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

In a retrospective review of 53 patients, 58 episodes of infection due to Acinetobacter calcoaceticus var. anitratus (Herellea vaginicola) were studied. Although the organism is widely distributed in nature, it is of relatively low virulence since colonization is more frequently noted than infection and since most infections occur in patients subjected to the epidemiologic pressures common to nosocomial, gram-negative bacillary infection: prior antibiotic therapy; instrumentation and manipulation (e.g., endotracheal intubation, urinary bladder catheterization, arterial and venous cannulation); surgery; hospitalization, especially with residence in an intensive care unit; severe underlying disease, either systemic (e.g., chronic obstructive pulmonary disease, malignancy) or localized to the infected area (e.g., prior bacterial or aspirational pneumonia, trauma). Pneumonia was the most common infection due to A. calcoaceticus, and occurred only in patients with a tracheostomy or endotracheal tube in place. In over half the 25 patients, more than one lobe was involved and bronchopneumonia was the usual roentgenographic appearance. Cavitation (2 patients) and empyema formation (3 patients) were uncommon. The severity of acinetobacter pneumonia is reflected in the high mortality rate (44% overall, with a 36% mortality rate due primarily to infection). Tracheobronchitis due to A. calcoaceticus was less severe than pneumonia since no patients died primarily as a result of the infection. Urinary tract infections occurred in five patients, none of whom were ill and none of whom died. Urinary bladder catheterization was thought to be responsible for infection in three patients, and in at least four of the five patients infection was restricted to the lower tract. Wound infections were noted in six patients who had undergone surgery and were related to the presence of foreign bodies in the operative site in five of the patients. Surgical debridement and/or drainage of the infected area was the primary therapeutic measure employed in most cases. Only one patient died and this was a result of noninfectious causes. Skin infection due to A. calcoaceticus was seen in two patients, one of whom exhibited fulminant, fatal cellulitis and septicemia in the setting of pancytopenia. All nine patients with acinetobacter septicemia had received antecedent antibiotic therapy, and in all cases intravenous catheters were in place at the time bacteremia occurred. Clinically, seven of the nine patients were in shock. The mortality rate was 44% overall, with a 22% mortality rate due to infection. Although septicemia was thought to be "line-related" in five of the nine patients, serious post-bacteremic complications developed in three patients: prosthetic valve endocarditis, suppurative thrombophlebitis and subhepatic abscess.
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PMID:Infections with Acinetobacter calcoaceticus (Herellea vaginicola): clinical and laboratory studies. 84 90

Histopathologic studies and isolation of virus and bacteria in culture were carried out for 71 children less than 5 years of age with fatal pneumonia. A potential microbial etiology was identified for 61 children (86%): bacteria for 19 (27%), virus for 16 (23%), and virus plus bacteria for 26 (37%). Staphylococcus was the most prevalent pathogen, alone or in combination with other organisms, followed by Pseudomonas aeruginosa. Viral infection may predispose to bacterial infection in some children. A correlation of clinical course, results of cultures, and morphologic changes revealed cofactors that may have contributed to a fatal outcome. Lung abscess, pericarditis, myocarditis, endocarditis, and meningitis were associated with bacterial infection. Many patients in this study had severe bronchopneumonia, with a high prevalence of complications such as abscess (62%), atelectasis (40%), pericarditis (28%), and empyema (7%). Such complications added to multiple infections, measles, and malnutrition contributed to the fatal outcome in these children.
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PMID:Etiology of infection and morphologic changes in the lungs of Filipino children who die of pneumonia. 212 58

Although Neisseria species other than N gonorrhoeae and N meningitidis normally comprise part of the commensal bacterial flora of the oropharynx, they may occasionally act as opportunistic pathogens. Infections in which these organisms have been implicated include cases of endocarditis, meningitis, septicaemia, otitis, bronchopneumonia and possibly genital tract disease. In this paper, the clinical and pathological features of such infections are described, together with a discussion of factors that may contribute to their development.
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PMID:The pathogenic potential of commensal species of Neisseria. 633 50

