunidad innata y la inmunidad adaptativa. Actualmente se han iniciado estudios con la posibilidad de utilizar esta clase de moléculas como nuevos fármacos en diferentes tipos de enfermedades infecciosas.Antimicrobial peptides are key effector molecules of the innate immune response. Generally, they are formed by 14-45 aminoacid residues; most of them have a positive charge and amphipathic properties. These peptides are secreted mainly by epithelial cells, neutrophils and macrophages. Based on sequence translation using computer programs, more than 800 types of antimicrobial peptides have been

  17. Isolated Tricuspid Valve Libman-Sacks Endocarditis in Systemic Lupus Erythematosus with Secondary Antiphospholipid Syndrome.

    Science.gov (United States)

    Unic, Daniel; Planinc, Mislav; Baric, Davor; Rudez, Igor; Blazekovic, Robert; Senjug, Petar; Sutlic, Zeljko

    2017-04-01

    Libman-Sacks endocarditis, one of the most prevalent cardiac presentations of systemic lupus erythematosus, typically affects the aortic or mitral valve; tricuspid valve involvement is highly unusual. Secondary antiphospholipid syndrome increases the frequency and severity of cardiac valvular disease in systemic lupus erythematosus. We present the case of a 47-year-old woman with lupus and antiphospholipid syndrome whose massive tricuspid regurgitation was caused by Libman-Sacks endocarditis isolated to the tricuspid valve. In addition, we discuss this rare case in the context of the relevant medical literature.

  18. A fatal endocarditis case due to an emerging bacterium: Moraxella nonliquefaciens

    Directory of Open Access Journals (Sweden)

    C. Duployez

    2017-01-01

    Full Text Available Moraxella nonliquefaciens is a Gram-negative coccobacillus considered as a commensal organism from the upper respiratory tract, with low pathogenic potential. The phenotypical conventional identification is difficult and the matrix-assisted laser desorption/ionization time-of-flight technology has increased the resolution of identification of this bacterium. We report a fatal case of endocarditis due to M. nonliquefaciens whose identification was confirmed by 16S rRNA, and we review the literature on this pathogen in endocarditis.

  19. A Case of Loeffler's Endocarditis Associated with Churg-Strauss Syndrome

    Science.gov (United States)

    Seo, Jeong-Sook; Kim, Dae-Hee; Kang, Duk-Hyun; Song, Jae-Kwan

    2010-01-01

    Loeffler's endocarditis is generally caused by hypereosinophilic syndrome. It is a restrictive cardiomyopathy characterized with eosinophilia and eosionophilic penetration leading to the fibrous thickening of endocardium of both ventricles, apical obliteration and heart failure. We report a case of a 23-year-old male with Loeffler's endocarditis caused by Churg-Strauss syndrome. The echocardiogram showed that biventricular failure with large thrombus in left ventricle. His symptoms and typical echocardiographic findings markedly improved within 2 months after treatment for Churg-Strauss syndrome. PMID:20661332

  20. MEDICAL vs. MEDICAL AND SURGICAL TREATMENT FOR BRUCELLA ENDOCARDITIS: A REVIEW OF THE LITERATURE

    Science.gov (United States)

    Keshtkar-Jahromi, Maryam; Razavi, Seyed-Mostafa; Gholamin, Sharareh; Keshtkar-Jahromi, Marzieh; Hossain, Mian; Sajadi, Mohammad

    2012-01-01

    This review was undertaken to determine the role of surgery in the treatment of brucella endocarditis. All English and French articles reporting brucella endocarditis (1966–2011) in Pubmed, Google and Scopus were reviewed. 308 cases were identified and Linear and Logistic regression was performed. Surgery improved outcomes by decreasing mortality from 32.7% in the medical treatment only group to 6.7% in the combined surgical and medical treatment group (p<.001). This association was still significant while controlling for other contributing factors. In the absence of a controlled trial, we recommend the utmost vigilance and consideration of surgical management in treating such patients. PMID:23102495

  1. Streptococcus sanguinis brain abscess as complication of subclinical endocarditis: emphasizing the importance of prompt diagnosis.

