Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-three patients with prosthetic valve endocarditis caused by methicillin-resistant Staphylococcus epidermidis were studied retrospectively for assessment of the role of rifampin treatment. Rifampin (900-1,200 mg daily) was administered in combination with either vancomycin or a beta-lactam antibiotic for an average of 38 days. Eight patients also received an aminoglycoside. Infection was cured in 16 (70%) of these patients; i.e., in 13 (87%) of 15 receiving rifampin plus vancomycin and in three (38%) of eight receiving rifampin plus a beta-lactam antibiotic (P = .025). The addition of rifampin to vancomycin regimens resulted in an increase in serum bactericidal activity. The selection of rifampin-resistant strains of S. epidermidis during treatment with a combination of antibiotics was noted in two patients with persistent infection. The rates of cure obtained with rifampin-beta-lactam combinations were similar to those obtained with beta-lactam agents alone; however, the cure rates obtained with rifampin plus vancomycin (with or without an aminoglycoside) were encouraging and merit further study.
 ...
PMID:Rifampin treatment of prosthetic valve endocarditis due to Staphylococcus epidermidis. 655 11

Cardiobacterium hominis, like other fastidious, opportunistic gram-negative bacilli, including Actinobacillus actinomycetemcomitans, Haemophilus aphrophilus, and Eikenella corrodens, is increasingly recognized as a cause of human disease. In this review the microbiologic and clinical features of C. hominis are discussed. The findings are based on observations of two infected patients (the case history of one was reported previously) and on reports in the literature of 32 others. Microbiologically, the chief distinguishing features of C. hominis are its characteristic colonial morphotype and its production of indole. Infection with C. hominis is clinically distinctive because of its chronic course (averaging 169 days among patients with endocarditis), the absence of documented infection outside of the bloodstream, and the high degree of responsiveness to treatment with penicillin.
 ...
PMID:Cardiobacterium hominis: review of microbiologic and clinical features. 662 85

After reviewing the physiopathology, the authors report the principal features of infectious arterial disease observed in a department of infectious diseases. Excluding iatrogenic arteritis, particularly after vascular surgery, and some vasculitis in which an infectious agent may play a role, only the classical but now rare causes are described: rickettsial disease, syphilis and typhoid. The most commonly observed problem at present is infectious aneurysms: primary aneurysms secondary to atherosclerosis in which salmonella is by far the predominant organism, before the staphylococci and streptococci. The most serious complication is the major risk of rupture which may be the presenting event. Secondary aneurysms are essentially those of endocarditis. The mechanism is not fully understood and they occur at different stages of the course of the disease. The main problem associated with these aneurysms is their multiplicity and localisation; the intracranial forms are the most common and most serious in the experience of the authors, with their difficulties of diagnosis and treatment: extracranial aneurysms are usually located in the main limb arteries. Adjacent secondary aneurysms are exceptionally rare. Tuberculous and viral causes of aneurysm are among the rarest etiologies discussed.
 ...
PMID:[Infectious arteriopathies]. 665 Oct 69

We are presenting a case of endocarditis due to a penicillin-tolerant Streptococcus bovis in a 65-year-old patient. The minimal bactericidal concentration of penicillin (40 mg/l) was more than 100-fold the minimal inhibitory concentration (0.08 mg/l). The MBC of penicillin was 0.31 mg/l in the presence of 1.25 mg/l gentamicin. Cross-sectional echocardiography revealed endocarditis of the anterior leaflet of the tricuspid valve and a vegetation on the aortic valve which appeared to be pedunculated and which prolapsed into the left ventricular outflow tract during diastole. During therapy, the pedunculated part of the vegetation disappeared without signs of embolization. After initial clinical improvement, the patient died of cerebral bleeding caused by a mycotic aneurysm of the left median cerebral artery. The patient's final outcome suggested an asymptomatic embolus. Cross-sectional echocardiography was distinctly superior to M-mode echocardiography in estimating changes in the size and shape of the valve vegetation. The results of the post-mortem examination of the aortic and tricuspid valves corresponded to the echocardiographic findings.
Infection
PMID:Endocarditis due to a penicillin-tolerant streptococcus bovis: microbiological findings and echocardiographic follow-up. 666 68

