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

Of 13,913 patients examined at autopsy between 1939 and 1980, the diagnosis of nonbacterial thrombotic endocarditis (NBTE) was made in 99 instances. There were 53 males and 46 females ranging in age from 4 to 89 years. Vegetations were found on the aortic valve in 39; the mitral in 37; the tricuspid in nine; and the mitral in 37; the tricuspid in nine; and the pulmonic in two. Two-valve involvement was present in 12 cases. Malignant neoplasms were found in 42 autopsies. Embolism to the brain was found in 33 cases and to other organs in 62. Coagulation abnormalities were documented in 22 cases, and a distinct picture of disseminated intravascular coagulation of thrombophlebitis elsewhere in the body should arouse suspicion of NBTE. The high incidence of multiple emboli and its association with malignant neoplasms and with a variety of cardiovascular, pulmonary, renal, and gastrointestinal disorders should provide clues for recognition of this serious disorder.
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PMID:Nonbacterial thrombotic endocarditis. A neurologic perspective of clinicopathologic correlations of 99 patients. 705 7

Five cases of extra-intestinal Campylobacter fetus infections are described and an additional 242 cases are reviewed from the literature. A variety of clinical syndromes are encountered including endocarditis; thrombophlebitis; meningitis; pneumonia and pleuritis; and infectious arthritis. Thirty-eight per cent of patients presented with bacteremia enteritis. Campylobacter fetus demonstrates a preference for endovascular surfaces. The majority of patients are male and have an underlying illness. Mortality is increased in patients infected with C. fetus intestinalis. Therapy is based on in vitro antibiotic susceptibility tests although the organism is usually sensitive to an aminoglycoside and chloramphenicol.
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PMID:The clinical spectrum of Campylobacter fetus infections: report of five cases and review of the literature. 726 60

In patients admitted to the hospital with community-acquired pneumonia, intravenous antimicrobials can be safely switched to oral administration when the patient shows evidence of early clinical improvement. In our institution, patients are switched to oral antibiotics when: (A) cough and respiratory distress are improving, (B) patient is afebrile for at least 8 h, (C) the white blood cell count is returning toward normal, and (D) there is no evidence of abnormal gastrointestinal absorption. Patients with respiratory infections of unknown etiology are switched to an oral antibiotic with the same spectrum of activity as the intravenous empiric antibiotic. Combining our prospective clinical studies, we have patient outcome data for more than 150 patients admitted to the hospital with community-acquired pneumonia, who were treated with switch therapy. The clinical cure rate was 99.3%. The total hospital savings for 1994 based on the 80 patients with community-acquired pneumonia who were treated with switch therapy was $114,080. Discontinuation of intravenous lines will decrease the patient's risk for local cellulitis, abscess formation, septic thrombophlebitis, line sepsis, and endocarditis. The early hospital discharge associated with switch therapy will decrease the patient's risk for other nosocomial infections such as urinary or respiratory tract infections. Switch therapy is associated with a clinical cure rate that is equivalent to conventional therapy. In the area of cost-effective use of antibiotics, switch therapy should be considered as one of the primary options for health care cost containment.
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PMID:Switch therapy in community-acquired pneumonia. 758 43

A prospective, observational study of 110 patients with serious infections due to Enterococcus spp. in 6 university and community teaching hospitals in Connecticut was conducted to define the epidemiology of community and nosocomial serious enterococcal infections and to determine risk factors, including antibiotic resistances, that contribute to outcome. Serious community and nosocomial enterococcal infections involved a variety of sites, and antibiotic resistance was common. Types of infection by major organ system were cardiovascular, 54% (catheter-related bacteremia 28%, primary bacteremia 18%, endocarditis 6%, septic thrombophlebitis 1%); intra-abdominal, 13% (including cholangitis, 6%); renal, 13%; skin and soft tissue, 5%; bone and joint, 4%; pleuropulmonary, 4%; central nervous system, 3%; deep surgical wound, 3%; and endometritis, 2%. Sixty-one percent of infections were nosocomial; 48% of these occurred in the intensive care unit. Enterococcus faecium was responsible for 20% of all infections. Antibiotic resistances among the infections included high-level gentamicin resistance (26%), ampicillin resistance (10%), and vancomycin resistance (8%). Clinical cure was achieved in 64% of patients; 6.8% of patients relapsed, 6.8% had recurrence of the infection with a different pathogen, and overall mortality was 23%. Ampicillin resistance and a high acute physiology and chronic health evaluation (APACHE) II score were highly predictive of lack of cure.
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PMID:An analysis of 110 serious enterococcal infections. Epidemiology, antibiotic susceptibility, and outcome. 762 54

Mycotic aneurysm of the posterior tibial artery and pseudophlebitis: role of color Doppler sonography A case of a 78-year-old male patient presenting with endocarditis caused by Streptococcus bovis and pseudophlebitis of the left lower limb is described. Color Doppler sonography ruled out thrombophlebitis and showed a large pulsatile mass of the posterior compartment of the leg due to a mycotic aneurysm of the posterior tibial artery. This aneurysm was confirmed by angiography and treated by surgery. The important role of color Doppler sonography for the diagnosis of this particular case is emphasized.
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PMID:[Mycotic aneurysm of the posterior tibial artery and pseudo-phlebitis: contribution of color Doppler ultrasonography]. 774 55

