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

The ability of Eikenella corrodens to cause endocarditis in catheterized rabbits was studied. E. corrodens 1073, the serum-resistant strain used in the study, was isolated from a human periodontitis lesion. Thirty-four rabbits, surgically catheterized across the aortic valve and injected intravenously 24 to 48 h later with 10(7) to 10(9) log-phase organisms, were studied. Only three rabbits developed positive blood cultures and only two rabbits died before the time of sacrifice at 14 days after infection. Autopsies showed that all rabbits developed aortic vegetations, 52% of which were culture positive for E. corrodens. The organisms were recovered from aortic vegetations in a mean concentration of 10(5.3) colony-forming units/g of tissue and from liver or kidney in 28% of the animals in concentrations from 10(2) to 10(4) colony-forming units/g. Indirect immunofluorescent staining of vegetations, with the use of specific rat antiserum to E. corrodens 1073 and fluorescein isothiocyanate-labeled goat antirat serum, revealed colonies of E. corrodens in culture-negative vegetations as well as in those which were culture positive. The results showed that E. corrodens was an effective pathogen in the rabbit model of endocarditis, in which the disease was infrequently bacteremic and rarely fatal.
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PMID:Experimental Eikenella corrodens endocarditis in rabbits. 37 35

There is scarce information on antibiotics prescription habits among dentists in general. The present investigation was undertaken to study some patterns of antibiotics prescription among Norwegian dentists. A total of 459 dentists (approximately 10% of Norwegian dentists) were randomly selected, and to each was mailed a letter describing the survey, accompanied by a questionnaire about age, type of practice, educational background and pattern of prescription of antibiotics. 78% of the dentists responded to these questions. The results indicate that during a typical week, 32% did not prescribe antibiotics, whereas 5% wrote greater than 5 prescriptions. The mean weekly number of prescriptions per dentist was 2.04. Periodontists and oral surgeons prescribed antibiotics significantly more often than did general practitioners and other disciplines. In addition, those with research and/or teaching experience seemed to prescribe significantly more often than those without. More than 1/3 of the sample indicated that they may prescribe antibiotics when treating periodontal diseases. Compared with other disciplines, periodontists prescribed such drugs significantly more often when treating periodontitis, but significantly less often in acute gingivitis, stomatitis and herpes simplex infections. Moreover, 22% of the dentists might prescribe antibiotics when the patient is in pain, 73 and 38% in cases of abscesses with or without generalized malaise, 2.5% in endodontic therapy, 60% to prevent general complications, and 68% for prophylactic use if the patient revealed a history of endocarditis. Norwegian dentists are somewhat restrictive in their prescription of antibiotics, but they mostly prescribe the correct drugs for the different conditions.
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PMID:Antibiotic prescribing practices among Norwegian dentists. 143 29

A 69-year-old man without previous cardiac disease was found over the last 9 months to have a markedly elevated erythrocyte sedimentation rate (ESR: 120 mm/1. h), haemolytic anaemia (haemoglobin 8.2 g/dl, lactate dehydrogenase 304 U/l), markedly reduced exercise tolerance, backache and weight loss of 5 kg. Radiological, biochemical and endoscopic examinations failed to provide a diagnosis. Nine blood cultures grew, at normal body temperature, Cardiobacterium hominis, a rare Gram-negative organism which can cause endocarditis. Echocardiography revealed endocarditis of the aortic valve with regurgitation. Despite protracted and high-dosage antibiotics (4 times daily 10 million U penicillin G for 6 days, followed by four times 5 million U penicillin G for 6 days, followed by four times 5 million U daily for five weeks, and three times daily 60 mg gentamycin for 10 days), as well as treatment of extensive chronic parodontitis, anaemia, haemolysis and increased ESR have now persisted for over a year, with negative blood cultures. Immune-complex phenomena are thought to be the reason for the persistence of signs of infection.
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PMID:[A protracted course in Cardiobacterium hominis endocarditis]. 182 63

The activity of various antibacterial agents (amoxicillin, josamycin, doxycycline and metronidazole) was established in vitro using a rapid micromethod. The activity of these agents, which are widely used in oral medicine, was evaluated against microorganisms responsible for periodontitis and bucco-dental infections. Their action against alpha-hemolytic streptococci (including pneumococci) which make up the majority of the indigenous oral flora was also tested. Amoxicillin was found to be effective against all the strains tested. Doxycycline was active against periodontal bacteria, but not against 50% of the streptococcal flora. Josamycin was found to be effective against streptococci, but appeared without effect on Eikenella corrodens and Actinobacillus actinomycetemcomitans. Metronidazole, inactive against streptococci, displayed greater activity towards the strict anaerobes. The use of these antibiotics for the treatment of bucco-dental infections, especially periodontitis, is discussed. For periodontitis and periodontal suppurations, antimicrobial agents present a valuable adjunct to local treatments such as scaling or rootplaning. This may prevent more serious infections such as endocarditis that can develop after tooth extraction.
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PMID:Evaluation of the activity of four antimicrobial agents using an in vitro rapid micromethod against oral streptococci and various bacterial strains implicated in periodontitis. 214 28

