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

A 75-year-old man suffered from suppurative thrombophlebitis as a complication of a peripheral venous catheter (1.2 x 45 mm Teflon). In spite of rapid removal of the catheter at the time of clinical diagnosis of phlebitis and adequate antibiotic treatment, the Staphylococcus aureus sepsis developed into lethal endocarditis. The risk of thrombophlebitis can be minimized by limiting (less than 72 hours) the duration of cannulation. If pus is detected within the lumen of the vein, surgical excision of the involved vein remains the treatment of choice.
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PMID:[Fatal peripheral catheter phlebitis]. 341 65

Four cases of purulent complications in the heart following acute myocardial infarction are described. Fever occurred during the first week after coronary occlusion. In one case thrombophlebitis at an infusion site was followed by purulent pericarditis. One patient had an infected mural thrombus with peripheral septic embolic, and two suffered from streptococcal endocarditis. The association between these infections and recent acute myocardial infarction could be related to tissue necrosis and local thrombosis, but the increasing risk of bacteremia following invasive monitoring procedures in these patients is a risk factor that should not be ignored.
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PMID:Infectious complications of acute myocardial infarction. 363 60

A 28-year-old woman developed thrombophlebitis migrans and right hemiparesis with motor aphasia. Chest X-ray revealed a plum-sized central infiltrate in the right lower lobe of the lung. Transbronchial lung biopsy showed bronchoalveolar carcinoma. Subsequently recurrent cerebral infarcts developed from which the patient died. Autopsy revealed nonbacterial thrombotic endocarditis as the cause of the cerebral infarcts. This form of endocarditis is characterized by the parallel occurrence of arterial emboli and thromboses of the superficial and deep veins. It develops in association with various diseases, especially malignant tumors, and is an expression of a generalized thrombosis disposition.
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PMID:[Recurrent cerebral emboli in nonbacterial thrombotic endocarditis]. 367 75

The characteristics features of right-sided endocarditis are summarized in this case report of a 30-year-old female admitted with a history of high grade, continuous, fever, breathlessness, and dry cough over a 10-day period. The patient had had an incomplete abortion 15 days earlier for which dilatation and curettage was performed. On examination, the patient was toxic, febrile with a pulse of 118/minute and respiration 36/minute. Her blood pressure was 110/70 mm Hg. There was soft, tender hepatomegaly and soft splenomegely. There also were scattered coarse crepitations over both lungs. The vaginal examination revealed posterior fornicial bogginess and tenderness. Urine and cervical pus swab showed growth of klebsiella. The blood culture was negative. A plan chest X-ray revealed multiple, small, basal, pulmonary infiltrates. Posterior colopuncture revealed a small quantity of clear, yellowish fluid. Abdominopelvic ultrasonography revealed an ill-defined haziness in the parauterine region. The patient was treated with ampicillin, gentamycin, and metronidazole, but she continued to deteriorate. An urgent exploratory laparotomy was performed. The patient died on the 2nd postoperative day. The autopsy findings revealed that the heart was normal in size and shape. The tricuspid valve showed a large vegetation projecting into the ventricle. Microscopic examination revealed polymorphonuclear infiltration with clumps of gram-negative bacillifocal areas of myocarditis also were seen. In lungs the right lower lobe showed a small, hemorrhagic infarct. Both the liver and spleen were congested. Kidneys showed multiple petechiae on the external surface and on the cut section. Endocarditis during pregnancy may be because of perinatal infections, urinary tract infection, or septic thrombophlebitis of pelvi veins. Septic abortion of pelvic infection secondary to IUD also can provide portal of entry for bacteria. The common organisms are streptococcus, staphylococci, and occasionally bacteroides and gram negative bacilli. Clinical suspicion of right-sided endocarditis is justified in any patient with prolonged fever, cough, pleuritic pain, tachycardia, and multiple pulmonary infiltrates. Heart murmurs are usually absent and if present are soft and may be heard at atypical sites.
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PMID:Tricuspid valve endocarditis following septic abortion. 371 Oct 12

