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

Membranous glomerulonephropathy (MGN) in South African black and mixed race children with the nephrotic syndrome is much commoner than in First-World countries. In this survey of 388 nephrotic children MGN was found in 51.9% of black and 20.9% of mixed race boys, and 25% of black and 5.6% of mixed race girls respectively, but was not present in 53 white and Asiatic nephrotic children. Aetiological or associated factors were documented in 84%: hepatitis B virus infection in 73%, congenital syphilis in 6% and systemic lupus erythematosus, D-penicillamine toxicity and Salmonella infective endocarditis in 1 case each. The prognosis depends on the cause and is much better than for adults with idiopathic MGN. After an average follow-up period of 4.5 years the overall remission rate was 78% and mean time to remission 30 months. One patient with syphilitic MGN died 15 years later; 3 patients are in mild renal failure. Corticosteroids and other immuno-suppressive therapy were ineffective and may do harm. The frequent occurrence of MGN is related to the high prevalence of predisposing infections in the affected population groups, and socio-economic rather than ethnic factors are important.
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PMID:Membranous glomerulonephropathy in childhood. 360 11

One-hundred-and-thirteen patients with endocarditis and valvular insufficiency were studied retrospectively with special regard to indications for operation and the optimum time for cardiac valve surgery. Thirty patients (group I) had acute, 63 (group II) subacute and 20 (group III) prosthetic valve endocarditis. Group I: Eleven patients underwent surgery in the acute stage, 8 while bacteremic; 5 of the latter died perioperatively. Of the 19 patients treated medically, 16 died. Group II: All patients underwent operation in a bacteria-free state. The mortality was 5%. Group III: Eight patients had early (less than 60 days postoperatively) and 12 late endocarditis. Total mortality was 40% (71% early and 25% late mortality). Ten patients underwent reoperation, with a mortality of 20%, compared with 60% in the medically treated group. The results support the indication for early operation in acute endocarditis with progressive cardiac failure and renal failure and prosthetic valve endocarditis, even during bacteremia.
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PMID:Role of surgery in infective endocarditis. 370 1

We report the results of a survey within the United Kingdom of the importance of persistent systemic infection in patients with unexplained renal disease who undergo renal biopsy. Twenty-two units participated. Overall 1.7 per cent of patients undergoing biopsy had an infection but there was large variation between units. Interstitial nephritis and amyloid deposits were more common in patients with infection, and minimal change nephropathy was less common than in patients undergoing biopsy but without infection. The respiratory tract was the most common site of infection but was rarely associated with glomerulonephritis of which the most common cause was infective endocarditis. Drug treatment may have caused the renal lesion in 16 per cent of patients. Amyloid deposits, present in 13.6 per cent of patients, was the most common cause of progressive renal failure. Most other patients had some improvement in renal function once the putative cause, whether infection or antibiotic, was removed.
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PMID:Persistent infection as a cause of renal disease in patients submitted to renal biopsy: a report from the Glomerulonephritis Registry of the United Kingdom MRC. 371 66

Thirty one (78%) of 40 consecutive patients (aged 13-79, mean 44 years) with infective endocarditis had congestive heart failure at presentation. Twenty six (65%) had had rheumatic heart disease and 17 (43%) patients had prosthetic valves. Eight (20%) patients had undergone dental procedures within three months of presentation. Blood cultures were positive in only 22 (55%) of the patients. In nine (41%) of them streptococci of the viridans group were isolated and in seven (32%) patients endocarditis was due to Staphylococcus aureus. Eight patients had Q fever endocarditis. Sixteen patients required operation because of haemodynamic deterioration while they were in hospital; 11 patients had native valves and five had prosthetic valves. Seven had emergency operations and were pyrexial at that time. Four of the seven died in hospital. Of the 12 who were alive and well after surgery only two required further surgery two and three years after the initial operation. Twelve (30%) of the 40 patients died in hospital; in 10 death was mainly due to left ventricular failure or congestive heart failure. All patients died who had renal failure (four cases), myocardial infarction (two cases), complete heart block (one case), or ventricular fibrillation (two cases) before operation. Six (33%) of the 18 patients with culture negative endocarditis died. Two of the four patients seen and treated more than 12 weeks after the onset of symptoms died, as did three of the five patients with prosthetic valves who required surgery while in hospital. Three patients with neurological complications survived and only two (29%) of the seven patients with blood cultures that were positive for Staphylococcus aureus died. Of these 40 high risk patients optimal antibiotic treatment and early surgery for haemodynamic difficulty ensured that 28 (70%) were discharged from hospital alive and well.
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PMID:Heart failure associated with infective endocarditis. A review of 40 cases. 394 52