The clinical and radiological manifestations were correlated with the necropsy findings in the lungs of 18 patients who died of Serratia marcescens infection. Ten died during a hospital epidemic affecting 74 patients. In 14, only Serratia was identified at autopsy; in 4, other organisms were also cultured. Ten patients had septicemia. The predominant radiological findings were focal bronchopneumonia in 13, lobar consolidation in 2, and diffuse nonhomogeneous infiltrates in 10. Small radiolucent areas within the infiltrates were seen in 5, a large pulmonary abscess in 1, and pleural effusion in 7. The predominant pathological findings were focal necrotizing bronchopneumonia (sometimes with microscopic abscesses) in 14 and diffuse hemorrhage in 3. Three patients had endocarditis and 3 others showed dissemination to the brain or kidneys.
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PMID:Serratia pneumonia. 700 38

Streptococcus suis type II was isolated from 170 pigs submitted to a veterinary diagnostic laboratory in Ontario, Canada, over a 1-year period. The most common disease condition with which the organism was identified was suppurative bronchopneumonia, usually secondary to enzootic pneumonia of pigs. The organism was also isolated in cases of pleuropneumonia, valvular endocarditis, arthritis, and vaginitis as well as from aborted fetuses. A condition characterized by neonatal disease and rapid death, usually within the first 24 hours of life, was identified in 23 pigs from 5 farms. Meningitis was identified in 15 weaned pigs from 8 farms. All S suis type II isolates tested for antimicrobial sensitivity were sensitive to penicillin and ampicillin. Most isolates were also sensitive to chloramphenicol and trimethoprim-sulfamethoxazole, but resistant to streptomycin and tetracycline. Accessions from which the organism was isolated were concentrated in the colder months of the year, with few or no isolates recorded in the summer months.
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PMID:Streptococcus suis type II-associated diseases in swine: observations of a one-year study. 714 61

From March 1977 to December 1978, postmortem examination was performed at Wadsworth Veterans Administration Medical Center for 20 patients who had had nosocomially acquired Legionnaires' disease. Seventeen patients died during the acute illness due to Legionnaires' disease, and three patients died after clinical resolution of the acute process. The only consistent postmortem findings were limited to the lungs. Confluent bronchopneumonia, and less frequently lobar pneumonia, was present in most cases. Although a spectrum of microscopic pulmonary findings was observed, the characteristic histologic features of acute Legionnaires' disease were an extensive intra-alveolar exudation of macrophages and neutrophils in varying proportions, erythrocytes, and fibrin. Lysis of the inflammatory cells was frequently found. Areas of coagulative necrosis of the lung parenchyma and edematous thickening of the alveolar septa were typically seen. Microscopy of lung tissue from the three patients who died after clinical resolution of the acute process revealed organized pneumonia, with patchy organization of the intra-alveolar exudate and focal obliteration of the alveolar septal framework. Associated postmortem findings were fibrinous endocarditis in one case and hemorrhagic infarction of the adrenal glands in two cases. Electron-microscopic examination of the lungs revealed as many as 23 separate bacillary profiles within a single macrophage. Septate binary fission or spore-like structures were not observed.
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PMID:Legionnaires' disease. Postmortem pathologic findings of 20 cases. 736 72

Fungal infections of the heart are infrequent postoperative complications in children, yet, when present are often fatal. Children autopsied at The Johns Hopkins Hospital from 1889 to the present were studied for cardiac fungal infection. Among the 14 children so identified, 8 developed cardiac fungal infection after surgery. All postoperative cardiac infections were caused by Candida species. All were autopsied since 1959. Gastrointestinal surgery was performed in 6 patients and cardiac surgery in 2. Candida infection was not confined to the endocardium; endocarditis developed in 2 patients, pericarditis in 1, and myocarditis in 5. None received cytotoxic agents or corticosteroids. Two patients died from direct cardiac involvement. Other deaths were related to Candida sepsis or bronchopneumonia. A clinical diagnosis of cardiac fungal infection was never made. Prolonged administration of multiple antibiotics, central venous catheterization, prematurity and immune deficiency predisposed to cardiac and systemic candidiasis. Clinical features facilitating early diagnosis are discussed. Removal of central venous catheters infected with Candida did not eliminate the source of continued sepsis, since Candida-laden vegetations related to the catheter adhered to the superior vena cava and endocardial surface. Postoperative cardiac candidiasis is a relatively new and persistent problem of early diagnosis and therapy. The post-surgical pediatric patient has major predisposing factors for cardiac candidiasis, which, if unrecognized, may be a source for continued dissemination or may in itself be the cause of death.
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PMID:Postoperative Candida infections of the heart in children: clinicopathologic study of a continuing problem of diagnosis and therapy. 738 69