    Science.gov (United States)

    Kassis, Hayah; Marnejon, Thomas; Gemmel, David; Cutrona, Anthony; Gottimukkula, Rajashree

    2010-06-01

    A 19-year-old male patient was diagnosed with S. sanguinis brain abscess of unknown etiopathology as a complication of subclinical endocarditis. While viridans streptococci are implicated in dental seeding to the heart, S. sanguinis brain abscesses are rare. Six previous cases of S. sanguinis brain abscess in the literature reported dental procedures and maxillofacial trauma. In our patient, there was no obvious source of infective endocarditis preceding the development of brain abscess. This demonstrates the importance of prompt diagnosis and initiation of antimicrobial therapy given the potential for long-term sequelae such as focal deficits and seizures.

  2. Delayed diagnosis of Q fever endocarditis in a rheumatoid arthritis patient

    Directory of Open Access Journals (Sweden)

    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.

  3. Catheter-related fungal endocarditis caused by Candida parapsilosis in a hemodialysis patient.

    Science.gov (United States)

    Shu, Ying; Yu, Shaobin; Zha, Ling; Fu, Ping; Cui, Tianlei

    2017-10-01

    Fungal endocarditis (FE) is commonly regarded as a rare but fatal disease. The incidence of infective endocarditis (IE) in hemodialysis (HD) patients is thought to be obviously higher than that in the general population. Moreover, IE occurs more likely in HD patients with catheters. With the increase of HD population and extensive use of catheters in HD patients, FE, as a special form of IE, may increase and bring new challenges to clinicians. We reported a case of FE associated with catheter infection in a 44-year-old woman on HD. The risk factors and treatment strategies of FE in HD patients were discussed. © 2017 International Society for Hemodialysis.

  4. Incidence and factors associated with infective endocarditis in patients undergoing left-sided heart valve replacement

    DEFF Research Database (Denmark)

    Østergaard, Lauge; Valeur, Nana; Ihlemann, Nikolaj

    2018-01-01

    Aims: Patients with left-sided heart valve replacement are considered at high-risk of infective endocarditis (IE). However, data on the incidence and risk factors associated with IE are sparse. Methods and results: Through Danish administrative registries, we identified patients who underwent left.......35-2.15), and cardiac implantable electronic device (CIED) (HR = 1.57, 95% CI 1.19-2.06) were among factors associated with an increased risk of IE. Conclusion: Infective endocarditis after left-sided heart valve replacement is not uncommon and occurs in about 1/20 over 10 years. Male, bioprosthetic valve, and heart...

  5. Staphylococcus aureus endocarditis with fast development of aortic root abscess despite relevant antibiotics

    DEFF Research Database (Denmark)

    Dahl, Anders; Hansen, Thomas Fritz; Bruun, Niels Eske

    2013-01-01

    We present a case of Staphylococcus aureus endocarditis in which a large abscess was formed in only 4 days, despite specific intravenous antibiotics and only few vague signs of disease progression. Our case seems to be the first to show echocardiographic documentation of how quickly an intracardiac...... abscess can develop despite relevant antibiotics. Clinically, the patient is remarkably unaffected, and thus even small signs of progression should lead to considerations about repeating the diagnostic imaging workup. This case illustrates how aggressive an infection S. aureus endocarditis may be...

  6. Cryptococcus neoformans infective endocarditis of native valves in an immunocompetent host

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    Moni Roy

    Full Text Available With the emergence of Human immunodeficiency virus (HIV and the resulting immunocompromised state, Cryptococcus neoformans infections have gained more importance in clinical practice. Cryptococcal infections in immunocompetent hosts continue to be uncommon. We present a rare case of Cryptococcus neoformans infective endocarditis (IE in a young immunocompetent male. As per our literature review, this is the first reported case of native valve Cryptococcus neoformans endocarditis in an immunocompetent host. All cases till date have been reported in patients with underlying immunocompromised state or prosthetic valve.

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

    International Nuclear Information System (INIS)

    Parvizi, R.; Varshouchi, M.; Alizadeh, R.

    2007-01-01

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

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

    International Nuclear Information System (INIS)

    Alam, A.; Tariq, M.

    2008-01-01

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

  9. 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....

