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

We studied the pharmacokinetics and in vivo antifungal action of SCH39304, a new antifungal azole compound, in rabbits. It crossed the blood-cerebrospinal fluid barrier in the presence or absence of meningeal inflammation, reaching approximately 60% of the simultaneous concentrations in serum. In the treatment of experimental cryptococcal meningitis, SCH39304 was as effective as fluconazole in reducing yeast counts in the subarachnoid space. SCH39304 and fluconazole both were highly effective against candida endophthalmitis, sterilizing the vitreous humor and the choroid and retina. SCH39304 suppressed candida endocarditis and reduced yeast counts in the kidney at all doses tested. SCH39304 was effective in the treatment of experimental cryptococcal meningitis and disseminated candidiasis. Further investigations in humans are warranted.
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PMID:Treatment of experimental cryptococcal meningitis and disseminated candidiasis with SCH39304. 255 78

A case of Candida albicans endocarditis is described which developed in a heroin addict with aortic valvulopathy after an episode of cutaneous and chondrocostal candidiasis related to the use of "brown" heroin. To our knowledge this is the first case reported in the English literature. This complication should be suspected in all heroin addicts with this new syndrome, especially if valvulopathy is present.
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PMID:Candida albicans endocarditis possibly related to systemic candidiasis in a heroin addict. 344 Apr 57

Two spontaneous cerulenin-resistant mutants of Candida albicans, 4918-2 and 4918-10, were unable to adhere in vitro in fibrin-platelet clots. Because in vitro adherence correlates well with colonization of nonbacterial thrombotic endocarditis on traumatized valvular endocardium, 50% infectious dose studies were performed with a rabbit model of endocarditis. Wild-type C. albicans required 10(3.6) +/- 0.12 cfu in comparison with 10(5.73) +/- 0.31 and 10(7.3) +/- 0.21 cfu for mutants 4918-2 and 4918-10, respectively. The relative avirulence of mutant strains in producing endocarditis was not attributed to accelerated clearance of these strains from the bloodstream. In fact, clearance of wild-type and mutant strains was almost identical. In the same animals renal candidiasis was observed with all strains of C. albicans, although the number of cfu per gram of kidney was higher after infection with wild-type C. albicans. Thus, strains of C. albicans with reduced ability to adhere in vitro to a fibrin-platelet matrix are relatively avirulent in the rabbit endocarditis model.
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PMID:Yeast adhesion in the pathogenesis of endocarditis due to Candida albicans: studies with adherence-negative mutants. 390 Feb 33

A parallel study of fluorescent, agglutinating, and precipitating antibodies to Candida albicans revealed that precipitating antibodies belong to the IgG class, whereas agglutinating antibodies reside in the IgG, IgM, and IgA classes. The three types as well as the three classes of antibodies were found in Candida endocarditis and mucocutaneous candidiasis. Immuno-absorption studies suggest that the three serological tests estimate antibodies to mannan determinants of Candida albicans.
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PMID:The relationship between fluorescent, agglutinating, and precipitating antibodies to Candida albicans and their immunoglobulin classes. 455 44

Forty-eight cases of deep mycoses were studied and treated with ketoconazole, each with in vitro evaluation of the minimum inhibitory concentrations (MIC) of the causative fungi, in vivo pharmacokinetic, clinical, and mycologic evaluations, several months to two years after the treatment was stopped. Excellent results were obtained in six cases of chronic mucocutaneous candidiasis, with restoration of immunologic disturbances; 23 cases of systemic candidiasis, including new aspects of heroin addicts with cutaneous, ocular, or osteoarticular manifestations; eight cases of histoplasmosis, five due to Histoplasma capsulatum and three to Histoplasma duboisii, with cure in seven and remission in one; one case of African blastomycosis (Blastomyces dermatitidis); three cases of mycetoma, two due to Monosporium apiospermum, one due to a dematiacious fungus; three cases of entomophthoromycosis with cure; one case of fungal arthritis, due to new hyphomycete similar to M. apiospermum, pathogenic for laboratory animals; one case of Drechslera longirostrata causing vertebral arthritis, following a fungal endocarditis and cured by combination of ketoconazole with amphotericin B, each agent alone being ineffective; and other deep mycoses.
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PMID:Laboratory and clinical assessment of ketoconazole in deep-seated mycoses. 629 50

Systemic candidiasis developed in a seven-week-old premature baby after 6 weeks treatment with antibiotics for suspected septicemia. At that time the echocardiogram showed a dense layer of echoes posteriorly to the anterior tricuspid leaflet during atrial systole. The diagnosis of Candida endocarditis with vegetations on the tricuspid valve and with right atrial thrombus secondary to the Candida infection was verified by autopsy.
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PMID:Echocardiographic diagnosis of Candida endocarditis of the tricuspid valve and of the right atrium in a young infant. 668 50

