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

The disease of a 34-year-old patient with relapsing cerebral embolisms, endocarditis, thrombophlebitis and hypercoagulopathy had the characteristics of paraneoplastic syndromes described and discussed in literature. Autopsy yielded a clinically unrecognised, dedifferentiated adenocarcinoma of the bronchial system. At an early stage of the disease cerebral embolisms had produced severe cerebral neurological signs with varying manifestations. This influenced not only the clinical picture and course of the disease to a considerable extent, but also focussed diagnostic attention on these signs to such a degree that the possibility of a masked carcinoma did not seem to suggest itself. The assumption of paraneoplastic linkups is supported by experimental and postmortem examinations on metabolic and immunological remote action of tumours on cardiac valves and on the vascular and coagulation system. However, the exact pathogenetic details are still largely unknown.
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PMID:[On relapsing paraneoplastic cerebral embolism. Case report and survey of literature (author's transl)]. 25 75

Septic pulmonary embolization occurs when an infected thrombus lodges in the pulmonary arterial tree. Pulmonary abscess, empyema, bronchopleural fistula, shock and death may follow. During the preantibiotic era, septic pulmonary embolization was a dread complication of septic thrombophlebitis occurring in the pelvis and after infections of the head and neck. More recently, the multiplicity of long term indwelling catheters has changed the epidemiologic aspect of this disease, pointing toward iatrogenic causes in many instances. The drug addict, however, remains the person at greatest risk of having septic pulmonary embolization develop. A clinical evaluation seeking drug abuse and related stigmata is extremely helpful in suggesting the proper cause, establishing the presence of right-sided endocarditis and directing appropriate therapy. Staphylococcus aureus is the most common offending organism in all patient populations except for the patient with thermal injury in which gram-negative organisms predominate. Early diagnosis and proper therapy, which includes high doses of parenteral antibiotics and control of the inciting septic focus in all instances, are prerequisites for a favorable outcome.
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PMID:Septic pulmonary embolization. 31 71

Cefoxitin was administered intravenously to 143 patients, 67% of whom were seriously ill. The rate of cure or improvement was 93%. The study was conducted in two phases; the first was an open, controlled clinical comparison of cefoxitin and cephalothin. In this phase, 28 patients received cefoxitin and 29 received cephalothin. In the second phase, cefoxitin alone was used for the treatment of an additional 115 patients. Twenty bacteremic patients treated with cefoxitin were cured or improved in 95% of cases. The infecting organism was eradicated in all bacteremic patients. All of 14 anaerobic or predominantly anaerobic infections were cured or improved. The infecting anaerobic organism was eliminated in 86% of the cases. Twenty-five patients infected by cephalothin-resistant, cefoxitin-susceptible gram-negative rods were cured. Three patients each with infective endocarditis and osteomyelitis were cured. The incidence of adverse experiences was: 1.4% drug eruption; 2% each asymptomatic serum transaminase elevation and leukopenia; and 2.5% asymptomatic eosinophilia. The incidence of severe thrombophlebitis was 5%. No permanent or serious adverse reactions were encountered. Although the numbers of patients in some categories were too small to permit statistical evaluation, I feel that cefoxitin may be a useful new antibiotic for treatment of infections caused by cehalothin-resistant bacteria and by anaerobic organisms.
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PMID:Results of a clinical trial of cefoxitin, a new cephamycin antibiotic. 33 68

A beta-haemolytic streptococcus was isolated from multiple blood cultures in a 56-year-old woman suffering from thrombophlebitis in a leg and from a 42-year-old man with endocarditis. Both strains were identified as group L streptococci by precipitation testing. Initially they were identified as group A streptococci on the basis of cultural characteristics, bacitracin sensitivity and fluorescent staining with an anti-group A conjugate. The two cases are an addition to the few existing reports on proved infection in humans by group L streptococci.
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PMID:Group L streptococci as the cause of bacteraemia and endocarditis. A case report. 39 75

