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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serious infections caused by organisms of the genus Bacillus developed in seven patients. Five drug abusers had either endocarditis or osteomyelitis, one leukemic patient had necrotizing fasciitis, and one patient had a ventriculoatrial shunt infection with recurrent bacteremia. All patients recovered. Experience with these cases reemphasizes the importance of not dismissing Bacillus organisms as culture contaminants, especially when isolated from blood, body fluids, or closed-space infections.
JAMA 1979 Mar 16
PMID:Serious infections from Bacillus sp. 10 58

Ninety-nine patients treated with penicillin G potassium, cephalothin sodium, or vancomycin hydrochloride were studied to evaluate single-drug therapy for nonenterococcal streptococcal endocarditis. Eighty-six patients survived; of these, 66 received penicillin alone. The maximum serum bactericidal titer obtained at the expected nadir of serum antibiotic concentration was 1:8 or greater in 70 (95%) of the 74 patients studied. No relapse occurred among the 66 patients treated wih penicillin. Only one patient experienced a relapse that occurred following therapy with suboptimal doses of vancomycin. Distinct second episodes of endocarditis occurred in five patients. While 13 patients died, none died of intractable infection. The treatment of endocarditis due to penicillin-susceptible streptococci with high-dose parenteral penicillin or a bactericidal penicillin substitute for four weeks or longer results in bacteriologic cure rates comparable with those achieved with combined penicillin-streptomycin regimens.
JAMA 1979 Apr 27
PMID:Single-antibiotic therapy for streptococcal endocarditis. 10 35

A thrombotic thrombocytopenic purpura (TTP)-like syndrome was the chief presenting feature in two patients with infective endocarditis. Clinical and laboratory aberrations of the syndrome were rapidly reversed by specific antimicrobial therapy. Hypocomplementemia and high levels of circulating immune complexes were detected initially in both patients. Because these returned to normal as the TTP syndrome abated, an immunopathologic mechanism may have been operative.
JAMA 1977 Aug 01
PMID:Thrombotic thrombocytopenic purpura-like syndrome associated with infective endocarditis. A possible immune complex disorder. 14 32

Two children with persistent bacteremia and endocarditis due to Staphylococcus aureus failed to respond to vancomycin therapy, even though serum levels greatly exceeded the inhibitory concentrations. The Staphylococcus from one patient was resistant to methicillin; the other patient had a penicillin hypersensitivity. There was a wide disparity between the minimum inhibitory and the minimum bactericidal concentrations of vancomycin. Striking clinical and laboratory evidence of improvement was demonstrated with the addition of rifampin therapy.
JAMA 1978 Oct 27
PMID:Staphylococcus aureus endocarditis. Combined therapy with vancomycin and rifampin. 24 93

A 14-year experience with streptococcal endocarditis was reviewed. The effect of single vs combination antibiotic therapy on the relapse rate was found to be comparable. Of 68 patients treated, four patients died during therapy. Two of 46 patients receiving single-agent and none of 18 patients receiving combination therapy experienced a relapse. Duration of symptoms before diagnosis was the main risk factor predisposing to relapse, which occurred in two of 13 patients with symptoms for longer than three months and in none of 51 patients with symptoms for three months or less before diagnosis. Combination therapy offered no advantage over a single agent in the latter group. Optimal therapy for patients with symptoms for longer than three months could not be determined in this study. However, no relapses were observed in this high-risk group when a single agent was given for longer than 21 days.
JAMA 1979 Apr 27
PMID:Streptococcal endocarditis (nonenterococcal, non-group A): single vs combination therapy. 43 Jul 47

Polymicrobial bacteremia increased from 6% in 1970 to 13% in 1975 in patients with bloodstream infections. This type of serious infection most commonly complicated genitourinary (27%) and gastrointestinal (26%) conditions, frequently followed invasive procedures (68%), was more common in hospitalized patients (73%), and was often associated with malignancies (25%) or immunosuppressive or cancer chemotherapy (34%). Although polymicrobial endocarditis was more commonly encountered in recent years, this infection accounted for only 4.5% of patients with multiple organism bacteremias. Gram-negative aerobic bacteria were isolated from 62% and anaerobic bacteria in 39% of patients with polymicrobial bacteremia compared with 37% and 14%, respectively, in patients with monomicrobial bacteremia. In the 88 patients with polymicrobial bacteremia, the mortality was 44.5%, compared with 18.0% in patients with monomicrobial bacteremia.
JAMA 1979 Sep 07
PMID:The increasing importance of polymicrobial bacteremia. 47 44

Because of problems of penicillin allergy or lack of veins for intravenous administration of antibiotics, nine patients with endocarditis were treated with clindamycin, administered intramuscularly. Five patients were heroin addicts with staphylococcal endocarditis and four had alpha-streptococcal endocarditis. The only therapeutic failure occurred in a patient with a strain of Staphylococcus aureus that became resistant to clindamycin in vivo. Such resistance has been reported to occur in vitro, and testing for it should prove useful in proper selection of cases for treatment with clindamycin, an agent that appears to be effective in selected cases of endocarditis.
JAMA 1978 Feb 13
PMID:Clindamycin in infective endocarditis. 56 32

Two patients with staphylococcal endocarditis were treated unsuccessfully with cefazolin sodium. One patient relapsed after 52 days of therapy. The second patient had concomitant central nervous system infection and failed to respond to cefazolin therapy. Both patients recovered with methicillin sodium or nafcillin sodium therapy. Other studies report unsuccessful therapy of staphylococcal endocarditis with cefazolin.
JAMA 1977 Feb 07
PMID:Unsuccessful treatment of staphylococcal endocarditis with cefazolin. 57 84

A urinary tract infection with possible septicemia and endocarditis developed in a 36-year-old man. The illness was complicated by pulmonary embolism, thrombocytopenia, hematemesis, hepatic dysfunction, paralytic ileus and accelerated hypertension. The latter finding suggested pheochromocytoma. Treatment with antibiotics and phenoxybenzamine hydrochloride was associated with notable clinical improvement. A chromaffin cell tumor was surgically removed above the lift kidney. Conclusively, a pheochromocytoma may mimic and be present in association with infection.
JAMA 1977 May 09
PMID:Infection and pheochromocytoma. 57 92

Immunofluorescent microscopy was performed on the clinically normal skin of 3 patients with infective endocarditis, 3 patients with bacteremia, and 6 normal subjects. Perivascular deposition of immunoglobulin and complement was demonstrated in two of the three patients with infective endocarditis and in none of the bacteremic or control subjects.
JAMA 1977 Sep 12
PMID:Skin immunofluorescence in infective endocarditis. 57 62


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