For one year all narcotic addicts admitted to the Detroit Medical Center with infectious endocarditis (74 cases) were compared with a control group of bacteremic addicts who had other infections (106 cases). Endocarditis was caused by Staphylococcus aureus (60.8% of cases), streptococci (16.2%), Pseudomonas aeruginosa (13.5%), mixed bacteria (8.1%), and Corynebacterium JK (1.4%). S. aureus endocarditis most frequently involved the tricuspid valve; streptococci infected left-sided valves significantly more often than other organisms (P = .001). Biventricular and multiple-valve infections were commonest in patients with pseudomonas endocarditis (P = .05). Two-dimensional echocardiography, when combined with an abnormal chest roentgenogram, was highly predictive of endocarditis. Bacteremia in the absence of endocarditis was associated with primary skin and soft tissue infection, mycotic aneurysm at the site of narcotic injection, septic arthritis, septic thrombophlebitis, pneumonia, osteomyelitis, mediastinal abscess, and unclassified infection. Polymicrobial bacteremia in the nonendocarditis group was associated with markedly increased morbidity. Mild hyponatremia occurred in 41% of all patients and was also associated with significantly increased morbidity. Analysis of the two groups disclosed similarities and differences with implications for the pathophysiology and treatment of addicts with bacteremic infection.
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PMID:Bacteremia in narcotic addicts at the Detroit Medical Center. II. Infectious endocarditis: a prospective comparative study. 375 55

Imipenem/cilastatin is the first of a new class of beta-lactam antibiotics called carbapenems. The antibacterial spectrum of imipenem exceeds any antibiotic investigated to date and includes gram-positive, gram-negative, and anaerobic organisms. Only methicillin-resistant organisms, Strep. faecium, Pseudomonas cepacia, and Pseudomonas maltophilia have been shown to be resistant. Imipenem is administered in a 1:1 ratio with cilastatin, which inhibits a renal enzyme (dehydropeptidase) and improves urinary recovery of imipenem. The elimination half-life of both compounds is 1.0 hours and recommended doses are 0.25-0.5 g iv q6h. Adverse events are similar in nature and incidence to beta-lactam antibiotics, with phlebitis/thrombophlebitis, diarrhea, nausea, skin rash, and elevations of hepatic enzymes most common. Clinical studies in phase II and III trials have shown imipenem/cilastatin to be effective in soft tissue infections, endocarditis, obstetrics and gynecology, complicated urinary tract infections, mixed anaerobic-aerobic infections, osteomyelitis, bacteremias, and pneumonias. Several comparative clinical trials have shown imipenem/cilastatin to be equal in efficacy to combination therapy. Imipenem/cilastatin may prove to be an alternative to combination antibiotic therapy because of its extremely broad spectrum of activity.
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PMID:Imipenem/cilastatin: the first carbapenem antibiotic. 391 Mar 85

23 postabortion and 4 postpartum patients who developed septicemia were treated in the Hospital Claude-Bernard, Paris from 1961-1972. These could be distinguished easily from cases of infectious shock because the disease developed over several days or weeks; only 1 patient had both shock and secondary staphylococcal septicemia. All infections were provoked by intrauterine manipulation, such as induced abortion, as sisted delivery, or cesarean section. Organisms cultured were usually staphylococcus (46%), Ristella pseudoinsolita (26%), or enteric organisms (30%); streptococcus was totally absent. Clinical signs were variable, described at length in pelvic, pulmonary, and cardiac categories. 2 women died of endocarditis and of renal thrombosis; 4 were cured by antibiotics only; the rest had surgery. 13 had thrombophlebitis, 5 had no venous lesion, 3 had infectious lesions such as retained placenta and a ruptured uterus. Antibiotics were continued 2 weeks after fever abated. Exploratory surgery in case of persistently positive culture or clinical thrombophlebitis resulted in 16 hysterectom ies, 16 salpingectomies, 16 venous ligatures, and 3 prosthetic cardiac valves in 24 operations in 22 patients. The authors urged that antibiotic therapy be thorough and based on cultured organisms.
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PMID:[Post-abortion and post-partum septico-pyemia. Apropos of 27 cases]. 472 Apr 14

