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

Data on mycoses known to be imported into the United Kingdom are sparse. Estimates on the prevalence of fungal infections have to be based on indirect and incomplete figures, obtained from isolation figures and reports of individual cases to co-ordinating centres such as the Mycological Reference Laboratory and the Communicable Disease Surveillance Centre of the Public Health Laboratory Service. Imported species of dermatophytes account for less than 1% of the total number of isolations made annually at mycological laboratories throughout the U.K. A suggested prevalence of dermatophytosis in this country is c. 250 000 cases per annum. Trichophyton rubrum may now be the most common species of dermatophyte. Other estimates of the frequencies with which infections are recorded each year include mycetoma (7-10), histoplasmosis (2-5), aspergilloma (50-80), invasive aspergillosis (10-30), Candida vaginitis (greater than or equal to 1 000 000), invasive candidiasis (10-80), Candida endocarditis (1-2) and cryptococcosis (6-10).
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PMID:Imported fungal infections. 52 46

A patient is presented in whom a left atrial myxoma was found to be infected with Histoplasma capsulatum. Histoplasmosis has not been previously associated with this tumor, nor has any fungus without preceding bacterial endocarditis and long-term antibiotic therapy. The clinical course in foru previously reported cases of bacterially infected myxoma is reviewed. There have been 18 prior cases of Histoplasma endocarditis and in two the patients have survived. Their clinical presentation and response to therapy are also reviewed, and pertinent therapeutic conclusions drawn. The role of echocardiography in this patient's evaluation and the ultimate successful therapy are discussed.
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PMID:Left atrial myxoma infected with Histoplasma capsulatum. 64 33

Two cases of disseminated histoplasmosis caused by H. capsulatum in Nigerian children are reported. This is a rare infection in this part of the world. The main clinical features were fever, weight loss, lassitude, lymphadenopathy, hepatosplenomegaly and severe anaemia, features indistinguishable from those of tuberculosis, Hodgkins and other reticuloses. Recognition of this infection in this environment is possible if it is considered in the differential diagnosis of pyrexia of undetermined origin and appropriate laboratory tests carried out on suitable specimens such as bone marrow, splenic aspirate or biopsy material. Treatment of choice is amphotericin B given intravenously, starting with 0-25 mg/kg. and increasing slowly to 1 mg/kg. Other useful drugs are Septrin and rifampicin which can be given concurrently. Subcutaneous abscesses and multiple bone lesions occurred in both our cases presumably as a result of blood stream infection, or embolisation from endocarditis.
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PMID:Disseminated histoplasmosis due to histoplasma capsulatum in two Nigerian children. 122 26

Endocardial involvement associated with disseminated histoplasmosis has been infrequently documented, especially among patients with prosthetic valves. The therapeutic approach to these patients is also not yet clearly defined. A 54-year-old man with prosthetic valve endocarditis due to histoplasmosis was successfully treated with amphotericin B. A review of the literature suggests that the optimal form of therapy is likely a combination of surgical replacement of the involved valve and high dose amphotericin B. Successful therapy with amphotericin B alone may, however, be achieved if surgery is not a viable option.
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PMID:Nonsurgical treatment of Histoplasma endocarditis involving a bioprosthetic valve. 198 70

20 patients (18 men, 2 women), 10 of whom were HIV +, were given Fluconazole (F) for either systemic candidiasis (13 cases), histoplasmosis (1), or cryptococcosis (6). The localization of the Candida infections (12 C. albicans, 1 C. tropicalis), were: septicemic (2), urinary (7), bronchial (2), esophageal (5), uveal (1), soft tissue (2), and 1 undetermined localization but a positive serology (1). On day (d) 1, Candidiasis patients were given an initial dose of 400 mg (for septicemia) or 200 mg (other localizations) of FIV or PO, then 200 or 100 mg per d. The length of treatment lasted from 28 to 70 d. Evolution was favorable in all the patients. 4 relapses occurred after the end of treatment: at 10 d, a septicemic candidiasis (C. tropicalis) in 1 patient who had prosthetic endocarditis; and at 1 month, digestive candidiasis in 3 HIV + patients. For the patient, infected by Histoplasma capsulatum, despite a clinical improvement, urine were still positive at day 75. The patients with cryptococcosis (5 meningitidis in the AIDS patients) and renal (1) (kidney transplant) were given on the average 400 mg a d, IV or PO (mean length 8 weeks). Only 5 patients were evaluable. For 2 of the meningitis patients with other localizations, standard treatment was instituted due to the persistence of positive cultures. For the 2 other patients, the cerebrospinal fluid (1) and the urine (1) were sterilized by the 3d week. But they relapsed 1 month after the treatment stopped. For the 18 patients evaluable, clinical and biological tolerance was good except for 1 patient with transaminases rise for which fluconazole was probably the cause.
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PMID:[Value of fluconazole in the treatment of systemic yeast infection]. 255 80

