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

To aid in the rapid diagnosis of staphylococcal infection, a solid-phase radioimmunoassay for Staphylococcus aureus antigen was developed and evaluated in rabbits with staphylococcal endocarditis. Test specimens containing antigen were added to polystyrene tubes coated with antibody to S. aureus. Antigens immobilized on the tube were detected by adding radiolabeled antibody to S. aureus. Sensitivity for antigen was 0.312 microgram/ml in buffer and 1.25 microgram/ml in 50% rabbit serum. Cross-reactions were not observed with antigens extracted from streptococci; however, antigen extracted from Staphylococcus epidermidis (which contained ribitol-teichoic acid) could also be detected at low concentrations. Antigen was detected in each of 12 rabbits with S. aureus endocarditis but not in control rabbits. This assay is sensitive, specific, reproducible, and capable of detecting antigens in the serum of rabbits with endocarditis.
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PMID:Solid-phase radioimmunoassay for detection of staphylococcal antigen in serum of rabbits with endocraditis due to Staphylococcus aureus. 7 24

Clinical features of 99 patients with staphylococcal infection were reviewed, and sera were tested by solid-phase radioimmunoassay and gel diffusion for staphylococcal antibodies to ascertain whether these variables predict the extent of infection and the need for prolonged therapy. Clinical features, including the presence of a primary site of infection or a continuous pattern of bacteremia, were not sufficient for differentiating endocarditis or complicated bacteremia from uncomplicated bacteremia. Patients with uncomplicated bacteremia were cured by 3 weeks of antibiotic therapy. Positive serologic tests for staphylococcal antibody helped distinguish patients with endocarditis or complicated bacteremia from patients with uncomplicated bacteremia. Radioimmunoassay was more sensitive than gel diffusion for identifying patients with complicated bacteremia. Our results indicate that patients with a positive antibody result 14 days after the onset of infection should be considered to have endocarditis or complicated bacteremia, but a negative antibody result would support short-term antibiotic therapy.
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PMID:Solid-phase radioimmunoassay for immunoglobulin G Staphylococcus aureus antibody in serious staphylococcal infection. 10 30

Gel-diffusion and the enzyme-linked immunosorbent assay (ELISA) were used to quantify and to identify the immunoglobulin class of teichoic acid antibodies in patients with chronic staphylococcal osteomyelitis and a wide variety of other infections. Teichoic acid antibodies were identified by gel-diffusion in 14 of 23 patients with staphylococcal endocarditis, six of 30 with staphylococcal bacteremia without endocarditis, four of 35 with staphylococcal skeletal infections, and one of 45 with nonstaphylococcal infections. None of the 20 patients with chronic staphylococcal osteomyelitis had positive gel-diffusion assays, even though many had had their infections for several years. The ELISA method was more sensitive than gel-diffusion in measuring teichoic acid antibodies, but was also much less specific. Teichoic acid antibodies were detected predominantly in the IgG fraction of serum. Our findings suggest that the presence and degree of antigenemia are more important than the duration of the staphylococcal infection in stimulating production of teichoic acid antibodies.
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PMID:Teichoic acid antibodies in chronic staphylococcal osteomyelitis. 10 31

Counterimmunoelectrophoresis (CIE) was utilized to determine antistaphylococcal precipitin antibody titers in patients with various staphylococcal diseases and in control subjects. Patients with staphylococcal disease comprised five cases of endocarditis, 22 of deep tissue infection (including seven cases of osteomyelitis), six of bacteremia and six of skin infection. Control subjects consisted of 31 patients with nonstaphylococcal bacteremias, 29 hospitalized patients without infection and 30 healthy subjects. Antistaphylococcal antibodies were present in all patients with staphylococcal endocarditis and deep tissue staphylococcal infection, and all but three had titers greater than or equal to 1:4. No significant difference in titers was found between these two groups of patients. Antibodies, although present in some patients in the other categories, were detected less frequently; only two patients had titers greater than or equal to 1:4. Thus, an antistaphylococcal antibody titer by CIE of 1:4 or greater may be an additional diagnostic parameter helpful in distinguishing patients with staphylococcal endocarditis or deep tissue infection from those with other forms of staphylococcal infection and from noninfected subjects.
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PMID:Correlation of antistaphylococcal antibody titers with severity of staphylococcal disease. 64 29

Mitral valve aneurysm is an uncommon complication of infective endocarditis. This report describes a patient with severe regurgitation due to perforations in a mitral aneurysm who required mitral valve replacement 9 years after a staphylococcal infection was superimposed on a billowing mitral leaflet. The unusual auscultatory signs and angiographic appearance could have led to diagnosis of the aneurysm.
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PMID:Mitral valve aneurysm after infective endocarditis in the billowing mitral leaflet syndrome. 87 3