  10. Manifestações neurológicas nas endocardites infecciosas - revisão de 103 casos estudados - 84 casos do Hospital dos Servidores do Estado-R.J. (1947-1978 e 19 casos do Hospital Estadual São Sebastião-R.J. (1975-1978

    Directory of Open Access Journals (Sweden)

    Adrelirio José Rios Gonçalves

    1980-12-01

    Full Text Available Os autores fazem uma revisão de 103 casos de endocardites infecciosas, dos quais 52 apresentaram manifestações neurológicas. Dos 52 que não tiveram problemas neurológicos, 39 faleceram 175%, enquanto que dos 51 que não tiveram alterações do sistema nervoso, apenas 18 evoluíram para o óbito 135,3%. A endocardite infecciosa com manifestações neurológicas, na presente série, foi dominante no sexo masculino. Os grupos etários mais envolvidos foram as crianças, adolescentes e adultos jovens. Houve outro pico importante em pacientes acima de 50 anos. Os critérios para o diagnóstico de endocardite infecciosa utilizados no presente estudo, foram os clássicos, acrescidos de outros considerados de extrema utilidade, à medida que a experiência foi sendo acumulada, acompanhando paralelamente as modificações dos padrões etiológicos, assim como as alterações dos espectros clínicos da doença, conseqüentes a muitos fatores aqui discutidos. Os principais distúrbios neurológicos observados foram as manifestações meningeias, 25/52 148,1%, alterações do comportamento, 20/52 (38,4%, fenômenos motores (paralisias e paresias, 20/52 (38,4%. Alterações do nível de consciência (torpor ou coma, ao lado de outras menos comuns, como cefaléia 16/52 (26,9%, convulsões, 10/52 (19,2%, afasia 7/52 (13,5% e manchas de Roth, 7/53 (13,5%. As manifestações neurológicas frequentemente foram múltiplas em um mesmo paciente. Nas formas de endocardite, foram em muitos casos praticamente as alterações que abriram e dominaram a cena clínica. As mais comuns foram: síndrome meningeia, síndrome vascular e encefalopatia tóxica. Foi difícil, em conseqüência de múltiplas manifestações neurológicas num mesmo paciente, estabelecer critérios entre a lesão neurológica e o prognóstico, embora o coma profundo, as convulsões, os distúrbios motores acentuados, a meningite e as alterações do comportamento, isoladamente ou em associa

  11. Endocarditis is not an Independent Predictor of Blood Transfusion in Aortic Valve Replacement Patients With Severe Aortic Regurgitation.

    Science.gov (United States)

    Dahn, Hannah; Buth, Karen; Legare, Jean-Francois; Mingo, Heather; Kent, Blaine; Whynot, Sara; Scheffler, Matthias

    2016-06-01

    This study sought to evaluate if the presence of endocarditis was independently associated with increased perioperative blood transfusion in patients undergoing aortic valve replacements (AVR) with aortic regurgitation. This was a retrospective study. Large Canadian tertiary care hospital. Six hundred sixty-two consecutive patients with aortic regurgitation score of 3 or higher undergoing AVR from 1995 to 2012. No interventions were performed in this retrospective study. After REB approval, data were obtained from a center-specific database. Univariate analysis was performed to identify variables that may be associated with transfusion of any allogeneic blood product perioperatively. A multivariate logistic regression was generated to identify independent predictors of perioperative transfusion. Unadjusted transfusion rates in patients with no endocarditis and with endocarditis were 32% and 70% (p70, urgent/emergent surgery, BMIEndocarditis was not an independent predictor of transfusion (OR = 0.748; 95% CI = 0.35-1.601). In patients undergoing AVR, unadjusted perioperative transfusion rates were higher when endocarditis was present. However, after adjustment, aortic valve endocarditis was not independently associated with blood transfusion. The authors' observation could be explained by the higher prevalence of many independent predictors of transfusion, such as comorbidities or more complex surgery, within the endocarditis group. Thus, AV endocarditis, in the absence of other risk factors, was not associated with increased perioperative transfusion risk. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Molecular Characterization of Endocarditis-Associated Staphylococcus aureus

    Science.gov (United States)

    Nethercott, Cara; Mabbett, Amanda N.; Totsika, Makrina; Peters, Paul; Ortiz, Juan C.; Nimmo, Graeme R.; Coombs, Geoffrey W.