Rats with periodontitis and catheter-induced aortic valve vegetations underwent dental extractions. Cultures of blood obtained 1 min later showed polymicrobial bacteremia in 19 of 19 rats, mostly due to viridans streptococci (18 of 19), Morganella (15 of 19), group G streptococci (13 of 19), and Staphylococcus aureus (10 of 19). Viridans streptococci circulated in higher numbers than did group G streptococci and S. aureus (P less than .01). Three days after dental extractions, 18 of 20 rats had endocarditis. Fifteen (83%) of 18 infections were due to group G streptococci, 9 (50%) of 18 were due to S. aureus, and 2 (11%) of 18 were due to viridans streptococci (P less than .05). In vitro, adherence to platelet-fibrin matrices of endocarditis strain 8 of group G streptococcus was two times greater than that of endocarditis strain S. aureus 23 and three to four times greater than that of Streptococcus sanguis 44 and Morganella morganii 93 (P less than 10(-5)). The inoculum size that produced endocarditis in 90% of rats after iv challenge was 10(5) cfu for group G streptococcus strain 8 and 10(7) for S. sanguis 44.
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PMID:Predictors of endocarditis in isolates from cultures of blood following dental extractions in rats with periodontal disease. 336 Nov 56

Capnocytophaga ochracea is a gram-negative, fusiform bacillus which is part of the normal human oral flora. This organism is often isolated from periodontal lesions of patients with periodontitis and is associated with sepsis in granulocytopenic patients. We report here a case of endocarditis caused by C. ochracea.
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PMID:Endocarditis caused by Capnocytophaga ochracea. 338

Actinobacillus actinomycetemcomitans is an oral bacterium which is being encountered with increasing frequency in infective endocarditis. This organism occurs in high numbers in periodontitis lesions of patients with localized juvenile periodontitis (periodontosis). It is present infrequently, and only in low numbers in most other individuals. Its common resistance to penicillin, erythromycin and vancomycin represents a clinical problem in patients at risk of developing endocarditis after dental treatment. However, the high activity of tetracyclines against A. actinomycetemcomitans may be useful in prophylactic endocarditis considerations by allowing a suppression of the organism prior to the institution of recommended prophylactic protocols. In this study, we determined the effect of systemic tetracycline-HCl therapy (1 gm/day) on the oral A. actinomycetemcomitans population in five localized juvenile periodontitis patients who were heavily infected with the organism. A. actinomycetemcomitans could not be detected in samples of subgingival and supragingival dental plaque and cheek mucosal surfaces following 14 days of administration of systemic tetracycline. The organism was still undetectable 3 weeks after therapy but it reappeared at a few oral sites at week 8 post-treatment. On the basis of this data, it is proposed that the prophylactic endocarditis therapy of patients with high numbers of penicillin-resistant A. actinomycetemcomitans include a two-stage approach: first, the systemic administration of tetracycline for 14 days, and second, institution of a conventional prophylactic protocol during the time of dental treatment.
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PMID:Suppression of penicillin-resistant oral Actinobacillus actinomycetemcomitans with tetracycline. Considerations in endocarditis prophylaxis. 657 27

Actinobacillus actinomycetemcomitans, an organism associated with rapidly destructive periodontal disease (periodontitis), is a rare cause of endocarditis in children. This report presents a case of A. actinomycetemcomitans endocarditis in a 6-year-old child with rapidly destructive periodontal disease. A leukotoxic antigen was documented in the strain of A. actinomycetemcomitans isolated from the patient's blood.
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PMID:Actinobacillus endocarditis associated with periodontal disease. 727 76

Human endodontic and periodontal infections are associated with complex microfloras in which approximately 150, (in apical periodontitis) and 350 (in marginal periodontitis) bacterial species have been encountered. These infections are predominantly anaerobic, with gram-negative rods being the most common isolates. The anatomic closeness of this microflora to the bloodstream can facilitate bacteremia and systemic spread of bacterial by-products and immunocomplexes. A variety of clinical procedures such as tooth extraction, periodontal and endodontic treatment, may cause translocation of microorganisms from the oral cavity to the bloodstream. The microorganisms that gain entrance to the blood circulate throughout the body, but are usually eliminated by the host (reticuloendothelial system) within minutes. However, in patients with ineffective heart valves or vascular diseases, bacteremia can be a potential danger, leading most commonly to infective endocarditis and myocardial or cerebral infarction. Other forms of systemic diseases such as brain abscesses, hematological infections and implant infections have also been related to oral microorganisms.
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PMID:Systemic diseases caused by oral microorganisms. 806 8

During episodes of dental bacteremia, viridans group streptococci encounter platelets. Among these microorganisms, certain Streptococcus sanguis induce human and rabbit platelets to aggregate in vitro. In experimental rabbits, circulating streptococci induced platelets to aggregate, triggering the accumulation of platelets and fibrin into the heart valve vegetations of endocarditis. At necropsy, affected rabbit hearts showed ischemic areas. We therefore hypothesized that circulating S. sanguis might cause coronary thrombosis and signs of myocardial infarction (MI). Signs of MI were monitored in rabbits after infusion with platelet-aggregating doses of 4 to 40 x 10(9) cells of S. sanguis 133-79. Infusion resulted in dose-dependent changes in electrocardiograms, blood pressure, heart rate, and cardiac contractility. These changes were consistent with the occurrence of MI. Platelets isolated from hyperlipidemic rabbits showed an accelerated in vitro aggregation response to strain 133-79. Cultured from immunosuppressed children with septic shock and signs of disseminated intravascular coagulation, more than 60% of isolates of viridans streptococci induced platelet aggregation when tested in vitro. The data are consistent with a thrombogenic role for S. sanguis in human disease, contributing to the development of the vegetative lesion in infective endocarditis and a thrombotic mechanism to explain the additional contributed risk of periodontitis to MI.
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PMID:Effects of oral flora on platelets: possible consequences in cardiovascular disease. 891 Aug 32


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