Infective endocarditis in heroin addicts has been reported to have a mortality as high as 85% and reports have varied widely regarding predominant valvular involvement and infecting microorganisms. A retrspective study was done and 61 cases of heroin-associated infective endocarditis were identified at Freedmen's Hospital and the District of Columbia General Hospital, Washington, DC between January 1969 and January 1973. Our results indicate that staphylococcal infection of the tricuspid valve has a much higher incidence in this population than has generally been believed and that it is the predominant presentation of infective endocarditis in these patients. The outcome of patients in our series compares favorably with previous reports and suggests that early diagnosis and prompt institution of appropriate antimicrobial therapy are important and may lead to improved survival in addicts with tricuspid endocarditis.
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PMID:Infective endocarditis as a complication of heroin use. 96 31

The incidence and characteristics of infective endocarditis were studied in a defined community over a four-year period. Seventy-eight cases were found, giving an incidence of 16 cases permillion per year. The commonest presenting features were those of infection; 53% had cardiac failure and 37% evidence of emboli when first seen. Twenty-three cases occurred on rheumatic heart valves, 13 on valvular prostheses, and 19 in previously normal hearts. Streptococcus viridans was the commonest organism, but there was a relatively high incidence of staphylococcal infection. Only four cases were preceded by dental manipulation, and no source for the infection was found in 46 patients. The mortality rate was 46%, cardiac failure and embolic phenomena accounting for 65% of deaths. It is unlikely that earlier diagnosis or cardiac surgery would have reduced the mortality appreciably.
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PMID:Infective endocarditis: a survey of cases in the South-East region of Scotland, 1969-72. 96 93

This report represents a comprehensive review of infective endocarditis in a major Australian centre between the years 1962 and 1971. During the later years of this study prosthetic valves were inserted in significant numbers and cardiac surgery became available in the treatment of endocarditis. The following major points emerged. There has been no reduction in the incidence of this disease within the period of study. A higher percentage of cases have followed surgery, particularly cardiac. There has been a decreased number of cases following dental extraction or urological surgery. A change in the pattern of the infective organisms was observed, particularly an increase in Staphylococcal infections, although Strep. viridans was the most frequent infecting agent. Infected prosthetic valves accounted for 11% of cases in the latter five year period, Staphylococcal infections being responsible for the majority of these cases. The mortality for prosthetic infections was 80%, and a loss of anticoagulant control contributed to death in 42% of patients. There was a reduction in mortality due to endocarditis from 39% between 1962 and 1966 to 24% between 1967 and 1971 (P less than 0-05).
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PMID:Infective endocarditis in a Sydney teaching hospital--1962-1971. 106 41

One hundred and five cases of bacteremia due to Staphylococcus aureus were reviewed to assess the current clinical spectrum of serious staphylococcal disease. Mortality was 21 percent, lower than previously reported. Patients could be separated into two groups according to the presence of identifiable primary staphylococcal infections; 63 bacteremic patients had such lesions, the remaining 42 lacked them. The latter group contained 24 of 26 cases of endocarditis. Illnesses in that group were marked by the presence (in 38 of 42 patients) of staphylococcal foci occurring secondary to bacteremia. Such foci were responsible for five of seven instances of relapse or treatment failure encountered in that group. Secondary staphylococcal foci occurred in only five of 63 patients with primary infections, and the response of this group to conventional therapy for bacteremia was satisfactory. This study suggests that endocarditis has become an unusual complication of identifiable primary staphylococcal infection. A clinical classification based on the presence of such lesions therefore separates bacteremic patients likely to be cured by conventional antibiotic therapy (those with primary infections but no secondary foci) from others (those with secondary foci, suggesting endocarditis) who should receive a more prolonged course of antibiotics.
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PMID:Staphylococcus aureus bacteremia. Current clinical patterns. 127 83

Thirty-three cases of infective endocarditis presenting during a 6.5 year period to a district general hospital were analysed retrospectively. The annual incidence was 22 cases per million population. Twenty-two cases had pre-existing cardiac disease, mainly valvular disease-usually rheumatic (nine cases) and prosthetic valves (10 cases). Recognizable precipitants such as recent surgery were uncommon. Two cases presented after deliberate drug overdose possibly due to depression exacerbated by systemic disease. Symptoms were usually non-specific. All but two cases had murmurs and most were pyrexial. Splinter haemorrhages and clubbing were seen in about 20% of cases. Viridans-type streptococci were the commonest infecting organisms (14 cases). Staphylococcal infection (six cases) was confined to intravenous drug abusers and patients with prosthetic valves. Five cases were culture negative. Cardiac failure was present in 13 cases at presentation and developed in seven others during treatment. Acute valve replacement was necessary in eight cases, and late replacement in three. Renal impairment (plasma urea > 8 mmol/l and/or plasma creatinine > 120 mumol/l) occurred in 19 cases during the course of their illness. Embolic phenomena occurred in 12 patients and mostly involved the central nervous system. In the 8 fatal cases, the cause of death was cardiac failure in six, cerebrovascular accident in one, and myocardial infarction in one. Four of the six patients who subsequently died of cardiac failure had been referred for surgery. Both those who were not referred had coexisting medical problems. Factors associated with increased mortality were age, male sex, cardiac failure (P < 0.01), renal impairment (P < 0.05), and embolic phenomena (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Infective endocarditis in a district general hospital. 143 86


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