Cefazolin sodium was tested in vitro against 308 isolates of Enterobacteriaceae, Pseudomonas aeruginosa, Neisseria meningitidis, Haemophilus influenzae, Staphylococcus aureus, and enterococcus. Broth and agar dilution and disk diffusion techniques were used with at least two sizes of inocula of organisms. Cefazolin was also studied in the treatment of 85 hospitalized patients with a variety of serious infections. In concentations of 5 mug or less/ml, cefazolin inhibited and killed more than 90% of isolates of Enterobacteriaceae with the exception of indole-positive Proteus and Enterobacter species. No isolate of P. aeruginosa and only a few of Enterobacter and enterococci were killed by 25 mug of cefazolin/ml, a concentration readily attainable in serum with a 500-mg dose given intramuscularly. Penicillin-susceptible as well as penicillin-resistant isolates of S. aureus were killed by 1 mug or less of cefazolin per ml; however, 25 mug/ml was required to kill 100% of the strains when the inoculum size was increased 100-fold. Cefazolin treatment appeared effective in 82 of 85 patients, including four with endocarditis. Pain was minimal after intramuscular injection, and thrombophlebitis was not observed in those treated intravenously. No patient developed a positive Coombs test, and no evidence of renal toxicity was apparent in clinical studies.
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PMID:Evaluation of cefazolin, a new cephalosporin antibiotic. 479 Jun 5

Anaerobic septicaemia is often a complication of preexisting anaerobic sepsis which is commonly a complication of surgical interference. The predominant anaerobic bacterial isolate in septicaemia if Bacteroides fragilis. Anaerobic cocci and clostridia are not infrequently found as causes of septicaemia. The incidence of polymicrobial septicaemia varies in the different reports. The clinical features of septicaemia due to anaerobic Gram-negative rods vary little from those due to facultative anaerobic Gram-negative rods. The entry portal of bacteroides and clostridia is the gastrointestinal tract and the female genital tract. The portal of entry of anaerobic cocci is the respiratory tract. Anaerobic septicaemia include a high incidence of jaundice, septic thrombophlebitis and metastatic abscess formation. When appropriate antibacterial agents are used for the treatment of anaerobic septicaemia, a mortality rate of 10% is seen while in the absence of treatment the mortality is high, 60-80%. Anaerobic bacteria is an uncommon but important cause of endocarditis. Most cases of anaerobic endocarditis are caused by anaerobic cocci, Propionibacterium acnes and B. fragilis. Predisposing factors and signs and symptoms of endocarditis caused by anaerobic bacteria are similar to those seen in endocarditis with facultative anaerobic bacteria with the following exceptions. There is a lower incidence of preexisting valvular heart disease, a higher incidence of thromboemboli events and a higher mortality rate with anaerobic endocarditis. The article is a review of our present knowledge of the normal anaerobic human microflora in relation to development of septicaemia and endocarditis, virulence factors in anaerobic bacteria, antibiotic susceptibility patterns of anaerobic bacteria and clinical findings in patients with anaerobic septicaemia respectively endocarditis.
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PMID:Anaerobic bacteria in septicaemia and endocarditis. 695 40

Fusobacterium necrophorum septicemia developed in five patients after an oropharyngeal infection. Four patients had sore throat or neck pain, and two had findings of jugular vein septic thrombophlebitis. Metastatic abscesses, including embolic pneumonia, empyema, septic arthritis, and osteomyelitis, also occurred. Four patients recovered and one died. Proper treatment requires recognition of the oropharyngeal source of the septicemia and its differentiation from endocarditis. Antibiotic therapy should be prolonged, and metastatic abscesses drained.
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PMID:Fusobacterium necrophorum septicemia following oropharyngeal infection. 695 28


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