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

Primary bacterial infection of myocardial tissue without associated endocarditis occurs only rarely. It is generally seen in the setting of overwhelming bacteremia. The most common bacterial cause of myocarditis is Staphylococcus aureus, although infections with a broad range of bacterial pathogens have been described. Pathologically, the disease process is characterized by multifocal studding of the myocardium with tiny abscesses, and the left ventricle is most commonly involved. Complications include cardiac dysfunction, rhythm disturbances, and myocardial rupture with secondary purulent pericarditis. Since virtually all information regarding primary bacterial myocarditis originates from autopsy studies conducted in the pre-antibiotic era, little is known about the modern approach to diagnosis and management of this clinical entity.
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PMID:Primary bacterial infection of the myocardium. 1270 39

Bartonella henselae can infect humans resulting in a wide range of disease syndromes including cat-scratch disease, fever with bacteremia, endocarditis, bacillary angiomatosis, and bacillary peliosis hepatis, among others. The nature and severity of the clinical presentation correlates well with the status of the hosts' immune system. Individuals with impaired immune function, including HIV infection, progress to systemic infections more often. Patients with intact immune function who become infected with B. henselae usually get cat-scratch disease, a disease that usually involves lymphadenopathy resulting from a strong cellular immune response to the bacterium. However, immunocompromised patients often progress to bacillary angiomatosis or bacillary peliosis hepatis. The reduced ability of the hosts immune response to control bacterial infection apparently results in a bacteremia of longer duration, and in some patients the presence of angiogenic lesions that are unique among bacterial infections to Bartonella. Recently, the role of immune effector cells that produce angiogenic cytokines upon stimulation with B. henselae has been proposed. Here, the current status of the role of the immune response in both controlling infection and in B. henselae-triggered immunopathogenesis is presented.
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PMID:The role of the host immune response in pathogenesis of Bartonella henselae. 1290 36

Botryomycosis is a rare bacterial infection of the skin and, rarely, viscera that is characterized by the formation of characteristic hyaline grains. We encountered a patient with Erysipelothrix rhusiopathiae endocarditis who developed visceral botryomycosis. He was a 54-year-old black man who presented in sepsis with a history of progressive weakness and severe weight loss. He died 10 hours after admission. At autopsy, endocarditis was identified, along with infarcts of the spleen and kidneys. Microscopically, visceral botryomycosis was seen. With these bacteria, an animal source is usually identified, although one was not found in this man. Erysipelothrix rhusiopathiae is an organism that is becoming identified in a range of infections in humans, the manifestations and pathophysiology of which are still being discovered.
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PMID:Visceral botryomycosis in a case of Erysipelothrix rhusiopathiae endocarditis. 1571 90

This review will highlight the potential application of procalcitonin, a novel marker of systemic bacterial infection, in two clinical settings relevant to cardiologists: infective endocarditis (IE) and lower respiratory tract infections (LRTI): The variability in the clinical presentation of infective endocarditis (IE) makes the diagnosis a clinical challenge. However, rapid diagnosis and initiation of effective treatment are essential to good patient outcome. Serum calcitonin precursor levels, including procalcitonin, are elevated in systemic bacterial infections and seem to be helpful in the diagnosis of IE. The utility of procalcitonin in clinical practice was examined in a prospective cohort of patients with the suspicion of IE. Procalcitonin was significantly higher in patients with IE (median 6.56 microg/L) as compared with patients with other final diagnoses (median 0.44 microg/L, p < 0.001). The area under the ROC curve using procalcitonin to predict infective endocarditis was 0.856, as compared to 0.657 for C-reactive protein. The optimum concentration of procalcitonin for the calculation of positive and negative predictive accuracy as obtained from the ROC curve was 2.3 microg/L. Using this cut-off, the test characteristics of procalcitonin were as follows: sensitivity 81%, specificity 85%, negative predictive value 92%, positive predictive value 72%. Although most LRTIs are due to viral infections, they are very often treated with antibiotics. This excessive use of antibiotics is believed to be the main cause of the spread of antibiotic-resistant bacteria. A procalcitonin-based therapeutic strategy has shown to reduce antibiotic usage in LRTI. Based upon serum procalcitonin levels, the use of antibiotics was more or less discouraged (<0.1 or <0.25 microg/L) or encouraged (> or =0.5 or > or =0.25 microg/L), respectively. Final diagnoses included pneumonia (36%), acute exacerbation of COPD (25%), and acute bronchitis (24%). Clinical and laboratory outcome was similar in both groups and favourable in 96.7%. In the procalcitonin group, the adjusted relative risk of antibiotic exposure was 0.49 (p < 0.001), as compared to the standard group. Thus, using a sensitive assay, procalcitonin-guidance substantially and safely reduced antibiotic usage in LRTI.
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PMID:What cardiologists do need to know about procalcitonin. 1571 98

Despite S. pneumoniae is one of main etiologies of invasive bacterial infection in children, it rarely causes infectious endocarditis in children. Pneumococcal endocarditis is a serious condition that affects mainly the mitral valve, with a rapidly destructive nature and a high fatality rate, demanding prompt medical and surgical treatment. We report a case of pneumococcal endocarditis in a school girl coming from extreme rurality who presented both meningitis and endocarditis, and whose blood cultures isolated penicillin resistant S. pneumoniae.
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PMID:[Pneumococcal endocarditis in children: report of a case due to penicillin resistant Streptococcus pneumoniae]. 1689 98

