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Query: UMLS:C0011849 (diabetes)
277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of bacterial endocarditis due to Listeria monocytogenes in a pregnant, Class D diabetic patient is presented. The importance of obtaining proper cultures and instituting appropriate antibiotic therapy promptly is emphasized. A favorable outcome was achieved in spite of the combined risk to the fetus of maternal diabetes and listeria endocarditis.
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PMID:Bacterial endocarditis due to Listeria monocytogenes in a pregnant diabetic. 61 85

Curettage of skin lesions was not followed by bacteraemia in 22 patients. The risk of bacterial endocarditis after curettage and other minor skin surgery is small but should not be overlooked in those with a prosthetic heart valve, a history of other cardiac surgery, a previous episode of infective endocarditis, drug addiction, diabetes, alcoholism, immunosuppression, or renal failure--especially where the skin lesion might be infected.
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PMID:Minor skin surgery. Are prophylactic antibiotics ever needed for curettage? 135

Of 1088 consecutive Ethiopian diabetic patients registered over 9 years 80 (7.4%) were diagnosed at or before age 15 years. There were 48 girls and 32 boys, with mean age of onset of 10.1 years. Diabetes had been present 10 years or less in 62, 11 to 20 years in 15, and more than 20 years in only 2. Twenty-two were rural, 27 had poverty certificates. Twenty-three have known diabetic relatives. The original mode of presentation could not be verified in 16, 7 presented in ketoacidosis, 5 were diagnosed by a diabetic relative, and the rest presented with the rapid onset of classical symptoms. To date, 43 have been ketoacidotic at least once. No pancreatic calcification was seen in 34 abdominal radiographs. Three of 6 newly diagnosed patients tested had islet cell surface antibodies. Three cases, initially suggestive of 'tropical malnutrition diabetes', evolved into typical type 1 diabetes. Serious complicating illnesses were tuberculosis (6), bacterial endocarditis (1) and rhinocerebral mucormycosis (1). Six patients have had metabolic cataracts. Ten patients (12%) have died, 4 of ketoacidosis and 4 of diabetic nephropathy. Childhood diabetes mellitus in Ethiopians is clinically very similar to type 1 diabetes elsewhere.
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PMID:Childhood diabetes mellitus in Ethiopians. 295 Nov 86

The group B streptococcus has been shown to be a major cause of meningitis in the newborn and an occasional cause of endocarditis and sepsis in postpartum women. Little attention has been devoted to this organism as a cause of bacterial endocarditis. Twelve patients with group B streptococcal endocarditis were seen at The Presbyterian Hospital, New York, NY, between 1974 and 1985. There were seven women, five men. Ages ranged from 32 to 81 years. Serious underlying disease was present in all - diabetes mellitus in seven, carcinoma in three (bladder in two, and breast in one), alcoholism in three, malnutrition in two, heroin addiction in one, tuberculosis in one, serious prior valvular heart disease in two. The aortic valve was affected in four patients - mitral in two, mitral and aortic in one, tricuspid in four, unknown in one. The presentation was acute in seven patients. Metastatic infection occurred in seven, heart failure in six, major emboli in four, septic pericarditis in one, myocardial abscess in one. The group B streptococcus should be considered as a pathogen capable of causing acute endocarditis in certain patients with defects of host defense, particularly patients with diabetes mellitus, carcinoma or alcoholism. Cardiac surgery may be necessary in these patients due to the rapid destruction of the valves which occurs, in spite of the fact that the organisms are usually highly susceptible to penicillin.
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PMID:Streptococcus agalactiae (group B) endocarditis--a description of twelve cases and review of the literature. 330 82

