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Query: UMLS:C0014118 (
endocarditis
)
15,629
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The aim of this study was to determine the causes of fever of unknown origin, to evaluate new diagnostic tests and to elucidate risk factors for chronic or life-threatening disorders. The medical records of 113 children who had undiagnosed fever for at least 3 weeks were reviewed. Infection (N = 41) was the most frequent cause of fever of unknown origin. Respiratory tract infections were the most common causes in infants and
endocarditis
and
tuberculosis
were more frequent in older children. Neoplastic disorders (N = 11) occurred in children older than one year. Juvenile rheumatoid arthritis (N = 9) was the most common collagen-vascular disorder (N = 15). Miscellaneous disorders and factitious fever occurred in 21 and 4 cases, respectively. Twenty-two patients remained undiagnosed. History and physical examination led to a final diagnosis in 81% of cases. Abdominal ultrasonography was performed in 71 patients (61%) and was helpful for diagnosis in 15%. Children with life-threatening or chronic disorders (N = 58) were older than those with self-limiting conditions (N = 55; P = 0.017). Cardiovascular and articular signs and symptoms were more frequent in the former group (P = 0.01).
...
PMID:Children with fever of unknown origin in Argentina: an analysis of 113 cases. 803 40
A 26-year-old man who had suffered from intermittent chills and fever over a two month period was quite clear of heart or kidney involved developed acute deterioration of renal function. A new pansystolic murmur over the apex of the heart was heard on auscultation, and echocardiography clearly showed a vegetation about 0.7-0.9 cm in size on the atrial site of the mitral value. Laboratory investigation displayed normochromic anemia with negative Coombs' test. Immunological studies were positive for rheumatoid factor and circulating immune complex. High serum levels of erythrocyte sedimentation rate and C-reactive protein, nephritic sediment of urinalysis and negative blood cultures for bacteria,
tuberculosis
or fungus were also noted. Abdominal sonography showed normal kidney size, bilaterally. Renal biopsy revealed typical crescentic glomerulonephritis. After intravenous penicillin therapy for two weeks, the serum creatinine level recovered from 6.7 mg/dl to 2.0 mg/dl and circulating immune complex disappeared. In consideration of cardiac insufficiency and the potential risk for complications of the vegetation, the patient underwent mitral valve replacement. Four weeks after operation, all the abnormal data had resolved completely. These data suggested that infective
endocarditis
with rapidly progressive glomerulonephritis is curable by antibiotic therapy and surgical intervention.
...
PMID:Infective endocarditis complicated with rapidly progressive glomerulonephritis: a case report. 880 7
Ageing of the immune system is a complex process involving both humoral and cell mediated immunity. Along with decline in immunity, morphological changes in various organ makes the elderly especially vulnerable to infection. In clinical practice, infections of respiratory tract and urinary tract,
endocarditis
, septicaemia and
tuberculosis
are commonly encountered in elderly subjects Atypical clinical presentation, slow response to treatment and high mortality are hall marks of infection in order patients. Antibiotic therapy in elderly needs to be early, empirical and broad spectrum through parenteral route, with early change over to oral therapy. Aminopenicillins and cephalosporins are safer drugs in old age as compared to aminoglycosides. Pneumococcal and influenza vaccines are recommended in elderly subjects with medical conditions with higher risk of mortality and complications.
...
PMID:Infections in the elderly. 936 61
Granulomas due to Mycobacterium
tuberculosis
are rarely observed in valvular structures. When observed, they are associated with disseminated
tuberculosis
in immunocompromised patients. We report the first case of tuberculous valvular
endocarditis
isolated in an immunocompetent patient. The patient had severe mitral valve regurgitation due to a perforation of the anterior leaflet of the mitral valve. M.
tuberculosis
was cultured from the vegetations and no other tuberculous foci were identified. This case exemplifies the protean manifestations of M.
tuberculosis
infections.
...
PMID:Valvular endocarditis due to Mycobacterium tuberculosis. 961 42
Splenomegaly was studied retrospectively at the University of California, San Francisco, School of Medicine, on all patients (N = 2,056) for the years 1913 to 1962. The patients were classified into several diagnostic groups, and these groups were tested for statistical significance (chi(2)) with many clinical and laboratory variables to determine their predictive value. Hematologic disorders were associated with 57% of cases of splenomegaly and 81% of cases of massive splenomegaly. Among patients with splenomegaly, 19% had infectious diseases, 11% had hepatic diseases, and 9% had congestive or inflammatory disorders. The residual 4% were considered to have primary splenic disorders or a disorder of unknown cause. The commonest diseases associated with splenomegaly were hematologic (acute and chronic leukemias), infectious (malaria,
endocarditis
, and
tuberculosis
), hepatic (chronic liver disease), congestive (congestive heart failure), inflammatory (thyrotoxicosis), and other (cancers not metastatic to the spleen). The diseases most frequently associated with massive splenomegaly were the chronic leukemias. The disease with the highest incidence of massive splenomegaly was myelofibrosis (23 of 29 patients, 78%). Splenectomy was performed in 154 patients (7%), primarily for hematologic amelioration and hepatic hypersplenism. Hematologic diseases showed significant associations with lymphadenopathy, generalized lymphadenopathy, massive splenomegaly, and cytoses (P .001) and with progressive splenic enlargement (P < .02). Infectious diseases showed significant association with fever, and hepatic diseases showed significant association with abnormal results of liver function tests (P < .001). The findings of this retrospective study should be validated prospectively.
...
