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)

We describe the case of a 45-year-old man with mitral and aortic prosthetic valve replacement who presented with symptoms of subacute bacterial endocarditis. Bartonella quintana was grown from blood after prolonged culture. The course of the disease was complicated by splenic infarction, glomerulonephritis resulting in progressive renal insufficiency, and cerebroventricular hemorrhage. Notably, cardiac ultrasonography showed no extensive vegetations but a strand-like lesion. Culture-positive B. quintana prosthetic valve endocarditis in a formerly healthy subject represents a newly observed entity. It should be added to the differential diagnosis of prosthetic valve endocarditis, especially when it presents with features suggesting subacute bacterial endocarditis.
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PMID:Bartonella quintana prosthetic valve endocarditis detected by blood culture incubation beyond 10 days. 1696 56

Systemic embolization is the most common extracardiac complication of active infective endocarditis (IE). The assessment of individual patient risk for embolic events in active IE is very difficult. Staphylococcal or fungal endocarditis, infections caused by HACEK and Abiotrophia spp. microorganisms, anterior mitral leaflet vegetations and vegetations with size >10 mm in TTE are associated with higher rate of arterial embolization. In this report we present a 66-year-old patient with active enterococcal aortic native valve endocarditis, with a history of gastric ulcers and with acute abdominal pain due to splenic infarction. We conclude that abdominal pain, particularly in the left-upper-quadrant, may be a sign of splenic infarction. Confirmation of this complication by ultrasonography provides important information about increased risk of future systemic embolic events.
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PMID:[Difficulties in the differential diagnosis of splenic infarction and splenic abscess in a patient with active infective endocarditis -- case report and current review]. 1794 72

Acute abdominal pain is one of the most common conditions confronted in the emergency department. Clues related to splenic infarction may be obscured, and the diagnosis is quite challenging even for experienced physicians or surgeons. For every patient diagnosed with splenic infarction, a scrutiny on the possible source of emboli should be carried out. In addition, splenic abscess must be suspected in patients of splenic infarction, especially if the infectious signs persist despite appropriate treatment. Rapid diagnosis and treatment are essential as its course can prove fatal. Infective endocarditis is the most common condition predisposing a patient to splenic abscess. Indeed, splenic abscess or infarction may be a disease entity at different stages in patients of infective endocarditis due to septic emboli of the spleen. The treatment of choice has been antibiotics, splenectomy, and valve replacement surgery. Herein, we report a case of splenic abscess and infective endocarditis cured by antibiotic treatment without the aid of drainage or surgery.
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PMID:Splenic infarction and abscess complicating infective endocarditis. 1985 37

Splenic infarct is a rare condition often related to haematological, cardiovascular, autoimmune or infectious diseases diagnosed with increasing frequency due to the large use of abdominal imaging techniques. Cryoglobulins are serum proteins that reversibly precipitate at low temperatures, small vessels vasculitis represent their most common clinical manifestation and are often associated with chronic liver disorders or with lymphoproliferative diseases. Here the authors report the cases of two patients, both affected by chronic liver disease associated with cryoglobulinemia, admitted to our unit for an on-going active infectious disease (without signs of endocarditis) who presented multiple splenic infarcts as an unexpected complication. The authors hypotize that in both cases splenic infarct may be related not only to a thrombogenic state or to splenic vasculitis but also to other immuno-mediate mechanism related to cryoglobulins synthesis and clearance.
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PMID:Splenic infarcts in chronic hepatopathy accompanied by cryoglobulinemia: two case reports. 2019 Jul 28

Peptostreptococcus sp., which are normal flora of human mucocutaneous surfaces, can be recovered in mixed infections involving the skin, soft tissue, respiratory tract, gastrointestinal tract and genitourinary tract. Peptostreptococci are rarely reported to be the cause of infective endocarditis. Because of their fastidiousness, peptostreptococci are difficult to isolate and are often overlooked. The authors report a case of Peptostreptococcus infective endocarditis of a native mitral valve complicated by splenic infarction. The authors also review the literature to identify features of infective endocarditis caused by Peptostreptococcus anaerobius.
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PMID:Peptostreptococcus anaerobius infective endocarditis complicated by spleen infarction. 2170 36

This case report describes a rare presentation of Streptococcus mitis endocarditis of the aortic and mitral valves, complicated by spontaneous splenic rupture due to splenic infarction, which led to massive intra-abdominal bleeding and ultimately death.
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PMID:Infective endocarditis complicated by splenic rupture and fatal intra-abdominal haemorrhage. 2201 45