Infective endocarditis is an uncommon manifestation of group B streptococcal disease. Seven cases of group B streptococcal endocarditis are reported herein. Another fifty-five cases published in the literature since 1962 are reviewed: the male to female ratio was 1.4:1. The average age was 53.8 years, and 45% of patients were 60 years of age or older. Two cases of nonsocomial endocarditis and two cases of polymicrobial endocarditis were identified. There were five cases of prosthetic valve endocarditis. Mitral and aortic valvular involvement were present in 48% and 29% of cases, respectively. Underlying heart disease was found in more than half of the cases. Rheumatic heart disease was the commonest underlying cardiac condition. Noncardiac underlying conditions included diabetes mellitus, alcoholism, pregnancy, intravenous drug abuse, and genitourinary disease. Onset was varied as was initial presentation of the disease. Large arterial thrombi were common. Overall mortality was 43.5%. Penicillin is the treatment of choice for group B streptococcal endocarditis. However, based on in vitro and in vivo studies as well as case reports, some authors feel that the combination of penicillin and an aminoglycoside is a superior regimen. Cephalothin or vancomycin are alternatives for patients who are allergic to penicillin.
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PMID:Group B streptococcal endocarditis: report of seven cases and review of the literature, 1962-1985. 351 20

The Transplant Service at the University of Minnesota Hospitals has performed over 2,000 kidney transplants. Fourteen of these patients have developed cardiac conditions necessitating surgical intervention at intervals of 9 to 144 months (mean 67 months) following their transplantation. These individuals had a mean age of 42 years, and five (36%) were diabetic. All patients had functioning renal allografts with preoperative serum creatinine levels ranging from 1.0 to 1.8 mg/100 ml (mean 1.4 mg/100 ml). Ten patients underwent aorta-coronary saphenous vein bypass grafting. One patient underwent bypass grafting and concomitant left ventricular aneurysmectomy. Native valvular endocarditis developed in two patients. One had tricuspid valve debridement for fungal endocarditis and the other had aortic valve replacement for bacterial endocarditis. The final patient had calcific aortic stenosis and coronary artery disease necessitating aortic valve replacement and coronary bypass. Two patients (14%) died perioperatively. One was a young woman with juvenile-onset diabetes and preinfarction angina who died suddenly several days after the operation; at autopsy, she was found to have an occluded graft to the right coronary artery and extensive infarction. The other was a 54-year-old woman with calcific aortic stenosis, coronary artery disease, and unstable angina who died perioperatively of uncontrollable arrhythmias. Autopsy suggested that she may have had an unsuspected infarction 1 to 2 days before the operation. The remaining 12 patients had uneventful postoperative courses and returned to Class I functional status from a cardiac standpoint. There has been one late death (7%), 45 months after successful coronary artery bypass grafting, as a result of complications attendant to a perforated gastric ulcer. The remaining 11 patients are alive and well at intervals of 8 to 93 months (mean 31 months) after operation. Postoperative serum creatinine levels at hospital discharge averaged 1.6 mg/100 ml, not significantly changed from preoperative levels. Cardiac operations can be performed safely in patients with functioning renal allografts. Patient survival is acceptable and preservation of renal function has been uniformly successful in surviving patients.
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PMID:Cardiac operations in patients with functioning renal allografts. 638 68

A retrospective analysis was undertaken of 365 consecutive patients, 75 women and 290 men with a mean age of 59.9 +/- 9.7 years, who had coronary artery bypass surgery during 1981. Complications classified as major were: mediastinal hemorrhage, pericardial tamponade, wound dehiscence, sternal osteomyelitis, myocardial infarction, bacterial endocarditis, dissecting aneurysm and diabetes insipidus. Complications classified as minor were: atrial fibrillation, postpericardiotomy syndrome, cellulitis, thrombophlebitis and phrenic nerve palsy. There were 48 patients (13%) with 52 major complications. Age more than 60 years, cardiopulmonary bypass time longer than 150 minutes, aortic cross-clamp time longer than 100 minutes, number of grafts greater than five and presence of diabetes mellitus were significantly associated with major complications. Complications tended to occur more frequently in women, obese patients and those with emergency operation or ejection fraction less than 30%, but the associations were not statistically significant. Physicians referring patients for coronary artery surgery should be cognizant of the incidence of morbidity along with the other risks and benefits when considering coronary artery bypass surgery.
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PMID:Coronary artery bypass surgery morbidity. 660 79

