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)

We report the cases of three adults with a history of intravenous drug abuse who developed endocarditis caused by Corynebacterium xerosis, Neisseria subflava, and Neisseria flavescens, respectively. No cases of endocarditis caused by C. xerosis or N. flavescens and only one case caused by N. subflava have previously been reported in association with narcotic addiction. The prominent clinical features in all patients included poor response to antibiotic therapy, persistent fever, and major embolic events. Stigmata of infection with human immunodeficiency virus, as manifested by oral candidiasis, cervical lymphadenopathy, and serologic evidence, were present in two of the three patients. At our institution, where Staphylococcus aureus remains the most frequent etiologic agent of narcotic-associated endocarditis, the occurrence of these three cases in a 9-month period is striking. We speculate that infection with human immunodeficiency virus may play a role in the pathogenesis of endocarditis caused by these unusual organisms.
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PMID:Unusual pathogens in narcotic-associated endocarditis. 235 5

In a study of 34 human immunodeficiency virus (HIV)-seropositive and 12 HIV-seronegative intravenous drug users with 40 and 14 episodes, respectively, of infective endocarditis (IE), there were no differences between groups in the presentation of IE. Staphylococcus aureus was the infecting microorganism in 75% of the HIV-positive patients and 86% of the HIV-negative patients. Overall survival for the HIV-positive patients was 85% compared with 93% for the HIV-negative patients. Ninety percent of patients with asymptomatic HIV infection survived, whereas 60% of patients in CDC group IV survived (P = .052). In contrast to New Jersey seroprevalence surveys showing HIV antibody in 10%-50% of intravenous drug users, HIV antibody seroprevalence rate in this selected population was 75%. IE in the HIV-seropositive intravenous drug user is essentially the same as in the seronegative user. However, patients with symptomatic HIV infection may be more likely to die from their IE. Intravenous drug users with IE have a greater-than-expected seroprevalence of HIV; the reason remains to be determined.
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PMID:Infective endocarditis in intravenous drug users: a comparison of human immunodeficiency virus type 1-negative and -positive patients. 240 95

To ascertain the incidence of infections in intravenous users of illicit drugs, we performed a retrospective study of 270 intravenous drug users (IVDUs) and 562 controls who did not use drugs over a seven-year period from 1978-1985. IVDUs had an increased overall incidence of infections (P less than 0.001) compared to controls, which was explained to a large degree by an increased incidence of hepatitis. Endocarditis and disseminated gonococcal infection were seen with increased frequency in IVDUs (P less than 0.05), but abscess and cellulitis were not. Neither acquired immunodeficiency syndrome (AIDS), tuberculosis, Pneumocystis pneumonia, nor disseminated viral or fungal infection were seen in IVDUs or controls. Heroin users, but not other IVDUs, had an increased incidence of infections not thought to be associated with needle use, suggesting impaired immunity. This study demonstrates that IVDUs have an increased incidence of infection compared to control subjects, but the kinds of infections have changed substantially over the past two decades. The presence of opportunistic pathogens in these patients should suggest concurrent infection with human immunodeficiency virus (HIV).
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PMID:Increased incidence of infections in intravenous drug users. 278 3

The case of a child with a severe immunodeficiency (purine-nucleoside-phosphorylase deficit) in whom an allogenic bone marrow transplant was performed is reported. CT scan showed image suggestive of cerebral infarction. Clinical course and hemostasis alterations suggest a non-bacterial thrombotic endocarditis. Neurologic complications in bone marrow transplant are review.
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PMID:[Severe encephalopathy in a bone marrow transplant in a case of immunodeficiency]. 310 46

Based on an analysis of the clinical picture of 248 cases of septic endocarditis, disorders in the immunologic status (reduction in the E-RFC, EAC-RFC counts, absolute count of Ea-RFC, significant rise of immunoglobulins of all classes, hypocomplementemia in 37.5% of patients, increase in the titer of circulating immune complexes in 86% of patients) the authors discuss the causes (virulence of the causative agent, immunodeficiency) that favour the development of septic endocarditis.
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PMID:[Septic endocarditis--a predictable or unpredictable disease? Clinico-immunologic aspects]. 348 29