Infective endocarditis is extremely rare in children with structurally normal hearts. The most common etiological agents are staphylococcal and streptococcal species. Nutritionally variant streptococci also classified as Abiotrophia species are a group of fastidious organisms that account for only 5% to 6% of all cases of culture-negative infective endocarditis. Only seven cases of Abiotrophia infective endocarditis have been previously reported in children with no underlying structural heart disease. We report two cases of Abiotrophia infective endocarditis in children without any predisposing factors. Both patients presented with nonspecific symptoms leading to delay in diagnosis. While bacteriological clearance was achieved in both cases, both had a complicated course including development of brain mycotic aneurysms, splenic infarction, renal failure, and irreversible damage to the mitral valve. Both patients required surgical removal of the native mitral valve and replacement. We also present review of seven cases with similar diagnosis published previously in literature and highlight important differences. Our cases highlight special challenges in management of Abiotrophia endocarditis in pediatric patients. As the organism may not be isolated in routine culture media, may present with atypical clinical symptoms and may have a complicated course even without antibiotic failure, a high index of suspicion should be maintained in children with subacute symptoms even with no underlying structural cardiac disease.
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PMID:Abiotrophia endocarditis in children with no underlying heart disease: a rare but a virulent organism. 2368 22

Splenic infarction is an extremely rare and unique presentation of brucellosis. Only few cases have been reported worldwide. We here report a case of a young man, presenting with acute onset of fever, left hypochondial pain, and vomiting. Further evaluation revealed multiple splenic infarcts and positive blood culture for brucellosis despite negative transesophageal echocardiography for endocarditis. Significant improvement in clinical symptoms and splenic lesions was achieved after six weeks of combination therapy against brucellosis.
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PMID:Acute Brucellosis with Splenic Infarcts: A Case Report from a Tertiary Care Hospital in Saudi Arabia. 2624 24

Acute splenic infarcts classically present with left upper quadrant pain, but may be discovered incidentally in many hospitalized patients with otherwise vague complaints. The purpose of our study was to document causes or predisposing conditions in patients found to have acute splenic infarctions on imaging. Following IRB approval, a retrospective review of an imaging database from May 2008 to May 2015 was performed for cases of acute splenic infarctions. The electronic medical record was then reviewed for potential predisposing factors or known causes. Specific note was made of cases with active malignancy, vascular disorders, or inflammatory conditions with an increased risk of vasculopathy. Echocardiogram and electrocardiogram results were reviewed when available. One hundred twenty-three patients with acute splenic infarcts were identified, 65 female and 58 male. The average age was 57 years (range of 22 to 88). Active malignancy was present in 40 patients or 33 %. The most common malignancy in patient with nontraumatic splenic infarctions was pancreatic cancer, present in 16 patients (13 %). In these patients, splenic infarction was due to direct invasion of vessels in the splenic hilum. Acute pancreatitis (severe) was directly responsible for splenic infarction in seven additional cases (6 %). Additional visceral infarcts were present in 18 patients (15 %), most commonly concomitant hepatic or renal infarcts. Documented atrial fibrillation was present in 12 patients, but only 2 cases of left-sided cardiac thrombi were seen on CT (1 atrial, and 1 ventricular thrombus). Eight cases of endocarditis with valvular vegetations were documented on echocardiography (7 %). Splenomegaly was present in 32 patients (26 %) with acute splenic infarction. In patients with nontraumatic splenic infarctions, there appears to be a relatively high association with active malignancy (up to a third of patients). Pancreatic disorders, malignant and inflammatory, also appear to be an important cause of splenic infarction, presumably due to the close proximity of the pancreas to the splenic vessels.
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PMID:Acute nontraumatic splenic infarctions at a tertiary-care center: causes and predisposing factors in 123 patients. 2679 23

A 38-year-old Caucasian man with uncontrolled diabetes mellitus type 2 was admitted with a 1-week duration of fevers, chills, and a non-productive cough. He had a left ischiorectal abscess 1 month prior to admission. Physical examination revealed caries on a left upper molar and a well-healed scar on the left buttock, but no heart murmur or evidence of micro-emboli. Blood cultures grew Streptococcus agalactiae. A transesophageal echocardiogram revealed a mobile mass in the right ventricle that attached to chordae tendineae without valvular disease or dysfunction. A computed tomography (CT) with contrast revealed the mass within the right ventricle, a left lung cavitary lesion, and a splenic infarction. He was initially treated with penicillin G for a week. Subsequently, ceftriaxone was continued for a total of 8 weeks. A follow-up CT showed no evidence of right ventricular mass 8 weeks after discharge. This is the first reported case of S. agalactiae mural infective endocarditis in a structurally normal heart.
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PMID:Streptococcus agalactiae mural infective endocarditis in a structurally normal heart. 2712 71


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