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

Infectious mural endocarditis is uncommon and not well documented. The clinical setting and pathologic features of five patients with Aspergillus mural endocarditis are described. Leukemia, carcinoma, renal transplantation, and hepatic failure were the primary diseases. Associated conditions include high-dose corticosteroids, cytotoxic therapy, renal failure, gram-negative sepsis, and endotracheal intubation. All patients received prolonged antibiotic therapy or treatment with three or more antibiotics. All had clinically undetected aspergillosis and severe fungal pneumonia. Fungal myocardial abscesses were present in each patient. Aspergillus mural endocarditis developed in more than 40% of patients with cardiac aspergillosis. Endocardial vegetations were contiguous with underlying myocardial infection; yet they may develop initially as a subendocardial focus rather than from a myocardial abscess. Aspergillus mural endocarditis progressed to destroy the mitral valve ring and served as a source of mycotic embolization to vital organs.
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PMID:Aspergillus mural endocarditis. 45 81

Data on mycoses known to be imported into the United Kingdom are sparse. Estimates on the prevalence of fungal infections have to be based on indirect and incomplete figures, obtained from isolation figures and reports of individual cases to co-ordinating centres such as the Mycological Reference Laboratory and the Communicable Disease Surveillance Centre of the Public Health Laboratory Service. Imported species of dermatophytes account for less than 1% of the total number of isolations made annually at mycological laboratories throughout the U.K. A suggested prevalence of dermatophytosis in this country is c. 250 000 cases per annum. Trichophyton rubrum may now be the most common species of dermatophyte. Other estimates of the frequencies with which infections are recorded each year include mycetoma (7-10), histoplasmosis (2-5), aspergilloma (50-80), invasive aspergillosis (10-30), Candida vaginitis (greater than or equal to 1 000 000), invasive candidiasis (10-80), Candida endocarditis (1-2) and cryptococcosis (6-10).
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PMID:Imported fungal infections. 52 46

A 55-year-old black man, an intravenous substance abuser who had an acute arterial embolus to the distal aorta originating from his mitral valve, was noted on pathologic examination of the clot to have aspergillosis emboli. The infective endocarditis also resulted in emboli to the brain with subsequent death.
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PMID:Acute aortic occlusion secondary to Aspergillus endocarditis in an intravenous drug abuser. 190 45

Fungal infections may account for 5-50% of serious infections in intravenous drug users, and for 5-50 per 100,000 hospital admissions. The fungi most commonly encountered are Candida and Aspergillus spp. Candidosis may be disseminated, with lesions in superficial structures, the eye and the skeletal system, or limited to the eye, the heart (as endocarditis) or the central nervous system. Aspergillosis usually presents as endophthalmitis or as central nervous system infection. Mucormycosis is also met with occasionally, and various fungi may cause endophthalmitis or endocarditis. Antifungal therapy for intravenous drug use-related infections is no different from that for similar mycoses in other patients, but the management of intravenous drug users requires considerable clinical skill.
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PMID:Fungal infections in drug users. 193 9

No controlled trials of therapy for invasive aspergillosis have been done. This review appraises 2,121 cases reported in 497 articles in the literature and analyzes 440 courses of treatment of infection at various body sites in 379 patients. The exclusion of early failures of therapy skews the results toward a favorable outcome. The rate of response to amphotericin B is 55%. Mortality from pulmonary aspergillosis in bone marrow transplant recipients exceeds 94% regardless of therapy, as does that from cerebral aspergillosis in all hosts. Amphotericin B (1 mg/[kg.d]) with flucytosine lowers mortality in neutropenic patients with pulmonary aspergillosis who did not receive a bone marrow transplant; relapse is common. Surgical debridement of aspergillus maxillary sinusitis is usually curative in nonimmunocompromised patients, whereas it increases mortality among neutropenic patients. Valve replacement is essential for aspergillus endocarditis. Both vitrectomy and intravitreal amphotericin B treatment are essential for aspergillus endophthalmitis. Flucytosine is somewhat useful clinically. Itraconazole shows efficacy in the treatment of pulmonary, skeletal, and pericardial aspergillosis. Although liposomal amphotericin B is less toxic than standard preparations of the drug, relevant data are limited. The proposed potentiation of amphotericin B by rifampin is unsupported by clinical data. Despite "conventional" therapy, mortality from invasive aspergillosis remains high; new approaches must be investigated.
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PMID:Antifungal and surgical treatment of invasive aspergillosis: review of 2,121 published cases. 226 90

