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

A hemophiliac with acquired immunodeficiency syndrome-related complex was seen with sepsis related to a ventricular septal abscess. The abscess was debrided and the septum was patched with a single layer of autologous pericardium. The patient recovered and survived 6 months before dying of acquired immunodeficiency syndrome. At autopsy, the septal patch was well healed with no evidence of recurrent endocarditis.
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PMID:Myocardial abscess in a patient with AIDS-related complex: pericardial patch repair. 231 Feb 61

A case of a female, intravenous (I.V.) drug user with respiratory distress syndrome as first manifestation 24 hours after admission, is presented. The clinical suspicion of tricuspid valve endocarditis associated to Pneumocystis carinii pneumonia arose because this patient was a member of a high-risk AIDS group. An empiric treatment was applied and the diagnosis was made posterior to this. We comment on the unusual coincidence of both pathologic states, highlighting the early diagnosis and treatment.
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PMID:[Respiratory distress in an addict on parenteral drugs with tricuspid endocarditis due to Staphylococcus aureus and with Pneumocystis carinii pneumonia]. 249 92

20 patients (18 men, 2 women), 10 of whom were HIV +, were given Fluconazole (F) for either systemic candidiasis (13 cases), histoplasmosis (1), or cryptococcosis (6). The localization of the Candida infections (12 C. albicans, 1 C. tropicalis), were: septicemic (2), urinary (7), bronchial (2), esophageal (5), uveal (1), soft tissue (2), and 1 undetermined localization but a positive serology (1). On day (d) 1, Candidiasis patients were given an initial dose of 400 mg (for septicemia) or 200 mg (other localizations) of FIV or PO, then 200 or 100 mg per d. The length of treatment lasted from 28 to 70 d. Evolution was favorable in all the patients. 4 relapses occurred after the end of treatment: at 10 d, a septicemic candidiasis (C. tropicalis) in 1 patient who had prosthetic endocarditis; and at 1 month, digestive candidiasis in 3 HIV + patients. For the patient, infected by Histoplasma capsulatum, despite a clinical improvement, urine were still positive at day 75. The patients with cryptococcosis (5 meningitidis in the AIDS patients) and renal (1) (kidney transplant) were given on the average 400 mg a d, IV or PO (mean length 8 weeks). Only 5 patients were evaluable. For 2 of the meningitis patients with other localizations, standard treatment was instituted due to the persistence of positive cultures. For the 2 other patients, the cerebrospinal fluid (1) and the urine (1) were sterilized by the 3d week. But they relapsed 1 month after the treatment stopped. For the 18 patients evaluable, clinical and biological tolerance was good except for 1 patient with transaminases rise for which fluconazole was probably the cause.
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PMID:[Value of fluconazole in the treatment of systemic yeast infection]. 255 80

Heart disease related to the acquired immunodeficiency syndrome (AIDS) encompasses a number of pathologic findings that may or may not be associated with specific cardiac signs and symptoms. A review of 30 reports revealed that cardiac disorders were apparent in 424 (74%) of 574 AIDS patients. Neoplasms and opportunistic infections each were reported in 46 (8%) patients. The area of the heart most commonly affected was the myocardium. Pericardial disease as a single disorder was apparent in 14 patients, the etiologic bases of which were Mycobacterium tuberculosis. Cryptococcus neoformans infection, and unspecified fibrinous pericarditis. Endocardial disease was histologically evident in 18 patients with nonbacterial thrombotic endocarditis, and one patient was found to have Nocardia asteroides endocarditis. Although cardiac symptoms (dyspnea and chest pains); signs (pulsus paradoxus and murmurs); or ECG, roentgenogram, or echocardiographic manifestations of AIDS may be significant, they are not generally helpful in establishing a clinical diagnosis. Echocardiograms and a heightened degree of clinical suspicion have proven useful in detecting cardiac dysfunction and life-threatening cardiac tamponade.
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PMID:AIDS-related heart disease: a review of the literature. 267 Dec 77

Yeast-like fungi that are commonly found on the skin and in the digestive tract of healthy people may be responsible for deep infections as well as for cutaneous and mucosal diseases. Such deep infections have long been known in the case of Candida spp.; they are facilitated by immunosuppression or by factors that enable this opportunistic organism to proliferate in the gut, skin or mucosae and to penetrate into deep tissues. In addition to such well-known clinical manifestations as septicaemia and endocarditis and to pulmonary, neuromeningeal, osteo-articular and ophthalmic lesions (to be systematically searched for), and apart from the special case of chronic granulomatosis, new syndromes have been described in heroin-addicts, including syndromes with deep cranial nodules and folliculitis. The difficult diagnosis often justifies and empirical treatment in neutropenic patients. In patients with AIDS, buccal and oesophageal candidiasis is common and sometimes reveals the syndrome, but other localizations are rarely encountered. Deep manifestations in the newborn are very seldom due to contamination by the mother; they are usually iatrogenic, so that their transmission can be prevented. More recently, deep mycoses caused by other fungi beside cryptococci have been described in fragile patients. Torulopsis glabrata, Trichosporon cutaneum or even Rhodotorula spp. may penetrate through catheters or drains and cause fungaemia and septicaemia. Malassezia furfur has been found in contaminated catheters and drains and causes pulmonary infections almost exclusively in premature infants under prolonged parenteral lipid diet.
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PMID:[Deep Candida and related yeast infections]. 268 88