Staphylococcal pneumonia is rare, has a high mortality and morbidity rate, and occurs commonly during influenza epidemics (airborne) or during the course of right sided bacterial endocarditis in drug addicts (blood borne). In recent years, much emphasis has been given to the staphylococcal infections in intravenous drug abusers. This report describes ten patients with staphylococcal pneumonia resulting from soft tissue infection who were previously healthy and had no history of drug abuse. They were 12 to 45 years old. Eight were male patients. Soft tissue infection was community-acquired in nine and was most commonly located in the lower extremities. Three patients had diabetes. All presented with a clinical picture of acute pneumonia. Hemoptysis occurred in three. Chest roentgenogram showed multiple large or small round discrete densities in most of the patients. Lobar involvement was notably absent. Eight developed cavitary lesions in their lungs. The average length of hospital stay was 40 days. One patient died and six developed complications. Staphylococcal etiology should be suspected in patients with acute pneumonia who have soft tissue infection or have characteristic chest roentgenogram findings; antistaphylococcal agents should be included in the therapeutic regimens of such patients until the results of the cultures are known.
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PMID:Hematogenous staphylococcal pneumonia secondary to soft tissue infection. 746 Jun 48

Infective endocarditis caused by Kingella denitrificans occurs rarely. A review of the literature reveals only 6 cases of endocarditis caused by the bacillus. K. denitrificans is normally a commensal of the upper respiratory airways, may exceptionally be responsible for endocarditis. A case of possible prosthetic endocarditis caused by K. denitrificans is presented. A 78-year-old male with Type II diabetes was admitted to the hospital complaining of fever, a sore throat and arthralgia. He underwent replacement surgery of a St. Jude medical prosthesis for aortic stenosis at the age of 75. The only physical findings at admission were a temperature of 38.2 degrees C and murmurs of mild mitral regurgitation. The liver and spleen were not palpable, and there were no skin or eye lesions. Laboratory findings were as follows: white blood cell count 9500/microliters with 77% neutrophils, erythrocyte sedimentation rate 71 mm/h (Westergren), blood urea nitrogen 50.2 mg/dl, serum creatinine 1.7 mg/dl and C-reactive protein 22.2 mg/dl. The Gram-negative bacillus isolated from the blood was identified as K. denitrificans by the identification system, namely ID test.FN-20 rapid (Nissui, Japan). Although an echocardiogram detected no vegetation, infective endocarditis was diagnosed because the same bacillus was detected by separate blood cultures and an obvious source of infection was not found other than the prosthetic valve. Initial treatment was flomoxef, which was changed to Ampicillin 2 g/day after K. denitrificans was identified. Ampicillin continued for 6 weeks. The clinical course was good and he did not require further surgery. He has been afebrile for 2 years after completing treatment. This case represents the first report of prosthetic valve endocarditis caused by K. denitrificans in Japan.
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PMID:[Prosthetic endocarditis caused by Kingella denitrificans in a patient with diabetes mellitus]. 928 46

Infective endocarditis caused by beta-hemolytic streptococci is infrequently seen. Members of the Infectious Diseases Society of America's Emerging Infections Network (EIN) were polled for cases of beta-hemolytic streptococcal endocarditis that were seen between 1 January 1994 and 31 December 1996. Thirty-one cases were submitted by 22 members. The patients' ages ranged from 4 months to 79 years, and 18 (58.1%) were males. Prosthetic valve infection occurred in six cases and intravenous drug abuse was noted in only one case. Diabetes mellitus was noted in 10 patients (32.3%). Group B beta-hemolytic streptococci accounted for over two-thirds of isolates (21 [67.7%] of 31). Twenty-five patients (80.7%) developed complications of infective endocarditis, and 15 (48.4%) underwent surgical intervention with valvular revision or excision. Sixty-one percent (19 of 31) received aqueous crystalline penicillin G either as monotherapy or in combination with gentamicin sulfate. In contrast to previously published data, the mortality rate (12.9%) among patients in this survey was remarkably low. There was no infection relapse documented in 16 of the remaining 27 patients for whom posttreatment follow-up information was available.
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PMID:Infective endocarditis caused by beta-hemolytic streptococci. The Infectious Diseases Society of America's Emerging Infections Network. 945 11


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