    2013-01-01

    Infective endocarditis (IE) is a life-threatening infection of the heart endothelium and valves. Staphylococcus aureus is a predominant cause of severe IE and is frequently associated with infections in health care settings and device-related infections. Multilocus sequence typing (MLST), spa typing, and virulence gene microarrays are frequently used to classify S. aureus clinical isolates. This study examined the utility of these typing tools to investigate S. aureus epidemiology associated with IE. Ninety-seven S. aureus isolates were collected from patients diagnosed with (i) IE, (ii) bloodstream infection related to medical devices, (iii) bloodstream infection not related to medical devices, and (iv) skin or soft-tissue infections. The MLST clonal complex (CC) for each isolate was determined and compared to the CCs of members of the S. aureus population by eBURST analysis. The spa type of all isolates was also determined. A null model was used to determine correlations of IE with CC and spa type. DNA microarray analysis was performed, and a permutational analysis of multivariate variance (PERMANOVA) and principal coordinates analysis were conducted to identify genotypic differences between IE and non-IE strains. CC12, CC20, and spa type t160 were significantly associated with IE S. aureus. A subset of virulence-associated genes and alleles, including genes encoding staphylococcal superantigen-like proteins, fibrinogen-binding protein, and a leukocidin subunit, also significantly correlated with IE isolates. MLST, spa typing, and microarray analysis are promising tools for monitoring S. aureus epidemiology associated with IE. Further research to determine a role for the S. aureus IE-associated virulence genes identified in this study is warranted. PMID:23616460

  13. Molecular characterization of endocarditis-associated Staphylococcus aureus.

    Science.gov (United States)

    Nethercott, Cara; Mabbett, Amanda N; Totsika, Makrina; Peters, Paul; Ortiz, Juan C; Nimmo, Graeme R; Coombs, Geoffrey W; Walker, Mark J; Schembri, Mark A

    2013-07-01

    Infective endocarditis (IE) is a life-threatening infection of the heart endothelium and valves. Staphylococcus aureus is a predominant cause of severe IE and is frequently associated with infections in health care settings and device-related infections. Multilocus sequence typing (MLST), spa typing, and virulence gene microarrays are frequently used to classify S. aureus clinical isolates. This study examined the utility of these typing tools to investigate S. aureus epidemiology associated with IE. Ninety-seven S. aureus isolates were collected from patients diagnosed with (i) IE, (ii) bloodstream infection related to medical devices, (iii) bloodstream infection not related to medical devices, and (iv) skin or soft-tissue infections. The MLST clonal complex (CC) for each isolate was determined and compared to the CCs of members of the S. aureus population by eBURST analysis. The spa type of all isolates was also determined. A null model was used to determine correlations of IE with CC and spa type. DNA microarray analysis was performed, and a permutational analysis of multivariate variance (PERMANOVA) and principal coordinates analysis were conducted to identify genotypic differences between IE and non-IE strains. CC12, CC20, and spa type t160 were significantly associated with IE S. aureus. A subset of virulence-associated genes and alleles, including genes encoding staphylococcal superantigen-like proteins, fibrinogen-binding protein, and a leukocidin subunit, also significantly correlated with IE isolates. MLST, spa typing, and microarray analysis are promising tools for monitoring S. aureus epidemiology associated with IE. Further research to determine a role for the S. aureus IE-associated virulence genes identified in this study is warranted.

  14. Evaluation of empirical treatment for blood culture-negative endocarditis.

    Science.gov (United States)

    Menu, Estelle; Gouriet, Frédérique; Casalta, Jean-Paul; Tissot-Dupont, Hervé; Vecten, Maude; Saby, Ludivine; Hubert, Sandrine; Salaun, Erwan; Theron, Alexis; Grisoli, Dominique; Lavoute, Cécile; Collart, Frédéric; Habib, Gilbert; Raoult, Didier

