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)

A 44-year-old female admitted to our hospital because of fever, purpura and macroscopic hematuria. She had been diagnosed as having ventricular septal defect (VSD). She noticed purpura with pain on bilateral legs and macroscopic hematuria since September 18, 1994. Three weeks later she also manifested a fever. Physical examination of admission revealed numerous purpura and leg edema. Laboratory data showed macroscopic hematuria, marked anemia (Hb 3.3 g/dl), leukocytosis, azotemia (Cr 2.7 mg/dl) and positive acute phase reactants. Increased serum immune complex level and hypocomplementemia were also found. The diagnosis of allergic purpura was made initially, but positive blood culture of Streptococcus mitis and the detection of vegetation attached to the right ventricular wall near the ostium of the VSD made the definite diagnosis of infective endocarditis (IE). Chemotherapy with PCG was started for two weeks but with no effect. The chemotherapy was altered to panipenem/betamipron with a daily dose of 3 g, Then, her fever fell and purpura, macroscopic hematuria and renal failure gradually disappeared. In this case, the cause of renal manifestations was considered to be immune complex glomerulonephritis. This is the first report of IE with macroscopic hematuria due to immune complex glomerulonephritis.
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PMID:[A case of infective endocarditis with purpura and macroscopic hematuria as initial manifestations]. 869 Sep 52

A 26-year-old man who had suffered from intermittent chills and fever over a two month period was quite clear of heart or kidney involved developed acute deterioration of renal function. A new pansystolic murmur over the apex of the heart was heard on auscultation, and echocardiography clearly showed a vegetation about 0.7-0.9 cm in size on the atrial site of the mitral value. Laboratory investigation displayed normochromic anemia with negative Coombs' test. Immunological studies were positive for rheumatoid factor and circulating immune complex. High serum levels of erythrocyte sedimentation rate and C-reactive protein, nephritic sediment of urinalysis and negative blood cultures for bacteria, tuberculosis or fungus were also noted. Abdominal sonography showed normal kidney size, bilaterally. Renal biopsy revealed typical crescentic glomerulonephritis. After intravenous penicillin therapy for two weeks, the serum creatinine level recovered from 6.7 mg/dl to 2.0 mg/dl and circulating immune complex disappeared. In consideration of cardiac insufficiency and the potential risk for complications of the vegetation, the patient underwent mitral valve replacement. Four weeks after operation, all the abnormal data had resolved completely. These data suggested that infective endocarditis with rapidly progressive glomerulonephritis is curable by antibiotic therapy and surgical intervention.
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PMID:Infective endocarditis complicated with rapidly progressive glomerulonephritis: a case report. 880 7

Isolated native nonrheumatic tricuspid valve endocarditis rarely is described in the absence of intravenous drug use, intracardiac catheters, or cardiac anomalies. We diagnosed tricuspid valve endocarditis in two elderly nonaddicted patients with recurrent pulmonary infiltrates, anemia, and microscopic hematuria that occurred during several months and was caused by Gemella morbillorum and Candida glabrata, respectively. We have reviewed 27 other cases of nonaddicted patients with tricuspid valve endocarditis from the literature and discussed etiology, clinical characteristics, and outcome. Mean age was 53.5 years (range, 22 to 74 years old), and 72% had underlying medical conditions. Staphylococcus oureus, Streptococcus bovis, and candida species were the causative organisms in 70% of the cases. Average duration of infection before diagnosis was 9.3 months. We conclude that isolated tricuspid valve endocarditis in nonaddicted patients occurs mainly in the middle-aged and older persons, mimicking chronic illness and community-acquired pneumonia. In the absence of a history of intravenous drug use, diagnostic delays are common. We suggest that right-sided endocarditis must be considered in any patient with the "Tricuspid Syndrome," consisting of recurrent pulmonary events, anemia, and microscopic hematuria. Careful evaluation of prior medical records and clinical course can be very helpful. Echocardiography and serial blood cultures provide the key to diagnosis.
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PMID:Isolated tricuspid valve endocarditis in nonaddicted patients: a diagnostic challenge. 929 48

