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

A 16-year (1965-1980) retrospective clinical study of septicemia and endocarditis was performed at a hospital for infectious diseases. 634 patients (74.5%) had septicemia, 138 (16.2%) endocarditis and 79 (9.3%) suspected endocarditis. The mean age was 55 years, 472 were males and 379 females. Predisposing underlying conditions were recognized in 89.2%. Gram-positive cocci (62.3%) dominated over gram-negative rods (29.5%). The most common causative organisms of septicemia were Staphylococcus aureus (22.4%) and Escherichia coli (20.2%), and of endocarditis, S. aureus (47.1%) and alpha haemolytic streptococci (21.0%). The overall fatality rate was 17.7% and was highest in infections caused by gram-negative rods and S. aureus. In septicemia the rate was 15.3% and in endocarditis 37.0%. Unfavourable prognostic factors were high age, endocarditis and underlying conditions such as haematological diseases and various other factors.
Infection
PMID:Septicemia and endocarditis, 1965-1980, in a Swedish university hospital for infectious diseases. 361 Mar 22

The authors report two cases of endocarditis secondary to Streptobacillus moniliformis. A 41 year-old man, bitten by a rat, is hospitalized 5 weeks later for an endocarditis demonstrated by echocardiography, with massive aortic escape and hemodynamic failure requiring emergency valve replacement: after a favorable course, the patient dies suddenly 4 months later. A 63 year-old woman is admitted for a septicemic syndrome with sterno-clavicular arthritis which occurred 10 days after a rat bite; followed by a transient ischemic cerebral vascular accident; echocardiogram shows a clubshaped bulge of the distal end of the large mitral valve; the course is uneventful under antibiotherapy. In both cases, blood cultures isolate a Streptobacillus moniliformis. Infections secondary to Streptobacillus moniliformis are rare; this Gram negative bacillus, saprophyte of the rat's rhinopharynx, is transmitted to man, most of the time, by bite, and this causes a septicemia, the evolution of which is usually favorable. Complications, especially endocarditis, are exceptionally rare: only 12 cases are found in the world's literature. The evolution is always fatal in the absence of treatment which must include the association penicillin-aminoside. Prophylaxis of this disease is provided by penicillin antibiotherapy which should be systematic after a rodent's bite.
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PMID:[Streptobacillus moniliformis endocarditis. Apropos of 2 cases]. 361 83

During a seven-year period, 38 children acquired multiply resistant Staphylococcus aureus (MRSA) after admission to a pediatric service. Eighteen children were thought to be colonized. Twenty-three infectious episodes occurred in the remaining 20 children. Infections included endocarditis (n = 2), pneumonia (n = 8), burn infection (n = 1), postoperative wound infection (n = 6), intra-abdominal abscess (n = 1), catheter sepsis (n = 2), urinary tract infection (n = 1), conjunctivitis (n = 1), and central nervous system shunt infection (n = 1). When patients infected with MRSA were compared by multivariate analysis with control subjects matched for age and unit of admission, patients with MRSA were hospitalized longer, underwent more surgical procedures, received more intravenous alimentation, and were more likely to require a tracheostomy; no correlation was found with administration of antibiotics. Twenty-six of the 34 discharged patients remained colonized with MRSA. Mortality in the infected patients was 20% (4/20), with a 38% (3/8) mortality rate for MRSA pneumonia.
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PMID:Endemic, multiply resistant Staphylococcus aureus in a pediatric population. Clinical description and risk factors. 367 68

A case of Listeria monocytogenes endocarditis occurring as a complication of a vascular access infection in a patient on chronic hemodialysis that was successfully treated with a combination of vancomycin and gentamicin is reported. The difficulties in the diagnosis and treatment of L. monocytogenes infections, especially endocarditis, in patients on chronic hemodialysis are discussed.
Infection
PMID:Listeria monocytogenes endocarditis in a patient on chronic hemodialysis, successfully treated with vancomycin-gentamicin. 373 26

Infections caused by species within the viridans streptococci have been associated with different clinical characteristics. We studied 36 patients with viridans streptococcal endocarditis. Complications were seen in 10 (32%) of 31 patients with native valve endocarditis and four (80%) of five with prosthetic valve endocarditis and included death in two, valve replacement in six, persistent infection in three, emboli in two, and congestive heart failure in nine. Two-dimensional echocardiograms demonstrated vegetations in 26 (72%) of 36, flail mitral valves in seven, disruption of aortic valve prosthesis in one, and perivalvular abscesses in three (two Streptococcus sanguis I and one Streptococcus intermedius I). All twelve patients with native valve endocarditis who suffered complications had vegetations detected by two-dimensional echocardiography, whereas seven patients with native valve endocarditis without vegetations, as detected by two-dimensional echocardiography, had no complications (P = .03). We found no significant correlation between streptococcal species and clinical outcome. To confirm our identifications, we sent 16 identical viridans streptococcal endocarditis isolates to five institutions; only three of 16 were identified as the same species by all five institutions. We conclude that viridans streptococcal endocarditis can be associated with a virulent clinical course and that there is marked variability in species designations of individual strains by different laboratories.
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PMID:Viridans streptococcal endocarditis: clinical, microbiological, and echocardiographic correlations. 374 73