PMID:Splenomegaly in 2,505 patients in a large university medical center from 1913 to 1995. 1913 to 1962: 2,056 patients. 973 88
Antimicrobial prophylaxis is used by clinicians for the prevention of numerous infections, including sexually transmitted diseases, human immunodeficiency virus infection,
tuberculosis
, rheumatic fever, recurrent cellulitis, meningococcal disease, recurrent uncomplicated urinary tract infections in women, spontaneous bacterial peritonitis in patients with cirrhosis, influenza, malaria, infective
endocarditis
, pertussis, plague, anthrax, early-onset group B streptococcal disease in neonates, and animal bite wounds. Certain opportunistic infections such as Pneumocystis carinii pneumonia in immunocompromised patients also can be effectively prevented with primary antimicrobial prophylaxis. Perioperative antimicrobial prophylaxis is recommended for various surgical procedures to prevent surgical site infection. Optimal antimicrobial agents for prophylaxis are bactericidal, nontoxic, inexpensive, and active against the typical pathogens that cause surgical site infection postoperatively. To maximize its effectiveness, intravenous perioperative prophylaxis should be given within 30 to 60 minutes before the time of surgical incision. Antibiotic prophylaxis should be of short duration to decrease toxicity, antimicrobial resistance, and excess cost.
...
PMID:Antimicrobial prophylaxis in adults. 1063 Jul 64
A 75 year old man was hospitalized because of rapid deterioration of his general condition, weight loss, night sweat and subfebrile temperature. The patient presented with severely reduced general condition, tachyarrythmia with previously known atrial fibrillation. Laboratory investigations revealed among others a moderately increased CRP-value, normal sedimentation rate and, initially, a normal white cell count. The differential diagnosis included neoplastic and infectious diseases (i.e.
endocarditis
,
tuberculosis
), endocrinopathies (i.e. thyreoditis) and general inflammatory or rheumatic diseases. An initially increased CMV-IgM-titer, a rising anti CMV IgG-titer and gradually developing atypical lymphocytosis in particular suggested diagnosis of severe CMV-infection. The diagnosis was confirmed by PCR positive for CMV-DNA in blood. The course of a CMV-primary infection may develop from asymptomatic infection over a mononucleosis-like syndrome to disseminated CMV-infection with multi organ involvement.
...
PMID:[75-year-old man with rapid deterioration of his general condition]. 1070 99
OBJECTIVE - To evaluate the cardiac abnormalities and their evolution during the course of the acquired immunodeficiency syndrome, as well as to correlate clinical and pathological data. METHODS - Twenty-one patients, admitted to the hospital with the diagnosis of acquired immunodeficiency syndrome, were prospectively studied and followed until their death. Age ranged from 19 to 42 years (17 males). ECG and echocardiogram were also obtained every six months. After death, macro- and microscopic examinations were also performed. RESULTS - The most frequent causes of referral to the hospital were: diarrhea or repeated pneumonias,
tuberculosis
, toxoplasmosis or Kaposi sarcoma. The most frequent findings were acute or chronic pericarditis (42%) and dilated cardiomyopathy (19%). Four patients died of cardiac problems: infective
endocarditis
, pericarditis with pericardial effusion, bacterial myocarditis and infection by Toxoplasma gondii. CONCLUSION - Severe cardiac abnormalities were the cause of death in some patients. In the majority of the patients, a good correlation existed between clinical and anatomical-pathological data. Cardiac evaluation was important to detect early manifestations and treat them accordingly, even in asymptomatic patients.
...
PMID:Cardiac abnormalities in the acquired immunodeficiency syndrome. A prospective study with a clinical-pathological correlation in twenty-one adult patients. 1075 83
A 79-year old woman, with a history of hypertension, presented with clinical features of congestive heart failure, fever, a purpuric rash, and left lower quadrant abdominal tenderness. Contrast computed tomography scan of the abdomen showed features of acute diverticulitis, and blood culture was subsequently positive for Klebsiella pneumoniae. Histological examination of a biopsy of the rash confirmed a diagnosis of leukocytoclastic vasculitis (LCV). The bacteremia responded to intravenous amoxycillin/clavulanic acid and gentamicin and the rash subsided. This case represents the first case of LCV complicating K. pneumoniae bacteremia in the English literature. The English literature on bacteria-associated LCV is reviewed. Taking aside organisms such as Rickettsia that cause endothelial invasion, the associated bacterial species tends to be subacute or chronic pathogens e.g. Mycoplasma pneumoniae, Mycobacterium
tuberculosis
, and Yersinia enterocolitica; or the disease process is of a subacute or chronic nature e.g.
endocarditis
, bronchiectesis, and cystic fibrosis, leading to prolonged exposure to pathogens that apparently cause acute pyogenic infections, such as K. pneumoniae.
...
PMID:Leukocytoclastic vasculitis complicating Klebsiella pneumoniae bacteremia. 1097 80
Subvalvular left ventricular aneurysms can be subaortic or submitral with variable etiology. This is a retrospective study of 19 subvalvular aneurysms seen in 16 cases. There were 12 isolated subaortic aneurysms, 3 isolated submitral aneurysms, and in 1 case with multiple subaortic and submitral aneurysms. Subaortic aneurysms were associated with infective
endocarditis
, while there seems to be a strong association between submitral aneurysms and
tuberculosis
. Five cases of subvalvular aneurysm has associated aneurysm sinus of Valsalva-this association suggests a congenital weakness in the attachment of aortic and mitral annuli to the underlying myocardium. Cardio Pathol 2000;9:267-271
...
PMID:Subvalvular left ventricular aneurysms. 1106 73
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