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

Endocarditis by Aspergillus species in patients without prior cardiovascular surgery is extremely rare and difficult to diagnose. We report and discuss a 69-year-old patient with hairy cell leukemia who developed severe bilateral pneumonia and metastatic subcutaneous nodules from which A. fumigatus was cultured. He died after 18 days of treatment with an adequate dose (0.7 mg/kg/day) of amphotericin B intravenously. Fungal endocarditis and a myocardial infarction due to a septic thrombotic occlusion of the left coronary artery by A. fumigatus appeared to be the cause of death. A. fumigatus could still be cultured from the aortic valve postmortem despite a total dose of 756 mg amphotericin B. In case of metastatic spread of Aspergillus spp., endocarditis should be suspected.
Infection
PMID:Aspergillus fumigatus, a rare cause of fatal coronary artery occlusion. 156 13

Early diagnosis and successful antimicrobial therapy have diminished the frequency of embolomycotic aneurysms, but infected aortic and small vessel aneurysms, arteriosclerotic plaques, and prosthetic grafts are becoming more common. A broad spectrum of pathogens, including Staphylococcus, Salmonella, Enterobacteriaceae, Pseudomonas aeruginosa, and some unusual organisms, are associated with this change. We treated four patients (three with abdominal aortic aneurysms and one with a prosthetic graft) with arterial infections caused by Listeria monocytogenes. Only seven other cases have previously been recorded in the world literature. Infection is suspected when a palpable or radiographically defined aneurysm is present with an otherwise obscure febrile illness. In about one-third of patients, blood cultures have yielded the pathogen. Newer imaging techniques have helped confirm the diagnosis. These infections are best managed by surgical resection in combination with long-term, appropriate antimicrobial therapy with ampicillin or sulfonamides. Unlike other adult listerial infection, except endocarditis, in arterial infection, immunosuppression and malignancy are not predisposing factors.
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PMID:Arterial infections due to Listeria monocytogenes: report of four cases and review of world literature. 161 63

Bacillus cereus is a ubiquitous organism that infrequently causes serious infections. We report a patient with B. cereus endocarditis involving a mechanical aortic valve. Data for 10 cases of B. cereus endocarditis reported in the literature are summarized. B. cereus is resistant to many commonly used antibiotics, a finding that has clinical significance for empirical antibiotic selection in patients with suspected endocarditis. Infection in patients with valvular heart disease in the few cases reported is associated with significant mortality and morbidity.
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PMID:Bacillus cereus endocarditis: report of a case and review. 157 91

A growing amount of clinical and experimental evidence suggests a link between infection and atherosclerotic diseases including both myocardial and cerebral infarction. A prime example is a greatly increased risk of stroke in septicaemic patients with and without endocarditis. Controlled clinical studies have recently shown, however, that certain other milder bacterial infections are also a risk factor for infarction. A preceding febrile respiratory infection was a major risk factor for stroke in young and middle aged patients. In patients with acute myocardial infarction Chlamydia pneumoniae and dental infections seem to be risk factors according to one controlled clinical study. Several possible mechanisms could explain the observed association of infection and infarction. For instance, infection causes a hypercoagulable state which increases the risk of thrombosis. In addition, infection has profound and harmful effects on prostaglandin and lipid metabolism. Infection may also have some role in the atherosclerotic process itself by inducing damage and inflammation in vascular endothelium in the presence of hypercholesterolemia. So far, however, little clinical evidence is available to suggest that by controlling infection the risk of infarction or development of atherosclerotic lesions might be reduced except in patients with endocarditis, where the risk of thromboembolic complications rapidly diminished when the infection is controlled with antimicrobial therapy.
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PMID:Infection as a risk factor for infarction and atherosclerosis. 175 23

In the group of 37 patients (pts) with infective endocarditis of aortic valve comparative analysis of echocardiograms with intraoperative or pathomorphological findings was performed. Infection caused development of vegetations in 17 pts, cusp rupture in 7 and perivalvular abscess in 4 pts. Echocardiographic examination enabled diagnosis of vegetations in 16 pts. In 2 pts abscess cavity was shown between mitral and aortic annulus. Two-dimensional echocardiography provided more detailed data concerning number and localization of vegetation, and development of perivalvular abscess cavity. However cusps rupture was shown by M-mode echograms in 4 from 7 pts. In the course of antibiotic therapy 7 pts died: from 30 pts treated surgically the result of treatment was beneficial in 27. The examinations confirmed poor clinical prognosis of premature mitral valve closure for the patients with aortic insufficiency.
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PMID:[Infectious aortic valve endocarditis. Echocardiographic evaluation]. 177 94

