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)

Caspofungin is an echinocandin agent approved for the treatment of invasive candidiasis and refractory aspergillosis. Compared with amphotericin B, caspofungin has an improved safety profile, but clinical experience with this agent is still accumulating. A 68-year-old man developed reversible severe thrombocytopenia, possibly due to caspofungin, after being successfully treated for Candida albicans endocarditis. Given the limited clinical experience with caspofungin, continued vigilance for unusual and serious adverse events associated with the drug is imperative.
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PMID:Caspofungin: a potential cause of reversible severe thrombocytopenia. 1562 37

Invasive aspergillosis is an emerging infection mainly affecting immunocompromised patients. This report details a case of Aspergillus fumigatus tricuspid native valve endocarditis complicated by recurrent septic pulmonary emboli in a young, non-intravenous drug user. He was treated by surgical resection of the posterior leaflet of the tricuspid valve and the vegetations, as well as by valvuloplasty, which was followed by a combination of liposomal amphotericin B and voriconazole as acute-phase therapy and voriconazole alone as suppression therapy.
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PMID:Aspergillus fumigatus tricuspid native valve endocarditis in a non-intravenous drug user. 1658 53

New immunosuppressive protocols and advanced surgical technique resulted in an improved outcome of pancreatic transplantation (PTx) with infection remaining the most common complication. Seventy-two enteric-drained whole PTxs performed at the Innsbruck University Hospital between September 2002 and October 2004 were retrospectively analyzed. Prophylactic immunosuppression consisted of either the standard protocol consisting of single bolus antithymocyteglobulin (ATG) (Thymoglobulin, Sangstat or ATG Fresenius) induction (9 mg/kg), tacrolimus (TAC), mycophenylate mofetil (MMF) and steroids (38 patients) or a 4-day course of ATG (4 mg/kg) tacrolimus and steroids with MMF (n = 19), or Sirolimus (n = 15). Perioperative antimicrobial prophylaxis consisted of Piperacillin/Tazobactam (4.5 g q 8 h) in combination with ciprofloxacin (200 mg q 12 h) and fluconazole (400 mg daily). Ganciclovir was used for cytomegalovirus (CMV) prophylaxis if donor was positive and recipient-negative. Patient, pancreas, and kidney graft survival at 1 year were 97.2%, 88.8%, and 93%, respectively, with no difference between the groups. All retransplants (n = 8) and single transplants (n = 8) as well as all type II diabetics and nine of 11 patients older 55 years received standard immunosuppression (IS). The rejection rate was 14% and infection rate 46% with no difference in terms of incidence or type according to the three groups. Severe infectious complications included intra-abdominal infection (n = 12), wound infection (n = 7), sepsis (n = 13), respiratory tract infection (n = 4), urinary tract infection (n = 12), herpes simplex/human herpes virus 6 infection (n = 5), CMV infection/disease (n = 7), post-transplant lymphoproliferative disorder (PTLD, n = 3), invasive filamentous fungal infection (n = 4), Clostridial/Rotavirus colitis (n = 1), and endocarditis (n = 1). All four patients in this series died of infectious complications (invasive aspergillosis n = 2) (one with Candida glabrata superinfection), invasive zygomycosis (n = 1), PTLD (n = 1). Five grafts were lost (vascular thrombosis n = 3, pancreatitis n = 1, noncompliance n = 1). Infection represented the most frequent complication in this series and all four deaths were of infectious origin. Better prophylaxis and management of infections now should be the primary target to be addressed in the field of pancreas transplantation.
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PMID:Infectious complications following 72 consecutive enteric-drained pancreas transplants. 1676 33

While invasive aspergillosis occurs typically in severely immunocompromised patients, cases of surgical site infection have been reported in immunocompetent individuals. The Medline, LILACS and EMBASE databases were searched for descriptions of cases of post-operative aspergillosis, and references from relevant articles and conference abstracts were reviewed. More than 500 cases of post-operative aspergillosis were found. Cardiac surgery (n = 188), ophthalmological surgery (n > 90) and dental surgery (n > 100) were associated with the majority of cases. Other cases involved wound infections (n = 22), bronchial infections (n = 30), mediastinitis (n = 11), pleural aspergillosis (n = 1), infections following orthopaedic surgery (n = 42), vascular prosthetic surgery (n = 22), breast surgery (n = 5), abdominal surgery (n = 10) and neurosurgery (n = 25). In most patients, the source was presumed to be airborne infection during the surgical procedure. Prevention of these infections requires special care of the ventilation system in the operating room. Successful treatment requires rapid diagnosis, surgical debridement and antifungal therapy, often with voriconazole. In order to improve the outcome, better diagnostic methods are needed, particularly for cases of endocarditis and aortitis.
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PMID:Post-operative aspergillosis. 1700 5

