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

Brucella infective endocarditis is an uncommon, but serious complication of brucellosis. The aortic valve is the most commonly affected cardiac valve. Due to characteristics of the infection, medical therapy alone is not sufficient in treating the disease and best results are obtained with surgery combination. We describe a case of Brucella endocarditis involving the aortic valve suspected in front of the clinical data and the results of serology, confirmed by the culture of the native valves. In association with the medical treatment, management valve replacement lead to a favorable medium-term evolution.
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PMID:[Brucella endocardititis: clinical particularities and therapeutic modalities]. 1679 33

Human brucellosis is a multiple organ disease that presents with fever and is most often transmitted via contaminated, unpasteurized goat milk and cheese. In chronic cases, focal complications (eg, spondylitis, neurobrucellosis and endocarditis) are frequently seen. Although the disease may be severely debilitating, the mortality rate is low. Fatal cases are often due to endocarditis. Because Brucella endocarditis is a rare complication (2% to 5%), therapeutic considerations are based on single-case experiences only. Therapy includes long-term antibiotic treatment using combinations of various antimicrobial drugs and surgical valve replacement when required. A case of Brucella endocarditis complicated by the infection of two valvular prostheses implanted after involvement of the mitral and aortic valve due to rheumatic fever is described. The patient was successfully treated by a medical and surgical approach. Therapeutic strategies in Brucella endocarditis are discussed in light of the current literature.
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PMID:Brucella endocarditis in prosthetic valves. 1697 82

Human brucellosis is an endemo-epidemic disease in the Trakya Region of Turkey. The aim of this retrospective study was to evaluate the clinical, laboratory findings, therapeutic features, and prognosis of the 47 patients (49% were female, age range: 17-76 years, mean age: 45 years) with human brucellosis followed up in Trakya University Hospital between 2001-2005. The patients were categorized as acute (64%), subacute (28%) and chronic (9%) brucellosis. Complications were detected in 51% of the patients and spondylodiscitis was the most common (30%) complication. Twenty-seven percent of patients with spondylodiscitis were classified as acute, 46% were subacute, and 27% were chronic brucellosis. Other complications were sacroileitis (9%), arthritis (4%), meningitis (4%), endocarditis (2%), and orchitis (2%). Positive blood cultures were detected in 80% and 54% of acute and subacute cases, respectively, however, blood cultures were all negative in the chronic cases. Overall positive blood cultures were observed in 68% of cases. Fifty-one percent of the patients were treated with doxycycline+streptomycin, and 40% with doxycycline+rifampicin. Two patients with meningitis were treated with doxycycline+rifampicin+ceftriaxone, and one patient with endocarditis was treated with doxycycline+rifampicin+cotrimoxazole combinations. Relapse was observed in two (4%) of the patients. Since serious complications were observed in half of the brucellosis patients, combination therapies were prolonged. Complete evaluation of patients with human brucellosis requires investigation of osteoartricular complications and modification of the duration of therapy according to the existing complication.
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PMID:[Evaluation of brucellosis patients in Trakya University Hospital]. 1700 56

Brucella endocarditis is a zoonosis transmitted by contaminated dairy products. Endocarditis is a rare complication of brucellosis and mainly the aortic valve is infected. We present the case of a female patient with prosthetic mitral valve endocarditis associated with QT prolongation and torsades de pointes. Transesophageal echocardiography revealed vegetation on both anterior and posterior mitral annulus. She was seropositive with Brucella agglutination titers of up to 1/320. The QT interval was markedly prolonged upon admission (QTc 530 ms). She experienced torsades de pointes several times. She underwent reoperation under an appropriate antibiotic regimen. She continued on triple antibiotic therapy for 12 months. She is now well and free of symptoms.
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PMID:A case of prosthetic mitral valve Brucella endocarditis complicated with torsades de pointes. 1715 24

Brucellosis is a zoonotic disease that causes systemic symptoms and can involve many organs and tissues. The major sources of infection are consumption of unpasteurized diary products and occupational contact. Brucella is a small, gram-negative coccobacillus that grows slowly in vitro. There are four species of brucella that are pathogenic for humans; in Israel Brucella melitensis is still the most frequent organism. There are several methods to identified the organism and make the diagnosis (1) isolation of brucella from blood, tissue specimens, body fluids and bone marrow; (2) agglutination test and (3) polymerase chain reaction (PCR) that has recently been shown to be a promising tool for the diagnosis of acute disease. Involvement of the musculoskeletal system is the most common complication of brucellosis, while meningitis and endocarditis are life-threatening complications. The standard treatment for acute and chronic brucellosis is a combination of doxycycline with a second drug such as rifampicin or gentamicin, in order to cure, prevent complications and relapse. Although the rate of occurrence is ever-decreasing due to vaccination of animals, nonetheless, the disease has not been eradicated in Israel. This review focuses on the clinical presentation, diagnosis, and mainly on complications of brucellosis and the available therapeutic options.
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PMID:[Brucellosis: clinical presentation, diagnosis, complications and therapeutic options]. 1718 58