Clinical features and immune status have been studied in seven previously healthy children with disseminated staphylococcal disease. Six of seven patients had a history of a viral-type illness before developing disseminated staphylococcal disease. Five patients had a petechial rash. Endocarditis occurred in three patients, two of whom had a cerebral embolism. All seven patients had an abnormal urinary sediment, and in two it was suggestive of glomerulonephritis. Two had transient renal failure. Three patients had evidence of pneumonia, one of the three developed pneumatoceles and one developed a pleural effusion. Four had osteomyelitis and/or septic arthritis. All patients had a transient abnormality of intracellular bacterial killing by neutrophils. One patient died. Three patients have residual valvular heart disease; one of the three patients has weakness of one arm and another has a seizure disorder. Cellular and humoral immunity in all six surviving patients is normal. We speculate that an antecedent viral infection temporarily suppressed neutrophil function and predisposed these children to secondary and severe staphylococcal disease.
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PMID:Clinical features and abnormal neutrophil function in disseminated staphylococcal disease. 398 77

Candida septic thrombosis of the great central veins is rarely diagnosed during life, and reports of survival with this condition are exceedingly rare. Eight patients with Candida septic thrombosis of the central veins, with six survivors, are reported. Seven of eight patients had multiple organ system failure following surgery or trauma. All patients had received broad spectrum antibiotics and total parenteral nutrition via a central catheter. Every patient showed features of venous thrombosis with localizing extremity edema and high grade candidemia. Intensive amphotericin B therapy (mean daily dose: 0.7 mg/kg) in all patients, combined with 5-fluorocytosine in five cases, resulted in cure and long-term survival in six patients who received 1600 to 3435 mg (mean: 26 mg/kg) total dose. None of these patients developed renal failure, while four showed improving renal function during treatment. In contrast to Candida endocarditis, septic central vein thrombosis caused by Candida appears to be curable medically in the majority of cases with intensive amphotericin B therapy (total dose: greater than or equal to 22 mg/kg), combined when feasible with 5-fluorocytosine.
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PMID:Candida septic thrombosis of the great central veins associated with central catheters. Clinical features and management. 405 12

This paper gives an account of five patients with glomerulonephritis complicating subacute infective endocarditis. In three patients with focal (segmental) glomerulonephritis granular deposits of immunoglobulin and C3 and reduced serum complement suggested an immune-complex aetiology; but in two patients with a diffuse proliferative glomerulonephritis no Ig or C3 was detected in the diseased glomeruli and the pathogenetic mechanism remained undetermined. Four of the five patients developed renal failure needing dialysis.
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PMID:Renal lesions of subacute infective endocarditis. 459 80

We describe a case of polimicrobial endocarditis in a patient with congenital aortic stenosis and end-stage renal failure in treatment with steroids and chronic haemodialisis. The blood culture grew e.coli, enterobacter sp, and s.epidermidis. Only a few papers in the literature have been devoted to this entity. Its frequency seems to be progressively higher. The present case is a good example to talk about the predisponent factors. The review of literature has shown that the occurrence of this entity is specially high among addicts, the most frequent bacteria are s.aureus, streptococci and pseudomonas and the mortality can be as high as 80%.
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PMID:[Polymicrobial endocarditis. Report of a case and review of the literature]. 634 4

We describe the third documented case of Listeria monocytogenes pericarditis. This occurred in a 54-year-old woman with end-stage renal failure on chronic hemodialysis. Her initial presentation was one of Listeria monocytogenes bacteremia, which apparently responded to two weeks of cefazolin sodium therapy. After cessation of therapy the patient returned with Listeria monocytogenes pericarditis, this responding completely to four weeks of erythromycin therapy. We could not rule out coexisting endocarditis, especially since we found high levels of circulating immune complexes which subsided as the patient's condition improved. Further immunological studies displayed a decrease in cellular functions. This case illustrates the importance of Listeria monocytogenes as a human pathogen in immunocompromised patients. Listeria should be included among the potential causative agents of pericarditis in such patients.
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PMID:Listeria monocytogenes pericarditis in a chronically hemodialyzed patient. 646 92

An autopsy study of 60 patients with fungal infections of the heart was undertaken. The patients ranged in age from 2 months to 79 years. Fifteen of the patients had undergone cardiac surgery; neoplasms were found in 13, renal failure in eight, bacterial infections in five, liver disease in five, gastrointestinal disorders in five, and immune disease in four; two had been intravenous drug abusers; other miscellaneous disorders were observed in three. The fungal infection was limited to the myocardium in 27 patients and to the endocardium in 17 patients. Myocardium and endocardium were involved in nine patients and pericardium and myocardium in five; two patients had pericarditis alone. The most frequent organism was Candida (62 per cent). Aspergillus (12 per cent) and Phycomycetes (12 per cent) were also found frequently. In 51 patients (85 per cent) other deep organs, usually lung, kidney, brain, or spleen were involved. Cultures for fungus had been positive in 26 patients prior to death, and postmortem cultures were positive in 29 patients. Patients who had undergone cardiac surgery had a higher incidence of endocarditis (93 per cent), with Candida (53 per cent) being the most frequent cause. Patients who had received antineoplastic drugs, antibiotics, or corticosteroids had a higher incidence of myocarditis (79 per cent), again most often due to Candida (60 per cent).
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PMID:Cardiac fungal infections: review of autopsy findings in 60 patients. 647 74


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