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

A growing amount of clinical and experimental evidence suggests a link between infection and atherosclerotic diseases including both myocardial and cerebral infarction. A prime example is a greatly increased risk of stroke in septicaemic patients with and without endocarditis. Controlled clinical studies have recently shown, however, that certain other milder bacterial infections are also a risk factor for infarction. A preceding febrile respiratory infection was a major risk factor for stroke in young and middle aged patients. In patients with acute myocardial infarction Chlamydia pneumoniae and dental infections seem to be risk factors according to one controlled clinical study. Several possible mechanisms could explain the observed association of infection and infarction. For instance, infection causes a hypercoagulable state which increases the risk of thrombosis. In addition, infection has profound and harmful effects on prostaglandin and lipid metabolism. Infection may also have some role in the atherosclerotic process itself by inducing damage and inflammation in vascular endothelium in the presence of hypercholesterolemia. So far, however, little clinical evidence is available to suggest that by controlling infection the risk of infarction or development of atherosclerotic lesions might be reduced except in patients with endocarditis, where the risk of thromboembolic complications rapidly diminished when the infection is controlled with antimicrobial therapy.
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PMID:Infection as a risk factor for infarction and atherosclerosis. 175 23

A total of 448 patients undergoing cardiovascular surgery were followed for the development of postoperative infection. Non-extracorporeal procedures were assigned to group 1 and open-heart procedures to group 2. The incidence of infection was compared in two groups who received prophylactic antibiotics. Patients (n = 253) received ampicillin alone (group 1) or in combination with gentamicin (group 2) for 7 days starting 1 day before the operation (period A). One hundred and ninety-five patients (period B) received cefazolin starting preoperatively 30 min before induction, alone (group 1) or in combination with gentamicin (Group 2) for 3 days. The percentage of patients developing infection in periods A and B for group 1 patients was 4.2% and 3.5% and for group 2 it was 25.8% and 18.7% respectively. The overall infection rate was 13%. The number of infection sites involved were 1.5 per infected patient. Urinary tract infections were the most frequent followed by endocarditis and other deep infections, wound infections and respiratory infection. Gram-negative rods were the predominant pathogens (Klebsiella spp. and Pseudomonas aeruginosa) during both periods (47 out of 70 isolates). Wound infections due to Gram-positive cocci were higher in period A (4/8) as compared to period B (1/5). During period B there were three cases of fungal endocarditis whereas no case occurred during period A. Although the incidence of infection was reduced during the period of cefazolin prophylaxis, the difference was not statistically significant.
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PMID:Postoperative infection in cardiac surgery: the influence of a change in prophylactic antibiotic regimen. 197 51

Sixty patients were treated with ciprofloxacin: 19 received only intravenous ciprofloxacin, 41 received intravenous followed by oral ciprofloxacin. The mean duration of therapy was 28 days in the intravenous only group and 10 days intravenously and 80 days orally in the intravenous/oral group. Ten (17 percent) patients received 200 mg intravenously every 12 hours and 49 (82 percent) 300 mg every 12 hours. The overall clinical response was 85 percent, with a bacteriologic response of 70 percent. The lowest bacteriologic response (38 percent) occurred in the 13 patients treated for Pseudomonas respiratory infection. Clinical response occurred in 24 of 26 patients with soft-tissue infection, and 10 of 13 patients with respiratory infection. Of three patients with endocarditis, therapy failed in two with resistance developing in Pseudomonas aeruginosa and Staphylococcus aureus. Overall, 19 percent of 26 P. aeruginosa isolates developed resistance to ciprofloxacin. Toxicity was minor, with phlebitis and nausea most commonly reported. Intravenously administered ciprofloxacin or intravenous followed by oral ciprofloxacin is a safe, effective therapy for serious infections due to multiply resistant gram-negative bacteria, including P. aeruginosa and S. aureus.
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PMID:Intravenous/oral ciprofloxacin therapy of infections caused by multiresistant bacteria. 251 58

