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

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

A rare case of ischemic stroke related to Herpes zoster infection of the eye and documented arteritis in an HIV-positive patient is analyzed. The woman, aged 32, who was born in Angola and lived in Zaire, was diagnoses at the Hospital Universitario de Santa Maria, Lisbon. She presented with a 5-month history of sudden hemiplegia, 4 months after onset of herpes zoster ophthalmicus. Among extensive diagnosis tests, she was positive for HIV by ELISA and Western blot, hepatomegaly, and generalized lymphadenopathy. She has left Herpes zoster ophthalmicus with ptosis bulbi and mottled discoloration of the skin over the distribution of the 1st division of the left trigeminal nerve, and right spastic hemiparesis. Her helper T-cell count was 952/cubic mm, and her T-cell ratio was 0.9. She had anemia, hypoalbuminemia, positive serology for cytomegalovirus, Herpes simplex, Epstein Barr virus, and hepatitis B. She had no bacterial infections, but her stool contained Trichuris trichiura eggs and giardia lamblia cysts. Her cardiovascular system and cerebrovascular fluid were negative. Computed tomography of the head showed an old left capsular infarct. Cerebral angiography showed arteritis of the left choroidal artery with occlusion. She was treated with metronidazole and mebendazole, and had surgery for removal of the left eye with a prosthetic replacement. Strokes are common in AIDS patients, resulting from fungal infections, endocarditis, infectious or non-infectious emboli, or arteritis from herpes zoster infections. This is the 1st published case of hemiplegia and Herpes zoster in a European or African patient with HIV-1.
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PMID:Herpes zoster and controlateral hemiplegia in an African patient infected with HIV-1. 186 23

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

Streptobacillus moniliformis is an uncommon human pathogen contracted from exposure to rodents. It usually produces a mild, protracted illness (rat-bite fever, Haverhill fever, erythema arthriticum epidemicum) that has either a favorable response to antibiotic therapy or spontaneously resolves. This report describes a fatal case of Streptobacillus moniliformis in an infant bitten by a wild rat. The autopsy findings included an interstitial pneumonia, fibrinous endocarditis, mild mononuclear meningitis, hepatosplenomegaly and lymphadenopathy, erythrophagocytosis, and sinusoidal mononuclear cell infiltrates in regional lymph nodes and the liver. To the authors' knowledge, this is the first report of the autopsy pathology findings of this agent.
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PMID:Fatal Streptobacillus moniliformis infection in a two-month-old infant. 271 62

Patients with bacteremia, bacterial endocarditis, or acquired immunodeficiency syndrome (AIDS) were prospectively studied using monoclonal antibody reagents to assess alterations in T-lymphocyte subpopulations. Patients with endocarditis had significantly higher ratios of T-helper (OKT4+) to T-suppressor-cytotoxic (OKT8+) cells than did patients with bacteremia alone. Staphylococcus aureus endocarditis patients had a mean ratio of 8.49 (range 4.73-22.36) while S aureus bacteremia had a mean ratio of 2.75 (range 2.15 to 3.21). Similar results were found with Staphylococcus epidermidis endocarditis (mean 1.62) and bacteremia (mean 1.23). Klebsiella pneumoniae endocarditis (5.10) and sepsis (4.32), and E coli bacteremia (2.15). Nine male patients with AIDS had markedly depressed ratios (mean 0.25, range 0.04 to 0.67) while eight male homosexuals with unexplained lymphadenopathy ("pre-AIDS") had normal or increased ratios. Bacteremic infections are associated with an increased OKT4+/OKT8+ ratio with the degree of increase dependent upon virulence, location, and duration of infection. The immunomodulating effects of infection are manifested in changes in T-cell subsets, and these measurements can be useful in clinical management.
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PMID:Infection and T lymphocyte subpopulations: changes associated with bacteremia and the acquired immunodeficiency syndrome. 609 86