    2017-01-01

    Much progress has been made in understanding the main causes of blood culture-negative endocarditis (BCNE). Few studies concerning BCNE treatment (due to previous antibiotics used or fastidious pathogens) are available. We performed this study to evaluate the effectiveness of our therapeutic protocol in BCNE, based on compliance with the protocol, outcome and 1 year mortality. We collected prospectively and analysed retrospectively cases of BCNE between 2002 and 2014, using a simplified and standardized protocol developed by our multidisciplinary team. We apply two kinds of protocols to treat BCNE, which include only four intravenous antimicrobial agents: amoxicillin, vancomycin, gentamicin and amphotericin B. We had 177 patients with definite BCNE. There were 154 (87.0%) patients treated with both appropriate antimicrobial agents and appropriate duration of treatment. We analysed the causes of inappropriate treatment in 13 (7.3%) cases and inappropriate duration in 10 (5.6%) cases. The treatment changes were justified in all cases except one of discharge against medical advice. The fatality rate was 5.1% (nine cases) and all deaths occurred in the group of patients who were treated with appropriate treatment; however, four deaths were not attributable to empirical treatment failure. Concerning the other deaths, the lack of surgical management, in association with empirical treatment, could explain our protocol's failure, such as poorly tolerated surgery. Our protocol is efficient and our mortality rate was low, compared with the literature review. This may result from a strategy that uses a sampling procedure and a standardized protocol at the same time. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  15. 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.

  16. Infective Endocarditis Epidemiology Over Five Decades: A Systematic Review

    Science.gov (United States)

    Slipczuk, Leandro; Codolosa, J. Nicolas; Davila, Carlos D.; Romero-Corral, Abel; Yun, Jeong; Pressman, Gregg S.; Figueredo, Vincent M.

    2013-01-01

    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. PMID:24349331

  17. Infective endocarditis epidemiology over five decades: a systematic review.

    Directory of Open Access Journals (Sweden)

    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.

  18. Incidence of infective endocarditis in England, 2000-13: a secular trend, interrupted time-series analysis.

    Science.gov (United States)

    Dayer, Mark J; Jones, Simon; Prendergast, Bernard; Baddour, Larry M; Lockhart, Peter B; Thornhill, Martin H

    2015-03-28

    Antibiotic prophylaxis given before invasive dental procedures in patients at risk of developing infective endocarditis has historically been the focus of infective endocarditis prevention. Recent changes in antibiotic prophylaxis guidelines in the USA and Europe have substantially reduced the number of patients for whom antibiotic prophylaxis is recommended. In the UK, guidelines from the National Institute for Health and Clinical Excellence (NICE) recommended complete cessation of antibiotic prophylaxis for prevention of infective endocarditis in March, 2008. We aimed to investigate changes in the prescribing of antibiotic prophylaxis and the incidence of infective endocarditis since the introduction of these guidelines. We did a retrospective secular trend study, analysed as an interrupted time series, to investigate the effect of antibiotic prophylaxis versus no prophylaxis on the incidence of infective endocarditis in England. We analysed data for the prescription of antibiotic prophylaxis from Jan 1, 2004, to March 31, 2013, and hospital discharge episode statistics for patients with a primary diagnosis of infective endocarditis from Jan 1, 2000, to March 31, 2013. We compared the incidence of infective endocarditis before and after the introduction of the NICE guidelines using segmented regression analysis of the interrupted time series. Prescriptions of antibiotic prophylaxis for the prevention of infective endocarditis fell substantially after introduction of the NICE guidance (mean 10,900 prescriptions per month [Jan 1, 2004, to March 31, 2008] vs 2236 prescriptions per month [April 1, 2008, to March 31, 2013], pinfective endocarditis increased significantly above the projected historical trend, by 0·11 cases per 10 million people per month (95% CI 0·05-0·16, pinfective endocarditis was significant for both individuals at high risk of infective endocarditis and those at lower risk. Although our data do not establish a causal association, prescriptions

  19. Acreditação e credenciamento de laboratórios de ensaio para diagnósticos de anemia infecciosa equina

    OpenAIRE

    Bordin, Ricardo

    2015-01-01

    Este trabalho apresenta uma contribuição ao processo de acreditação e credenciamento aos laboratórios de ensaio no escopo da Anemia Infecciosa Equina (AIE). Consiste em uma proposta de priorização de requisitos para a acreditação, credenciamento e biossegurança de laboratórios de ensaio, desenvolvida por sete etapas metodológicas: 1) descrição dos elementos que caracterizam um laboratório de AIE e utilização da experiência do laboratório de estudo como facilitador do processo de acreditação; ...

  20. 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.

  1. 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

  2. [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.

