Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Locoregional expression of cat scratch disease is well known, but despite advances in microbiology over the last 10 years leading to the description of two new bacteria (Afipia felis, Bartonella henselae) the infective agent responsible for cat scratch syndrome remains unknown. Until the 80s, only one systemic disease was attributed to infection with a germ in the Bartonella genus: trench fever. With the onset of the AIDS epidemic, new clinical syndromes caused by Bartonella bacteria have been described: bacillary angiomatosis, hepatic peliosis, cases of recurrent septicemia, cases of endocarditis, etc. More recently, atypical forms of cat scratch disease including systemic diseases have been reported in immunocompetent subjects. Although quite rare (1% of the cases), such types of expression can raise questions as to diagnosis both in terms of clinical signs and in terms of bacteriological findings. Clinical and experimental data do not provide a clear direction for treatment but would suggest that prolonged use of aminoglycosides is useful.
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PMID:[Visceral localizations of cat-scratch disease in an immunocompetent patient]. 872 80

A prospective study was performed from march 31 st 1991 to september 30th 1992 on cardiac involvement in course of AIDS. Clinical, electric, sonographic and radiologic aspects were analysed within 83 patients of the study. In this cohort, 45.8% of patients had shown a cardiac involvement through all strates and respectively: a pericarditis with effusion in 24 patients (27.7%), a dilated cardiomyopathy in 14 patients (16.9%) and infective endocarditis in 1 patient (1.2%). Dispncea between classes II and IV of NYHA was the main complaint. Tachycardia, silent cardiac sounds and congestive heart failure were the prominent features of the clinical examination of the cohort. Because of the likely high prevalence of cardiac manifestations in course of AIDS, clinicians and researchers have to pay attention to this situation.
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PMID:[A clinical study of cardiac manifestations related to acquired immunodeficiency syndrome (AIDS) in Kinsaha]. 874 16

Splenomegaly was studied at a municipal teaching hospital in an 11-year retrospective review. The 170 patients were classified into six diagnostic groups. The associated clinical and laboratory features were tested for statistical association (X2), to determine predictive values. Hepatic diseases caused 36% of the splenomegaly; hematologic, 35%; infectious diseases (ID), 16%; inflammatory, 5%; primary splenic, 4%; and other, 3%. The acquired immunodeficiency syndrome (AIDS) occurred in 54% of patients with ID. Hematologic diseases were significantly associated (P < 0.01) with massive splenomegaly, left upper quadrant (LUQ) abdominal tenderness, and all blood "cytoses." The most common disease with massive splenomegaly was myelofibrosis. Surprisingly, hepatic diseases caused 29% of massive splenomegaly. Hepatic diseases were significantly associated (P < 0.01) with hepatomegaly, abnormal liver-function tests (LFT), and blood "cytopenias." Compared with previous reports, both congestive heart failure and endocarditis now rarely cause splenomegaly. All blood "cytopenias" had highly significant associations (P < 0.01) only with hepatic diseases, which suggests that hypersplenism remains a useful concept for the splenomegaly of liver disease.
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PMID:Splenomegaly at a United States County Hospital: diagnostic evaluation of 170 patients. 885 64

The problem of drug abuse in America encompasses all ages, economic, and ethnic groups. The Office of the Chief Medical Examiner (OCME) has recorded a continuous increase in drug abuse deaths in Maryland over the past seven years. This report focuses on the epidemiological characteristics and pathological findings of victims of fatal drug abuse in Maryland investigated by the OCME in 1992 and 1993. A retrospective study of OCME cases in 1992 and 1993 yielded a total of 605 deaths caused by drugs of abuse. 426 deaths were the result of narcotic drug use, 66 deaths due to cocaine, 102 deaths involved both narcotics and cocaine, 6 deaths were due to phencyclidine (PCP) and 5 involved both PCP and narcotic drugs. Drug abuse deaths most often involved individuals who were male (86%) and black (64%). Their ages ranged from 15 to 68 years with the majority (58%) of victims being in their 30's. Of the 605 drug deaths, 393 (65%) had a known history of drug abuse. 279 (46%) exhibited needle tracks, of which only 94 (16%) had identifiable fresh needle puncture marks. Drug paraphernalia (needles, syringes, etc.) was found at the scene in 22% of the cases. Twenty-nine (4.8%) cases showed complications of drug abuse which included pneumonia, endocarditis or myocarditis, pulmonary embolism, AIDS and intracerebral hemorrhage. 87 (14.4%) were positive for HIV antibodies, an incidence much higher than that identified in our general autopsy population (2.6%). Drugs of abuse were also found in a significant portion of the homicides examined at this office in 1992 and 1993. 323 of the 1265 homicide victims (25%) showed evidence of some form of illicit drug activity.
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PMID:Observations on drug abuse deaths in the State of Maryland. 893 5