To examine the impact of the AIDS epidemic on morbidity and mortality in a defined population of intravenous drug users, we analyzed overall and cause-specific death rates, AIDS incidence, and acute medical hospitalizations among patients in a long-term methadone maintenance program in New York City for the years 1984 through 1987 (midyear population for each year 828 to 891; demographic characteristics did not differ). The number of deaths while in treatment increased from 11 (13.3/1000) in 1984 to 39 (44.2/1000) in 1987. Deaths from AIDS increased from 3.6/1000 to 14.7/1000, deaths due to bacterial pneumonia/sepsis from 3.6/1000 to 13.6/1000; deaths from cirrhosis, drug overdose, trauma, and other causes remained relatively stable. AIDS incidence rose from six cases/1000 in 1984 to 20.4.1000 in 1987. Hospitalizations for AIDS, pneumonia, tuberculosis, and endocarditis/sepsis increased from 84.9/1000 in 1986 to 144.8/1000 in 1987. These data suggest that the AIDS epidemic has had a profound effect on patterns of morbidity and mortality among intravenous drug users in this methadone program population. Drug treatment programs may be important sites for targeting clinical services for drug users with AIDS, although the increasing burden of AIDS-related disease will require expansion of existing funding and treatment resources.
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PMID:Impact of the AIDS epidemic on morbidity and mortality among intravenous drug users in a New York City methadone maintenance program. 278 2

To ascertain the incidence of infections in intravenous users of illicit drugs, we performed a retrospective study of 270 intravenous drug users (IVDUs) and 562 controls who did not use drugs over a seven-year period from 1978-1985. IVDUs had an increased overall incidence of infections (P less than 0.001) compared to controls, which was explained to a large degree by an increased incidence of hepatitis. Endocarditis and disseminated gonococcal infection were seen with increased frequency in IVDUs (P less than 0.05), but abscess and cellulitis were not. Neither acquired immunodeficiency syndrome (AIDS), tuberculosis, Pneumocystis pneumonia, nor disseminated viral or fungal infection were seen in IVDUs or controls. Heroin users, but not other IVDUs, had an increased incidence of infections not thought to be associated with needle use, suggesting impaired immunity. This study demonstrates that IVDUs have an increased incidence of infection compared to control subjects, but the kinds of infections have changed substantially over the past two decades. The presence of opportunistic pathogens in these patients should suggest concurrent infection with human immunodeficiency virus (HIV).
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PMID:Increased incidence of infections in intravenous drug users. 278 3

Although the diagnosis of AIDS-associated heart disease is becoming routine, its treatment has not been reported except in anecdote. Also, it has been unclear whether the odds of successful treatment are altered because of the presence of cardiac involvement per se. This communication reports the authors' treatment of 18 patients with AIDS-associated heart disease. Their results are combined with the treatment results of all patients reported in the literature to date with AIDS-associated heart disease. Treatment success, defined as eradication of the organism and no relapse, was achieved in their patients with M. tuberculosis (M. tb), cardiac cryptococcosis, and Salmonella typhimurium. M. tb required emergency pericardiectomy (well tolerated in all patients), then administration of rifampin, isoniazid, and ethambutol. Cryptococcosis was treated acutely with amphotericin B and flucytosine, then with maintenance amphotericin B. The response, which included resolution of congestive heart failure, occurred within a week. Salmonella endocarditis was cured with administration of ampicillin and netilmicin for one month. When the patients' data were combined with those of patients from the literature, the authors found that the odds of successful treatment for tuberculous pericarditis were somewhat lower than if the tuberculosis was extracardiac (50% vs 67%). With cryptococcal heart disease, the odds of successful treatment were actually significantly better than when only extracardiac disease was present. The authors conclude that infectious forms of AIDS-associated heart disease are often treatable. Although some cardiac infections are less likely to respond to treatment if there is cardiac involvement, mostly the response to treatment is similar to the response with only extracardiac involvement.
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PMID:Treatment of AIDS-associated heart disease. 281 20

Topics concerning intravenous drug use and AIDS are reviewed. Topics include seroprevalence of HIV among users worldwide, evidence that iv drug users will alter behavior to avoid AIDS, results of safer injections programs, no evidence for reduction in high-risk behavior regarding sexual transmission of AIDS by users, diversity in HIV prevalence among users, and clinical aspects of their disease. Seroprevalence of HIV among drug users has remained at about 30% in the U.S. and parts of Europe, while lower in Asia and South America. There is now evidence from several places in Europe and the U.S. that many iv drug users will change drug injecting behavior to avoid AIDS. A conceptual model of new social norms needed to change behavior involves 3 stages: knowing the dangers of AIDS, having the means to change behavior (treatment or clean syringes), and a mechanism to reinforce the new behavior (perceived efficacy or social approval). There is no evidence that safer injection programs either keep users from going to treatment or increase numbers of users. In contrast, there is no evidence for improved sexual risk-taking behaviors among users, a fact which argues for stronger efforts to prevent already infected users from spreading HIV. The public, policy-markers, and researchers are unaware that seroprevalence of HIV varies with the type of drug injected (cocaine; heroin; amphetamine), and with socioeconomic status of the user (ethnic minority; majority). The clinical presentation, infection rate, persistence of infection, and mortality rate among iv drug users differs from that of the general AIDS population. Endocarditis, tuberculosis and bacterial pneumonias are 3 of the common findings in drug users. Even "non-AIDS" deaths apparently due to immunosuppression are reported in drug users. There may be undiscovered co-factors in HIV infection in this population.
AIDS 1988
PMID:HIV and intravenous drug use. 314 82

Right-sided staphylococcal endocarditis has been described in drug-addict, but not in association with an Acquired Immunodeficiency Syndrome. A case of a 26 years old drug-addict woman with AIDS related complex is reported. Antibiotic therapy, produced a favourable evolution on the illness. This case support the usefulness of two-dimensional echocardiography for detecting one of the possible complications associated with AIDS.
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PMID:[Tricuspid endocarditis caused by Staphylococcus aureus in AIDS. Discussion of a case]. 316 74


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