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

Infection remains a major problem in the early phase after heart transplantation. Immunosuppressive therapy is the most important predisposing factor. It may also reactivate preexisting latent endogenous infections. Unspecific symptoms and a chronic clinical course, as described in this report, may suggest infective endocarditis of the cardiac allograft. From this case, we do not suggest a general antibiotic prophylaxis for heart transplant recipients; however, special precaution should be considered in heart transplant patients with a history of endocarditis.
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PMID:[Infectious endocarditis following orthotopic heart transplantation]. 231 78

We reviewed retrospectively 31 cases of candidemia in children with central venous catheters. Infection rate was significantly higher in 1- to 4-year-old children with central venous catheters. Infection rate was significantly higher in 1- to 4-year-old children than in other age groups (8.4% vs. 2.2%; P less than 0.05). Serious sequelae occurred in 11 (35%) cases and included fatal outcome (5 instances), Candida endocarditis (2), renal abscesses, meningitis, arthritis and osteomyelitis (1 each). Complications were significantly more common in infants than in older children (P less than 0.05) and appeared 3 to 52 days after the first positive blood culture (mean, 16 days). In fatal cases catheters were left in place a significantly greater number of days than in nonfatal cases (P less than 0.05). A literature review identified 43 additional cases of catheter-related candidemia described in 11 series. The rate of Candida infection in the group as a whole was 2.7%. Patients treated with catheter removal plus amphotericin B had a significantly higher cure rate then patients treated with catheter retention plus amphotericin B (P = 0.009). Prompt catheter removal remains crucial in the treatment of catheter-related candidemia.
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PMID:Candidemia in children with central venous catheters: role of catheter removal and amphotericin B therapy. 235 15

The efficacy of ciprofloxacin alone and in combination with azlocillin was compared with that of azlocillin plus tobramycin in a rat model of aortic valve endocarditis due to Pseudomonas aeruginosa. MICs against the infecting strain of ciprofloxacin, azlocillin and tobramycin were 0.125, 8, and 0.5 mg/l, respectively. Antimicrobials were administered 24 h after bacterial challenge and for six days. Mean peak/trough serum levels for ciprofloxacin (50 mg/kg i.v. q 12 h), azlocillin (500 mg/kg i.v. q 12 h) and tobramycin (6.5 mg/kg i.v. q 12 h) were: 10.5/0.2, 386/less than 16, and 6.2/less than 0.6 mg/l, respectively. Ciprofloxacin alone was more effective than the combination azlocillin-tobramycin in increasing survival (p less than 0.05), sterilizing blood (p less than 0.05) and valves (p less than 0.001), and in reducing bacterial titers in vegetations (p less than 0.001). Ciprofloxacin-azlocillin combination was not more effective than ciprofloxacin alone. Drug resistance was not encountered in post-treatment isolates with any therapy regimen.
Infection
PMID:Efficacy of ciprofloxacin alone and in combination with azlocillin in experimental endocarditis due to Pseudomonas aeruginosa. 249 29

IgG or IgM anticardiolipin antibodies were present in the sera of 67% of 33 patients with Hansen's disease, in 53% of 30 patients with tuberculosis and in 50% of 16 patients with endocarditis. Despite the high frequency of these antibodies, no patient had a history of thrombosis or abortion. Anti-denatured DNA antibodies were tested in patients with tuberculosis and patients with Hansen's disease. Only in the latter group did we observe a statistically significant association between anticardiolipin and anti-denatured DNA antibodies. Anticardiolipin binding activity, however, could not be inhibited by preincubation of sera with a variable concentration of denatured DNA. These data suggest that: a) Anticardiolipin antibodies in infectious diseases do not necessarily participate in the pathogenesis of thrombotic or obstetric complications; b) Anti-denatured DNA and anticardiolipin antibodies in the population studied do not have a cross-reaction.
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PMID:Anticardiolipin antibodies in patients with infectious diseases. 250 Oct 63