In a retrospective study covering a 13-year period and a population of 817,900 inhabitants, 13 cases of invasive infection caused by Haemophilus species other than Haemophilus influenzae were found. Ten of the infectious episodes were caused by Haemophilus parainfluenzae and three by Haemophilus aphrophilus. The clinical manifestations comprised endocarditis, meningitis, pleuropneumonia, epiglottitis and septicaemia from an unknown focus. These 13 infectious episodes caused by uncommon Haemophilus species constituted less than 3% of the total number (473) of invasive Haemophilus infections registered during the same period of time. Invasive H. influenzae infections were more common in all age groups than infections caused by other Haemophilus species. In contrast to H. influenzae infections, which predominate in childhood, invasive infections due to uncommon Haemophilus species had no predilection for any age group.
Infection
PMID:Invasive infections caused by Haemophilus species other than Haemophilus influenzae. 387 45

Group B streptococcal bacteremia outside the perinatal setting is not commonly emphasized. This report reviews all episodes of group B streptococcal bacteremia during a four and a half year period in a large community teaching hospital. Fourteen episodes occurred in neonates, four in parturient women, and 28 in other adults. Bacteremic adults were usually elderly with an average age of 68 years. Group B streptococcal bacteremia occurred in adults with various underlying diseases, including diabetes mellitus, liver disease, peripheral vascular disease, and hematologic disease, and in those receiving long-term steroid therapy. Infections causing group B streptococcal bacteremia in adults included decubitus ulcers, pneumonia, endocarditis, cellulitis, arthritis, osteomyelitis, and meningitis. Thirteen of 28 episodes of group B streptococcal bacteremia in adults were hospital-acquired. Overall mortality in adults was 70 percent. Group B streptococcal bacteremia in adults outside of the perinatal setting is associated with significant underlying diseases and has a high mortality.
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PMID:Group B streptococcal bacteremia in a community teaching hospital. 388 11

Infection is a major complication of pacemaker treatment. Antibiotic prophylaxis has been used in association with pacemaker surgery with conflicting results, and conclusive prospective trials are lacking. This investigation indicated that systemic antibiotic prophylaxis was of benefit when infections occurred frequently. The effect of local antibiotic prophylaxis was comparable with that of systemic prophylaxis at generator replacements. No serious adverse effects of the prophylaxis were noted. However, with modern surgical methods and hygienic principles, antibiotic prophylaxis did not seem to be necessary at implantation of new cardiac pacemakers. Once infection had developed it was difficult to eradicate and serious complications sometimes occurred. Most infections commenced in the pacemaker pocket. A few cases were cured by antibiotic treatment alone but, particularly if the infection spread along the electrode, surgery was strongly needed and in the presence of endocarditis and/or septicemia all foreign material should be removed if possible. The most common causal microorganisms of pacemaker infections were Staphylococcus aureus and Staphylococcus epidermidis. Routinely performed pre-, per- and postoperative cultures were of no prognostic value. Persistent use of antibiotics could select for methicillin-resistant coagulase-negative staphylococci, therefore bacteriological monitoring of wound infections was considered important. The dosage schedules used for cloxacillin and flucloxacillin gave satisfactory serum concentrations peroperatively. Local treatment with cloxacillin in the pacemaker pocket peroperatively gave adequate concentrations in tissue fluid from the pocket 24 h after the operation, as did systemic administration of flucloxacillin. The pharmacokinetics of flucloxacillin in these elderly patients differed in some respects from that found in healthy volunteers. Plasma elimination half-life was almost twice as long. Despite the high degree of plasma protein binding, flucloxacillin appeared to pass rapidly and efficiently to extravascular compartments, such as a pacemaker pocket.
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PMID:Pacemaker infections. A clinical study with special reference to prophylactic use of some isoxazolyl penicillins. 390 38

We reviewed infectious complications during 7,671 days of central venous (Hickman) catheter use in 47 patients receiving intensive cytotoxic and supportive therapy for malignant disease. Colonization of the catheter was identified in eight cases of septicemia, two associated with endocarditis. Septicemia was successfully treated in four of five patients after removal of the catheter and in two of three in whom the catheter remained in situ. Infection of the exit site occurred in five patients but in only one was there associated septicemia. Poor patient compliance with the recommended regimen for catheter care was suspected. Thus, the overall rate of catheter-related infection was 1.6 per 1,000 days. Guidelines are discussed for removal of the catheter for suspected catheter-related infection.
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PMID:Infective complications of prolonged central venous (Hickman) catheterization. 400 96

We have reviewed 107 cases of staphylococcal bacteraemia in order to assess the current clinical spectrum of serious staphylococcal sepsis in Zimbabwe, where staphylococcal bacteraemia is common. Infection was hospital-acquired in 35 cases and community-acquired in 72 cases. The mortality rate was 28%. Most patients were young, with predisposing conditions such as prematurity, protein-caloric malnutrition and measles. The length of the prodromal illness tended to be short and a primary site of infection, usually the lungs or skin, was obvious in 66% of patients. In 30% there was evidence of metastatic spread, usually to meninges, bone, joint and muscle, but endocarditis was uncommon. Metastatic infection was rare when infection was acquired in hospital. Death appeared to be associated with measles, protein-caloric malnutrition, acquisition of infection in hospital, absence of an obvious focus of infection and with inappropriate antibiotic therapy. Aggressive treatment with antibiotics intravenously was the rule. A combination of penicillin and an aminoglycoside was favoured until the nature of the infecting organism was established. Of those patients who died, 38% had received less than 72 h antibiotic therapy. Multiple antibiotic resistance is now widespread in Zimbabwe.
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PMID:Staphylococcal bacteraemia in Zimbabwe 1983. 403 14


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