A retrospective study of 10 horses with bacterial endocarditis was performed in order to describe the echocardiographic findings in horses with bacterial endocarditis, in conjunction with clinical signs and post mortem findings, and to evaluate the usefulness and the formulation of a prognosis. Echocardiographic and post mortem examinations were performed in 7 horses. Post mortem examination alone was performed in 2 horses and echocardiographic examination alone performed in one horse. No breed or sex predilection was obvious. Mean age +/- s.d. was 2.12 +/- 3.32 years. Predominant clinical signs and abnormal clinical pathology data were fever, cardiac murmur, tachycardia, tachypnoea, hyperfibrinogenaemia, anaemia and leucocytosis. Pasteurella/Actinobacillus spp. and Streptococcus spp. were most commonly cultured. Vegetative lesions were found most frequently on the mitral valve and secondarily on the aortic valve. The location and number of lesions identified with echocardiography in the horses accurately described the lesions found on post mortem examination. Medical treatment was attempted in 50% of the horses. Serial echocardiography was used to assess the response to treatment in 2 horses. All horses with vegetative lesions of the mitral and/or aortic valve died or were subjected to euthanasia due to the severity of their cardiac disease. Both horses with tricuspid valve endocarditis were cured of the infection, one horse returned to racing after antimicrobial therapy and the other was subjected to euthanasia due to severe laminitis.
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PMID:Bacterial endocarditis in horses: ten cases (1984-1995). 930 68

Clinical, hematological, cytogenetic and pathohistological findings in 14 patients with high eosinophilia allowed the authors to distinguish 2 groups of patients: with symptomatic (secondary) and idiopathic hypereosinophilic syndromes (6 and 8 patients, respectively). The latter was characterized by hepato- and splenomegaly, specific cardiac lesion (thromboplastic endocarditis), non-infectious fever, anemia and thrombocytopenia, marked hypercellularity of the bone marrow with inhibition of erythro- and megakaryocytopoiesis. Ph'-chromosome occurred in 2 out of 8 cases. Biopsy and autopsy histology in all cases of idiopathic hypereosinophilic syndrome were typical for myeloproliferative diseases. In symptomatic hypereosinophilic syndrome the above features were not registered.
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PMID:[Idiopathic and symptomatic hypereosinophilic syndromes (their comparative characteristics based on 14 cases)]. 942 54

Jehovah's Witness who require operation represent a challenge to the physician because of the patients' refusal to accept blood transfusion. We report an 8-year-old male of Jehovah's Witness who underwent a surgical treatment of infective endocarditis. He was transferred to our hospital because of high fever and heart murmur. Echocardiogram revealed a developing vegetation of aortic cusps and an aneurysmal change of the non-coronary sinus Valsalva. On admission he was complicated by anemia, purulent meningitis and suppurative arthritis of left knee. There were no signs of cardiac failure. Erythropoietin (6000 U thrice weekly) and iron (60 mg daily) were given for 11 weeks prior to surgery, raising the hemoglobin level from 9.2 g/dl to 18.4 g/dl. Aortic valve replacement and plasty of the sinus Valsalva were then performed. Intraoperatively hemoglobin concentration dropped to 10.3 g/dl and it raised to 15 g/dl postoperatively. We also used Cell-Saver to reduce blood loss. The patient made an uncomplicated recovery. Erythropoietin therapy contributed substantially to the successful outcome of this case.
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PMID:[Open heart surgery in a Jehovah's Witness boy--a case report of successful management of aortic regurgatation and aneurysm of sinus Valsalva due to infective endocarditis]. 945 16