Several necropsy reports have suggested that cerebral vascular disease (CVD) is more frequent in HIV positive patients than in HIV negative individuals of the same age, although clinical signs are rare. We describe three patients for whom CVD was the clinical manifestation that led to diagnoses of HIV infection. The patients were two men and a woman aged 29, 52 and 66, respectively, with differing risk factors for CVD: smoking (3), blood hypertension (2), endocarditis (1) and free protein S deficiency (1). The risk factors for HIV infection were also different. The CVD diagnoses were confirmed by computed tomography, which revealed lacunar infarction in two cases with favorable outcomes and embolia-like infarction with subarachnoid hemorrhage in the third patient, who died a few days later. CD4 levels varied (50, 130 and 689/mm3). Our observations lead us to the following conclusions: 1) CVD can be a first clinical manifestation of HIV infection and the disease that allows seropositivity to be diagnosed. Although CVD usually presents in advanced stages of HIV infection, it can also occur in seropositive patients who do not meet the criteria for AIDS. 2) The classical risk factors for vascular disease probably play a dominant role in the etiology of CVD in such patients, alongside systemic complications related to the virus; the direct role of HIV remains to be determined. 3) AIDS should be considered and ruled out in patients with CVD who are at risk for HIV infection, even in older patients with vascular risk factors.
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PMID:[Cerebrovascular disease as a form of presentation of HIV infection]. 900 48

A 36-old-woman was admitted with an infectious syndrome, respiratory insufficiency and vasculitis. There was a history of chronic intravenous drug abuse, sexual promiscuity and rheumatic heart disease. She had HIV positive tests. The vasculitis and heart failure worsened and the patient died of stroke. At autopsy it was found histologic evidence of AIDS, rheumatic heart disease with Aschoff nodes, infective endocarditis with cerebral abscesses and thalamic infarction.
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PMID:[Rheumatic heart disease and infective endocarditis in a patient with acquired immunodeficiency syndrome]. 918 24

The cat-scratch disease (CSD) is known as a nosological entity since 1950. It was diagnosed by the clinical symptoms, epidemiologic data, and the intracutaneous test of Hanger and Rose. The aetiologic agent is Bartonella (formerly Rochalimaea) henselae occurring in thirty to fifty percent of healthy cats. The gramnegative alpha-2-proteobacteria cause the CSD but also fever in healthy humans. Patients suffering from AIDS show bacillary angiomatosis, bacillary peliosis hepatis, endocarditis, and septicemia. There is an open question for other aetiologic agents causing CSD as cofactors. For example, Afipia felis is found to a certain extent from patients suffering from CSD. Furthermore, Rothia dentocariosa was isolated in lymphnodes of CSD patients, and also other grampositive rods may play an important role together with B. henselae in CSD.
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PMID:[Cat-scratch disease: historical, clinical, phylogenetic and taxonomic aspects]. 919 73

