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

Early reports of Candida krusei in man describe the organism as a transient, infrequent isolate of minor clinical significance inhabiting the mucosal surfaces. More recently it has emerged as a notable pathogen with a spectrum of clinical manifestations such as fungaemia, endophthalmitis, arthritis and endocarditis, most of which usually occur in compromised patient groups in a nosocomial setting. The advent of human immunodeficiency virus infection and the widespread use of the newer triazole fluconazole to suppress fungal infections in these patients have contributed to a significant increase in C. krusei infection, particularly because of the high incidence of resistance of the yeast to this drug. Experimental studies have generally shown C. krusei to be less virulent than C. albicans in terms of its adherence to both epithelial and prosthetic surfaces, proteolytic potential and production of phospholipases. Furthermore, it would seem that C. krusei is significantly different from other medically important Candida spp. in its structural and metabolic features, and exhibits different behaviour patterns towards host defences, adding credence to the belief that it should be re-assigned taxonomically. An increased awareness of the pathogenic potential of this yeast coupled with the newer molecular biological approaches to its study may facilitate the continued exploration of the epidemiology and pathogenesis of C. krusei infections.
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PMID:Candida krusei: biology, epidemiology, pathogenicity and clinical manifestations of an emerging pathogen. 796

Reports of invasive Group B Streptococcus infection in adults with underlying medical conditions have been increasing. Ocular infection with this organism is unusual. Metastatic endophthalmitis in adults caused by this organism has been reported rarely and has only been associated with endocarditis. We encountered two cases of Group B streptococcal metastatic endophthalmitis in adults who did not have endocarditis. These cases reflect the increasing incidence of invasive Group B Streptococcus infection with its varying manifestations. Additionally, they emphasize the importance of considering this pathogen as a cause of metastatic endophthalmitis in adults with predisposing illnesses.
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PMID:Group B streptococcal metastatic endophthalmitis. 815 32

Group G streptococci can cause serious infections in patients with predisposing factors. Involvement of the eye has rarely been reported in patients without ocular history. Two cases of group G streptococcal endocarditis which presented with an endogenous endophthalmitis are reported. Topical and systemic antimicrobial therapy resulted in recovery, but visual outcome was poor.
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PMID:Endophthalmitis as presenting symptom of group G streptococcal endocarditis. 818 45

Bacillus cereus is a gram-positive aerobic or facultatively anaerobic spore-forming rod. It is a cause of food poisoning, which is frequently associated with the consumption of rice-based dishes. The organism produces an emetic or diarrheal syndrome induced by an emetic toxin and enterotoxin, respectively. Other toxins are produced during growth, including phospholipases, proteases, and hemolysins, one of which, cereolysin, is a thiol-activated hemolysin. These toxins may contribute to the pathogenicity of B. cereus in nongastrointestinal disease. B. cereus isolated from clinical material other than feces or vomitus was commonly dismissed as a contaminant, but increasingly it is being recognized as a species with pathogenic potential. It is now recognized as an infrequent cause of serious nongastrointestinal infection, particularly in drug addicts, the immunosuppressed, neonates, and postsurgical patients, especially when prosthetic implants such as ventricular shunts are inserted. Ocular infections are the commonest types of severe infection, including endophthalmitis, panophthalmitis, and keratitis, usually with the characteristic formation of corneal ring abscesses. Even with prompt surgical and antimicrobial agent treatment, enucleation of the eye and blindness are common sequelae. Septicemia, meningitis, endocarditis, osteomyelitis, and surgical and traumatic wound infections are other manifestations of severe disease. B. cereus produces beta-lactamases, unlike Bacillus anthracis, and so is resistant to beta-lactam antibiotics; it is usually susceptible to treatment with clindamycin, vancomycin, gentamicin, chloramphenicol, and erythromycin. Simultaneous therapy via multiple routes may be required.
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PMID:Bacillus cereus and related species. 826 90

Endophthalmitis is a rare complication of Escherichia coli-induced septicemia. Nine cases of endogenous endophthalmitis caused by E. coli have been reported previously, all except one in patients with diabetes. The most common primary site of infection is the urinary tract. The course of illness is rapidly progressive with a poor visual prognosis. Concurrent systemic morbidity, including body abscesses and endocarditis, is high. We report an additional case of endogenous endophthalmitis from E. coli in a diabetic woman. Enucleation was required despite aggressive topical and systemic treatment. The pertinent literature is reviewed.
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PMID:Endogenous endophthalmitis caused by Escherichia coli. 846 Aug 86

The E. faecalis cytolysin represents a new class of cytolytic agents which are related to a family of antibacterial peptides termed lantibiotics. Despite considerable similarity at the genetic level, the E. faecalis cytolysin differs from the lantibiotics in several respects. First, the E. faecalis cytolysin consists of two dissimilar precursors, both of which are required to effect target cell lysis. A second important difference is that the E. faecalis cytolysin is active against eukaryotic as well as Gram-positive prokaryotic cells. Originally identified as a haemolysin [32], the E. faecalis cytolysin has been shown to make a contribution to bacterial virulence in endocarditis [8, 33] and endophthalmitis [7] models, and the cytolytic phenotype is enriched among clinical isolates of the organism [2, 3]. Similarities between the E. faecalis cytolysin and lantibiotics such as nisin (which is used as a food preservative in several countries [34] and is the subject of continuing attempts at rational design of lantibiotic-based food preservatives [25]), and the observation of an association between the E. faecalis cytolysin and bacterial virulence indicate that it may be possible to engineer lantibiotics to a point where undesired toxic or cytolytic activities will arise. Further comparison of the chemical, structural and biological properties of the E. faecalis cytolysin and classical lantibiotics will define these limits.
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PMID:The Enterococcus faecalis cytolysin determinant and its relationship to those encoding lantibiotics. 858 41