The aim of this study was to determine the causes of fever of unknown origin, to evaluate new diagnostic tests and to elucidate risk factors for chronic or life-threatening disorders. The medical records of 113 children who had undiagnosed fever for at least 3 weeks were reviewed. Infection (N = 41) was the most frequent cause of fever of unknown origin. Respiratory tract infections were the most common causes in infants and endocarditis and tuberculosis were more frequent in older children. Neoplastic disorders (N = 11) occurred in children older than one year. Juvenile rheumatoid arthritis (N = 9) was the most common collagen-vascular disorder (N = 15). Miscellaneous disorders and factitious fever occurred in 21 and 4 cases, respectively. Twenty-two patients remained undiagnosed. History and physical examination led to a final diagnosis in 81% of cases. Abdominal ultrasonography was performed in 71 patients (61%) and was helpful for diagnosis in 15%. Children with life-threatening or chronic disorders (N = 58) were older than those with self-limiting conditions (N = 55; P = 0.017). Cardiovascular and articular signs and symptoms were more frequent in the former group (P = 0.01).
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PMID:Children with fever of unknown origin in Argentina: an analysis of 113 cases. 803 40

Streptococcus viridans usually are an etiologic agent in odontogenic infection and endocarditis and only in some cases have been acknowledged as a respiratory pathogens. We present two cases of Streptococcus mitis bacteremic pneumonia with secondary mitral endocarditis in two patients that were been admitted by a respiratory infection (pneumonia), and later diagnosticated of mitral endocarditis. We dismiss the fisiopathogenic possibility of pneumonia with secondary pulmonary septic embolisms. With this description we help to prove the S. mitis respiratory system pathogenicity and show the known risk of endocarditis in any case of Streptococcus viridans bacteremic infection.
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PMID:[Mitral endocarditis secondary to Streptococcus mitis bacteremic pneumonia]. 909 Oct 32

To study the aerobic and anaerobic microbiology of liver and spleen abscesses and correlate the results with predisposing factors, potential causes and routes of infection, clinical and laboratory data of 48 patients with liver abscesses and 29 with spleen abscesses treated between 1970 and 1990 were reviewed retrospectively. In liver abscesses, a total of 116 isolates (2.4 isolates/specimen) was obtained; 43 were aerobic and facultative species (0.9 isolates/specimen) and 73 were anaerobic species or microaerophilic streptococci (1.5 isolates/specimen). Aerobic bacteria only were isolated from 12 (25%) abscesses, anaerobic bacteria only from eight (17%), and mixed aerobic and anaerobic bacteria from 28 (58%); polymicrobial infection was present in 38 (79%). The predominant aerobic and facultative isolates were Escherichia coli (11 isolates), Streptococcus group D (8), Klebsiella pneumoniae (5) and Staphylococcus aureus (4). The predominant anaerobes were Peptostreptococcus spp. (18 isolates), Bacteroides spp. (13), Fusobacterium spp. (10), Clostridium spp. (10) and Prevotella spp. (4). There were 12 isolates of micro-aerophilic streptococci. S. aureus and beta-haemolytic streptococci were associated with trauma; Streptococcus group D, K. pneumoniae and Clostridium spp. with biliary disease; and Bacteroides spp. and Clostridium spp. with colonic disease. In splenic abscesses, a total of 56 isolates (1.9 isolates/specimen) was obtained; 23 were aerobic and facultative species (0.8 isolates/specimen), 31 were anaerobic species or micro-aerophilic streptococci (1.1 isolates/specimen) and two were Candida albicans. Aerobic bacteria only were isolated from nine (31%) abscesses, anaerobic bacteria from eight (28%), mixed aerobic and anaerobic bacteria from 10 (34%) and C. albicans in two (7%); polymicrobial infection was present in 16 (55%). The predominant aerobic and facultative isolates were E. coli (5 isolates), Proteus mirabilis (3), Streptococcus group D (3), K. pneumoniae (3) and S. aureus (4). The predominant anaerobes were Peptostreptococcus spp. (11 isolates), Bacteroides spp. (5), Fusobacterium spp. (3) and Clostridium spp. (3). S. aureus, K. pneumoniae and Streptococcus group D were associated with endocarditis, E. coli with urinary tract and abdominal infection, Bacteroides spp. and Clostridium spp. with abdominal infection and Fusobacterium spp. with respiratory infection.
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PMID:Microbiology of liver and spleen abscesses. 985 43