Clinical and pathologic findings in a 65-year old woman with fever of unknown origin are described in this report. Generalized aspergillosis with endocarditis was demonstrated at autopsy. The patient had no recognized risk factors for the development of fungal infection. A functional transvenous pacemaker lead, inserted 2 years previously, was completely encased in a large infected thrombus and may have been the initial site of infection. Septicemia and endocarditis are rare but well-described complications of cardiac pacing, and should be considered in the differential diagnosis of fever of unknown origin in patients with pacemakers.
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PMID:Disseminated aspergillosis and pacemaker endocarditis. 258 Feb 83

A 53 year old man with an anaplastic bronchial carcinoma was hospitalised for septic shock and acute respiratory distress after a cutaneous, probably staphylococcal infection, and died in spite of anti-staphylococcal antibiotherapy. The autopsy showed pulmonary, cardiac, cerebral and renal aspergillosis. A right heart aspergillous endocarditis, very rare in this pathology, was also discovered but there were no cardiac valves lesions. The patient was in an "immunodepressed" state as usually observed in pulmonary aspergillosis. The endocardial localisation of aspergillosis and the "pseudo-miliary" appearances of the pulmonary lesion indicated an extra-pulmonary portal of entry, cutaneous or intravenous which is unusual in this pathology. This hypothesis is supported by previous reports of pulmonary aspergillosis where right heart endocarditis is exceptionally rare and by aspergillous left heart endocarditis after open heart surgery where pulmonary aspergillosis is absent.
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PMID:[Right endocarditis in disseminated aspergillosis]. 299 56

Aspergillus vegetative endocarditis developing in a patient with acute lymphocytic leukemia during the phase of hematological remission has led to a fatal outcome, complicated with severe hemolytic anemia with red cell fragmentation. Systemic aspergillosis may involve heart valves with underlying disorders, but seldom affects intact valves even in severely compromised hosts. Among such rare cases so far reported, only 2 cases have been documented in acute leukemia, despite a huge prevalence of pulmonary and systemic aspergillosis in hematological malignancies. Our present case is essentially the same as in the preceding two cases in that endocarditis occurred during the hematological remission. These clinical, observations may suggest that every leukemic patient suffering from aspergillosis is susceptible to the valvular complication after, rather than during, the period of severe myelosuppression, because platelets play an important role in the formation of thrombotic lesions.
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PMID:Aspergillus vegetative endocarditis complicated with schizocytic hemolytic anemia in a patient with acute lymphocytic leukemia. 309 30

Among 78 patients who died after bone marrow transplantation, neurologic complications were present in 55 (70%) and were the cause of death in 5 (6%). Metabolic encephalopathy occurred in 29 patients (37%). CNS infections included aspergillosis (3), herpes simplex encephalitis (2), and Listeria monocytogenes meningitis (1). Six additional patients had neuropathologic changes possibly due to cytomegalovirus infection. Cerebrovascular complications occurred in five patients (two hemorrhages and three infarcts). All infarcts were associated with endocarditis. The rate of nonbacterial thrombotic endocarditis was significantly higher (p less than 0.001) than in the general autopsy population. CNS leukemia and therapy-induced injury were rare. There was no evidence of graft-versus-host disease involving the CNS.
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PMID:Neurologic complications of bone marrow transplantation. 388 33

A rare case of the generalized aspergillosis in a man of 39 is described. Aspergillosis developed in the presence of portal liver cirrhosis and chronic alcoholism. The case was marked by aspergillosis endocarditis with spheroid fungi growths on the heart valves in the form of fungus ball, widespread embolism with fungus mycelium and thrombovasculitis with the development of infarcts in the inner organs and brain.
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PMID:[Generalized aspergillosis]. 652 70


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