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

The authors report two cases of prosthetic valve endocarditis due to Coxiella burnetii. The histories were chronic and complex suggesting an auto-immune disease: prolonged recurrent fever despite antibiotic therapy with a biological inflammatory syndrome whilst blood cultures remained negative. The first patient presented with prosthetic valve dehiscence and acute glomerulonephritis. The second patient had coagulation defects with prosthetic valve thrombosis, mesenteric adenopathy and congestive cardiac failure without prosthetic valve dysfunction. In suspected endocarditis with negative blood cultures, serological tests should be extended to intracellular pathogens difficult to identify and justifying specific and prolonged bactericidal therapy (fluoroquinolones, cyclines, rifampincine). Long-term serological surveillance is essential even when the outcome could have led to the termination of antibiotic therapy. Usually, antibiotic therapy provides a bacteriological cure, but treatment has to be continued for at least 3 years, and, in some patients, all their lives. Valve replacement is reserved for haemodynamic complications of the pathology which determine the ultimate prognosis.
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PMID:[Coxiella burnetii endocarditis on a mechanical valvular prosthesis. Apropos of 2 cases]. 764 71

A 38-year old man was admitted for investigation of suspected endocarditis presenting with two cerebrovascular accidents and pyrexia. The initial clinical, echocardiographic and infectious investigations were normal, apart from a neutrophilic leukocytosis. The clinical course was marked by the recurrence of systemic embolism in the lower limbs, the appearance of cervical and axillary lymphadenopathy and, within a short period of time, of massive aortic valve vegetations. The diagnosis of aspergillosis was made from the culture of a peripheral embolus recovered by a Fogarty catheter and this was confirmed by the positivity of serological investigations. The patient died within two months despite antifungal therapy. Aspergillus endocarditis is characterised by its rapid progression, the volume and embolic tendency of the vegetations, the relative inefficacy of medical therapy and the potential benefits of early surgical management.
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PMID:[Primary aspergillus endocarditis]. 836 29

Two women and two men were infected with the human immunodeficiency virus type 1 (HIV-1) transmitted by renal transplantation from i.v. drug-addicted donors in 1984. The four recipients were treated with cyclosporine and methylprednisolone (one patient only for three months because of early graft failure). Two patients died 66 and 74 months after transplantation, one of endocarditis and one of cerebral hemorrhage. Despite several infections including urinary tract infection (n = 8), peritonitis (n = 1), shunt infection (n = 1), bronchitis (n = 1), salmonellosis (n = 1), herpes stomatitis (n = 2), herpes zoster (n = 1), and cytomegalovirus (n = 1), and despite treatment of several rejection episodes (n = 8), none of them had or has infections typical of the acquired immunodeficiency syndrome (AIDS). However, two patients developed cervical lymphadenopathy and one autoimmune thrombocytopenia 15-20 months after HIV-1 infection. Their T helper cell counts (355/microliters to 75/microliters) and helper/suppressor T cell ratios (1.0-0.2) are distinctly lowered. One patient has membranous glomerulopathy with virus-like particles within and on the outside of the basement membrane and tubuloreticular inclusions in glomerular endothelial cells. We evaluated the case reports of 53 patients with HIV-infection caused by an infected transplant or by blood transfusions during or shortly after transplantation. The cumulative incidence of AIDS was significantly lower in 40 transplant patients with an immunosuppressive regimen including cyclosporine than in 13 transplant patients receiving immunosuppressive treatment without cyclosporine (5-year cumulative risk of AIDS: 31% versus 90%, P = 0.001).
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PMID:The effect of cyclosporine on the progression of human immunodeficiency virus type 1 infection transmitted by transplantation--data on four cases and review of the literature. 821 77

We describe a case of aggressive Bartonella henselae endocarditis in an immunocompetent man who owned a cat. Aortic valve replacement was required, and his infection was diagnosed by histology, serology, and polymerase chain reaction analysis. The manifestations of his disease included mediastinal lymphadenopathy, glomerulonephritis, myocarditis, and a petechial rash; the unusual finding of a positive titer of c-antineutrophil cytoplasmic antibodies was noted. Serological titers were markedly elevated for > 1 year despite clinical improvement.
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PMID:Bartonella henselae endocarditis in an immunocompetent adult. 864 87


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