Ceforanide, a new cephalosporin antibiotic with a long half-life (3 h), can be administered twice daily. We evaluated its antimicrobial activity, pharmacology, and clinical efficacy. Twenty-seven patients with infections due to susceptible organisms received ceforanide, 0.5, 1, or 2 g, intramuscularly or intravenously every 12 h for 6 to 28 days. In vitro studies with the clinical isolates from 27 patients treated plus 263 additional isolates showed that ceforanide was active against cephalothin-susceptible gram-positive and gram-negative microorganisms. In addition, ceforanide inhibited 65% of cephalothin-resistant Escherichia coli and 65% of Enterobacter spp. at </=12.5 mug/ml. After a single 1-g intramuscular dose, the mean peak plasma concentration at 1 h was 48.9 mug/ml and that at 12 h was 4.7 mug/ml. Plasma accumulation occurred in some patients. The infections included 10 pneumonias, 3 with bacteremia and 1 with empyema; 11 soft tissue infections, 4 with abscesses and 3 with sepsis; and 3 urinary tract infections. One case each of endocarditis, osteomyelitis, and septic thrombophlebitis, all due to Staphylococcus aureus, were treated. Clinical response was satisfactory in all patients; bacteriological response was satisfactory in 26 of 27 patients. Ceforanide was well tolerated. Three patients developed mild increases in liver enzymes, and one developed slight eosinophilia. In another case, the antibiotic was discontinued because of a fivefold rise in serum glutamic-oxalacetic transaminase (aspartate aminotransferase) and serum glutamic-pyruvic transaminase (alanine aminotransferase) and a twofold rise in lactic acid dehydrogenase and alkaline phosphatase.
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PMID:Ceforanide: in vitro and clinical evaluation. 50 95

Campylobacter fetus is a rare cause of endocarditis that is difficult to diagnose because of the fastidiousness of the organism. The source of infection is unknown and it may involve a normal or previously damaged aortic valve. The onset is insidious, and if there is a prior history of recent onset of fever, thrombophlebitis, and diarrhea, infection caused by this organism should be considered. Echocardiography may be useful. The organism is sensitive to a variety of antibiotics, including the combination of penicillin and streptomycin. The prognosis and survival are good.
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PMID:Gram-negative endocarditis caused by Campylobacter fetus. 70 8

Analysis of 182 patients with chronic disseminated intravascular coagulopathy and malignancy shows common features. Migratory thrombophlebitis occurred in 96 patients while at least a single episode of thrombophlebitis was noted in 113. Seventy-five of the patients bled and 45 had arterial emboli in various organs. Twelve patients had the triad of thrombophlebitis, hemorrhage, and arterial emboli, often sequentially. Hematologic data showed derangements associated with intravascular coagulation, the most prominent of which were hypofibrinogenemia and thrombocytopenia. Other abnormalities included prolonged prothrombin time, increased fibrinogen-fibrin degradation products, decreased levels of factors V and VIII, cryofibrinogenemia, and microangiopathic hemolytic anemia. Forty-one patients had lesions of non-bacterial thrombotic endocarditis at autopsy; 31 of these had arterial emboli during life. None of the lesions were infected. Mitral and aortic valves were most frequently involved. No single mechanism that causes the disseminated intravascular coagulopathy has been identified. However, cell products--secretions and enzymes--and the cells themselves have been proposed as the procoagulant(s) responsible for the syndrome. In addition to treatment of the underlying neoplasm, symptomatic disseminated intravascular coagulopathy should be controlled. Heparin is the drug of choice for treatment of this problem, very little benefit having been observed with warfarin therapy. Long-term use of anticoagulants is potentially feasible for control of chronic disseminated intravascular coagulopathy, but without effective control of the underlying tumor ultimately will be unsuccessful.
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PMID:Trousseau's syndrome and other manifestations of chronic disseminated coagulopathy in patients with neoplasms: clinical, pathophysiologic, and therapeutic features. 83 36