  3. Fibrinogen and fibronectin binding cooperate for valve infection and invasion in Staphylococcus aureus experimental endocarditis

    NARCIS (Netherlands)

    Que, Yok-Ai; Haefliger, Jacques-Antoine; Piroth, Lionel; François, Patrice; Widmer, Eleonora; Entenza, José M; Sinha, Bhanu; Herrmann, Mathias; Francioli, Patrick; Vaudaux, Pierre; Moreillon, Philippe

    2005-01-01

    The expression of Staphylococcus aureus adhesins in Lactococcus lactis identified clumping factor A (ClfA) and fibronectin-binding protein A (FnBPA) as critical for valve colonization in rats with experimental endocarditis. This study further analyzed their role in disease evolution. Infected

  4. Nonbacterial thrombotic endocarditis in a Japanese autopsy sample. A review of eighty cases

    Energy Technology Data Exchange (ETDEWEB)

    Chino, F; Kodama, A; Otake, M; Dock, D S

    1974-01-01

    A study of nonbacterial thrombotic endocarditis was carried out in a series of 3404 autopsies performed upon A-bomb survivors in Hiroshima in the period 1953--70. The prevalence of the lesion was 2.4%, with a greater frequency among the elderly and among females, and with a significant relationship to malignant neoplasms. There was a great prevalence among cancers of the colon and rectum and female genitourinary tract. No relationship was noted between nonbacterial thrombotic endocarditis and radiation exposure. Histologic findings in the heart valve leaflets in close proximity to the verrucae suggest that in association with severe systemic disease, there appears a process consisting of degenerative changes in valve collagen and ground substance, with subsequent denudation of endothelium, localized almost entirely to the apposing leaflet surfaces of the left-heart valves. The verrucae of nonbacterial thrombotic endocarditis are then formed upon this abnormal leaflet surface. There is no doubt that this lesion represents a clinically important complication of severe systemic disease. It also seems likely that in some cases nonbacterial thrombotic endocarditis may complicate an illness which may otherwise be curable. Increasing awareness of this pathologic entity, coupled with echocardiographic techniques, will permit more frequent diagnosis in living

  5. Peripheral ischaemic retinopathy and neovascularisation in a patient with subacute streptococcus mitis-induced bacterial endocarditis.

    Science.gov (United States)

    Leysen, Laura S; Kreps, Elke O; De Schryver, Ilse; Hoornaert, Kristien P; Smith, Vanessa; De Zaeytijd, Julie

    2017-01-01

    Objective: To describe a patient with peripheral retinal ischaemia and neovascularisation who was diagnosed with streptococcus mitis-induced bacterial endocarditis. Methods: Retrospective analysis of case report. A 57-year-old man presented with a history of a rapidly progressive, bilateral, painless visual loss. He also suffered from pain in the neck and lower back and a weight loss of 10 kg. He underwent a full ophthalmologic work-up, laboratory investigations, and imaging of the spine. Results: BCVA was reduced to 20/40 in the right eye and 20/32 in the left eye. Fundoscopy showed rare intra-retinal haemorrhages including few Roth spots and cotton wool lesions. Fluorescein angiography demonstrated large areas of peripheral retinal ischaemia and neovascularisation. Imaging of the spine showed spondylodiscitis on several levels. Further imaging and blood cultures confirmed bacterial endocarditis of the mitral valve. Streptococcus mitis was subsequently identified as the causative organism. Conclusion: Peripheral retinal ischaemia and neovascularisation were previously unrecognised as a feature of infectious endocarditis. Therefore, their presence, apart from the classic Roth spots, should prompt the consideration of infectious endocarditis in the etiologic work-up.

  6. Peripheral ischaemic retinopathy and neovascularisation in a patient with subacute streptococcus mitis-induced bacterial endocarditis

    Directory of Open Access Journals (Sweden)

    Leysen, Laura S.

    2017-09-01

    Full Text Available Objective: To describe a patient with peripheral retinal ischaemia and neovascularisation who was diagnosed with streptococcus mitis-induced bacterial endocarditis. Methods: Retrospective analysis of case report. A 57-year-old man presented with a history of a rapidly progressive, bilateral, painless visual loss. He also suffered from pain in the neck and lower back and a weight loss of 10 kg. He underwent a full ophthalmologic work-up, laboratory investigations, and imaging of the spine.Results: BCVA was reduced to 20/40 in the right eye and 20/32 in the left eye. Fundoscopy showed rare intra-retinal haemorrhages including few Roth spots and cotton wool lesions. Fluorescein angiography demonstrated large areas of peripheral retinal ischaemia and neovascularisation. Imaging of the spine showed spondylodiscitis on several levels. Further imaging and blood cultures confirmed bacterial endocarditis of the mitral valve. Streptococcus mitis was subsequently identified as the causative organism. Conclusion: Peripheral retinal ischaemia and neovascularisation were previously unrecognised as a feature of infectious endocarditis. Therefore, their presence, apart from the classic Roth spots, should prompt the consideration of infectious endocarditis in the etiologic work-up.

