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

Seventy episodes of Staphylococcus aureus sepsis occurring over a nine-year period in pediatric cancer patients are reviewed. Prominent findings at the time of diagnosis included fever, granulocytopenia, and active malignancy. Probable or suspected sites of primary infection were present in 40 episodes (57%). Serious direct complications of staphylococcal sepsis included only three cases of pneumonia and one of myositis. However, second infections by other organisms developed in 16 episodes (24%), resulting in nine nonstaphylococcal infectious deaths during therapy. Endocarditis and osteomyelitis never occurred in this group of patients. The median duration of antistaphylococcal therapy was 15 days.
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PMID:Staphylococcus aureus sepsis in children with cancer. 63 75

Candida albicans arthritis is uncommon. Although occasional instances of meningitis, osteomyelitis, endocarditis, pneumonia, and extensive visceral involvement due to Candida species have been reported, only 7 documented cases of arthritis caused by Candida albicans are found in the literature. The present case was an infant with a gastroschisis defect of the abdominal wall, who required multiple surgical procedures, prolonged antibiotic therapy, and parental intravenous hyperalimentation. Following a blood stream infection with Candida albicans, septic arthritis of the left knee developed. Treatment with intravenous Amphotericin-B over a 6-week period was successful in eridicating the infection. The child is completely well 9 months after discharge from the hospital. Factors which may predispose patients to infection by Candida albicans include prolonged antibiotic therapy. corticosteroids, generalized debilitation, malnutrition, parental hyperalimentation, and immunosuppressive therapy. Amphotericin-B therapy may be associated with considerable toxicity including azotemia, hepatic dysfunction, and hematologic abnormalities. The therapeutic regimen of Amphotericin-B is effective but a 6-week course of antifungal therapy may be necessary to eradicate septic arthritis of Candida albicans. Surgical drainage is probably indicated only for recent infections.
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PMID:Candida arthritis. A case report and review of the literature. 80 14

A randomized, prospective study of the relative effectiveness of broad-spectrum versus specific antistaphylococal antibiotic prophylaxis in patients having open-heart surgery was performed between May, 1972, and June, 1973. All patients undergoing open-heart surgery was assigned randomly (by hospital number) to receive either methicillin or cephalothin beginning the night before operation. There were 132 patients in the cephalothin group and 129 in the methicillin group. There was no statistically significant differences in age or duration of hospitalization, cardiopulmonary bypass, urinary tract drainage, or postoperative fever. There was a significant difference in the ratio of male to total patients (cephalothin group, 0.67; methicillin group, 0.52; p less than 0.02) and duration of operation (cephalothin group, 4.27 hours; methicillin group, 3.87 hours; p less than 0.05). The methicillin group had a statistically significant higher rate of urinary tract infection (cephalothin group, 3 cases; emthicillin group, 22 cases, p less than 0.05), pneumonia (cephalothin group, no cases; methicillin group, 9 cases; p less than 0.01), and episodes of sepsis and prosthetic valve endocarditis (cephalothin group, no cases; methicillin group, 11 cases, p less than 0.001). The incidence of wound infections and positive blood cultures from blood obtained immediately after termination of cardiopulmonary bypass was not significantly different between the two groups. Cephalothin has replaced methicillin as the routine prophylaxis for open-heart surgery at our institution.
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PMID:Antibiotic prophylaxis for open-heart surgery. 83 52

Pneumococcal pneumonia in two or more lobes in frail, elderly patients; staphylococcal and Gram-negative rod pneumonia in patients of any age; lung abscesses; septicemia; endocarditis; peritonitis; and meningitis are life-threatening infections. To save patients with these infections, the physician should know the causative organism and educate himself by cultures; estimate the whole body bacterial burden and decrease bacterial numbers by incision and drainage where large collections of pus are accessible; choose antibiotics with care and use two antibiotics if serious prognostic signs are present initially, if there is a change for the worse, or if the laboratory report indicates that multiple organisms are present; check the serum bactericidal level and repeat this test if the route of antibiotic administration is changed; watch for and treat underlying disease; and always monitor for septic shock. Aged patients need special care, as they often have severe underlying disease. The bacterial burden is often high before infection is recognized in elderly patients, and age itself interferes with host defenses.
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PMID:Life-threatening infections: how to choose the right antibiotics. 84 91