A 12-year-old girl with a high fever underwent echocardiography and was found to have a myxoma that arose from the atrial side of the anterior mitral valve leaflet. The tumor was successfully excised. Histologic examination of the tumor showed myxoma cells and an organized thrombus with bacterial colonization. The patient was discharged from the hospital on antibiotic treatment. After remaining asymptomatic for 3 weeks, she was readmitted with acute abdomen. Ultrasonography and magnetic resonance angiography detected intra-abdominal hemorrhaging and a saccular aneurysm of the abdominal aorta. The patient underwent successful emergency surgery. To our knowledge, no other report has been published concerning an abdominal aortic aneurysm secondary to bacterial infection of a cardiac myxoma. Although complications this severe are rarely observed in patients who have endocarditis, early recognition and treatment can be life-saving.
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PMID:Ruptured abdominal aortic aneurysm after resection of an infected cardiac myxoma. 1762 77

The prevalence and risk factors for treated bacterial infections (i.e., skin abscess or cellulitis, osteomyelitis, or endocarditis) were investigated among a community sample of drug users with a history of injection drug use (IDU) who tested negative for Hepatitis C (HCV). Participants were IDUs in an HCV reduction intervention trial followed for 24 months. Among 109 participants, 9.2% reported a bacterial infection during follow-up. Non-Caucasian participants and those who had injected for longer periods at baseline were less likely to experience a bacterial infection at follow-up. IDUs with no history of HCV infection experience bacterial infections, but at lower rates than other IDU cohorts. Behavioral interventions should target bacterial infections as well as HCV or HIV prevention outcomes.
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PMID:Predictors of bacterial infections among HCV-negative injection drug users in Rhode Island. 1829 37

Whipple's disease is a chronic, multisystemic, curable, bacterial infection that usually affects middle-aged men. It has a wide range of clinical manifestations. In the historical presentation, weight loss and diarrhoea are the most common symptoms and are preceded in three-quarters of cases by arthritis for a mean of six years. Long-term, unexplained, seronegative oligoarthritis or polyarthritis of large joints with a palindromic or relapsing course is typical. In most patients, periodic acid-Schiff staining of proximal small bowel biopsy specimens reveals inclusions within the macrophages, corresponding to bacterial structures. However, patients may have no gastrointestinal symptoms, negative jejunum biopsy results and even negative PCR tests. Even in the absence of gastrointestinal symptoms, Whipple's disease should be considered in case of negative blood culture endocarditis, unexplained central neurological manifestations or unexplained arthritis. Identification of the causative bacterium, Tropheryma whipplei, has led to the development of PCR as a diagnostic tool, particularly useful in patients in the early stages of the disease or with atypical disease. The recent cultivation of T. whipplei and the complete sequencing of its genome should improve our understanding and treatment of the disease. The future development of an assay for detection of specific antibodies in the serum and generalization of the immunohistochemical detection of antigenic bacterial structures may allow earlier diagnosis, thereby preventing the development of the severe late systemic and sometimes fatal forms of the disease.
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PMID:[Whipple's disease]. 1872 96

Infections with rare pathogens are being recognized with increasing frequency in severely immunocompromised patients. As a result of these patients' underlying compromised defenses and susceptibility to atypical organisms, tissue biopsies from patients within this population may demonstrate nonclassical histopathological findings. Here, we describe an unusual granulomatous reaction to gram-positive cocci in the skin of a 52-year-old man undergoing salvage chemotherapy for acute myeloid leukemia. The patient presented with a papular eruption on the arms, trunk, and face and fever; concomitant blood cultures were positive for Rothia mucilaginosa and Streptococcus salivarius. Histologic evaluation revealed a granulomatous dermatitis associated with numerous small, round, predominantly intracellular bacteria. Classically, cutaneous infiltrates associated with coccoid bacterial infections are suppurative and not granulomatous. The intracellular organisms stained positive for Gram, periodic acid-Schiff, and Grocott methenamine silver stains, suggestive of R. mucilaginosa. Rothia mucilaginosa, a component of the oral flora, was first reported as a human pathogen in 1978. Although the majority of cases in the literature have described R. mucilaginosa bacteremia, other reported manifestations include meningitis, endocarditis, pneumonia, osteomyelitis, and peritonitis. To our knowledge, however, only 1 prior report has described a cutaneous manifestation of R. mucilaginosa septicemia, which occurred in a patient with neutropenia. This is the second reported case of an infectious granulomatous dermatitis associated with R. mucilaginosa bacteremia and raises awareness of this unusual histopathological presentation in the setting of a bacterial infection affecting the skin.
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PMID:Infectious granulomatous dermatitis associated with Rothia mucilaginosa bacteremia: A case report. 1994 Jul 46

Rhabdomyolysis secondary to bacterial infection has only rarely been investigated, and there are case reports of the same mainly in adults. This article describes the first reported case of rhabdomyolysis in a child secondary to Staphylococcus aureus endocarditis. A 12-year-old child presented with myalgia, pyrexia and dark urine and was found to have infective endocarditis due to S. aureus.
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PMID:Rhabdomyolysis in a Child Secondary to Staphylococcus aureus Endocarditis. 2030 Apr 6


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