Candida has become the most prevalent cerebral mycosis at autopsy, indicating a significant incidence coupled with inadequate eradication. Of 29 patients with systemic candidiasis, 48 percent (14 of 29) also had central nervous system involvement. Of these patients, however, only 21 percent (three of 14) had antemortem diagnosis, and only one of these three patients remains alive; the two patients with antemortem diagnosis who died had a meningeal form that, although easier to document on the basis of cerebrospinal fluid examination, is now distinctly rarer than other forms of the disease in adults. The lone surviving patient was treated with amphotericin B for endocarditis and mycotic aneurysms of the cerebral vessels. One clue to central nervous system candidal infection was the striking correlation between cardiac and cerebral involvement; 80 percent of patients with myocardial or valve infection also had central nervous system candidiasis. Most forms of immunosuppression represent a risk factor for both the systemic and cerebral mycoses. Neuropathologically, there is a spectrum of disease entities associated with Candida, including two previously unrecognized lesions reported herein: fungus balls of both white and gray matter and mycotic aneurysms secondary to Candida parapsilosis. Other parenchymal presentations include thrombosis, vasculitis, abscess, hemorrhage, and demyelination. For drug therapy such as amphotericin B to be more effective, earlier diagnosis of these parenchymal infections must be sought.
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PMID:Candidal infection in the central nervous system. 669 50

Candidosis was recognized retrospectively in the hearts of 20 of 8,975 patients (0.2%) who had complete postmortem examinations done in Central Kentucky and South Florida. This mycosis, characterized by myocardial micro-abscesses with yeasts and pseudohyphal elements in 18 patients, was the most common fungal cardiac infection. Noncaseating granulomas were seen in only one patient. Infective endocarditis due to Candida species was found in seven individuals and involved the mitral valve most frequently. The 20 infected persons varied in age from 20 days to 65 years, with a mean age of 37 years, and included 11 males and nine females. All had compromising, usually benign, underlying diseases complicated by antibiotic therapy for suspected or proven Gram-negative sepsis. Typically, these patients were extremely ill, and eight had recognized conduction disturbances including altered heart rates and rhythms. Deep candidosis was considered a major factor in every patient's death. Experimental deep candidosis in 12 infected, adult laboratory rats was characterized by similar haphazardly scattered myocardial microabscesses with fungal elements in eight (67%). Endocarditis in the rats was not seen in this intracardiac injection model. Widespread antibiotic exposure in patients who have compromising underlying diseases portends an increasing incidence of deep candidosis, which as the potential to infect any tissue, particularly the heart, and to create cardiac arrhythmias and death.
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PMID:The potentially lethal problem of cardiac candidosis. 698 62

Arabinitol is a pentitol generated in large quantitites by several species of Candida, including Candida albicans. The level of arabinitol in the sera of infected animals and humans was determined by gas-liquid chromatography of an acetone extract of the serum. Experimentally infected mice with pyelonephritis due to C. albicans had elevated levels of arabinitol; rabbits with pyelonephritis did not have elevated levels, nor did rabbits with catheter-induce cystitis, but rabbits with endocarditis developed elevated levels of arabinitol shortly before death. A prospective study in patients clinically suspected of having invasive candidiasis failed to show elevated levels of arabinitol in most. Mice and patients not colonized or infected with yeasts but with renal failure had high serum levels of arabinitol. The data indicate that an elevated level of arabinitol in the serum of a patient without renal disease is suggestive of invasive candidiasis, but normal serum levels do not contradict the diagnosis.
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PMID:Serum levels of arabinitol in the detection of invasive candidiasis in animals and humans. 701 20

Two cases of mycotic emboli of the peripheral vessels are presented, and 42 additional cases from the literature are analyzed. Male patients predominate 3:1. Candida and Aspergillus are the usual pathogens. Initial presentation as large vessel peripheral emboli is characteristic (77%), with emboli originating from either the aortic or mitral valves. Cerebral emboli may proceed of follow the peripheral embolization. Predisposing factors include open-heart surgery, antibiotic therapy, concomitant infection, and intravenous drug abuse. Early symptoms of fungemia are nonspecific, with blood cultures positive in only 43% of cases. The overall mortality rate was 84%-73% in patients who did not undergo previous open-heart surgery, and 96% in patients who underwent previous open-heart surgery. Patients with Candida infection seem to do better than those with Aspergillus endocarditis (19% survival versus 5%). Aggressive therapy, including embolectomy, early valve replacement, and prolonged antifungal drug therapy, is advised.
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PMID:Mycotic emboli of the peripheral vessels: analysis of forty-four cases. 702 28


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