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

Glomerulonephritis may complicate infections due to various microorganisms. These microorganisms are bacterial, fungal, viral or parasitic. Considerable clinical and experimental evidence has accumulated to indicate that glomerular injury is due to in situ immune complex deposition. In France, renal lesions are more often due to focal skin infection and sinus or visceral abscesses, with or without endocarditis, rather than to pharyngeal streptococcal infection. Staphylococcal infections are a frequent cause, especially in intravenous illicit drug users. Recovery requires suppression of the infective agent. However, in severe forms, after initial acute glomerular damage the evolution may be characterized by the development of chronic glomerulonephritis.
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PMID:[Glomerulonephritis of infectious origin]. 180 54

We have examined case records for patients who received teicoplanin alone for endocarditis or Staphylococcus aureus bacteraemia. All patients with streptococcal endocarditis were cured (viridans group 14/14; Group D 4/4). Cure rates for other organisms were: Enterococcus faecalis 3/5; S. aureus 5/10 and coagulase negative staphylococci 2/3. Doses for six patients who failed because of poor response were 3.3-4.2 mg/kg. Teicoplanin treatment cured 41/48 patients with S. aureus bacteraemia; treatment failed in two patients because of adverse events. Doses in the remaining treatment failures were 2.1-5.0 mg/kg. In comparison, 48 patients in Dundee hospitals received ten different drugs in 20 combinations for S. aureus bacteraemia; 29 patients received cloxacillin or flucloxacillin but initial doses varied from 0.25-2.0 g. We conclude that the European database does provide evidence that teicoplanin monotherapy is effective for serious infection with Gram-positive bacteria. Doses for staphylococcal infection should probably be at least 6 mg/kg. The upper limit of the teicoplanin dosage range remains to be determined but there is evidently considerable confusion about appropriate regimens for 'standard' therapy.
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PMID:Teicoplanin monotherapy of serious infections caused by gram-positive bacteria: a re-evaluation of patients with endocarditis or Staphylococcus aureus bacteraemia from a European open trial. 182 76

Experience of many years in surgical treatment of prosthetic valve endocarditis (RVE) is analyzed. Patients whose condition was serious were operated on for a second time: 91.6% had preoperative functional class IV, in half of them circulatory disorders were of stage IIB--III; 62.4% were subjected to reoperation for emergency indications. Twenty-five reoperations were performed for early PVE with 52% hospital mortality, 23 reoperations-for late term PVE with mortality of 30.4%. The most frequent cause of PVE was staphylococcal infection which showed a tendency to increase in the recent years. In early PVE the severity of the condition in the recent years. In early PVE the severity of the condition was due to sepsis and intoxication, in late-term PVE it was caused by disorders of hemodynamics which were usually induced by dysfunction of the prosthesis. The results of surgical management of PVE depended on the severity of the patient's condition before the operation, timely performance of the operation, and the efficacy of antibacterial therapy.
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PMID:[Surgical treatment of endocarditis following heart valve prosthesis]. 235 65

We have reviewed 108 cases of bacterial endocarditis treated surgically since 1968. The mean age of the patients was 47.7 +/- 15.6 years (+/- SD) (range, 14-79 yr). Seventy-seven percent were male. The most common causative organisms were staphylococci (46%), streptococci viridans group (5%), and other streptococci (20%). Forty-five percent, 25%, and 13% of patients had native aortic valve, native mitral valve, or native double valve (AV/MV) involvement, respectively. Eighteen patients had prosthetic valve endocarditis. No patient underwent surgery for tricuspid valve endocarditis. Seventy-three patients were considered to have active endocarditis (AE) (positive blood or tissue cultures and/or annular abscess). The 35 remaining patients had healed endocarditis (HE). Preoperative complications in patients with either AE or HE were stroke (11%, 11%), renal failure (33%, 3%; p less than 0.001), pulmonary edema (83%, 34%; p less than 0.001), anemia (36%, 8%; p less than 0.01), and inotrope dependence (22%, 6%; p less than 0.05). Hospital mortality for native valve AE was 19.5% (11/56), and for healed endocarditis, 5.7% (2/35). Independent predictors of hospital mortality were inotrope dependence (p less than 0.001), annular abscess (p less than 0.01), pulmonary edema (p less than 0.01), and staphylococcal infection (p less than 0.05). The 5-year actuarial survival for operative survivors was 68.4 +/- 7.5% (AE) and 78.3 +/- 9.2% (HE). We conclude that the operative mortality for patients with continuing sepsis is high and that surgery should be undertaken early in staphylococcal endocarditis. If surgery is successful, then the long-term prognosis is good.
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PMID:The surgical treatment of infective endocarditis. 272 63

We reviewed fourty-six patients who had undergone surgery for infective endocarditis in the past fifteen years and identified risk factors affecting the outcome. Twenty-nine patients had infection of the native valve only, 11 had infective endocarditis associated with congenital heart disease, and 6 had prosthetic valve endocarditis. Overall hospital mortality was 6.5%. Prosthetic valve endocarditis carried a higher mortality (33%) than native valve endocarditis (3.4% or congenital heart disease with infective endocarditis (0%). For the patients with active endocarditis, the early mortality rate was higher (13%) than with inactive endocarditis (3.2%). Staphylococcal infections were more likely to cause severe valve destruction and residual infection than streptococcal infection. Our results indicated that surgical management of infective endocarditis should be done after the completion of adequate antibiotic therapy. Early diagnosis should reduce the mortality, prevent fatal complications, and lead to qualitative improvement of infective endocarditis.
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PMID:[Surgical management of infective endocarditis]. 274 10