Animal models have proven to be invaluable in bridging the gap between in vitro susceptibility testing of an antibiotic and anticipating results obtained in clinical studies. Variables such as antibiotic concentration, inoculum of organism, and pharmacokinetic parameters of the drug can be carefully controlled to provide information about the principles of treating infectious diseases as well as an evaluation of specific antimicrobial agents. End points of treatment can be precisely defined (that is, CSF sterility in meningitis, vegetation counts of bacteria in endocarditis) to allow a quantitative evaluation of a new antibiotic. However, it is important to realize that there may be differences in disease pathogenesis and antibiotic pharmacokinetics between experimental infections in animal models and infections in humans. Therefore, results in animal models should be interpreted with caution and compared with results obtained with antimicrobial regimens in clinical studies. Perhaps one of the most useful features of animal models is suggesting which antimicrobials would not be expected to be of therapeutic benefit in man.
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PMID:Applications of therapy in animal models to bacterial infection in human disease. 250 10

A retrospective examination was made of eleven patients that developed prosthetic valve endocarditis (PVE) during the period from January 1960 to December 1987. Infection occurred in one patient within 60 days after surgery and in 10 thereafter. Causative organism was found in 6 patients. As organism, Staphylococcus species were noted in 4 patients and Peptstreptococcus was noted in one patient and Aspergyllus was noted in one patient. Three of eleven patients received medical treatment only and the other 8 patients were received surgical treatment. Mortality rate was 67% in medical group and 29% in surgical group. Two patients with medical treatment died of cerebral infarction about 40 days after the onset of PVE. In surgical group one patient died of uncontrollable Aspergillus infection and the other one died of dyspnea. No survivors who was treated surgically have developed reinfection or relapse of infection but four of them developed perivalvular leakage and needed reoperation. Absolute removal and closure of the valve ring abscess and reconstruction of defect should be considered for those needed surgical treatment to prevent reinfection and relapse developing.
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PMID:[Treatment of prosthetic valve endocarditis--analysis of eleven cases]. 258 73

Capnocytophaga species are gram-negative rods which may cause disease in both non-immunocompromised and immunocompromised hosts. We describe a case of endocarditis due to Capnocytophaga ochracea in a non-immunocompromised patient with a decrease of blood CD4/CD8 ratio and lymphocyte proliferative response to ConA during infection. In vitro experiments showed that C. ochracea decreased lymphocyte proliferation to mitogens (ConA, PHA), cell surface CD4 antigen and IL2 receptor expression on peripheral blood mononuclear cells (PBMC) from normal volunteers.
Infection
PMID:T lymphocyte disorder after Capnocytophaga ochracea endocarditis. 261 26

Gemella haemolysans, a coccus related to the "Streptococcaceae", was isolated from the blood of a patient with endocarditis. The patient was successfully treated with a combination of penicillin G and tobramycin, followed by clindamycin. The taxonomy of this organism, especially its relationship to "Streptococcus morbillorum" is discussed and previously reported cases of Gemella infections are reviewed.
Infection
PMID:Endocarditis caused by Gemella haemolysans. 261 27

Q fever is an zoonosis caused by Coxiella burnetti, the clinical features of which are often nonspecific and self-limited. Involvement of the central nervous system is rare and is usually seen as a complication of endocarditis caused by this rickettsial organism in the chronic disease. Specific neurological manifestations in the course of the acute illness aseptic meningitis, encephalitis, toxic confusional states, extrapyramidal signs, dementia and behavioral disturbances. We describe a patient who developed reversible bilateral abducens nerve paralysis and bilateral optic neuritis in the course of acute Q fever meningoencephalitis.
Infection
PMID:Q fever meningoencephalitis associated with bilateral abducens nerve paralysis, bilateral optic neuritis and abnormal cerebrospinal fluid findings. 261 30

46 Staphylococcus aureus endocarditis episodes diagnosed with strict criteria in non drug addict patients, and 25 episodes in drug addict patients have been comparatively analyzed. Infection was found in the left side of the heart in 87% of the non addict patients and in 16% of the addicts. On the contrary, 84% of the addicts had endocarditis of the tricuspid and pulmonary valves while only 13% of the non addicts had right heart involvement. The right side endocarditis in the non addicts was always due to intracardiac catheters. 54% of the endocarditis episodes in the non addicts were fatal. Only two addicts, both when had left side endocarditis, died. Mortality was conditioned by infection of the left side of the heart as well as by the existence of heart failure. No significant differences were found between the evolution of patients treated with only one agent or of those treated with a beta-lactam antibiotic plus gentamicin. The emergency valve replacement significantly improved the prognosis of patients with prosthetic valve endocarditis.
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PMID:[Endocarditis caused by Staphylococcus aureus in drug addicts and non-addicts: the same microbe in 2 diseases]. 262 24


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