Guidelines for antibiotic prophylaxis of infective endocarditis prior to fibreoptic bronchoscopy, are based on only five studies, which showed a bacteraemia rate of <1% among 291 patients studied. T his study was designed to expand the current data regarding the frequency of bacteraemia following fibreoptic bronchoscopy. Aerobic and anaerobic cultures of venous blood and of lavage fluid were drawn from 200 consecutive patients undergoing fibreoptic bronchoscopy without respiratory infection or antibiotic treatment prior to the procedure. The true bacteraemia rate was calculated after excluding probable "contaminated" blood cultures. A possible correlation between type of procedure performed during the bronchoscopy and occurrence of bacteraemia was investigated. Positive blood cultures were noted following 26 bronchoscopy examinations. Coagulase negative Staphylococcus was found in the cultures of 18 patients, coagulase positive Staphylococcus in 3 patients, nonhaemolytic streptococci and a Klebsiella species in 2 patients each, and beta haemolytic streptococcus in one patient. After exclusion of 13 "contaminated" specimens the bacteraemia rate was 6.5% (13/200 patients). This study showed a bacteraemia rate of 6.5%, significantly higher than previously recognized in a cohort of patients undergoing fibreoptic bronchoscopy without either pulmonary infection or an unusually high rate of invasive procedures. These findings should be taken into account in future evaluations of recommendations for antibiotic prophylaxis of endocarditis.
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PMID:Incidence of bacteraemia following fibreoptic bronchoscopy. 1057 21

Homeless people in developed countries have specific problems predisposing them to infectious diseases. Respiratory infections and outbreaks of tuberculosis and other aerosol transmitted infections have been reported. Homeless intravenous drug users are at an increased risk of contracting HIV, and hepatitis B and C infections. Skin problems are the main reason the homeless seek medical attention, and these commonly include scabies, pediculosis, tinea infections, and impetigo. Many foot disorders are more prevalent in the homeless including ulcers, cellulitis, erysipelas, and gas gangrene. The louse transmitted bacteria Bartonella quintana has recently been found to cause clinical conditions in the homeless such as urban trench fever, bacillary angiomatosis, endocarditis, and chronic afebrile bacteraemia. Treatment of homeless people is complicated by financial constraints, self-neglect, and lack of adherence. Patients with serious and contagious illnesses should be hospitalised. Physicians should be aware of these specific issues to enhance care.
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PMID:Infections in the homeless. 1187 79

Respiratory infections are challenging for clinicians and new microbes or those considered previously as normal flora or less virulent forms seen responsible for some cases. Thus, the case reported here is a nosocomial pneumonia caused by Corynebacterium pseudodiphteriticum in a man suffering chronic obstructive pulmonary disease and resolved with cefotaxime. This microorganism is part of the oropharingeal bacterial flora and is therefore associated mainly with respiratory disease an less commonly with endocarditis, prostheses or wound infections. Susceptibility testing found uniform susceptibility to b-lactamases, aminoglycosides, rifampin and tetracycline. Susceptibility to ciprofloxacine is variable and resistance to macrolides (erythromycin and clindamycin) was frequent.
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PMID:[Pneumonia caused by Corynebacterium pseudodiphteriticum, an entity worth knowing]. 1242 Jun 32

A previously healthy woman having recently retired to old-age pension contracted a mild respiratory infection. During a peroral course of antibiotics, the inflammatory values continued to elevate. Admission to hospital was followed by stroke, revealing an underlying endocarditis. The patient succumbed suddenly two days later. In this clinical-pathological meeting case report we review the cause of it all.
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PMID:[Violent endocarditis in a previously healthy woman]. 1934 Oct 42


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