In a retrospective review of 53 patients, 58 episodes of infection due to Acinetobacter calcoaceticus var. anitratus (Herellea vaginicola) were studied. Although the organism is widely distributed in nature, it is of relatively low virulence since colonization is more frequently noted than infection and since most infections occur in patients subjected to the epidemiologic pressures common to nosocomial, gram-negative bacillary infection: prior antibiotic therapy; instrumentation and manipulation (e.g., endotracheal intubation, urinary bladder catheterization, arterial and venous cannulation); surgery; hospitalization, especially with residence in an intensive care unit; severe underlying disease, either systemic (e.g., chronic obstructive pulmonary disease, malignancy) or localized to the infected area (e.g., prior bacterial or aspirational pneumonia, trauma). Pneumonia was the most common infection due to A. calcoaceticus, and occurred only in patients with a tracheostomy or endotracheal tube in place. In over half the 25 patients, more than one lobe was involved and bronchopneumonia was the usual roentgenographic appearance. Cavitation (2 patients) and empyema formation (3 patients) were uncommon. The severity of acinetobacter pneumonia is reflected in the high mortality rate (44% overall, with a 36% mortality rate due primarily to infection). Tracheobronchitis due to A. calcoaceticus was less severe than pneumonia since no patients died primarily as a result of the infection. Urinary tract infections occurred in five patients, none of whom were ill and none of whom died. Urinary bladder catheterization was thought to be responsible for infection in three patients, and in at least four of the five patients infection was restricted to the lower tract. Wound infections were noted in six patients who had undergone surgery and were related to the presence of foreign bodies in the operative site in five of the patients. Surgical debridement and/or drainage of the infected area was the primary therapeutic measure employed in most cases. Only one patient died and this was a result of noninfectious causes. Skin infection due to A. calcoaceticus was seen in two patients, one of whom exhibited fulminant, fatal cellulitis and septicemia in the setting of pancytopenia. All nine patients with acinetobacter septicemia had received antecedent antibiotic therapy, and in all cases intravenous catheters were in place at the time bacteremia occurred. Clinically, seven of the nine patients were in shock. The mortality rate was 44% overall, with a 22% mortality rate due to infection. Although septicemia was thought to be "line-related" in five of the nine patients, serious post-bacteremic complications developed in three patients: prosthetic valve endocarditis, suppurative thrombophlebitis and subhepatic abscess.
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PMID:Infections with Acinetobacter calcoaceticus (Herellea vaginicola): clinical and laboratory studies. 84 90

During all of 1974 we surveyed, for illnesses and deaths, about 407,000 yearling feedlot cattle. The morbidity was 5.1%, with a case mortality of 18.9% and a population mortality of 1.0%. Both morbidity and mortality were higher during fall and winter than during spring and summer. Of the 3,943 dead cattle, 1,988 were necropsied. The most prevalent diseases were: pneumonia, 48%; diphtheria, 6%; brisket disease, 6%; hemorrhagic colitis, 5%; riding injury, 4%; bloat, 3%; calculosis, 2%; endocarditis, 2%; abomasal ulcers, 2%; bovine viral diarrhea, 2%; embolic pulmonary aneurysm, 1%; and pulmonary edema, 1%.
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PMID:Diseases of yearling feedlot cattle in Colorado. 95 27

Twelve patients with acute or chronic pneumonia due mainly to gram-negative bacilli, two patients with pseudomonas endocarditis, and two patients with seratia sepsis were treated with 80-160 mg of tobramycin in two daily doses. Fourteen infected patients with underlying leukemia or lymphoma received this dose of tobramycin combined with cefazolin or penicillin. Most respiratory infections were cured or markedly improved. with eradication or significant reduction in the number of infecting organisms. One case of pseudomonas endocarditis and both cases of serratia sepsis were also cured. Combined treatment with tobramycin and beta-lactam antibiotics resulted in clinical and bacteriological improvement in 50% of systemic immunodepressed patients with sepsis and/or pneumonia.
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PMID:Clinical evaluation of tobramycin in respiratory and systemic infections in immunodepressed and normal patients. 97 80

Sixteen cattle affected by thrombosis of the posterior vena cava were examined post mortem and the various lesions are described. The thrombus was in the hepatic portion in 12 animals and in the intrathoracic part in four. Thrombi had formed as a result of phlebitis in 13 cases in which hepatic or post-diaphragamatic abscesses were present but the aetiology of the other three was not discovered. Embolism from the vena cava thrombus resulted in pulmonary lesions in every case: these included pulmonary arterial thrombo-embolism, pulmonary arteritis, pulmonary endarteritis, chronic suppurative pneumonia and the formation of multiple pulmonary abscesses. The pulmonary arterial lesions had given rise to mycotic aneurysms of that vessel and rupture of these was followed by massive haemoptysis or intrapulmonaary haemorrhage. Pulmonary arterial aneurysms are not common in man and are very rare in animals, except in association with vena cava thrombosis of cattle. However, the "Hughes-Stovin" syndrome of man has some features in common with the condition described in cattle and these are discussed. The different sequelae of posterior vena cava thrombosis and infective endocarditis of the right heart in cattle are also considered.
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PMID:Pulmonary arterial thrombo-embolism and pulmonary arterial mycotic aneurysms in cattle with vena caval thrombosis: a condition resembling the Hughes-Stovin syndrome. 98 55

Right-sided endocarditis occurred in a 40-year-old woman with ventricular septal defect. This association is uncommon in adults. Because of the changing and variable clinical patterns of this disease, it is difficult to make a prompt diagnosis. In this case diagnosis was delayed for almost a year. The occurrence of pneumonia due to Streptococcus viridans was the most important extracardiac manifestation.
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PMID:Right-sided endocarditis and ventricular septal defect. 100 Apr 44

An outbreak of infections with pigmented Serratia marcescens involving 3 patients in a cardiothoracic surgical intensive care unit is reported. A respirator is thought to have been the source of pneumonia in 2 patients, and fomite spread from 1 of these is considered responsible for the induction of fatal endocarditis in the third patient. This outbreak demonstrates the rapid dissemination of a bacterial strain within the unit, several methods of dissemination, the wide variation in apparent virulence of the organism, the alterations of antibacterial host defense which made bacterial disease possible and which determined the site of infection, and the difficulties of adequate therapy. The third patient is the seventh reported with serratia infection of a prosthetic heart valve.
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PMID:Outbreaks of Serratia marcescens infections in a cardiothoracic surgical intensive care unit. 109 94


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