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

Although cerebral angiography should be approached with caution in the diagnosis of inflammatory cerebro-vascular disease there are some characteristic angiographic findings which may be helpful for classification and differential diagnosis. The proximal cerebral arteries are favourably affected by basal meningitis and thrombangiitis obliterans with resulting stenoses and occlusions. Whereas those inflammations originating from neighbouring skull structures mostly involve the intracavernous parts of the carotid artery, the tuberculous and mycotic arteritis prefer the supraclinoid carotid siphon. Peripheral vascular changes are found in luetic endangiitis, necrotizing and toxic angiitis and in collagenoses. Simultaneous involvement of the temporal arteries is of great diagnostic importance demonstrating the systemic character of the inflammatory process; in Horton's arteritis it can be a pathognomonic finding. Infectious endocarditis, some mycoses and malaria may lead to embolic occlusion of cerebral vessels. Mycotic aneurysms mostly have a broad base or a fusiform shape and do not prefer the localizations of congenital aneurysms. Angiographically, abscesses, tuberculomas and viral encephalitis may result in circumscribed hypervascularized areas. The characteristic angiographic findings are exemplified and discussed on the basis of 8 cases of inflammatory cerebro-vascular disease (tuberculosis, pneumococcal and unspecific bacterial meningitis, syphilis, mycosis, Takayasu-syndrome, panarteritis nodosa, temporal arteritis).
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PMID:[Inflammatory cerebro-vascular disease: angiographic findings and distribution patterns (author's transl)]. 0 27

A case of pneumococcal endocarditis in an infant is reported together with a review of seven cases previously described in the literature. The prominent presenting symptoms of this usually fatal disease consisted of tachycardia, tachypnea, and cardiomegaly. A new murmur was heard in six of the eight patients. Fever was infrequent. Blood cultures were positive when done. The mitral valve was the site of infection in seven of the patients. In contrast to adult patients, pneumonia and meningitis are rarely encountered in children with pneumococcal endocarditis. The disease was fatal in all four patients before the penicillin era and in three of four patients who received penicillin.
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PMID:Pneumococcal endocarditis in infants. 15 10

Rarely is endocarditis attributed to the species of Hemophilus. Most frequently implicated are H aphrophilus and H parainfluenzae, but H influenzae also is seen. We report six cases of endocarditis due to H aphrophilus or H parainfluenzae and review the literature. Emboli to skin, lungs, kidneys, spleen, brain, and other organs are common complications, and acute glomerulonephritis and meningitis often occur. Ampicillin is the mainstay of antimicrobial therapy for patients whose isolates are sensitive to it, but the duration of antimicrobial therapy necessary for eradication of the infection is not clear. Studies of antimicrobial synergism are warranted in instances of endocarditis caused by ampicilin- or penicillin-resistant strains of Hemophilus, or when patients are allergic to penicillin; in these instances, combination antimicrobial therapy must be given when bactericidal synergism can be demonstrated. Intensive management of complications caused by embolization is crucial to patient survival.
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PMID:Hemophilus endocarditis: new cases, literature review and recommendations for management. 30 87

Haemophilus influenzae is an aerobic pleomorphic gram-negative coccobacillus that requires both X and V factors for growth. It grows poorly, if at all, on ordinary blood agar unless streaked with Staph. aureus. It grows well on chocolate agar. Because this medium is often not used in culturing specimens from adults and because the organism may be overgrown by other bacteria, the frequency of H. influenzae infections has undoubtedly been seriously underestimated. This is aggravated by the failure of many physicians to obtain blood cultures in suspected bacterial infections and the failure of many laboratories to subculture them routinely onto chocolate agar. H. influenzae, along with Streptococcus pneumoniae, is a major factor in acute sinusitis. It is probably the most frequent etiologic agent of acute epiglottitis. It is probably a common, but commonly unrecognized, cause of bacterial pneumonia, where it has a distinctive appearance on Gram stain. It is unusual in adult meningitis, but should particularly be considered in alcoholics; in those with recent or remote head trauma, especially with cerebrospinal fluid rhinorrhea; in patients with splenectomies and those with primary or secondary hypogammaglobulinemia. It may rarely cause a wide variety of other infections in adults, including purulent pericarditis, endocarditis, septic arthritis, obstetrical and gynecologic infections, urinary and biliary tract infections, and cellulitis. Antimicrobial susceptibility testing is somewhat capricious in part from the marked effect of inoculum size in some circumstances. In vitro and in vivo results support the use of ampicillin, unless the organism produces beta-lactamase. Alternatives in minor infections include tetracycline, erythromycin, and sulfamethoxazole-trimethoprim. For serious infections chloramphenicol is the best choice if the organism is ampicillin-resistant or the patient is penicillin-allergic.
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PMID:Haemophilus influenzae infections in adults: report of nine cases and a review of the literature. 31 Sep 43

Endocarditis due to group B streptococci occurred in two men associated with meningitis in one and septic arthritis in the other. Therapy with penicillin failed in the first patient necessitating aortic valve replacement. Clindamycin therapy was not curative in the second and the patient responded to a four-week course of vancomycin therapy.
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PMID:Endocarditis associated with disseminated group B streptococcal infection. 34 8