Twenty-five patients were admitted to two hospitals in Hong Kong for Streptococcus suis infection between 1984 and 1993. Among them, 15 (60%) had an occupational exposure to pigs or pork, and four had a clear history of skin injury up to 16 days before admission. Examination of the cerebrospinal fluid of 21 patients confirmed the presence of meningitis in every case; the remaining four patients who did not have lumbar punctures had each presented with arthritis, bronchopneumonia, endocarditis and pyrexia without neck stiffness. The only fatality was a patient admitted in septicaemic shock with evidence of meningitis and disseminated intravascular coagulation. Of the 24 survivors, 16 (67%) acquired varying degrees of hearing loss as a result of meningitic involvement. All the isolates of S. suis were sensitive to penicillin or ampicillin, which was used alone or in combination with other antibiotics for every patient. Two patients had a relapse of symptoms when penicillin was stopped, but were successfully treated after the antibiotic was resumed for a total of 6 weeks. Over 100 cases of S. suis infection have been described previously, with a geographic distribution heavily biased towards Northern Europe and Southeast Asia. Lack of awareness of this unique zoonosis may be a reason why it is not diagnosed more readily elsewhere.
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PMID:Streptococcus suis infection in Hong Kong. 789 87

In this paper we report on the spectrum and frequency of lesions observed in a prospective study of naturally occurring infections with Streptococcus suis type 9 (SS-9) in weaned pigs. SS-9 produced arthritis, meningitis, interstitial pneumonia, and endocarditis in 100%, 91%, 73%, and 42%, respectively, of pigs dying from the disease. The lesions were similar to those caused by S. suis type 2 (SS-2), however, SS-9 produced a different frequency of lesions. In SS-2 infections, bronchopneumonia is the most commonly observed lesion; meningitis, arthritis, and endocarditis are less frequently observed. Thus, SS-9 produced a different distribution of lesions from that reported for SS-2. Possible explanations for the differences found are discussed.
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PMID:Lesions caused by natural infection with Streptococcus suis type 9 in weaned pigs. 794 3

We reviewed the autopsy records of 56 patients who had undergone BMT at the Detroit Medical Center during 1988-1992. Most patients (43 of 56) had died within 2 months of BMT. One or more infections were identified at autopsy in 25 of 40 (63%) allogeneic and four of 16 (25%) autologous BMT recipients. Microorganisms isolated at autopsy were cytomegalovirus (CMV) (14 patients), yeasts (13 patients), molds (aspergillus six patients, mucor one patient) and bacteria (seven patients). Presence of infection was not identified or proven prior to death in nine of 14 patients (65%) with CMV, six of 13 patients (46%) with yeasts and four of six patients (67%) with aspergillus. Most bacterial infections (five of seven patients) were identified ante-mortem. Lungs and the gastrointestinal tract were the organ systems mostly involved in patients with or without autopsy-identified infections. Pathologic findings in the lungs were diffuse alveolar damage, interstitial pneumonia and bronchopneumonia and, in the gastrointestinal tract, were ulcerations and hemorrhages of esophagus, stomach, small and large intestines. Examination of the heart showed non-bacterial thrombotic endocarditis (NBTE) in five patients, four with right-sided involvement only. Failure to identify non-bacterial pathogens ante-mortem and their frequent association with mortality in bone marrow transplant patients are high-lighted in the present study.
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PMID:Autopsy-identified infections among bone marrow transplant recipients: a clinico-pathologic study of 56 patients. Bone Marrow Transplantation Team. 854 65


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