We report a case of histoplasmosis capsulati endocarditis simultaneously infecting a mitral and aortic porcine bioprostheses. Histologically, the fungus demonstrated a diversity of morphologies, ranging from typical, intracellular, 2- to 5-micron yeast cells, to septate and branching hyphae, to bizarre hyphae with vesicular swellings. Cultures obtained from both valves were positive in four days. The combination of unexpected histologic appearance and rapid growth in culture may pose problems in diagnosis.
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PMID:Filamentous Histoplasma capsulatum endocarditis involving mitral and aortic valve porcine bioprostheses. 383 57

Progressive disseminated histoplasmosis (PDH) is a rare consequence of infection with Histoplasmia capsulatum. Usually fatal if untreated, PDH generally is cured by appropriate amphotericin B treatment. Of 31 persons with uncomplicated PDH treated with amphotericin B, we found that relapse occurred in five (16%) after an interval of up to nine years after initial therapy. Review of these five cases and 31 additional relapsing cases from the literature indicates that fungal endocarditis or endarteritis without surgical treatment, underlying lymphoreticular neoplasm, and amphotericin B dosage of less than 2 g appear to be associated with relapse of PDH.
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PMID:Conditions associated with relapse of amphotericin B-treated disseminated histoplasmosis. 627 96

Forty-eight cases of deep mycoses were studied and treated with ketoconazole, each with in vitro evaluation of the minimum inhibitory concentrations (MIC) of the causative fungi, in vivo pharmacokinetic, clinical, and mycologic evaluations, several months to two years after the treatment was stopped. Excellent results were obtained in six cases of chronic mucocutaneous candidiasis, with restoration of immunologic disturbances; 23 cases of systemic candidiasis, including new aspects of heroin addicts with cutaneous, ocular, or osteoarticular manifestations; eight cases of histoplasmosis, five due to Histoplasma capsulatum and three to Histoplasma duboisii, with cure in seven and remission in one; one case of African blastomycosis (Blastomyces dermatitidis); three cases of mycetoma, two due to Monosporium apiospermum, one due to a dematiacious fungus; three cases of entomophthoromycosis with cure; one case of fungal arthritis, due to new hyphomycete similar to M. apiospermum, pathogenic for laboratory animals; one case of Drechslera longirostrata causing vertebral arthritis, following a fungal endocarditis and cured by combination of ketoconazole with amphotericin B, each agent alone being ineffective; and other deep mycoses.
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PMID:Laboratory and clinical assessment of ketoconazole in deep-seated mycoses. 629 50

A patient with valvular heart disease was found to have disseminated histoplasmosis and Histoplasma endocarditis. Refractory congestive heart failure secondary to severe progressive aortic insufficiency and the presence of a large valvular vegetation necessitated aortic valve replacement, which was timed to coincide with the midpoint of a course of therapy with 4 gm of amphotericin B. The patient has done well since the completion of treatment.
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PMID:Histoplasma capsulatum endocarditis requiring aortic valve replacement for aortic insufficiency. 737 95

A 40-year-old man with aortic stenosis and disseminated histoplasmosis did not respond to treatment with itraconazole. Though there was no haemodynamic deterioration, valvar regurgitation, or embolic phenomena a presumptive diagnosis of infective endocarditis was made. This was confirmed at aortic valve replacement. Antifungal treatment was continued for 18 months after valve replacement and serological tests for Histoplasma became progressively more negative during a three year follow up.
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PMID:Histoplasma endocarditis on a stenosed aortic valve presenting as dysphagia and weight loss. 828 May 27


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