In a clinical trial including 701 patients 6-((R)-2-[3-methylsulfonyl-2-oxo-imidazolidine-1-carboxamido]-2-phenyl-acetamido)-penicillanic acid sodium salt (mezlocillin, Baypen) proved effective in the treatment of severe infections. It showed a particularly high efficacy in septicaemia and endocarditis and in purulent meningitis. In cases unresponsive to previous treatment with other antibiotics mezlocillin was effective in about two-thirds of the cases. Side effects were slight and of the same nature as those accompanying other penicillins.
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PMID:[Results of a multicentric clinical study of mezlocillin in Japan (author's transl)]. 39 30

Although a common cause of infection in animals, group C streptococci are rarely noted to be pathogenic in man. A total of 150,000 blood cultures obtained at the Mayo Clinic from 1968 to 1977 revealed group C streptococci in only eight patients. Acute bacterial endocarditis, meningitis, pheumonia, cellulitis and bacteremia due to group C streptococci are described in a host who had undergone immunosuppression (immunosuppressed host), and the relatively few cases previously reported are reviewed. Although severe, these infections may respond favorably to penicillin therapy. Endocarditis caused by group D streptococci is acute and destructive, and associated with early cardiac decompensation. The manifestations of cellulitis and pneumonia are similar to those when group A streptococci are causative organisms. Meningitis due to group C streptococci is acute and severe, and responds slowly to antimicrobial therapy. Colonization also occurs.
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PMID:Infections due to group C streptococci in man. 43 51

Seven cases of adult Haemophilus parainfluenzae infections diagnosed by positive blood cultures are compared with cases previously reported in the English literature. Three patients had pneumonia, while the others had epiglottitis with meningitis, pharyngitis, arthritis, and endocarditis, respectively. Nonendocarditic manifestations of adult H parainfluenzae infection were reported in four other cases. In addition to the diseases of our patients, H parainfluenzae also has been isolated from cerebral abscesses. Patients did well with antibiotic therapy and there were no deaths. Patients did well with antibiotic therapy and there were no deaths. Report of antibiotic sensitivity testing of 50 strains disclosed 6% of isolates resistant to ampicillin sodium, with all sensitive to chloramphenicol. If the antibiotic sensitivity of the organism is unknown, then chloramphenicol therapy should be instituted until adequate susceptibility studies have been performed. If the organism is sensitive to ampicillin, then this is the drug of choice.
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PMID:Adult bacteremic Haemophilus parainfluenzae infections. Seven reports of cases and a review of the literature. 47 36

Group C streptococci are generally considered to be a rare cause of infection in man. Infections due to these microorganisms, however, are common in several animal species. To our knowledge, the literature contains only two previous cases of meningitis in man which were due to group C streptococci. In one of these cases meningitis developed as a complication of endocarditis due to group C streptococci. Our recent clinical experience with a patient with severe acute meningitis caused by group C streptococci is reported and the pertinent literature is reviewed. The illness manifested itself as a severe form of acute meningitis, with slow but statisfactory response to therapy with penicillin.
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PMID:Meningitis due to group C streptococci in an adult. 68 81

A collection of 820 isolates of streptococci and aerococci from human blood or internal organs was classified by means of a set of cultural and biochemical tests. Of these, 719 (712 streptococci and 7 aerococci) were from patients believed to be suffering from a systemic infection: endocarditis 317; a purulent lesion in an internal organ ("purulent disease") 152; bacteriaemia 250. The endocarditis streptococci included members of all recognisable taxa, but only certain of these were common: Streptococcus sanguis, 16-4%; dextran-positive and usually mannitol-fermenting strains of S. bovis (S. bovis I), 15-1%; S. mutans, 14-2%; S. mitior, 13-2%. Streptococci of the "alpha-haemolytic" taxa (S. sanguis, S. mitior and related strains) formed only 44-8% of the total. When the percentage frequency of streptococcal taxa among the endocarditis and "non-endocarditis" isolates was compared, the dextran-forming taxa (S. mutans, S. bovis I, S. sanguis, and dextran-positive streptococci otherwise resembling S. mitior) all had higher "endocarditis : non-endocarditis" ratios than did any of the non-dextran-producing taxa. Endocarditis increased in frequency with age, and showed an excess of males over females up to the age of 65 years. In young patients (less than 35 years), "alpha-haemolytic" streptococci predominated; with increasing age, the proportion of other streptococci increased progressively but the absolute numbers of isolations of "alpha-haemolytic" streptococci did not fall. Infections with S. mutans were prominent in the age-group 35-54 years and with S. bovis I at ages greater than or equal to 55 years. A history of previous heart disease was more often obtained in endocarditis due to "alpha-haemolytic" streptococci than in other streptococcal endocarditis. The streptococcus most often isolated from purulent lesions in internal organs was S. milleri (29-3%). It was associated with brain abscess, meningitis, pleural empyema and a variety of intra-abdominal abscesses. The only common predisposing factor in endocarditis was previous heart damage. In other systemic streptococcal diseases, other general or local predisposing causes could be observed, mainly in infections with the "pyogenic" groupable streptococci, the enterococci and S. milleri.
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PMID:Streptococci and aerococci associated with systemic infection in man. 78


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