A 50-year-old woman was referred to our hospital because of skin purpura, anemia, high fever, and acute renal insufficiency. Five years ago, she had been diagnosed as having ventricular septal defect without any complications. A blood culture drawn during the hospitalization grew Streptococcus viridans. She was diagnosed as having infective endocarditis-induced crescentic glomerulonephritis (GN) according to echocardiography and renal biopsy results. Although antibiotic treatment alone showed no apparent efficacy, after the initiation of plasmapheresis, the high fever and acute renal insufficiency were dramatically improved. After clinical stability was achieved, closure of the ventricular septal defect was performed. This result suggests that plasmapheresis may be beneficial in the treatment of infective endocarditis-induced crescentic GN. The possible mechanisms of this therapy are discussed.
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PMID:Infective endocarditis-induced crescentic glomerulonephritis dramatically improved by plasmapheresis. 970 18

The first case of Q fever endocarditis that has been diagnosed in Mexico is presented. A 10-year-old girl with discrete subaortic stenosis (SAS) and patent ductus arteriosus (PDA) was seen in December of 1996 with fever, hepatomegaly and splenomegaly. She presented also anemia, leukopenia, hypergammaglobulinemia, positive rheumatoid factor, cryoglobulinemia, antinuclear and anticytoplasmic antibodies (anti-RNA-proteins and anti-DNA). An aortic valve vegetation was seen by echocardiogram. Blood-cultures were negative. Antibody test for Coxiella burnetii was positive. Treatment with doxicyclin was initiated as soon the diagnosis was done. PDA was closed, SAS was liberated and two aortic vegetations were resected. Endocarditis in Q fever occurs when there is predisposing heart disease and/or immunodeficiency. Effective therapy has not yet been established. The diagnosis of Q fever endocarditis is difficult; it should be considered, in case of clinical suspicion of endocarditis with negative blood-cultures.
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PMID:[Coxiella burnetii endocarditis. A report of the first case diagnosed in Mexico]. 981 Mar 69

A diagnosis of Q fever endocarditis was made in 7 patients, 6 with predisposing factors and 3 with occupational risk factors. Prompt recognition of Coxiella burnettii endocarditis is required when clinical signs of endocarditis such as fever, anaemia, elevated liver transaminases, congestive cardiac failure are accompanied by negative blood cultures. Serological evidence of elevated antibody titres to Phase I and Phase II antigens of Coxiella burnettii are diagnostic. Prolonged antimicrobial therapy combined with surgery has resulted in the marked reduction of mortality from 50 per cent of 17 per cent when Q fever endocarditis is revisited almost 20 yr later.
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PMID:Q fever endocarditis revisited. 1009 46

The infective endocarditis is a septic syndrome caused by an infection in endocardium or in heart valves. The majority of patients with infective endocarditis develop normocytic anemia. The metabolic studies in septic shock syndromes documented an intensive proteolysis of muscles, visceral organs and blood proteins, and probably of erythropoietin as a glycoprotein as well. The aim of the study was to assess the erythropoietin level in patients with infective endocarditis severe anemia and preserved renal function. Erythropoietin concentration was measured in blood serum in 12 patients (11 men and 1 woman), mean age 48 +/- 8 years, with infective endocarditis. The patients had clinical symptoms of endocarditis, positive blood bacteriological cultures and echocardiography features. All patients had serious normocytic anemia with mean hemoglobin concentration 5.40 +/- 0.48 mmol/L. The control group consisted of 7 healthy persons (5 men and 2 women), mean age 50 +/- 7 years, with hemoglobin concentration 8.70 +/- 0.60 mmol/L. The concentration of erythropoietin at the patients with bacterial endocarditis was 144.04 +/- 17.80 mIU/mL versus 67.28 +/- 6.29 mIU/mL in the control group (p = 0.0002). We conclude that in patients with infective endocarditis and serious normocytic anemia without renal insufficiency the concentration of erythropoietin is increased.
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PMID:[The level of erythropoietin in serum of patients with anemia during infective endocarditis]. 1072 24


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