  7. Synchrotron radiation infrared microspectroscopy to assess the activity of vancomycin against endocarditis vegetation bacteria.

    Science.gov (United States)

    Batard, Eric; Jamme, Frédéric; Montassier, Emmanuel; Bertrand, Dominique; Caillon, Jocelyne; Potel, Gilles; Dumas, Paul

    2011-06-01

    Infrared microspectroscopy was used to show that vancomycin alters infrared spectra of endocarditis vegetation bacteria, and that vancomycin effects on bacterial biochemical contents are unevenly distributed between peripheral and central areas of bacterial masses. Infrared microspectroscopy is useful to study the activity of antibacterial agents against bacteria in tissues. Copyright © 2011 Elsevier B.V. All rights reserved.

  8. [Clinical demonstrations: Heart rupture in acute myocardial infarct. Infectious endocarditis. Wolff-Parkinson-White syndrome].

    Science.gov (United States)

    Nager, F

    1984-12-08

    This clinical demonstration includes three topics of clinical cardiology: myocardial rupture in acute myocardial infarction, infective endocarditis, and WPW-syndrome with paroxysmal supraventricular tachycardia. In the first part three cases with septal perforation or papillary muscle rupture are demonstrated. Our experience with myocardial rupture (free wall, septum, papillary muscle) during the last six years is summarized with special reference to the significance and the differential diagnosis of systolic regurgitant murmurs after myocardial infarction. Special features of acute mitral incompetence (papillary muscle dysfunction) in myocardial infarction are outlined and diagnostic guidelines for differentiation between septal perforation and papillary muscle rupture are discussed. In the second part two patients with aortic (e.g. mitral) valve rupture in the course of infective endocarditis are presented. The synoptic comparison of these two patients is related to the results of our own clinical studies on the changing pattern of infective endocarditis (epidemiologically, clinically) during the last three decades. The clinical picture of acute aortic valve rupture is outlined and the bedside signs indicating catastrophic complications of infective endocarditis are summarized. In the third part the odyssey of a patient with WPW-syndrome and consecutive paroxysmal supraventricular tachycardia is described. Progress in electrophysiological analysis of the re-entry circles in preexcitation syndromes is outlined.

  9. 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...

  10. Libman–Sacks endocarditis, and other echocardiographic findings in systemic lupus erythematosus: Case report

    Directory of Open Access Journals (Sweden)

    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.

  11. Libman–Sacks endocarditis, and other echocardiographic findings in systemic lupus erythematosus: Case report

    OpenAIRE

    Hamza, Mohamed Atef; Allam, Lamyaa

    2012-01-01

    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).

  12. Impact of bicuspid aortic valve on complications and death in infective endocarditis of native aortic valves.

    Science.gov (United States)

    Kahveci, Gokhan; Bayrak, Fatih; Pala, Selcuk; Mutlu, Bulent

    2009-01-01

    We retrospectively investigated the impact of bicuspid aortic valve on the prognosis of patients who had definite infective endocarditis of the native aortic valve.Of 51 patients, a bicuspid aortic valve was present in 22 (43%); the other 29 had tricuspid aortic valves. On average, the patients who had bicuspid valves were younger than those who had tricuspid valves. Patients with a tricuspid valve had larger left atrial diameters and were more likely to have severe mitral regurgitation.Periannular complications, which we detected in 19 patients (37%), were much more common in the patients who had a bicuspid valve (64% vs 17%, P = 0.001). The presence of a bicuspid valve was the only significant independent predictor of periannular complications. The in-hospital mortality rate in the bicuspid group was lower than that in the tricuspid group; however, this figure did not reach statistical significance (9% vs 24%, P = 0.15). In multivariate analysis, left atrial diameter was the only independent predictor associated with an increased risk of death (hazard ratio, 2.19; 95% confidence interval, 1.1-4.5; P = 0.031).In our study, patients with infective endocarditis in a bicuspid aortic valve were younger and had a higher incidence of periannular complications. Although a worse prognosis has been reported previously, we found that infective endocarditis in a native bicuspid aortic valve is not likely to increase the risk of death in comparison with infective endocarditis in native tricuspid aortic valves.

