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)

Pathologic studies were done on 20 hearts of patients who had typical clinical signs and symptoms of Kawasaki disease. The cardiac lesions were classified according to the duration of illness at the time of death. Stage I (zero to nine days) was characterized by acute perivasculitis and vasculitis of the microvessels (arterioles, capillaries, and venules) and small arteries, and acute perivasculitis and endarteritis of the three major coronary arteries (MCAs). Pericarditis, myocarditis, inflammation of the atrioventricular conduction system, and endocarditis with valvulitis were also present. Stage II (12 to 25 days) was characterized by panvasculitis of the MCAs and aneurysm with thrombus in the stems. Myocarditis, coagulation necrosis, lesion of the conduction system, pericarditis, and endocarditis with valvulitis were also present. In stage III (28 to 31 days), granulation of the MCAs and disappearance of inflammation in the microvessels were noted. Patients in stage IV (40 days to 4 years) had scarring with severe stenosis in the MCAs. Fibrosis of the myocardium, coagulation necrosis, lesions of the conduction system, and endocardial fibroelastosis were also present. The features observed revealed Kawasaki disease to be acute and inflammatory. The angiitis begins in the microvessels and fibrinoid necrosis of the media is rare. The disease is one with a pathologic pattern previously unknown.
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PMID:Pathology of the heart in Kawasaki disease. 26 36

We review the major advances that have occurred in the diagnosis and treatment of cardiac diseases in children during the last four decades. During this period, most forms of congenital heart disease have become treatable by operation, and diagnosis has become possible through echocardiography alone. Operative mortality has dropped, and long-term follow-up shows excellent results in most patients. The incidence of rheumatic fever has declined, although it has increased recently in several areas of the United States. The occurrence of infective endocarditis and of myopericarditis has remained stable, while the recently described Kawasaki disease can affect the coronary arteries in children and appears to represent a new condition.
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PMID:Forty years of cardiac disease in children. Progress and problems--first of three parts. 194 32

Septicemia encountered at Kawasaki Municipal Hospital between 1985 and 1986 were studied clinically. Forty six patients had monomicrobial and 5 has polymicrobial infections, respectively. Out of these 46 patients with septicemia, 17 were due to Escherichia coli, 7 were due to Klebsiella pneumoniae and 4 were due to Staphylococcus aureus. Ten patients had hepatobiliary, 7 had hematological, 7 had malignant diseases as underlying diseases, respectively. Out of 10 patients complicated with septic shock, 7 died. Twenty three patients were community acquired infections. The age of most of the patients were over 50. The mortality rate of more than 65-year-old patients were higher than that of other patients. Our of 5 patients with septicemia due to polymicrobial infection, only 1 patient with erythroleukemia died. Fifty patients were treated mainly with beta-lactam antibiotics such as piperacillin or cefmetazole alone or in combination with aminoglycosides and so on. Three patients with infective endocarditis were encountered during this period. Two were due to alpha-streptococcus and 1 was due to Enterococcus. A 41-year-old patient with mitral valve insufficiency and metastatic gastric carcinoma to the bone marrow were complicated with disseminated intravascular coagulation. This patient, however, was successfully treated with a daily dose of 24 mega units of benzylpenicillin, and was given gabexate mesilate, concomitantly.
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PMID:[Clinical studies on septicemia and infective endocarditis encountered between 1985-1986]. 250 8

Kawasaki disease affects children under 4 years of age and is characterized by fever, mucocutaneous rash and cervical lymph node enlargement. It is often complicated by coronary vasculitis and/or pericarditis, myocarditis and endocarditis. Echocardiography is indispensable to diagnose and follow up these complications. A study of the literature and of 4 personal patients showed that it is also useful for the early detection of coronary aneurysm and simple dilatation of the coronary arteries. The sensitivity and specificity of echocardiography in recognizing these complications are such that coronary angiography is exceptionally required. In the search for a cause of prolonged fever in children, the sensitivity of echocardiography makes it possible to diagnose an atypical form of Kawasaki disease.
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PMID:[Value of echocardiography in the diagnosis of a complicated form of Kawasaki's disease]. 250 97

Out of the 10 patients with infective endocarditis (IE) at Kawasaki Municipal Hospital, 8 had IE due to streptococcus viridans. Out of 8 patients with streptococcus IE, 6 were successfully treated with benzyl penicillin alone or in combination with kanamycin. One patient was cured with cephaloridine. Two hundred and thirty IE patients admitted to hospitals at Kantou District were also studied. Ninety nine of 116 patients with streptococcus viridans IE were successfully treated with potentially active in vitro against streptococcus viridans. Out of 16 staphylococcus IE patients, 11 patients died. Eight patients died within 8 days from the beginning of the antibiotic administration. Out of 7 enterococcal IE patients, 5 were successfully treated with ampicillin alone or in combination with aminoglycosides. Forty three patients were diagnosed as IE despite negative blood culture. The echo cardiogram showed 23 patients had vegetation. Benzyl penicillin was given to 28 patients and 23 were cured. Out of 9 patients with culture negative IE treated with ampicillin, 8 were cured. Four patients were successfully treated with cephems.
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PMID:Recent trend of chemotherapy for infective endocarditis in Japan. 402 Oct 65