One of the complications of brucellosis is infective endocarditis, which carries a high mortality rate if undiagnosed or misdiagnosed. We report a case of Brucella infective endocarditis, which was diagnosed serologically and by polymerase chain reaction. After Brucella specific treatment, patient showed dramatic improvement clinically, as evident by echocardiogram findings and other investigations.
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PMID:Infective endocarditis due to brucella. 1718 49

Brucella abortus, a facultative intracellular pathogen, is of tremendous zoonotic importance because of its ability to induce spontaneous abortion in cattle and other livestock. It is also known to cause persistent undulant fever, endocarditis, arthritis, osteomyelitis and meningitis in humans. The available vaccines against this dreadful infection suffer from limitations like short-term immunity, increased risk of hypersensitivity and low prophylactic index in the recipients. In the present study, we have demonstrated that liposomal form of a recombinant ribosomal L7/L12 protein, a B-T cell antigen of B. abortus, activates strong immune response in the host. In contrast, free antigen generates moderate immune response in the immunised animals. The liposomisation of rL7/L12 protein causes tremendous increase in cell-mediated immune response in terms of delayed type hypersensitivity, T-cell proliferation and up-regulation in type I cytokine expression, etc. Moreover, the liposome encapsulated antigen elicited stronger humoral immune response as compared to standard vaccine (S-19) or IFA-L7/L12 combination in the immunised animals. The effectiveness of liposome-based vaccine was also substantiated by better systemic clearance of bacterial load after challenging the animals with B. abortus 544 pathogen. The results of the present study suggest the potential of liposome-based rL7/L12 antigen as prospective and efficient candidate vaccine capable of eliciting both cell mediated as well as humoral immune responses against experimental murine brucellosis.
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PMID:Liposomised recombinant ribosomal L7/L12 protein protects BALB/c mice against Brucella abortus 544 infection. 1729 51

Brucella endocarditis is a rare and life threatening complication of brucellosis. It usually involves the aortic valve and successful management requires a combination of medical treatment and valve replacement. We describe a case of tricuspid valve and defibrillator lead brucella endocarditis induced by the implantation of the defibrillator itself. Our patient was admitted to hospital with a 2-week history of fever, back pain and night sweats. One month prior to admission, due to episodes of syncope, he was hospitalized at the Cardiology Department and because of a low grade fever he underwent complete investigation with no result. His original symptoms relapsed 2 days after dischargement. Although serological tests were not indicative, blood cultures grew Brucella melitensis and transesophageal echocardiography showed a vegetation on tricuspid valve, which was mildly regurgitant. Fever subsided 2 days following start of triple antibiotic therapy and 2 weeks later the defibrillator and the pacemaker were surgically explanted.
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PMID:A 70-year-old stock-breeder with tricuspid valve and defibrillator lead brucella endocarditis. 1739 20

We report two cases of successful treatment of Brucella endocarditis. Both of them were treated with antibiotics and aortic valve replacement after Brucellosis was diagnosed. In one of these cases emergency operation was required. Our observations suggest that a combined surgical and medical treatment is the best option for the management of this disease. B. endocarditis should be operated after improvement of clinical status but emergency cardiac surgery may be required if heart failure develops.
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PMID:Valve replacement for Brucella endocarditis: two case reports. 1765 33

Brucellosis is an important zoonotic disease that causes abortion in cattle and undulant fever, arthritis, endocarditis and meningitis in human. In spite of the fact that immunization could be an efficient measure to control brucellosis, not a single ideal vaccine against this important disease has been developed so far. In order to develop an effective vaccine against Brucella abortus (B. abortus), various protective immunodominant gene/protein products of the pathogen have been studied in combination with different adjuvants. For example, recombinant ribosomal protein L7/L12 (rL7/L12) although an interesting T-cell antigen, normally failed to evoke protective immune response when used in free form. In the present study we have demonstrated that Escherischia coli (E. coli) lipid liposome (escheriosome)-mediated cytosolic delivery of recombinant rL7/L12 protein can elicit strong immunological responses in the Balb/c mice. In contrast, egg PC/Chol liposome entrapped rL7/L12, in a manner similar to its free form, was found to impart relatively poor immune response. Furthermore, escheriosome entrapped rL7/L12 protein elicited high IgG2a isotype response suggestive of its relevance in imparting protection against brucellosis in mice. Altogether the present study is a clear indicative of the possible use of escheriosome-based delivery of rL7/L12 protein to induce protective immune responses against experimental murine brucellosis.
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PMID:Escheriosome-mediated delivery of recombinant ribosomal L7/L12 protein confers protection against murine brucellosis. 1793 56


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