A case of polypous endocarditis which affects the tricuspid valve and whose genesis remains unclear (a septic state, an idiopathic disease?) is described. Clinically the disease has taken its course as a chronically recurring form of pulmonary thromboembolism. Morphologically it concerns to a massive fibroplastic verrucous endocarditis of the tricuspid valve and a more slightly expressed similar process in the wall of the right atrium and ventricle, combined with a significant fibrosis of the myocardium. The death has come from a massive thrombotic embolism in the two branches of the pulmonary artery on the background of a great number of small thromboembolic and hemorrhagenic infarctions with a different duration in the two lobes of the lung, which lead to an adaptable reconstruction of many lung vessels. The presence of a discrete affection of the aortic valve according to a rheumatic type and the combination of the disease, in the described case, with essential hypertension and thrombophlebitis undergone in the past, give a reason to discuss the possibility of taking into account these diseases in etiopathogenesis of the described myocardiopathy.
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PMID:[Polypous endocarditis of the tricuspid valve. The morphological changes in the heart and lung in one case]. 780 19

Arterial and venous thrombotic occlusions, migrating thrombophlebitis, pulmonary artery branches embolism, abacterial thrombotic endocarditis, paradoxal hemorrhages, thrombotic microangiography arising in patients with various malignant tumours are understood under hemostasiologic paraneoplastic syndrome. The following factors are at the basis of paraneoplasia pathogenesis: 1) procoagulants synthesis by tumour cells, namely tissue factor and activators of blood coagulation factor X; 2) procoagulant activity of tumour-associated macrophages and their activity in the extra- and intravascular conversion of fibrinogen into fibrin; 3) damage of vascular endothelium by tumour cells and cytokines, for example necrotizing factor of tumours; 4) multifactorial enhancement of thrombocyte aggregational properties. According to the current concepts, such neoplastic phenomena as metastasizing, uncontrolled growth, escaping from immunological control, secondary tumour changes are viewed through the disturbances of hemostasiologic balance.
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PMID:[Thrombosis and embolism as paraneoplastic syndrome]. 784 15

We report two cases of Campylobacter fetus endocarditis. The first case involved a bicuspid native aortic valve in a 60-year-old woman, and the second involved a prosthetic aortic valve in a 76-year-old woman. No source of infection was identified in either case. Despite antibiotic therapy, hemodynamic deterioration necessitated valve replacement; both patients recovered completely. C. fetus is an uncommon cause of human infection but may be responsible for severe illnesses such as endocarditis and thrombophlebitis because of its tendency to attack the vascular endothelium. Review of the literature revealed 21 cases of endocarditis caused by this organism, usually involving the aortic valve. To our knowledge, there are only two reported cases of prosthetic valve endocarditis. Our second patient is the oldest one encountered so far with this condition.
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PMID:Campylobacter fetus endocarditis: two case reports and review. 801 32

Intravascular (IV) catheter sepsis is a widely recognized complication of IV therapy or monitoring, but little emphasis has been placed on the morbidity and cost associated with this infection. To assess the consequences of IV catheter sepsis, we examined the medical records of 94 patients with 102 episodes of IV catheter sepsis due to percutaneously inserted catheters. Major complications occurred in 33 (32%) of the episodes and included septic shock (12 episodes), sustained sepsis (12), suppurative thrombophlebitis (7), metastatic infection (5), endocarditis (2), and arteritis (2). One patient died due to sepsis, and hospital stay was clearly prolonged in 15 episodes. The risk of major complications was highest in episodes of IV catheter sepsis caused by Candida, Pseudomonas aeruginosa, Staphylococcus aureus, or multiple pathogens, and the most severe complications were usually caused by S. aureus. The hospital cost of IV catheter sepsis was assessed by reviewing medical and billing records to identify extra medical care and then multiplying charges for that care by the appropriate cost-to-charge ratio. The average cost per episode, adjusted to 1991 dollars, was $3,707 for all episodes and $6,064 for episodes caused by S. aureus. The morbidity and cost associated with IV catheter sepsis warrant substantial efforts to minimize the incidence of this complication and especially to prevent cases due to S. aureus.
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PMID:Consequences of intravascular catheter sepsis. 832 10

The use of various medical devices including indwelling vascular catheters, cardiac pacemakers, prosthetic heart valves, chronic ambulatory peritoneal dialysis catheters and prosthetic joints has greatly facilitated the management of serious medical and surgical illness. However, the successful development of synthetic materials and introduction of these artificial devices into various body systems has been accompanied by the ability of microorganism to adhere to these devices in the environment of biofilms that protect them from the activity of antimicrobial agents and from host defense mechanisms. A number of host, biomaterial and microbial factors are unique to the initiation, persistence and treatment failures of device-related infections. Intravascular catheters are the most common devices used in clinical practice and interactions associated with these devices are the leading cause of nosocomial bacteremias. The infections associated with these devices include insertion site infection, septic thrombophlebitis, septicemia, endocarditis and metastatic abscesses. Other important device-related infections include infections of vascular prostheses, intracardiac prostheses, total artificial hearts, indwelling urinary catheters, orthopedic prostheses, endotracheal tubes and extended wear lenses. The diagnosis and management of biofilm-associated infections remain difficult but critical issues. Appropriate antimicrobial therapy is often not effective in eradicating these infections and the removal of the device becomes necessary. Several improved diagnostic and therapeutic modalities have been reported in recent experimental studies. The clinical usefulness of these strategies remains to be determined.
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PMID:Biofilms in device-related infections. 851 69


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