By means of anaerobic culture for 3-4 weeks a variant strain of Propionibacterium acnes was isolated from one lymph-node biopsy specimen, and from blood samples of five of twenty-three patients with early Kawasaki disease, but from only one of fifteen blood samples from patients after 8 days' illness. No anaerobe was isolated from sixty age-matched controls with various disorders, but the same bacillus with the same serotype was isolated from house-dust mites from six patients' homes. Patients had significantly higher serum agglutination titres to these strains than controls. The antigen moiety of P acnes was found in the patients' circulating immune complexes. Inoculation of animals caused various inflammatory lesions, particularly in the reticuloendothelial system, and coronary arteritis, myocarditis, and endocarditis in one of them, suggesting that the bacillus is pathogenic. The culture filtrate of this strain showed toxicity in tissue culture. This variant strain of P acnes may have a causative role in Kawasaki disease and house-dust mites a role as vectors.
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PMID:Variant strain of Propionibacterium acnes: a clue to the aetiology of Kawasaki disease. 614 Apr 93

Systemic pathological alterations were studied in thirty-seven autopsied patients with Kawasaki disease. Systemic vasculitis was the most characteristic pathological finding and was present in all the patients. In addition to the vasculitis, there was a high incidence of inflammatory lesions in various organs and tissues: in the heart, endocarditis, myocarditis, and pericarditis; in the digestive system, stomatitis, sialoduct-adenitis, catarrhal enteritis, hepatitis, cholangitis, pancreatitis, and pancreas ductitis; in the respiratory system, bronchitis and segmental interstitial pneumonia; in the urinary system, focal interstitial nephritis, cystitis, and prostatitis; in the nervous system, aseptic leptomeningitis, choriomeningitis, gangliontis, and neuritis; in the hematopoietic system, lymphadenitis, splenitis, and thymitis. Dermatitis, panniculitis or myositis were also observed in some patients. Therefore, Kawasaki disease is a systemic inflammatory disease which mainly affects the cardiovascular system. These systemic inflammatory lesions are considered to correspond to the variegated clinical manifestaitions. The relationship between Kawasaki disease and infantile polyarteritis nodosa (IPN) were discussed, based on the clinicopathological characteristics.
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PMID:General pathology of Kawasaki disease. On the morphological alterations corresponding to the clinical manifestations. 744 9

Seventy-nine patients with mucocutaneous lymph node syndrome were evaluated prospectively by clinical examination, electrocardiography, chest radiography, M mode and two dimensional echocardiography and thallium-201 myocardial scanning. Serial changes were categorized according to the duration of illness: stage I (1 to 10 days), stage II (11 to 20 days), stage III (21 to 30 days), stage IV (31 to 60 days) and stage V (61 days to 40 months). The presence of myocarditis in stages I and II was suggested in 40 of 79 patients (50.6 percent) by electrocardiographic, echocardiographic, radiographic and clinical abnormalities. Myocarditis was accompanied by pericarditis in six patients and by both endocarditis and pericarditis in one patient. These signs of inflammation were resolved by stage III in all but three patients with electrocardiographic abnormalities. In the active stage, large coronary arterial lesions were suspected only because of an abnormal spherical echo-free space in the region of the coronary arteries on two dimensional echocardiograph as well as electrocardiographic evidence of deep Q waves in leads II, III and aVF. One or more coronary aneurysms developed in 11 patients, primarily in stage II; regression of the aneurysm was noted in 5 of these patients during stages III, IV and V. Aneurysm regression demonstrated by angiography did not correlate with echocardiographic changes in aneurysm size in one patient. Moreover, the occurrence of coronary aneurysm did not correlate with the presence of signs of carditis, because the frequency of carditis was the same in patients with and without aneurysm.
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PMID:Clinical course of cardiovascular involvement in the mucocutaneous lymph node syndrome. Relation between clinical signs of carditis and development of coronary arterial aneurysm. 746 84

Acquired heart disease in children may result in significant morbidity and mortality. Advances continue to be made in understanding Kawasaki disease, acute and chronic rheumatic heart disease, infective endocarditis, myocarditis, and dilated cardiomyopathy. The role of superantigens, particularly bacterial toxins, in the pathogenesis of Kawasaki disease continues to be defined. Intravascular ultrasound promises to improve the assessment of coronary arteries in Kawasaki disease. Current recommendations for the long-term management of Kawasaki disease are discussed. Significant changes in the epidemiology of acute rheumatic fever and endocarditis are noted. Updates on the role of echocardiography as well as current therapeutic issues in these diseases are addressed. The application of immunologic and molecular biologic techniques have implicated genetic and immune factors in the pathogenesis of myocarditis and cardiomyopathy. The relationship between viral infection and subsequent dilated cardiomyopathy, as well as the role of autoimmune mechanisms in the pathogenesis of these disorders, remains controversial.
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PMID:Advances in acquired pediatric heart disease. 778 68

This is one of a series of statements discussing the practice of gastrointestinal endoscopy in common clinical situations. It is intended to aid endoscopists in determining the appropriate use of antibiotic prophylaxis for patients undergoing gastrointestinal endoscopic procedures. Guidelines for the appropriate practice of endoscopy are based on a critical review of the available data and expert consensus. Controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data appear. Clinical consideration may justify a course of action at variance from these recommendations. Recommendations on prophylaxis against infective endocarditis were developed in conjunction with the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease of the Council of Cardiovascular Disease in the Young of the American Heart Association.
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PMID:Antibiotic prophylaxis for gastrointestinal endoscopy. American Society for Gastrointestinal Endoscopy. 867 48


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