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

A fifty-four-year-old woman died from multiple brain infarction and hemorrhage in the bilateral cerebrum, cerebellum, and brainstem, with renal infarction. She developed hematuria and transient blindness sixteen days before admission. Low-grade fever, heart murmur, and aortic valve vegetation on ultrasonic cardiography suggested infectious endocarditis. Autopsy study revealed occult adenocarcinoma in the lung and nonbacterial thrombotic endocarditis, but infective endocarditis was not histologically confirmed. The patient was considered to be a rare case of nonbacterial thrombotic endocarditis who developed multiple small infarctions mainly in the brainstem and cerebellum. Nonbacterial thrombotic endocarditis seems to be still an important disease as the embolic source, even if cryptic, of systemic thromboembolism.
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PMID:Multiple brain infarction and hemorrhage by nonbacterial thrombotic endocarditis in occult lung cancer--a case report. 812 93

Two cases of granulomatous endocarditis are reported. The patients developed aortal endocarditis refractory to antibiotics. Therefore, aortal valve replacement was performed. In both cases, Streptococcus viridans was demonstrated in culture and bacterioscopically to be the cause of infection. Histological examination of the valves showed characteristic endocarditis with fibrinoid necrosis and histiocytic granulomas. Streptococci were found in the cytoplasm of macrophages. The possible causes of this special form of infectious endocarditis are discussed.
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PMID:[Granulomatous endocarditis caused by streptococcus]. 815 74

A 63-year-old male patient with multiple myeloma developed congestive heart failure due to streptococcus endocarditis prior to the initiation of chemotherapy. Doppler echocardiographical examination revealed the presence of a large vegetation on the anterior mitral leaflet as well as the association of severe mitral regurgitation. Surgical repair (mitral valve replacement) was urgently undertaken and the postoperative course resulted in uneventful recovery. In immunodeficient patients with such a streptococcus sepsis, the possibility of infectious endocarditis should be taken into consideration and proper management is mandatory in these circumstances.
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PMID:Multiple myeloma complicated with streptococcal endocarditis successfully treated by mitral valve replacement. 818 Apr 37

Cell surface components of viridans streptococci and enterococci have been shown to stimulate the release of tumor necrosis factor alpha (TNF) and interleukin-6 from monocytes/macrophages. In the sera from 10 patients with subacute enterococcal or streptococcal endocarditis, however, the levels of both cytokines were low or undetectable, with elevated TNF levels on admission in 3 patients with complicated disease. Soluble TNF receptor levels were significantly elevated compared with those of healthy controls. When patients with malaria were used as a control group of acute intravascular infection with high circulating TNF values, the ratio between soluble TNF receptors and TNF on admission was significantly greater in the patients with subacute bacterial endocarditis. Besides different amounts of circulating TNF, enhanced TNF receptor shedding may have an important role in the pathogenesis of subacute versus acute clinical disease following human intravascular infection.
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PMID:Circulating tumor necrosis factor alpha (TNF), soluble TNF receptors, and interleukin-6 in human subacute bacterial endocarditis. 822 16

The analysis is presented of clinical picture, running, therapy and prognosis of infectious endocarditis in 67 patients over 60. They appeared to develop progressive cardiac failure, frequent thromboembolism of the cerebral vessels. The disease is often associated with other age-related disorders, proved difficult for differential diagnosis. Elderly patients show resistance to antibacterial therapy more frequently and have worse prognosis for endocarditis outcome.
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PMID:[Infectious endocarditis in middle-aged and elderly patients]. 830

One hundred and one consecutive patients with infectious endocarditis were examined by transthoracic (TTE) and transoesophageal echocardiography (TEE). There were 71 cases of endocarditis on native valves (N) and 30 cases of endocarditis on prosthetic valves (P). The detection of vegetations was significantly greater by TEE (93%), than by TEE (73%) on native valves but the rate of detection of endocarditis on prosthetic valves was low and identical with both methods. Out of a total of 18 abscesses, only 6 were detected by TEE compared with 15 by TEE. There were 3 false negative results by TEE: small anterior abscesses marked by the prosthesis or aortic calcifications. In addition, TEE demonstrated 3 perforations and 2 mycotic aneurysms of the mitral valve. The lesions were confirmed anatomically in 48 cases. The sensitivity of TEE was 94% and the specificity was 84.5%; the negative predictive value was 87.5%. These results show that TEE is significantly superior in the detection and morphological analysis of vegetations. It is the method of choice for the diagnosis of abscesses, especially in prosthetic valve endocarditis.
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PMID:[Diagnostic contribution of transesophageal echocardiography in infectious endocarditis. Apropos of 101 cases]. 833