In a retrospective review of 53 patients, 58 episodes of infection due to Acinetobacter calcoaceticus var. anitratus (Herellea vaginicola) were studied. Although the organism is widely distributed in nature, it is of relatively low virulence since colonization is more frequently noted than infection and since most infections occur in patients subjected to the epidemiologic pressures common to nosocomial, gram-negative bacillary infection: prior antibiotic therapy; instrumentation and manipulation (e.g., endotracheal intubation, urinary bladder catheterization, arterial and venous cannulation); surgery; hospitalization, especially with residence in an intensive care unit; severe underlying disease, either systemic (e.g., chronic obstructive pulmonary disease, malignancy) or localized to the infected area (e.g., prior bacterial or aspirational pneumonia, trauma). Pneumonia was the most common infection due to A. calcoaceticus, and occurred only in patients with a tracheostomy or endotracheal tube in place. In over half the 25 patients, more than one lobe was involved and bronchopneumonia was the usual roentgenographic appearance. Cavitation (2 patients) and empyema formation (3 patients) were uncommon. The severity of acinetobacter pneumonia is reflected in the high mortality rate (44% overall, with a 36% mortality rate due primarily to infection). Tracheobronchitis due to A. calcoaceticus was less severe than pneumonia since no patients died primarily as a result of the infection. Urinary tract infections occurred in five patients, none of whom were ill and none of whom died. Urinary bladder catheterization was thought to be responsible for infection in three patients, and in at least four of the five patients infection was restricted to the lower tract. Wound infections were noted in six patients who had undergone surgery and were related to the presence of foreign bodies in the operative site in five of the patients. Surgical debridement and/or drainage of the infected area was the primary therapeutic measure employed in most cases. Only one patient died and this was a result of noninfectious causes. Skin infection due to A. calcoaceticus was seen in two patients, one of whom exhibited fulminant, fatal cellulitis and septicemia in the setting of pancytopenia. All nine patients with acinetobacter septicemia had received antecedent antibiotic therapy, and in all cases intravenous catheters were in place at the time bacteremia occurred. Clinically, seven of the nine patients were in shock. The mortality rate was 44% overall, with a 22% mortality rate due to infection. Although septicemia was thought to be "line-related" in five of the nine patients, serious post-bacteremic complications developed in three patients: prosthetic valve endocarditis, suppurative thrombophlebitis and subhepatic abscess.
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PMID:Infections with Acinetobacter calcoaceticus (Herellea vaginicola): clinical and laboratory studies. 84 90

Septic phlebitis is characterized clinically by a local syndrome in an arm, the chest or a leg, by an irregular temperature (toothsaw curve), by blood cultures that are simultaneously or successively positive for one or several pathogenic microorganisms, by repeated, multiple infected embolism and by the possibility of endocarditis as a complication. Septic phlebitis occurs either spontaneously (staphylococcosis, syndrome of angina pectoris and infarction), or through secondary infection by secondary microbial colonization of a thrombosis of gynecological or obstetrical origin or, thirdly, as the consequence of venous catheterization (perfusion, pacemaker, explorations). Prevention is based on the selection of the material (silastic piercing catheters), the choice of the site of injection, the observation of strict surgical asepsis and of choice of the fluid injected (no corticoids, nor heparin which inactivates the oligosaccharides). As regards the curative treatment, no use should be made either of heparin or of anti-inflammatory agents (especially no corticoids); first of all, the material that has caused the thrombophlebitis should be withdrawn immediately; secondly, 24 to 36 hours later, a specific antibiotic treatment should be instituted and after two weeks, if still necessary, surgical ligation may be carried out of the inferior vena cava, the subclavian vein or the brachiocephalic venous trunk, depending on the localization of the phlebitis.
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PMID:[Septic phlebitis. Its consequences and its treatment]. 86 44

As opposed to acute or subacute orificial localizations, suppurative parietal endocarditis is a very rare entity (5 cases in 3,900 autopsies). More readily localized in the left heart and being generators of systemic emboli, they remain latent until anatomically verified. Two circumstances promote their occurrence : the focal point caused by the mural thrombus of a recent myocardial infarction ; septicemic infections with pulmonary localization and neighbouring thrombophlebitis within the context of intense depression of immunity.
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PMID:[Suppurative parietal endocarditides]. 97 Aug


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