We describe 10 new cases of bacteremia due to Stomatococcus mucilaginosus and review eight other cases that have been described in the literature. The most common clinical presentations were endocarditis, catheter-related infection, and septicemia. Commonly associated risk factors were intravenous drug abuse, cardiac valve disease, the presence of foreign bodies (especially indwelling vascular catheters), and immunocompromised states. S. mucilaginosus bacteremia is readily treatable with antibiotics. This organism is of low virulence, but appears to be an emerging pathogen. Infection due to S. mucilaginosus is likely to be underreported because the organism may be easily misidentified and information on it is not included in the databases of many automated microbiologic identification systems.
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PMID:Infections due to Stomatococcus mucilaginosus: 10 cases and review. 177 36

Infection with Trichosporon beigelii is an uncommon cause of endocarditis. Of the eight cases of T. beigelii endocarditis that have been reported (one herein and seven previously), six involved prosthetic heart valves and two involved native heart valves. The clinical manifestations of this infection included embolization of the superficial femoral artery or of the bifurcation of the posterior tibial and peroneal arteries in three of these patients (two with prosthetic valve and one with native valve endocarditis). In seven of the eight reported cases, blood cultures were positive for the organism. Although clinical isolates of the organism are generally reported to be susceptible to amphotericin B, isolates can vary in their sensitivities to antifungal agents in vitro depending on the methodology used, and clinical response to therapy with antifungal agents in a regimen that includes amphotericin B is generally poor. Only two of six patients who were treated with antifungal agents survived endocarditis caused by T. beigelii and were apparently cured; one of these patients was also managed surgically with valve replacement. Infection with T. beigelii should be considered in the differential diagnosis of endocarditis in immunocompetent patients, particularly those who have a prosthetic heart valve. Rapid, aggressive therapy may be necessary to eradicate this organism.
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PMID:Endocarditis due to Trichosporon beigelii: in vitro susceptibility of isolates and review. 186 40

Fifteen strains of Enterococcus faecalis, all clinical blood culture isolates from patients with endocarditis, were studied by kill-kinetic experiments using penicillin G, ampicillin and amoxicillin alone and in combination with tobramycin. The median minimal inhibitory concentrations (MIC), were penicillin 4 mg/l, ampicillin 2 mg/l, amoxicillin 2 mg/l and tobramycin 32 mg/l. Equipotent doses of the antibiotics (1/2 x MIC, 1 x MIC and 4 x MIC) were used in the kill-kinetic studies. Synergism was studied using a combination of 1/2 x MIC of the beta-lactam antibiotic and 8 mg/l of tobramycin. The bactericidal activity did not exceed 10(+3) cfu/ml at 5 hours for any single compound. After 5 h all three beta-lactam antibiotics in combination with tobramycin resulted in synergism, i.e. more than one hundredfold reduction of colony forming units (cfu) as compared to the most active single agent. Amoxicillin had a significantly higher bactericidal potential than ampicillin or penicillin both alone and in combination with tobramycin. The clinical significance of these findings warrants further studies in vivo.
Infection
PMID:Bactericidal effect of penicillin, ampicillin, and amoxicillin alone and in combination with tobramycin against Enterococcus faecalis as determined by kill-kinetic studies. 190 88

A case of prosthetic valve endocarditis caused by Corynebacterium pilosum in a 79-year-old woman developed eighty years after aortic valve replacement with bovine pericardium bioprosthesis is described. In spite of the antibiotic therapy she presented an unfavourable course that led to her death.
Infection
PMID:Prosthetic valve endocarditis caused by Corynebacterium pilosum. 191 38

Deep sternal wound infection following open-heart surgery caused sternal osteitis in eight patients and mediastinitis in 27 during 1980-1989. The incidence of such infection was 0.5%. Infection was more common during the last 2 years than in 1980-1987 (0.8% vs. 0.4%), and when bilateral internal mammary artery grafts were dissected (3.2% vs. 0.6% when only one internal mammary artery was used). Cure of mediastinitis was achieved by primary closed irrigation in four of 13 patients and by primary open treatment in five of ten. Muscle flap was employed in totally ten patients and omentum in four before final elimination of infection. Of the 27 patients with mediastinitis, eight (30%) died in the post-operative period of cardiac failure (3 cases), disseminated infection (2), bleeding (2) or aspiration (1). The 5-year survival rate was 43%. Prosthetic value endocarditis caused one late death and necessitated one reoperation. If eradication of postoperative mediastinitis is not achieved by early diagnosis, debridement and closed irrigation, transposition of muscle or omentum should be considered.
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PMID:Management of deep sternal wound infection after cardiac surgery--Hanuman syndrome. 194 4


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