Infectious endocarditis around indwelling pacemakers is rare (0.15% of all implantations). They have a gloomy prognosis with a global mortality rate of nearly 34% as emerges from this review of the literature concerning 58 cases of infectious endocarditis published within the past 16 years. On the basis of the 6 cases which the authors report, they stress the importance and sometimes difficulty of using ultrasound in a positive diagnosis. Cardiographic ultrasound, which can determine the size and emboligenic nature of vegetations is capital in choosing how to remove the pacemakers. Percutaneous ablation by simply pulling or by catheterization currently gives the best results, but it may be necessary to resort to surgery involving right atriotomy if emboligenic vegetations are present. By combining antibiotic treatment and ablation of the intracavitary material, a cure is obtained in 92% of cases. These figures should be compared with the lack of success of using antibiotic treatment alone which results in a high level of mortality (84%).
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PMID:[Infectious endocarditis on permanent endocavitary pacemakers: value of echocardiography and review of the literature]. 836 22

Between 1969 and 1990 six patients (aged 14 to 64 years, mean 43 years) underwent in situ reconstruction for mycotic aneurysm of the ascending aorta. The primary source of infection was endocarditis in three patients (subacute bacterial endocarditis [n = one patient], sepsis with acute endocarditis [n = one patient]), sepsis with sternal osteomyelitis in one, sepsis with purulent pericarditis in one, and generalized febrile illness in one. In five of six patients the treatment consisted of the excision of changed tissue combined with a composite graft (n = one patient), a xenopericardial patch repair (n = one patient), a Dacron graft repair and aortic valve replacement (n = one patient), a Dacron graft repair alone (n = one patient), and a lateral suture combined with double valve replacement (n = one patient). In one patient with perforation of the mycotic aneurysm into the pulmonary artery, the place of rupture was oversewn without excision of the aortic or pulmonary artery tissue. Two patients with local pericardial inflammation were reoperated on during the hospital stay; one of them because of recurrent mycotic aneurysm of the ascending aorta at the other location and the other because of infection of the suture line after the Dacron patch repair. Antibiotic therapy was intravenously administered for 2 to 12 weeks postoperatively and continued orally for 4 to 8 weeks. The mean observation time was 6 years (range 4 months to 16 years). There was no late graft infection, except the chronic infection of the suture line in one patient who died suddenly 4 months after the operation. There was no early death, and there were three late deaths (chronic myocardial failure, one patient, chronic renal failure, one patient, sudden death, one patient). We concluded that in situ reconstruction for mycotic aneurysm of the ascending aorta combined with prolonged antibiotic therapy is an appropriate procedure with satisfactory early and good long-term results.
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PMID:In situ repair of mycotic aneurysm of the ascending aorta. 842 61

This retrospective study was based on 157 cases of infectious endocarditis observed in the Cardiology department of Ibn Rochd Hospital in Casablanca between January 1983 and December 1994. The mean age of the patients was 27.5 years (11 to 65 years) with a male predominance (62.8%). Infectious endocarditis was secondary to rheumatic valvular heart disease in 63.% of patients and was primary in 29.9% of cases. Mitral or mitro-aortic valve involvement was clearly predominant. A portal of entry of the infection was identified in 63% of patients. It was dental in 64% of cases. Blood cultures were positive in 42% of cases with a predominance of unclassifiable Streptococci (37.8%) and coagulase-negative Staphylococci (25.7% of cases). Echocardiography was very useful, particularly in the presence of negative blood cultures. It demonstrated specific lesions of infectious endocarditis in 73.2% of cases and revealed very large, mobile vegetations in every case complicated by systemic embolism. The clinical course was complicated by heart failure (47.8%), renal failure (14.6%) or neurological lesions (11.5%). The global mortality was 28.7%, related to refractory heart failure in most cases.
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PMID:[Bacterial endocarditis in Morocco]. 856 37

A patient with two bioprostheses was admitted to hospital with pyrexia and a small vegetation on the aortic bioprosthesis visible only on transoesophageal echocardiography without aortic incompetence. Blood cultures were negative. Serology to Coxiella burnetti was positive at high dilution and confirmed the diagnosis of infectious endocarditis. Medical therapy with doxycycline and chloroquine was instaured without surgery. A Coxiella burnetti infection should be systematically searched for in all cases of endocarditis with negative blood cultures. The features of this infection, particularly the aetiological circumstances, diagnosis, history and treatment are reviewed.
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PMID:[Coxiella burnetti endocarditis on bioprosthesis. Apropos of a case]. 867 45


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