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)

Two patients had bacteremia with Center for Disease Control group DF-2 Gram-negative rods. Previously described patients infected with this organism had clinical syndromes including cellulitis, meningitis, and endocarditis, and generally were severely ill. One of our patients had acute oligoarticular arthritis. The other had fever, headache, malaise, and a generalized rash. In neither case was bacterial infection considered likely at onset, and neither patient received antibiotic therapy. Both patients recovered completely. The organism is a fastidious Gram-negative rod that only recently has been characterized. Methods for isolating and identifying the organism are reviewed. The spectrum and frequency of illnesses caused by this organism are probably greater than previously recognized.
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PMID:Infection with CDC group DF-2 gram-negative rod: report of two cases. 624 27

An increased mean platelet volume (MPV), measured by the Coulter counter model S plus, was found in 13 of 25 patients with proven septicaemia but in none of 25 patients with localised bacterial infection and negative blood cultures. The increase in MPV was found both in patients with normal and low platelet counts and was not related to a particular micro-organism. Patients who responded favourably to antibiotic treatment all had normal MPVs after one week of treatment. However, 9 of 11 patients with a prolonged course of their infection due to endocarditis or abdominal abscesses had raised MPVs after seven days of treatment, and four patients who died of infection in the first week all had increased MPVs on the day of their death. An increased MPV in a patient with bacterial infection possibly indicates that the infection has become invasive--that is, that septicaemia has occurred. A persistent rise or further increase indicates that treatment is inadequate.
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PMID:Increased mean platelet volume in septicaemia. 634 37

To determine the incidence of transient bacteremia associated with laparoscopy, a prospective study was carried out in 113 patients with diverse liver diseases. Blood samples for aerobic and anaerobic cultures were obtained for each patient immediately before laparoscopy, within three minutes after creation of pneumoperitoneum and within three minutes after needle biopsy of the liver. Five subjects were culture positive, and all isolates were of the propionibacterium species. Positive cultures did not correlate with the nature of underlying liver disease, and none of these patients developed clinical evidence of bacterial infection. Positive isolates might be assumed to be contaminants, but the fact propionibacterium has been known to cause endocarditis cannot be ignored. Until further evidence accumulates, antibiotic coverage in "high risk" patients with cardiac lesions who are predisposed to endocarditis undergoing laparoscopy may be warranted.
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PMID:Evaluation of blood cultures following laparoscopy. 645 17

The relation between the duration of bacterial infection and circulating immune complexes (CIC) level was evaluated using the C1q binding assay in a group of patients with well defined clinical sepsis. Fifty-four patients with endocarditis and 35 with post-open heart surgery mediastinitis were prospectively studied over a period of 2 years. CIC were detected in 42% of patients studied. Interindividual variations were observed but it was found that the level of CIC increased statistically with time (P less than 0.001). CIC were statistically linked with cryoglobulinemia (P less than 0.001), rheumatoid factor (P less than 0.001) and a decreased CH50 (P less than 0.05). CIC were more frequent in patients with endocarditis (53%) than in patients with mediastinitis (24%). However, when the duration of the infection was taken into account the difference was no longer significant. No relation could be evidenced between the incidence of CIC and clinical symptoms including prognosis and renal signs. In our experience, determination of CIC does not have a critical clinical value.
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PMID:Circulating immune complexes and severe sepsis: duration of infection as the main determinant. 708 30

Lipoteichoic acid (LTA), a component of the cell wall of most gram-positive bacteria, has been shown to play a significant role in the initiation and progression of bacterial infection. However, little is known of its position in the cytokine network involved in the induction and perpetuation of inflammation. In this study, we assessed whether the macrophage activating and chemotactic cytokine macrophage inflammatory protein-1 alpha (MIP-1 alpha) was expressed in the setting of localized gram-positive infection. Furthermore, we determined whether LTA purified from either Staphylococcus aureus or Streptococcus pyogenes could induce the expression of MIP-1 alpha mRNA and protein from human blood monocytes. Immunohistochemical staining of human endocardial samples obtained from patients with acute S. aureus endocarditis revealed cell-associated MIP-1 alpha expression by neutrophils, macrophages, and fibroblasts. Treatment of human peripheral blood monocytes in vitro with LTA isolated from either S. aureus or S. pyogenes resulted in both the time- and dose-dependent expression of MIP-1 alpha mRNA. Similarly, staphylococcal and streptococcal LTA induced the dose-dependent production of MIP-1 alpha protein after 24 h in culture. These studies suggest that LTA may play an important role in triggering the recruitment and activation of leukocytes that characterizes the host response to gram-positive bacterial invasion.
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PMID:Macrophage inflammatory protein-1 alpha expression in vivo and in vitro: the role of lipoteichoic acid. 799 29

Situations which can be considered at risk for infective endocarditis are those causing a bacteremia, which is necessary for the development of an endocarditis. Such situations can be identified by clinical studies evaluating the rate at which a bacteremia occurs after some procedures or because of lesions, then the risk of endocarditis after such a bacteremia. Without considering preexisting cardiac lesion and age, some situations seem to be at risk of subsequent endocarditis: acute bacterial infection for which antibiotherapy is necessary; procedures involving the mouth with the exception of superficial caries and bloodless supragingival prosthetic preparations; oesophageal dilatation, laser endo-oesophageal procedures, sclerosis of oesophageal varices; colonoscopy and sigmoidoscopy for cancer lesions, gastrointestinal procedures on a potentially infected gastrointestinal tract (cholecystectomy, colectomy...); tonsillectomy and adenoidectomy; naso-tracheal intubation; instrumental procedures involving the ureter or kidney, and prostatic or urinary tract biopsies and surgery; procedures performed on infected skin. In cardiac patients at high risk, in addition to the above retrograde cholangiography, colonoscopy and rectosigmoidoscopy, lithotripsy. In these situations the risk of endocarditis is probably linked to the rate of bacteremia, the size of inoculum, and the bacteria, compared with spontaneous bacteremia without any procedure, where the inoculum is low and bacteria is considered as non pathogenic. A prophylaxis has to be discussed in such situations, which are probably involved in less than 10% of endocarditis.
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PMID:[Situations and procedures with risk of bacterial endocarditis (intracardiac surgery excluded)]. 802 96

