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

Following cardiac surgery with extracorporeal circulation three children became ill with a postperfusion syndrome. Besides typical clinical and haematological findings (fever, hepatosplenomegaly, lymphomonocytosis with "atypical" lymphocytes) demonstration of characteristic antibody sequential titres (IgG and IgM antibodies against cytomegalovirus) was possible. The importance of this syndrome rests in the problems of differential diagnosis which occur at the beginning of clinical symptoms (differentiation from endocarditis, septicaemia, hepatitis).
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PMID:[Post-perfusion syndrome in childhood (author's transl)]. 18 21

A rare case of ischemic stroke related to Herpes zoster infection of the eye and documented arteritis in an HIV-positive patient is analyzed. The woman, aged 32, who was born in Angola and lived in Zaire, was diagnoses at the Hospital Universitario de Santa Maria, Lisbon. She presented with a 5-month history of sudden hemiplegia, 4 months after onset of herpes zoster ophthalmicus. Among extensive diagnosis tests, she was positive for HIV by ELISA and Western blot, hepatomegaly, and generalized lymphadenopathy. She has left Herpes zoster ophthalmicus with ptosis bulbi and mottled discoloration of the skin over the distribution of the 1st division of the left trigeminal nerve, and right spastic hemiparesis. Her helper T-cell count was 952/cubic mm, and her T-cell ratio was 0.9. She had anemia, hypoalbuminemia, positive serology for cytomegalovirus, Herpes simplex, Epstein Barr virus, and hepatitis B. She had no bacterial infections, but her stool contained Trichuris trichiura eggs and giardia lamblia cysts. Her cardiovascular system and cerebrovascular fluid were negative. Computed tomography of the head showed an old left capsular infarct. Cerebral angiography showed arteritis of the left choroidal artery with occlusion. She was treated with metronidazole and mebendazole, and had surgery for removal of the left eye with a prosthetic replacement. Strokes are common in AIDS patients, resulting from fungal infections, endocarditis, infectious or non-infectious emboli, or arteritis from herpes zoster infections. This is the 1st published case of hemiplegia and Herpes zoster in a European or African patient with HIV-1.
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PMID:Herpes zoster and controlateral hemiplegia in an African patient infected with HIV-1. 186 23

Rheumatoid factors (RF) occur during the course of various infections such as leprosy, infective endocarditis, tuberculosis, trypanosomiasis, visceral larva migrans, infectious mononucleosis, influenza A, hepatitis A or cytomegalovirus. When first described it seemed logical to assume that host-self-immunization with autologous immune complexes provided the initial stimulus for RF production. Subsequently extensive characterization of bacterial, parasitic and viral Fc receptors has suggested an alternative explanation for rheumatoid factor associated with infections. It seems possible that patients make an initial immune response to infecting agent Fc receptors and that anti-anti-Fc receptors or anti-idiotypes either then directly stimulate rheumatoid factor production or are themselves rheumatoid factors. Such a hypothesis might also be applied to rheumatoid arthritis itself where either infecting agent or autologous cell Fc receptors could be the initial immunizing epitopes involved in rheumatoid factor production.
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PMID:Rheumatoid factors in subacute bacterial endocarditis and other infectious diseases. 307 Jul 27

Among 78 patients who died after bone marrow transplantation, neurologic complications were present in 55 (70%) and were the cause of death in 5 (6%). Metabolic encephalopathy occurred in 29 patients (37%). CNS infections included aspergillosis (3), herpes simplex encephalitis (2), and Listeria monocytogenes meningitis (1). Six additional patients had neuropathologic changes possibly due to cytomegalovirus infection. Cerebrovascular complications occurred in five patients (two hemorrhages and three infarcts). All infarcts were associated with endocarditis. The rate of nonbacterial thrombotic endocarditis was significantly higher (p less than 0.001) than in the general autopsy population. CNS leukemia and therapy-induced injury were rare. There was no evidence of graft-versus-host disease involving the CNS.
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PMID:Neurologic complications of bone marrow transplantation. 388 33

The acquired immunodeficiency syndrome (AIDS) is characterized by a severe idiopathic deficiency in T-cell mediated immunity. Homosexuals, intravenous drug abusers and Haitians are predominantly affected, predisposing them to opportunistic infections and neoplasms. In this study, the central nervous system (CNS) was examined at autopsy in 29 AIDS patients. Significant CNS complications occurred in 55%, mainly related to opportunistic infections similar to those seen in patients with other causes of immunosuppression. Progressive multifocal leukoencephalopathy (three cases), cytomegalovirus (CMV) encephalitis (five cases), cryptococcal meningitis (four cases), Mycobacterium avium-intracellulare (three cases), and toxoplasmosis (one case) were found. Widespread microglial nodules were observed in 20 patients, 80% of whom had CMV inclusions elsewhere at autopsy. Primary cerebral lymphoma (one case) and lymphomatoid granulomatosis (one case) were present. Subarachnoid (five cases) and intraparenchymal (three cases) hemorrhage was seen although these were not usually clinically significant. A single case of embolic arterial obstruction with cortical infarction was due to non-bacterial thrombotic endocarditis.
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PMID:Neuropathologic findings in the acquired immunodeficiency syndrome (AIDS). 394 50