Native valve endocarditis caused by Aspergillus spp. is an uncommon disease with a high mortality rate. Generally, Aspergillus is isolated from affected valve in post-mortem or biopsy specimens. However, its isolation from blood cultures is exceedingly rare. We report a case of fungal endocarditis in a native mitral valve with the isolation of Aspergillus fumigatus both in valve vegetation and in blood culture bottles. The patient underwent valve replacement and antifungal treatment with voriconazole and caspofungin, but he died on post-operative day 45 with disseminated aspergillosis confirmed by necropsy. Paradoxically, galactomannan antigen detection in serum was negative. This is the third case of Aspergillus endocarditis with positive blood culture reported in the literature.
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PMID:[Native valve Aspergillus fumigatus endocarditis with blood culture positive and negative for galactomannan antigen. Case report and literature review]. 1760 38

Invasive aspergillosis (IA) is an emerging infectious disease in different groups of immunocompromised patients. In transplant recipients, intensification of immunosuppressive therapy to treat allograft rejection poses a major risk factor for IA. We present the clinical features, diagnostic findings and outcome of a kidney transplant recipient who developed pulmonary aspergillosis complicated by endocarditis of his native tricuspid valve. Despite replacement of the valve and treatment with combined antifungal therapy, the patient died of an acute pulmonary bleeding.
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PMID:Fatal right-sided endocarditis due to Aspergillus in a kidney transplant recipient. 1771 Jun 27

Transplant recipients are very susceptible to invasive aspergillosis, which increases mortality rate. Disseminated aspergillosis in the liver transplant recipient can affect virtually any organ and endocarditis is often lethal despite cardiac surgery and antifungal therapy. We report the case of a eight-month-old girl who presented with Aspergillus fumigatus endocarditis 18 days after liver transplantation that was successfully treated by a combination of antifungal drugs associated to a low dosage of immunosuppressive therapy.
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PMID:Aspergillus fumigatus endocarditis in a pediatric liver transplant recipient: favorable outcome without cardiac surgery. 1839 13

Voriconazole is a broad-spectrum triazole antifungal agent indicated for invasive aspergillosis, refractory Candida infections, and other emerging invasive fungal infections. Adverse cutaneous reactions associated with voriconazole therapy occur in fewer than 10% of treated patients and range from mild erythematous eruptions to life-threatening reactions such as the Stevens-Johnson syndrome and toxic epidermal necrolysis. Photosensitivity reactions are an uncommon but characteristic dermatitis in voriconazole recipients, particularly following chronic administration. We report a case of voriconazole-induced phototoxicity in a 50-year-old male with Candida parapsilosis endocarditis that reversed on discontinuation of the drug.
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PMID:Voriconazole-induced photosensitivity. 1880 50

The prevalence of Aspergillus endocarditis (AE) is increasing in the hospital population. Aspergillus species contribute to approximately 25 % of all cases of fungal endocarditis. This study is a descriptive report of the use of nested PCR to detect DNA specific for Aspergillus species in serum for the diagnosis of cardiac infections. Open heart surgery was performed on patients and collected samples were examined microscopically and cultured. Ten sera in total from five patients were extracted for Aspergillus DNA and nested PCR with Aspergillus species primers was carried out. The lowest limit of detection for the PCR assay was 1 c.f.u. (ml serum) (-1). The PCR was positive in three patients. Culture of valvular tissue confirmed the growth of Aspergillus fumigatus in one patient and Aspergillus niger in two patients. In this study we have demonstrated the presence of invasive aspergillosis in patients who had undergone open heart surgery and the usefulness of a molecular assay for the diagnosis of AE.
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PMID:Molecular diagnosis of Aspergillus endocarditis after cardiac surgery. 1914 36

Invasive aspergillosis is an emerging infection mainly affecting immunocompromised patients. Aspergillus endocarditis remains a rare infection and usually occurs following cardiac surgery for prosthetic valves. This is an uncommon case of a 60-year-old asthmatic male who developed allergic bronchopulmonary aspergillosis during the course of his illness, and while receiving low dose oral steroids, he subsequently developed right-sided Aspergillus mural and native valvular endocarditis with extensive invasive pulmonary aspergillosis.
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PMID:Aspergillus endocarditis in a known case of allergic bronchopulmonary aspergillosis: an autopsy report. 1921 Dec 74


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