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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

I report that a 75-year-old man with severe atherosclerosis experienced two episodes of bacteremia with Streptococcus pyogenes of type emm87. Recurrent sepsis with S. pyogenes is extremely rare, and a foot ulcer was the suspected point of entry. The patient did not develop opsonizing antibodies to the isolate.
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PMID:Recurrent sepsis caused by Streptococcus pyogenes. 2134 45

Accumulated evidence has strongly suggested that the long-term effects of periodontal diseases can be linked to more serious systemic conditions such as cardiovascular diseases, diabetes, and complications of pregnancy. Especially, a prevalence of coronary heart disease was found to be significantly increased in patients with periodontitis after adjusting for risk factors such as smoking, diabetes, alcohol intake, obesity, and blood pressure. Furthermore, various studies have shown that Porphyromonas gingivalis, a major periodontal pathogen, is able to exacerbate atherosclerosis following oral-hematogenous spread due to the bacteremia. By P. gingivalis, endothelial cells activate and upregulate various adhesion molecules, thus increasing the likelihood of macrophage diapedesis and subsequent conversion to foam cells thus furthering athroma progression. These findings likely indicate the tight relationship between periodontitis/periodontal pathogens and cardiovascular diseases.
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PMID:[Cardiovascular diseases and periodontal diseases]. 2220 Oct 98

Helicobacter cinaedi has been increasingly recognized as an emerging pathogen. Reports of recurrent bacteremia and isolation of H. cinaedi organisms from a patient with myopericarditis led us to postulate that H. cinaedi is associated with chronic inflammatory cardiovascular diseases such as atrial arrhythmias and atherosclerosis. To assess any association of H. cinaedi with atrial arrhythmias, a retrospective case-control study of patients attending Kumamoto University Hospital from 2005 to 2009 was performed. The arrhythmia status of these patients was determined from their electrocardiography and electrophysiological studies. Multiple logistic regression analysis was used to identify independent risk factors. In a comparison of case patients (n= 132) with control subjects (n= 137), H. cinaedi seropositivity was identified as an independent risk factor for atrial arrhythmia (odds ratio, 5.13; 95% confidence interval, 3.0-8.7; P < 0.001). There were no significant differences, however, between these two groups with respect to anti-H. pylori IgG concentrations, anti-Chlamydophila pneumoniae IgG concentrations, and other studied variables. IgG concentrations against H. cinaedi and H. pylori were inversely correlated, which suggests cross-immunity between these two bacteria. Also, to explore any association of H. cinaedi with atherosclerosis, immunohistochemical analysis of atherosclerotic aortic tissues collected post mortem from nine patients was performed. Immunohistochemistry of atherosclerotic aortic tissues from all nine patients detected H. cinaedi antigens inside CD68(+) macrophages. These findings provide the first evidence, to our knowledge, of a possible association of H. cinaedi with atrial arrhythmias and atherosclerosis.
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PMID:Potential association of Helicobacter cinaedi with atrial arrhythmias and atherosclerosis. 2230 25

The role of periodontal disease remains a headline-generating topic. Periodontal disease, caused chiefly by bacteria, is characterized by inflammation, bacteremia, a strong immune response, and loss of connective tissue attachment and bone. It is speculated that a continuous long-term exposure to oral bacteremia and bacterial toxins induces immune responses that could contribute to coronary atherosclerosis and, in conjunction with other risk factors, lead to coronary heart disease and myocardial infarction. Periodontal disease might initiate pathological changes in blood vessel walls and act as a precursor of atherosclerosis in susceptible hosts. Many causal factors can play a role in heart diseases. Periodontal disease caused by pathogen bacteria as a low-grade inflammation could represent one of several possible causal factors of heart disease.
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PMID:Potential correlation between periodontitis and coronary heart disease--an overview. 2231 76

Nontyphoid Salmonella (NTS) can cause invasive diseases in the elderly. Notably, the most feared complication of NTS bacteremia is endovascular infection. The risk factors for infected aortic aneurysm include old age and atherosclerosis. Extended use of antimicrobial therapy (> 2 weeks) for NTS bacteremia should be considered for those who demonstrate the risk factors for endovascular infection, even when a metastatic focus is clinically elusive. Herein, we report the case of a 75-year-old patient with diabetes mellitus, hypertension, chronic kidney disease, and myocardial infarction who died of an infected aortic aneurysm despite 3 weeks of antibiotic therapy that was administered to treat the initial NTS bacteremia.
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PMID:Is 2 weeks of antibiotic therapy enough to treat elderly patients with nontyphoid Salmonella bacteremia? A case report of fatal endovascular infection. 2257 27

Coronary artery disease, one of the leading causes of worldwide adult mortality, is most commonly atherosclerotic in pathogenesis. Nonatherosclerotic etiologies are quite rare. In the latter category, infective arteritis or infective vasculitis of the coronary arteries is a very rare but well-recognized subtype, usually discovered at autopsy. In this article, we present the clinicopathologic necropsy data of 10 patients in whom infective coronary arteritis was the leading cause of death. Among the 10 cases, the male/female ratio was 6:4, and with the exception of a 2-year-old female child, all the other patients were adults with an age range of 26 to 59 years. Of the 10 cases, 6 had infective endocarditis along with history of rheumatic heart disease in 3 patients, whereas 2 other patients had strong clinical suspicion of bacteremia or septicemia. The remaining 2 cases had preexisting coronary atherosclerosis with a history of stent placement in 1 of them. All our cases showed on histopathology acute obliterative inflammatory infiltrate consisting mainly of neutrophils along with bacterial colonies (in most of them) involving the epicardial and intramural coronary arteries. To the best of our knowledge, this is the largest series of infective coronary arteritis to be reported in the world.
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PMID:Infective coronary arteritis: a pathological analysis at autopsy. 2283 81

