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)

An enzyme-linked immunosorbent assay (ELISA) was used with purified alpha-toxin and teichoic acid preparations to measure the IgG and IgM response in Staphylococcus aureus infections. After determining antibodies in a normal population, cut-off levels were set for all age groups. ELISA with alpha-toxin was more sensitive than the antistaphylolysin neutralization test (ASTA). Determining IgM antibodies with the two antigens was found to be of limited diagnostic value. Positive IgG titers against alpha-toxin were found in 21 of 27 patients (78%) with endocarditis, 11 of 14 (79%) with complicated septicemia, eight of 20 (40%) with uncomplicated septicemia and in 12 of 22 (54%) with chronic osteomyelitis. The IgG responses to teichoic acid and alpha-toxin were somewhat different when measured by ELISA, and the parallel performance of the two assays resulted in improved serological diagnostics. The number of positive patients increased to 89%, 86%, 65% and 64%, respectively, in the four groups with a diagnostic specificity of 93%. In septicemic staphylococcal infections, the diagnosis could be established in all patients (28 of 28) with adequately spaced paired samples.
Infection
PMID:The role of antibodies against alpha-toxin and teichoic acid in the diagnosis of staphylococcal infections. 686 37

The present study is an attempt to define the uncommon bacteria (UB) causing endocarditis and to evaluate their prevalence and clinical significance. Review of 13 series (including ours) revealed that UB were the infecting organisms in 105/1989 patients (5.3%). The leading bacteria were: Pneumococcus, Haemophilus sp., Corynebacterium sp., Neisseria sp., Streptobacillus moniliformis, Cardiobacterium hominis and Erysipelothrix sp. These data are similar to those obtained from 111 sporadic case reports published in English during the last 6 yr and cited in the Index Medicus. Infection by UB usually resembles that by the common bacteria. However, Haemophilus sp. seems to affect mainly the young and is associated with major arterial occlusions, and Brucella is claimed to have a greater affinity to the aortic valve. UB are more frequent in patients with polymicrobial infections and their diagnosis is often delayed. Greater awareness to the possibility of infections with UB is needed for early diagnosis and improved prognosis.
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PMID:Infective endocarditis caused by uncommon bacteria. 687 16

Infections of the cardiovascular system, besides involving both natural and prosthetic heart valves, vascular grafts, and indwelling venous and arterial cannulas, may cause mycotic aneurysms. The latter frequently complicate endocarditis; however, they may occur as isolated phenomena. Enterobacteriaceae are uncommon etiologic agents in vascular infections; however, a patient is reported who presented initially with a bacteremia due to Yersinia enterocolitica biogroup 4 and despite antimicrobial therapy developed a mycotic aneurysm of the left internal carotid artery. Clinical manifestations, pathogenesis, and treatment of yersiniosis are reviewed.
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PMID:Mycotic aneurysm due to Yersinia enterocolitica. 689 58

Elderly persons are prone to more frequent or greater morbidity and higher mortality from selected infectious diseases than the average population. Factors that may affect this increased predilection or poorer prognosis include environmental exposure, normal physiological changes of aging, coexistence of chronic diseases and alteration of host defense mechanisms. Infections to which the aged are particularly vulnerable are pneumonia, influenza, tuberculosis, urinary tract infection, Gram-negative bacteremia, intra-abdominal sepsis, soft tissue infection, infective endocarditis, bacterial meningitis, bacterial arthritis and herpes zoster infection.
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PMID:Important infections in elderly persons. 703 32

Bacterial adherence as a result of specific surface properties may be a contributory factor in the pathogenesis of bacterial endocarditis giving certain types of bacteria a selective advantage to cause this disease. Adherence could interact with other pathogenetic mechanisms, and this interaction could promote or hamper the development of endocarditis. Dextran production by streptococci, the activation of the clotting system by monocyte tissue thromboplastin, and phagocytic removal of bacteria from the vegetational surface by granulocytes and monocytes are examples of interacting mechanisms that could contribute to the pathogenesis of bacterial endocarditis.
Infection 1982
PMID:The role of bacterial adherence in the pathogenesis of infective endocarditis. 710 16

A pathological study has been performed on 10 infected Hancock bioprostheses removed from nine patients who died of prosthetic endocarditis. The devices had been in place from 2 to 87 months (average 37.5), the interval between operation and onset of infection averaging 30 months. The offending organisms were Gram negative bacteria in three patients (Klebsiella pneumoniae, Enterobacter cloacae, and Serratia marcescens), Gram positive bacteria in two (Staphylococcus aureus and Streptococcus viridans), and fungi in four (Candida species in three and Aspergillus species in one). Gross examination of the explants revealed in most cases a vegetative endocarditis of one porcine valve leaflets. Septic embolization occurred in five cases owing to the high friability of the vegetations. Prosthetic valve incompetence was the commonest type to dysfunction observed because of tears, perforations, and even complete destruction of the cusps. Prosthetic valve stenosis following obstruction of the valve orifice by infected polypous masses was noted in two cases. Clumps of infective organisms were detected deep in the cusp tissue in most cases on histologic examination. Infection located on the paraprosthetic tissues, associated with ring abscess, valve detachment, and insufficiency, was observed only once. According to the results of investigation, endocarditis on porcine bioprostheses is associated with a better preserved native valvular ring as viewed at reoperation. Therefore surgical intervention appears appropriate in the presence of severe hemodynamic complications after adequate antibiotic treatment. However, infection of these particular prostheses still carries an extremely high mortality. In the present series, this poor outcome might be explained by the frequently associated septic and thromboembolic events.
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PMID:Pathological study of infective endocarditis on Hancock porcine bioprostheses. 723 Aug 61