Infective endocarditis is associated with a high mortality, but previous studies have suggested that the major complications of the condition might be prevented by early surgery. Of 50 patients treated for infective endocarditis at the Montreal Heart Institute from 1977 to 1982, 30 were treated nonsurgically and the remaining 20 underwent early valve replacement before preoperative antibiotic therapy was completed. Of these 20, 14 had native valve endocarditis and 6 prosthetic valve endocarditis. The organisms involved were Streptococcus sp in 11, Staphylococcus aureus in 2, gram-negative organisms in 3 and Candida parapsilosis in 1. Blood cultures remained negative in three patients. There were three early deaths (15%) following operation and one late death (5%). Infection on implanted prostheses did not recur, but reoperation was required in one patient because of prosthetic dehiscence 7 months after initial implantation. All resected valves displayed evidence of infection. Follow-up was obtained in all survivors. After an average follow-up of 26 months, 12 patients remained in functional class I and 4 in class II (New York Heart Association classification). Early valve replacement has resulted in improved survival of patients with infective endocarditis and is now associated with a low operative mortality and morbidity.
 ...
PMID:Early valve replacement in active infective endocarditis. 674 47

Because of its high morbidity and mortality, endocarditis will remain an important pediatric problem. Obtaining adequate culture information prior to starting antibiotics to ensure an accurate early diagnosis coupled with aggressive medical and surgical management is likely to give the best outcome. These patients are generally best handled by a team approach with the child's primary physician, cardiologist, infectious disease consultant, and cardiovascular surgeon working in close harmony.
 ...
PMID:Anti-infective therapy of infectious endocarditis. 685 72

An enzyme-linked immunosorbent assay (ELISA) was used with purified alpha-toxin and teichoic acid preparations to measure the IgG and IgM response in Staphylococcus aureus infections. After determining antibodies in a normal population, cut-off levels were set for all age groups. ELISA with alpha-toxin was more sensitive than the antistaphylolysin neutralization test (ASTA). Determining IgM antibodies with the two antigens was found to be of limited diagnostic value. Positive IgG titers against alpha-toxin were found in 21 of 27 patients (78%) with endocarditis, 11 of 14 (79%) with complicated septicemia, eight of 20 (40%) with uncomplicated septicemia and in 12 of 22 (54%) with chronic osteomyelitis. The IgG responses to teichoic acid and alpha-toxin were somewhat different when measured by ELISA, and the parallel performance of the two assays resulted in improved serological diagnostics. The number of positive patients increased to 89%, 86%, 65% and 64%, respectively, in the four groups with a diagnostic specificity of 93%. In septicemic staphylococcal infections, the diagnosis could be established in all patients (28 of 28) with adequately spaced paired samples.
Infection
PMID:The role of antibodies against alpha-toxin and teichoic acid in the diagnosis of staphylococcal infections. 686 37

The present study is an attempt to define the uncommon bacteria (UB) causing endocarditis and to evaluate their prevalence and clinical significance. Review of 13 series (including ours) revealed that UB were the infecting organisms in 105/1989 patients (5.3%). The leading bacteria were: Pneumococcus, Haemophilus sp., Corynebacterium sp., Neisseria sp., Streptobacillus moniliformis, Cardiobacterium hominis and Erysipelothrix sp. These data are similar to those obtained from 111 sporadic case reports published in English during the last 6 yr and cited in the Index Medicus. Infection by UB usually resembles that by the common bacteria. However, Haemophilus sp. seems to affect mainly the young and is associated with major arterial occlusions, and Brucella is claimed to have a greater affinity to the aortic valve. UB are more frequent in patients with polymicrobial infections and their diagnosis is often delayed. Greater awareness to the possibility of infections with UB is needed for early diagnosis and improved prognosis.
 ...
PMID:Infective endocarditis caused by uncommon bacteria. 687 16

A 42 year old man without history of rheumatic heart disease was admitted to the hospital with severe aortic insufficiency and heart failure. There were no clinical data of an infectious disease. The bidimensional echocardiogram showed vegetations involving the aortic valve leaflets. With the diagnosis of acute aortic insufficiency caused by infective endocarditis the patient was submitted to surgery. During surgery the existence of endocarditis secondary to a mycotic agent was demonstrated. The fungus was latter identified as aspergillus fumigatus. The postoperative course was uneventful. The good results obtained in this case confirm recent reports advising an urgent surgical approach of cases of infective endocarditis secondary to mycotic agents, and support the view that echocardiography may be a valuable tool in the diagnosis of this entity.
 ...
PMID:[Aspergillus endocarditis. Report of a case treated surgically with success]. 703 62

Elderly persons are prone to more frequent or greater morbidity and higher mortality from selected infectious diseases than the average population. Factors that may affect this increased predilection or poorer prognosis include environmental exposure, normal physiological changes of aging, coexistence of chronic diseases and alteration of host defense mechanisms. Infections to which the aged are particularly vulnerable are pneumonia, influenza, tuberculosis, urinary tract infection, Gram-negative bacteremia, intra-abdominal sepsis, soft tissue infection, infective endocarditis, bacterial meningitis, bacterial arthritis and herpes zoster infection.
 ...
PMID:Important infections in elderly persons. 703 32


<< Previous 1 2 3 4 5 6 7 8 9 10