The diagnosis of infective endocarditis remains a challenge to physicians providing primary care. On one hand this type of infection will be rarely encountered in primary care, but on the other hand this disease carries an enormous detrimental potential. Furthermore infective endocarditis, particularly in its initial phase, often has an uncharacteristic presentation with findings and symptoms shared with many much more frequent and often harmless diseases. To confront these difficulties, which are responsible for the often delayed diagnosis of infective endocarditis, strict rules must be applied. In patients at risk for infectious endocarditis no antibiotic therapy should be instituted without prior cultures. Also, in all other patients aimless, "blind" antibiotic therapy without diagnosis of a bacterial infection should be avoided. In patients with uncharacteristic symptoms and findings compatible with the diagnosis of infective endocarditis that persist for more than 5 days, blood cultures prior to any antibiotic therapy are warranted in addition to other clinical exams and tests. The sensitivity of echocardiography in detecting infective endocarditis is frequently overestimated. Furthermore, transesophageal echocardiography in endocarditis high-risk patients requires antibiotic prophylaxis which would obscure bacteriological diagnosis. For these reasons echocardiography should not be used as first test method when considering the diagnosis of infective endocarditis.
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PMID:[Infectious endocarditis]. 802 80

Research was carried out into the prevalence of streptococcal types isolated from pigs that died of septicaemia, meningo-encephalitis, endocarditis, and pneumonia and which were brought in for investigation from 1 january 1988 to 31 December 1991. Cultures were prepared from the liver, spleen, kidneys, and brains of all animals and from the heart valves, joints, bronchi, and lungs of animals with pathological changes. The results are presented in six tables. As a group, streptococci were a major source of bacterial infection in septicaemia (38%), meningo-encephalitis (21%), and endocarditis (74%). Of the streptococcus types. Streptococcus suis type 2 was isolated the most often in sepsis (36%), meningo-encephalitis (52%), and endocarditis (36%). Streptococcus suis type 1 was found not only in piglets up to the age of weaning but also in older pigs and was a common pathogen in pigs with endocarditis. The discussion takes into consideration data from the literature. It is concluded that the significance of streptococcus infections, and those involving Streptococcus suis types 1 and 2 in particular, has increased under the influence of environmental and management factors (scaling-up of production, import of pigs from abroad, extermination and control of other pig diseases).
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PMID:[Streptococcal infections as cause of death in pigs brought in for necropsy]. 813 11

Infective endocarditis (I.E.) is a common bacterial infection of the endocardium, which before the advent of antibiotics, had a high mortality rate. Endocarditis has been described as a serious and a potentially fatal condition in which the heart beats in a muffled march towards the grave, in quick time in the acute form and with a slower, but as deadly rhythm, in the subacute form. I.E. can occur at any period of life, but presently, there has been a shift towards younger individuals due to intravenous drug abuse. Thus the overall incidence since the pre-antibiotic era has remained constant. This has been the situation in spite of the periodic revisions made by the American Heart Association (AHA) for the guidelines for antibiotic prophylaxis. In India there are no guidelines issued by any professional organisations and hence the decision to use antibiotic prophylaxis depends on the dentist's awareness of the patient's predisposition, the standard regime learnt from a textbook, the patient's economic status and belief to comply with the advice and the choice of antibiotic, route of administration and dose. In this paper, an attempt is made to collect data on the incidence of I.E. from two large teaching hospitals and use it to decide whether antibiotic prophylaxis of patients predisposed to I.E. should be followed or not.
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PMID:Infective endocarditis, the conundrum of antibiotic prophylaxis. 949 12

Evidence of infection with spirorchid flukes (Digenea: Spirorchidae) was sought at necropsy of 96 stranded green turtles, Chelonia mydas, that were examined during the course of a survey of marine turtle mortality in southeastern Queensland, Australia. Three species of spirorchid (Hapalotrema mehrai, H. postorchis, and Neospirorchis schistosomatoides) were identified. Severe disease due to spirorchid fluke infection (spirorchidiasis) was implicated as the principal cause of mortality in 10 turtles (10%), and appeared to be one of multiple severe problems in an additional 29 turtles (30%). Although flukes were observed in only 45% of stranded C. mydas in this study, presumed spirorchid fluke infection was diagnosed in an additional 53% of turtles, based principally on characteristic necropsy lesions and to a lesser extent on the histopathological detection of spirorchid eggs. Characteristic necropsy lesions included miliary spirorchid egg granulomas, which were observed most readily on serosal surfaces, particularly of the small intestine. Cardiovascular lesions included mural endocarditis, arteritis, and thrombosis, frequently accompanied by aneurysm formation. Resolution of thrombi was observed to occur via a combination of granuloma formation about indigestible components (spirorchid fluke egg shells) and exteriorization through the vessel wall, which resulted in granulomatous nodules on the adventitial surface. Septic aortic thrombosis complicated by disseminated bacterial infection, observed in five turtles, was recorded for the first time. Egg granulomas were ubiquitous in turtle tissues throughout this study. Although they generally appeared to be mild or incidental lesions, they were occasionally associated with severe multifocal granulomatous pneumonia or meningitis.
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PMID:Lesions caused by cardiovascular flukes (Digenea: Spirorchidae) in stranded green turtles (Chelonia mydas). 954 32


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