The low-grade oral infection chronic periodontitis (CP) has been implicated in coronary artery disease risk, but the mechanisms are unclear. In this study, a pathophysiological role for blood dendritic cells (DCs) in systemic dissemination of oral mucosal pathogens to atherosclerotic plaques was investigated in humans. The frequency and microbiome of CD19(-)BDCA-1(+)DC-SIGN(+) blood myeloid DCs (mDCs) were analyzed in CP subjects with or without existing acute coronary syndrome and in healthy controls. FACS analysis revealed a significant increase in blood mDCs in the following order: healthy controls < CP < acute coronary syndrome/CP. Analysis of the blood mDC microbiome by 16S rDNA sequencing showed Porphyromonas gingivalis and other species, including (cultivable) Burkholderia cepacia. The mDC carriage rate with P. gingivalis correlated with oral carriage rate and with serologic exposure to P. gingivalis in CP subjects. Intervention (local debridement) to elicit a bacteremia increased the mDC carriage rate and frequency in vivo. In vitro studies established that P. gingivalis enhanced by 28% the differentiation of monocytes into immature mDCs; moreover, mDCs secreted high levels of matrix metalloproteinase-9 and upregulated C1q, heat shock protein 60, heat shock protein 70, CCR2, and CXCL16 transcripts in response to P. gingivalis in a fimbriae-dependent manner. Moreover, the survival of the anaerobe P. gingivalis under aerobic conditions was enhanced when within mDCs. Immunofluorescence analysis of oral mucosa and atherosclerotic plaques demonstrate infiltration with mDCs, colocalized with P. gingivalis. Our results suggest a role for blood mDCs in harboring and disseminating pathogens from oral mucosa to atherosclerosis plaques, which may provide key signals for mDC differentiation and atherogenic conversion.
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PMID:Microbial carriage state of peripheral blood dendritic cells (DCs) in chronic periodontitis influences DC differentiation, atherogenic potential. 2289 Dec 82

Aneurysms of the coronary arteries are rare and are usually associated with atherosclerosis in adults. Mycotic coronary artery aneurysms are exceedingly uncommon and are typically associated with systemic bacteremia, endocarditis, or septic emboli. Literature and data describing the management of mycotic coronary artery aneurysms are limited. This case describes the successful diagnosis of a large right coronary artery aneurysm by transesophageal echocardiogram as well as the successful management of the aneurysm.
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PMID:The diagnosis and treatment of a mycotic coronary artery aneurysm: a case report. 2393 87

Anaerobiospirillum succiniciproducens is rarely associated with bacteremia but results in significant mortality. Almost all reported bacteremia cases have occurred in immunocompromised hosts, such as those with alcoholic liver disease, atherosclerosis, recent surgery, malignancies, or acquired immunodeficiency syndrome. We describe here, to our knowledge, the first clinical evidence for A succiniciproducens bacteremia in a healthy man. A 61-year-old man had fallen from a roof and was admitted to our emergency department with severe left flank pain without an external wound. He was given transcatheter arterial embolization for the left kidney injury on the same day, and his condition stabilized. Four days after admission, he had fever without gastrointestinal signs and symptoms. Spiral-shaped, gram-negative anaerobic bacteria were isolated from 2 sets of blood cultures, and the oxidase and catalase test results were negative. The isolated bacteria were different from the Campylobacter spp. On the next day, the bacteria were confirmed as A succiniciproducens by 16S rRNA sequencing. The patient responded to sulbactam/ampicillin. On day 13, the patient was discharged with a 7-day prescription for oral amoxicillin/clavulanate. Six months after admission, the patient was free of recurrent infection. A succiniciproducens bacteremia can occur in healthy adults. When large gram-negative spiral-shaped bacteria are detected, this bacterial species should be considered and differentiated from the Campylobacter spp because A succiniciproducens is often resistant to macrolide antibiotics.
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PMID:Anaerobiospirillum succiniciproducens-induced bacteremia in a healthy man. 2444 May 90

The majority of risk factors for chronic inflammatory diseases are unknown. This makes personalized medicine for assessment, prognosis, and choice of therapy very difficult. It is becoming increasingly clear, however, that low-grade subclinical infections may be an underlying cause of many chronic inflammatory diseases and thus may contribute to secondary outcomes (e.g., cancer). Many diseases are now categorized as inflammatory-mediated diseases that stem from a dysregulation in host immunity. There is a growing need to study the links between low-grade infections, the immune responses they elicit, and how this impacts overall health. One such link explored in detail here is the extreme sensitivity of myeloid dendritic cells (mDCs) in peripheral blood to chronic low-grade infections and the role that these mDCs play in arbitrating the resulting immune responses. We find that emerging evidence supports a role for pathogen-induced mDCs in chronic inflammation leading to increased risk of secondary clinical disease. The mDCs that are elevated in the blood as a result of low-grade bacteremia often do not trigger a productive immune response, but can disseminate the pathogen throughout the host. This aberrant trafficking of mDCs can accelerate systemic inflammatory disease progression. Conversely, restoration of dendritic cell homeostasis may aid in pathogen elimination and minimize dissemination. Thus it would seem prudent when assessing chronic inflammatory disease risk to consider blood mDC numbers, and the microbial content (microbiome) and activation state of these mDCs. These may provide important clues ("the canary in the coal mine") of high inflammatory disease risk. This will facilitate development of novel immunotherapies to eliminate such smoldering infections in atherosclerosis, cancer, rheumatoid arthritis, and pre-eclampsia.
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PMID:Blood dendritic cells: "canary in the coal mine" to predict chronic inflammatory disease? 2447 66


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