The possibility of acquiring a viral infection by blood transfusion, although recognized for nearly 20 yr, is often ignored. Surgeons and internists submit patients to sophisticated, and sometimes invasive, diagnostic and therapeutic procedures without considering this possibility. We report here on two patients in whom febrile illness appeared about 5 wk after surgery. Both had received multiple blood transfusions in the perioperative period. Initial diagnoses indicated typhoid fever in one patient who received chloramphenicol therapy, and endocarditis in the other patient who was given massive combined antibiotic therapy. Both were later diagnosed by serologic methods as having cytomegalovirus and Epstein-Barr virus infection, respectively. Review of the literature reveals that this mechanism of acquiring these frequently asymptomatic viral infections is surprisingly common.
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PMID:Late postoperative fever--viral infection following multiple blood transfusion. 630 80

Fifty patients with acquired immune deficiency syndrome had complications affecting the central or peripheral nervous systems or both. The patients were either male homosexuals, intravenous drug abusers, or recently arrived Haitian refugees. They ranged in age from 25 to 56. Central nervous system complications were of four kinds: (1) Infections included Toxoplasma gondii abscesses in 5 patients, progressive multifocal leukoencephalopathy in 2, cryptococcal meningitis in 2, Candida albicans in 1, and possible Mycobacterium avium intracellulare in 3. Eighteen patients suffered a subacute encephalitis possibly attributable to cytomegalovirus infection. (2) Tumors consisted of primary lymphoma of the brain in 3 patients and meningeal invasion by systemic lymphoma in 4. (3) Vascular complications included nonbacterial thrombotic endocarditis in 2 patients and cerebral hemorrhages in the setting of thrombocytopenia in 3. (4) Undiagnosed central nervous system problems were evidenced as focal brain lesions in 3 patients and self-limiting aseptic meningitis in 4. Peripheral neuropathy occurred in 8 patients.
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PMID:Neurological complications of acquired immune deficiency syndrome: analysis of 50 patients. 631 74

Two women and two men were infected with the human immunodeficiency virus type 1 (HIV-1) transmitted by renal transplantation from i.v. drug-addicted donors in 1984. The four recipients were treated with cyclosporine and methylprednisolone (one patient only for three months because of early graft failure). Two patients died 66 and 74 months after transplantation, one of endocarditis and one of cerebral hemorrhage. Despite several infections including urinary tract infection (n = 8), peritonitis (n = 1), shunt infection (n = 1), bronchitis (n = 1), salmonellosis (n = 1), herpes stomatitis (n = 2), herpes zoster (n = 1), and cytomegalovirus (n = 1), and despite treatment of several rejection episodes (n = 8), none of them had or has infections typical of the acquired immunodeficiency syndrome (AIDS). However, two patients developed cervical lymphadenopathy and one autoimmune thrombocytopenia 15-20 months after HIV-1 infection. Their T helper cell counts (355/microliters to 75/microliters) and helper/suppressor T cell ratios (1.0-0.2) are distinctly lowered. One patient has membranous glomerulopathy with virus-like particles within and on the outside of the basement membrane and tubuloreticular inclusions in glomerular endothelial cells. We evaluated the case reports of 53 patients with HIV-infection caused by an infected transplant or by blood transfusions during or shortly after transplantation. The cumulative incidence of AIDS was significantly lower in 40 transplant patients with an immunosuppressive regimen including cyclosporine than in 13 transplant patients receiving immunosuppressive treatment without cyclosporine (5-year cumulative risk of AIDS: 31% versus 90%, P = 0.001).
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PMID:The effect of cyclosporine on the progression of human immunodeficiency virus type 1 infection transmitted by transplantation--data on four cases and review of the literature. 821 77

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

The incidence of aspergillosis in kidney transplant recipients is low and most commonly occurs in the early posttransplantation period. We report an unusual case of a 52-year-old female patient with Aspergillus endocarditis as a late complication after kidney transplantation, presumably spread from a necrosis in the gut, associated with previous cytomegalovirus colitis. As complications, the patient experienced septic embolization into the coronary and pulmonary arteries, and an infarction of the right parietal cortex and insula. The patient died as a result of global heart failure after a 10-day course of antimycotic therapy with amphotericin B plus 5-flucytosine during surgical valve replacement.
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PMID:An unusual case of Aspergillus endocarditis in a kidney transplant recipient. 1060 62


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