The bis triazole agent fluconazole is used widely in the treatment of superficial and deep mycoses. A single oral dose of fluconazole 150 mg gives a mean long term clinical cure rate of 84 +/- 5% and is considered a valuable alternative to other topical antifungal drugs for vaginal candidiasis. A clinical cure rate of 90.4% for oropharyngeal candidiasis was obtained with 100mg daily for a minimum of 14 days; however, as for the other azoles the rate of relapse was large (40%) in immunocompromised patients. A daily dose of 100mg for at last 3 weeks gave satisfying outcomes for oesophageal candidiasis. Most patients (71 to 86%) with signs and symptoms of urinary tract candidiasis show beneficial clinical results when given oral fluconazole 50mg for several weeks. Fluconazole 50 to 150 mg given for weeks or months results in over 90% clinical cure or improvement for cutaneous mycosis including tinea, pityriasis, cryptococcosis and candidiasis. Prolonged (6 to 12 months) fluconazole 150 mg once a week is needed to treat onychomycosis successfully. Higher oral doses (200 to 400 mg daily) for long periods are generally used to treat deep mycoses such as meningitis, ophthalmitis, pneumonia, hepatosplenic mycosis and endocarditis. Fluconazole is effective for treating the fungal peritonitis which can complicate continuous ambulatory peritoneal dialysis (CAPD). A regimen of 50 mg intraperitoneally or 100 mg orally was used in these patients with impaired renal function. The dosage schedules used to treat disseminated fungal infections due to systemic mycoses with different or multiple foci of infections vary widely, with doses of 50 to 400 mg given orally or intravenously for between 1 week and several months. The most recent clinical reports have investigated the use of prophylaxis with fluconazole 100 to 400 mg daily, in immunocompromised patients. Fluconazole is found in body fluids such as vaginal secretions, breast milk, saliva, sputum and cerebrospinal fluid at concentrations comparable with those determined in blood after single or multiple doses. There is an excellent linear plasma concentration-dose relationship, but the mycological and clinical responses do not appear to be well correlated with the dose. A total maximum daily dose of 1600 mg is recommended to avoid neurological toxicity. Data from pharmacokinetic studies conducted in patients, mainly those with AIDS, and using a 1-compartment model give very constant parameters similar to those obtained in healthy individuals. Bioavailability, measured in HIV-positive patients and those with AIDS, exceeded 93% for tablets, suspension and suppositories. The time to reach peak plasma concentrations (tmax) was 2.4 to 3.7 hours. The peak plasma drug concentration (Cmax) obtained after a 100 mg oral dose was 2 mg/L. Areas under the concentration-time curve (AUC) obtained in different studies all correlate well with the dose (r = 0.926). The AUC determined after 200 and 25 mg suppositories were similarly well correlated. Hypochlorhydria does not affect the absorption of fluconazole, neither does food intake, race (Japanese or Caucasian) or gastrointestinal resection. Binding to plasma protein is low (11.14%) and is increased to 23% in cancer patients. Fluconazole is rapidly distributed to the tissue, where it accumulates. Tissues fall into 1 of 4 groups of increasing drug concentration: blood, bone and brain have the lowest concentrations, and spleen has the highest. The volume of distribution (Vd) remains stable at 46.3 +/- 7.9L and is considered to be an 'invariant' parameter across species. Fluconazole is poorly metabolised and is mainly eliminated unchanged in the urine. The percentage of the dose recovered in the urine in 48 hours is close to 60%. Concentrations in the urine are high and the half-life (t1/2) is long (37.2 +/- 5.5h) in patients, mainly those with AIDS, which is not significantly different from the t1/2 (31.4 +/- 4.7 hours) in healthy individuals. (ABSTRACT TRUN
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PMID:Clinical pharmacokinetics of fluconazole in superficial and systemic mycoses. 925 Apr 23

Polymicrobial endocarditis (PE) is uncommon, whether in series of cases of polymicrobial bacteriemia or of endocarditis. Among the 201 cases of infective endocarditis seen between 1986 and 1995 by an infectious diseases service, 12 patients had PE (6%). Nine were males, mean age was 28 years and ten were active intravenous drug users. All of them were HIV (+) and 50% had AIDS. Eleven subjects had infection of the tricuspid valve and 58% developed septic pulmonary emboli. The most common organism encountered was Staphylococcus aureus in 8 patients followed by Streptococcus viridans and S. pneumoniae in three. The most common combinations of organisms were S. aureus and S. pneumoniae in 3 cases and S. aureus and Pseudomonas aeruginosa in two. Two patients died, one with Xantomona maltophilia and another with Candida albicans. The symptoms of PE were usually indistinguishable from endocarditis caused by a single organism and the prognosis depended on the species rather than the number of organisms isolated.
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PMID:[Polymicrobial endocarditis: a clinical and evolutive study of 12 cases diagnosed during a 10-year period]. 925

The basidiomycosis, fungal infections provoked by basidiomycetes or agaric fungi have been recorded at growing frequencies in the medical literature, especially after the advent of AIDS in 1991. The basidiospores of these fungi, scattered in the atmosphere and transported by winds or air currents, reach the maxillary sinuses through the nasal route, most of the times causing signs and symptoms of chronic sinusitis. Basidiomycetes have also been isolated from sputum, especially Schizophyllum commune. Lesions of the buccal mucosa, brain abscesses, onychomycosis and endocarditis have been described, with a growing interest in this type of deep mycosis on the part of mycologists and infectologists. The present paper reports descriptions of mycetism as well as infectious processes caused by basidiomycetes, such as Schizophyllum commune, Ustilago maydis (= Ustilago zeae) and Coprinus cinereus.
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PMID:Basidiomycosis: a review of the literature. 929 82


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