  13. 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

  14. The additional value of three-dimensional transesophageal echocardiography in complex aortic prosthetic heart valve endocarditis

    NARCIS (Netherlands)

    Tanis, Wilco; Teske, Arco J.; Van Herwerden, Lex A.; Chamuleau, Steven; Meijboom, Folkert; Budde, Ricardo P J; Cramer, MJ

    2015-01-01

    Background Two-dimensional transthoracic and transesophageal echocardiography (2DTTE and 2DTEE) may fail to detect signs of prosthetic heart valve (PHV) endocarditis due to acoustic shadowing. Three-dimensional (3D) TEE may have additional value; however, data are scarce. This study was performed to

  15. Rapid Diagnosis of Histoplasma capsulatum Endocarditis Using the AccuProbe on an Excised Valve

    Science.gov (United States)

    Chemaly, Roy F.; Tomford, J. Walton; Hall, Gerri S.; Sholtis, Mary; Chua, Jimmy D.; Procop, Gary W.

    2001-01-01

    Histoplasma capsulatum is an infrequent but serious cause of endocarditis. The definitive diagnosis requires culture, which may require a long incubation. We demonstrated the ability of the Histoplasma capsulatum AccuProbe to accurately identify this organism when applied directly on an excised valve that contained abundant yeast forms consistent with H. capsulatum. PMID:11427583

  16. Comprehensive evaluation of Streptococcus sanguinis cell wall-anchored proteins in early infective endocarditis.

    Science.gov (United States)

    Turner, Lauren Senty; Kanamoto, Taisei; Unoki, Takeshi; Munro, Cindy L; Wu, Hui; Kitten, Todd

    2009-11-01

    Streptococcus sanguinis is a member of the viridans group of streptococci and a leading cause of the life-threatening endovascular disease infective endocarditis. Initial contact with the cardiac infection site is likely mediated by S. sanguinis surface proteins. In an attempt to identify the proteins required for this crucial step in pathogenesis, we searched for surface-exposed, cell wall-anchored proteins encoded by S. sanguinis and then used a targeted signature-tagged mutagenesis (STM) approach to evaluate their contributions to virulence. Thirty-three predicted cell wall-anchored proteins were identified-a number much larger than those found in related species. The requirement of each cell wall-anchored protein for infective endocarditis was assessed in the rabbit model. It was found that no single cell wall-anchored protein was essential for the development of early infective endocarditis. STM screening was also employed for the evaluation of three predicted sortase transpeptidase enzymes, which mediate the cell surface presentation of cell wall-anchored proteins. The sortase A mutant exhibited a modest (approximately 2-fold) reduction in competitiveness, while the other two sortase mutants were indistinguishable from the parental strain. The combined results suggest that while cell wall-anchored proteins may play a role in S. sanguinis infective endocarditis, strategies designed to interfere with individual cell wall-anchored proteins or sortases would not be effective for disease prevention.

  17. Effects of changes in management of active infective endocarditis on outcome in a 25-year period

    NARCIS (Netherlands)

    Verheul, H. A.; van den Brink, R. B.; van Vreeland, T.; Moulijn, A. C.; Düren, D. R.; Dunning, A. J.

    1993-01-01

    The clinical outcome and long-term follow-up of 130 consecutive patients (141 episodes) with active infective endocarditis who were treated between 1966 and 1991 were analyzed. There was a shift toward a higher proportion of referred patients (39 to 78%), patients aged > 60 years (11 to 41%) and

  18. 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

  19. Presence of a biomaterial implant facilitates induction of experimental infective endocarditis due to streptococci and staphylococci

    NARCIS (Netherlands)

    Zaat, S. A. J.; Dankert, J.; VanderWerff, J.; Brokke, P.; Feijen, J.

    1995-01-01

    Infective endocarditis (IE) usually is studied using animals with catheters inserted into the heart, which causes formation of platelet-fibrin thrombi (vegetations, VGs). We used two rabbit models to study the respective roles of the catheter and the VGs in the development of IE. The influence of

  20. 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.