Infection with Chlamydia trachomatis is an important cause of nongonococcal urethritis and cervicitis, and may be the most common sexually transmitted disease in the United States. Associated complications include epididymitis, proctitis, salpingitis, bartholinitis, arthritis, perihepatitis, and endocarditis. Perinatal transmission of infection may result in neonatal inclusion conjunctivitis and/or pneumonia of infancy. Chlamydial genital infection should be suspected in a patient (male or female) who presents with a gonorrhea-like syndrome but whose laboratory studies fail to demonstrate Neisseria gonorrhoeae. Such patients, together with their sex partners, should receive antichlamydial therapy; the uncomplicated genital infections respond well to oral treatment with tetracycline, erythromycin, and sulfonamide. The most important cause of treatment failure in nongonococcal urethritis is lack of simultaneous treatment of both patient and partner.
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PMID:Chlamydial genital infections: manifestations and management. 725 29

Simple quantitative serological tests demonstrating Staphylococcus epidermidis agglutinins and C-reactive protein were used for the early detection of ventriculo-atrial shunt colonization by this organism. Tests in normal children and adults in various age groups throughout life confirmed Bayston's ovservations that those tested attained a titre up to 1:160 TO S. epidermidis agglutinogen. In contrast, the titre in children with colonised shunts and in adults with S. epidermidis endocarditis, both conditions which are usually accompanied by bacteraemia, rose to much higher levels, sometimes up to 1:5120. The routine combination of both tests has proven to be of considerable diagnostic value, particularly in early or recent colonisation.
Infection 1980
PMID:The early serological detection of colonisation by Staphylococcus epidermidis of ventriculo-atrial shunts. 737 58

The clinical features of 19 patients with prosthetic valve endocarditis due to diphtheroids were studied. Infection was noted within 60 days of cardiac surgery in 12 (63 percent) patients. Prosthetic dysfunction and infection of the valve annulus was common (74 percent). Agar dilution minimal inhibitory concentrations for 18 diphtheroids isolated from patients with prosthetic valve endocarditis indicated that 88 percent were susceptible to gentamicin, amikacin, streptomycin, erythromycin and tetracycline; all strains were susceptible to vancomycin. In time-kill studies vancomycin was highly bactericidal as was gentamicin for susceptible strains. For gentamicin-susceptible strains, penicillin-gentamicin combinations were synergistic regardless of the susceptibility of the strains to penicillin. Bactericidal synergy of penicillin-gentamicin combinations was not seen with gentamicin-resistant strains. The biochemical and physiologic features of 20 strains were studied; with the exception of colonial morphology, 18 strains were found to be similar. Four strains were classified as belonging to the group JK by the Center for Disease Control (CDC) and 14 other strains fulfilled CDC criteria for group JK diphtheroids. A technique and criteria for single disc diffusion susceptibility testing are suggested.
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PMID:Diphtheroid prosthetic valve endocarditis. A study of clinical features and infecting organisms. 744 50

Aortic prosthetic valve endocarditis is frequently associated with a perivalvular ring abscess which destroys the normal annulus, so that it is difficult to seat a new prosthesis. Between November, 1974, and January, 1980, we treated four patients with aortic prosthetic endocarditis by translocation of the aortic valve, closure of the native coronary artery ostia, and placement of saphenous vein bypass grafts to the coronary arteries. In each case operation was undertaken because of progressive congestive heart failure resulting from aortic regurgitation; two patients had systemic emboli, and two patients had uncontrolled infection. Infection was due to Enterococcus in three instances and to an unknown organism in one. Total ischemic times averaged 2 hours, 15 minutes; a 25 mm Dacron graft containing a porcine valve was used to replace the ascending aorta and aortic valve, and two or three saphenous vein grafts were placed to distal coronary arteries. One patient died 40 days postoperatively of renal failure and Pseudomonas pneumonia with an intact repair. The other three patients were hospital survivors, with one doing well until dying of chronic active hepatitis 12 months postoperatively. The other two patients are alive at 4 months and 18 months with satisfactory hemodynamic function and are free of infection. Translocation of the aortic valve for prosthetic valve endocarditis is a useful alternative when conventional replacement techniques cannot be utilized.
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PMID:Translocation of the aortic valve for prosthetic valve endocarditis. 745 30


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