Metastatic bacterial endophthalmitis caused by Klebsiella pneumoniae is a unique but well-known phenomenon in Taiwan, where most cases occur in diabetic patients with pyogenic liver abscesses. However, endogenous Escherichia coli endophthalmitis is quite rare. The most common primary site of this infection is the urinary tract and the incidence of concurrent systemic infections, such as abscess formation and infective endocarditis, is high. This illness has a rapidly progressive clinical course associated with a poor prognosis for recovery of visual acuity. This is a report of a case of endogenous E. coli endophthalmitis originating from a renal abscess in a diabetic woman. Despite aggressive local and systemic treatment, evisceration was required to prevent the infection from spreading.
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PMID:Endogenous Escherichia coli endophthalmitis. 864 97

Erythromycin and other macrolides have enjoyed a renaissance in the 1970s, 1980s and 1990s secondary to the discovery of "new' pathogens such as Chlamydia, Legionella, Campylobacter and Mycoplasma spp. Erythromycin is an important therapeutic agent in the paediatric age group for several reasons: (a) it exhibits proven efficacy for a wide range of infections (upper and lower respiratory tract infections, skin/skin structure infections, prophylaxis of endocarditis/acute rheumatic fever/ophthalmia neonatorum and pre-colonic surgery, campylobacteriosis, chlamydial and ureaplasmal infections, diphtheria, whooping cough, streptococcal pharyngitis) and gastrointestinal (GI) dysmotility states; (b) intravenous formulations are widely available; and (c) it is available in a number of formulations as a generic product, which is likely to result in significant cost savings. Nevertheless, erythromycin and similar earlier macrolides are characterised by a number of drawbacks including a narrow spectrum of antimicrobial activity, unfavourable pharmacokinetic properties and poor GI tolerability. Newer macrolides such as clarithromycin and azithromycin are useful in serving the needs of paediatric patients who are erythromycin-intolerant or who have infections caused by organisms that are intrinsically erythromycin-resistant, or for which a high percentage of strains are resistant (e.g. Haemophilus influenzae, Helicobacter pylori, Mycobacterium avium complex). In addition, these newer macrolides may be considered as alternatives to oral amoxicillin-clavulanic acid, second or third generation cephalosporins, or erythromycin plus sulphonamide in this patient population. Selection between specific macrolides and between macrolides and other antibiotics in the paediatric population is likely to depend, at least for the immediate future, on separate comparisons of product availability, cost, effectiveness and tolerability profiles.
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PMID:Macrolide antibiotics in paediatric infectious diseases. 870 92

Propionibacterium acnes belongs to the cutaneous flora of humans and is rarely considered a pathogen in human diseases. It is a frequent contaminant in blood cultures; however, in some patients it has been identified as the causative agent of life-threatening infections. Within the last years we have observed an abrupt increase in severe P. acnes infections which prompted us to study in detail the clinical and microbiological features, risk factors, and outcomes of these cases. In a retrospective review of microbiological records of 905 Propionibacterium isolates from a five-year period (1990-95), 70 were identified from 20 patients with clinical and microbiological evidence of a P. acnes infection. The clinical syndromes included endocarditis (7 patients), post-craniotomy infections (6 patients), arthritis and spondylodiscitis (4 patients), endophthalmitis (2 patients) and pansinusitis (1 patient). The predominant predisposing conditions were previous surgery preceding the infection from 2 weeks to 4 years and implantation of foreign bodies such as prosthetic heart valves, intraocular lenses and ventriculo-peritoneal shunts. Therapy consisted of intravenous antibiotics in all cases and surgical procedures to remove infected tissue in eighteen patients. The outcome was favorable in sixteen patients (80 percent) who had a complete recovery. These data confirm the pathogenic potential of P. acnes in late post-surgical infections, in particular after implantation of a foreign body, and suggest a combined therapeutic approach with intravenous antibiotics and surgical removal of the infected tissue.
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PMID:Severe infections caused by Propionibacterium acnes: an underestimated pathogen in late postoperative infections. 943 90

Coagulase-negative staphylococci have long been regarded as apathogenic but their important role as pathogens and their increasing incidence have been recognized and studied in recent years. Although specific virulence factors are not as clearly established as they are in Staphylococcus aureus, it seems clear that factors such as bacterial polysaccharide components are involved in attachment and/or persistence of bacteria on foreign materials. Coagulase-negative staphylococci are by far the most common cause of bacteremia related to indwelling devices. Most of these infections are hospital-acquired, and studies over the past several years suggest that they are often caused by strains that are transmitted among hospitalized patients. Other important infections due to coagulase-negative staphylococci include central nervous system shunt infections, native or prosthetic valve endocarditis, urinary tract infections, and endophthalmitis. Intravenous treatment of systemic infections is usually required because coagulase-negative staphylococci have become increasingly resistant to multiple antibiotics.
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PMID:Coagulase-negative staphylococci: role as pathogens. 1007 74


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