All investigators apparently agree that the most common and compelling reason for using more than one antibiotic to treat a single organism is to achieve a bactericidal effect. Most studies, both retrospective and prospective, have demonstrated that two effective antibiotics yield better results than one in neutropenic patients and/or those with rapidly fatal underlying disease, despite the absence of consistent in vitro synergy. Bacteremias caused by Pseudomona aeruginosa or Klebsiella pneumoniae may be benefited most by synergistic combinations. This may not be true for patients with non-neoplastic disease and normal granulocyte counts, or for patients infected with other species of gram-negative bacilli. Synergistic bactericidal activity is necessary for the successful therapy of endocarditis due to P. aeruginosa, but it may not assure success. The systemic immunodeficiency of neutropenic patients may parallel a localized immunodeficiency in endocarditis, since leukocytes are not effectively mobilized to the site of infection in endocarditis. Antagonistic antibiotic combinations are likely to be particularly harmful in neutropenic patients.
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PMID:Rationale for use of antimicrobial combinations in treatment of gram-negative infections. A review of recent reviews. 635 6

The authors describe a rare case of diffused thrombosis of the superficial veins in the whole body and periphlebitis with perivascular abscesses in an human immunodeficiency virus (HIV)-infected drug abuser who was using neck veins to inject cocaine and heroin. In addition the patient presented oral candidiasis, hepatitis C virus infection, bronchopneumonitis, and endocarditis of the tricuspid valve with valvular failure. The conditions of the patient needed repeated vascular catheterizations for therapy administration. Similar pathologies, in HIV-infected patients, highly increase the risk of opportunistic infections, especially in the encephalic territory; in addition the need for vascular catheterizations represents a further risk factor for bacterial infections.
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PMID:Drug injection in jugular veins: a new risk factor for vascular diseases in HIV-infected patients? A case report. 748 28

Mb. Whipple is a rare systemic disorder with multiple manifestations. We present a case-story demonstrating the typical course: migrating, non-deforming arthralgies are years later followed by diarrhoea, loss of weight, fatigue and pronounced biochemical disturbances. Intestinal biopsy shows numerous PAS-positive, diastaseresistent macrophages, and antibiotic treatment is initiated. After a somewhat prolonged course, complicated with Giardiasis and endocarditis, the patient recovers. Four months after the cessation of antibiotic treatment, however, the patient shows clinical signs of relapse, and treatment is restarted. The etiological agent has recently been identified as a gram-positive actinomycete called Tropheryma Whippleii. There are some, but not unequivocal, signs of a cellular immunodeficiency, perhaps predestinating certain patients to the disease. The course is usually favourable, when treated with relevant antibiotics. Relapse is not uncommon, and is very problematic when the CNS is involved. Therefore, a combination treatment with good penetration of the blood-brain barrier is recommended--e.g. two weeks treatment with parenterally administered streptomycin and benzylpenicillin followed by sulphamethoxazole-trimethoprim orally for one year.
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PMID:[Whipple disease. A rare systemic disorder with multiple manifestations]. 750 46

Originally limited to trench fever, infections due to Rochalimaea now comprise manifestations particular to patients with human immunodeficiency virus (bacillary angiomatosis and hepatic peliosis), but also manifestations as diverse as isolated fever, septicaemia, endocarditis, lymphocytic meningitis, or central neurological disorders, in immunodepressed or immunocompetent subjects. The involvement of Rochalimaea in cat-scratch fever remains debated. Microbiological analysis used for diagnosis has been modified to allow isolation of these new bacteria, whose culture is slow and difficult, in the course of the above-cited clinical manifestations, which should further extend the range of Rochalimaea infections.
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PMID:[A new bacterium: Rochalimaea]. 752 33

The aetiology of cat scratch disease remains controversial since both Afipia felis and Bartonella (Rochalimaea) henselae have been isolated from diseased lymph nodes. Bartonella henselae, Bartonella (Rochalimaea) quintana and Bartonella (Rochalimaea) elizabethae cause endocarditis and Bartonella bacilliformis cause septicemia (Oroya's fever) in non-immunocompromized patients, and Bartonella henselae and Bartonella quintana cause fever, bacillary angiomatosis, and visceral peliosis in human immunodeficiency virus-infected patients. Bartonella quintana is the historical agent of trench fever and we recently isolated it from chronic adenopathy. The diagnosis of Afipia felis and Bartonella infections relies upon the isolation of the bacterium from blood, node tissue after inoculation of cell cultures systems and molecular identification, and upon the serology. In vitro both species are sensitive to aminoglycosides, and we recommend aminoglycosides be included in antibiotic regimens for treating cat scratch disease and Bartonella infections.
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PMID:[Cat-scratch disease and disease caused by Bartonella (Rochalimaea)]. 753 31


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