Staphylococcal infection is common in Malaysian hospitals. A recent survey of 22 Malaysian hospitals revealed that staphylococci were isolated from almost 40% of positive blood cultures. A more detailed analysis of such cases in our own hospital showed that almost 70% of Staphylococcus aureus and about 16% of coagulase-negative staphylococcal isolates were associated with clinically-significant disease. Staphylococcal bacteraemia was seen mainly in neonatal sepsis, skin and soft tissue infections, pneumonia, arthritis, osteomyelitis, endocarditis and postoperative sepsis. Multiply-resistant S. aureus were encountered in all the hospitals surveyed. Resistance rates to penicillin ranged from 40% to almost 100% while methicillin resistance rates of up to 25% were reported from several hospitals.
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PMID:Staphylococcal infection in Malaysian hospitals. 289 92

A 53 year old man with an anaplastic bronchial carcinoma was hospitalised for septic shock and acute respiratory distress after a cutaneous, probably staphylococcal infection, and died in spite of anti-staphylococcal antibiotherapy. The autopsy showed pulmonary, cardiac, cerebral and renal aspergillosis. A right heart aspergillous endocarditis, very rare in this pathology, was also discovered but there were no cardiac valves lesions. The patient was in an "immunodepressed" state as usually observed in pulmonary aspergillosis. The endocardial localisation of aspergillosis and the "pseudo-miliary" appearances of the pulmonary lesion indicated an extra-pulmonary portal of entry, cutaneous or intravenous which is unusual in this pathology. This hypothesis is supported by previous reports of pulmonary aspergillosis where right heart endocarditis is exceptionally rare and by aspergillous left heart endocarditis after open heart surgery where pulmonary aspergillosis is absent.
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PMID:[Right endocarditis in disseminated aspergillosis]. 299 56

An exfoliatin B-producing strain of Staphylococcus aureus was isolated from two adults with typical staphylococcal scalded skin syndrome (SSSS). One patient developed desquamation after a local staphylococcal infection of the hand, and the other developed exfoliation after nosocomially acquired staphylococcal endocarditis. Neither patient was immunocompromised, had evidence of renal insufficiency, or manifested other potential risk factors for SSSS. Purified toxin, isolated from the causative organisms, produced a Nikolsky sign in neonatal mice. The toxins were shown to be exfoliatin B by biochemical and immunologic methods and heretofore had been described only in children with SSSS. Analysis of plasmid DNAs from both strains revealed a 23-megadalton plasmid with identical restriction endonuclease digestion fragments. One isolate belonged to phage group II (3B/3C/6/7/47/54/55), whereas the other isolate belonged to phage groups I and III (7/29/52/52A/53/54/80). The observation that a non-phage group II exfoliatin-producing strain of S. aureus may produce SSSS in adults indicates the need to better define the diagnostic criteria for SSSS. Immunocompetent adults may remain susceptible to some strains of exfoliatin B-producing S. aureus.
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PMID:Staphylococcal scalded skin syndrome in two immunocompetent adults caused by exfoliatin B-producing Staphylococcus aureus. 313 45

One hundred and six patients were analysed in order to assess the effect of a more aggressive surgical policy in relation to the delays in diagnosis of infective endocarditis. The average duration of symptoms before diagnosis was 9.7 weeks, even though the patients had sought medical advice at a relatively early stage of their illness (2.2 weeks). Three of the 29 (10.3%) patients who were treated surgically died and all three were operated upon five weeks or later after diagnosis. Seventy-seven patients did not have surgery and 15 died (19.5%). The outcome of surgical treatment for prosthetic valve endocarditis was no worse than for native valve endocarditis. The mortality of prosthetic valve endocarditis including early infections was 32% with medical but only 10% with surgical management compared with 14.5% and 10.5% in native valve endocarditis. Endocarditis cannot always be prevented but earlier diagnosis would reduce mortality and prevent complications. When medical treatment is failing then surgery should be considered early and urgently particularly in staphylococcal infection or when large mobile vegetations are recognized; surgery is mandatory in fungal endocarditis. Earlier diagnosis would greatly reduce the current high incidence of surgery, but that depends on a much heightened index of suspicion amongst both general practitioners and hospital physicians.
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PMID:Duration of symptoms and the effects of a more aggressive surgical policy: two factors affecting prognosis of infective endocarditis. 404 95

Staphylococcus aureus is a ubiquitous organism that is normally carried on the skin and body surfaces of man. The nares are sites frequently colonized, and patients and hospital personnel represent the major source of infection. The occurrence of staphylococcal infection depends on the availability of staphylococci and the host resistance to infection. Factors that influence the carrier rate of S. aureus include minimal colonizing dose, effects of antimicrobial therapy, disinfectants in the environment, coincidental respiratory infections, possible effect of immune factors, duration of hospital stay, and regular needle injections. Certain patients such as drug abusers, patients with diabetes, and patients with chronic renal failure are at high risk of S. aureus infections. although underlying immune deficiencies are present, increased carrier rate also might be related to regular needle use, as shown among allergy patients. The significance of carrier state has been defined in outbreaks in hospital nurseries, postoperative patients, and systemic infections such as endocarditis in the drug abuser, the toxic shock syndrome, and dermatologic infections.
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PMID:Skin and skin structure infections in the patient at risk: carrier state of Staphylococcus aureus. 637 66


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