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

Yersinia entercolitica endocarditis has rarely been described before. This is the first report of prosthetic valve Yersinia enterocolitis endocarditis, complicated by infected brain embolization. The patient, however, completely recovered after 6 weeks of combined therapy with ceftriaxone and gentamicin.
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PMID:Yersinia enterocolitica endocarditis on a prosthetic valve. 148 May 43

Septicemia is a rare but serious complication of infection with Yersinia enterocolitica (Y.e.). Seven cases of Y.e. septicemia are presented. Five of the patients had no underlying disease predisposing to septicemia. Five patients displayed recurrent episodes of septicemia, despite treatment with recommended doses of antibiotics to which the isolates were sensitive in vitro. One patient developed endocarditis which required surgical replacement of the aortic valve. Other clinical manifestations were arthritis, diverticulitis and pulmonary abscesses. The outcome was fatal to 3 elderly patients. The serological response to Y.e. was followed by tube agglutination and a diffusion-in-gel enzyme-linked immunosorbent assay. One patient, with a benign course of illness, had transient elevated Y.e. antibody titres, while the 3 cases with a protracted disease showed sustained antibody responses for 6-18 months. Blood isolates of Y.e. had ordinary virulence characteristics identical to fecal isolates and produced extracellular beta-lactamase. All isolates were sensitive in vitro to trimethoprim-sulfamethoxazole, mecillinam, piperacillin, cefotaxime, ceftazidime, chloramphenicol and gentamicin. The lowest MIC values were recorded for mecillinam. Full synergistic activity was demonstrated when mecillinam was combined with trimethoprim-sulfamethoxazole, cefuroxime or rifampicin.
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PMID:Yersinia enterocolitica septicemia: clinical and microbiological aspects. 353 2

A patient with Yersinia enterocolitica endocarditis was seen with bacteremia, valvular vegetation, new heart murmur, and septic embolism. To our knowledge, this is the first reported case of Y enterocolitica infectious endocarditis and is yet another clinical manifestation of disease produced by this organism.
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PMID:Yersinia enterocolitica endocarditis. 663 36

Infections of the cardiovascular system, besides involving both natural and prosthetic heart valves, vascular grafts, and indwelling venous and arterial cannulas, may cause mycotic aneurysms. The latter frequently complicate endocarditis; however, they may occur as isolated phenomena. Enterobacteriaceae are uncommon etiologic agents in vascular infections; however, a patient is reported who presented initially with a bacteremia due to Yersinia enterocolitica biogroup 4 and despite antimicrobial therapy developed a mycotic aneurysm of the left internal carotid artery. Clinical manifestations, pathogenesis, and treatment of yersiniosis are reviewed.
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PMID:Mycotic aneurysm due to Yersinia enterocolitica. 689 58

Endocarditis is a rare manifestation of Yersinia enterocolitica infection. The case of a 45-year-old man who presented with high fever and in whom prosthetic valve Yersinia enterocolitica endocarditis was diagnosed is described. The patient was successfully treated with ceftriaxone plus tobramycin, as proved by negative cultures of the prosthesis removed at the end of therapy. Including the patient reported, only 12 cases of Yersinia enterocolitica endocarditis have been published to date, two of which describe prosthetic cardiac valve endocarditis. The clinical characteristics do not distinguish septicemia from involvement limited to the cardiac valves. Diagnosis, however, has been improved by progress in echocardiography. Prognosis is grave but can be ameliorated if appropriate antimicrobial agents are administered, i.e. the combination of a third-generation cephalosporin plus an aminoglycoside. Fluroquinolones may also constitute an attractive therapeutic alternative.
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PMID:Yersinia enterocolitica endocarditis: case report and literature review. 775 78

Yersinia enterocolitica is a gram negative bacillus that emerged in the past two decades as an important enteric pathogen associated with a wide spectrum of clinical manifestations. The authors present a seroepidemiological survey, in 200 hospitalized patients, and describe three curious case reports of this infection, including a serious case of endocarditis.
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PMID:[Yersinia enterocolitica. A seroprevalence study and report of 3 clinical cases]. 833 56

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.
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PMID:Leukocytoclastic vasculitis complicating Klebsiella pneumoniae bacteremia. 1097 80

The gram-negative coccobacillus, Actinobacillus actinomycetemcomitans, is the putative agent for localized juvenile periodontitis, a particularly destructive form of periodontal disease in adolescents. This bacterium has also been isolated from a variety of other infections, notably endocarditis. Fresh clinical isolates of A. actinomycetemcomitans form tenacious biofilms, a property likely to be critical for colonization of teeth and other surfaces. Here we report the identification of a locus of seven genes required for nonspecific adherence of A. actinomycetemcomitans to surfaces. The recently developed transposon IS903phikan was used to isolate mutants of the rough clinical isolate CU1000 that are defective in tight adherence to surfaces (Tad(-)). Unlike wild-type cells, Tad(-) mutant cells adhere poorly to surfaces, fail to form large autoaggregates, and lack long, bundled fibrils. Nucleotide sequencing and genetic complementation analysis revealed a 6.7-kb region of the genome with seven adjacent genes (tadABCDEFG) required for tight adherence. The predicted TadA polypeptide is similar to VirB11, an ATPase involved in macromolecular transport. The predicted amino acid sequences of the other Tad polypeptides indicate membrane localization but no obvious functions. We suggest that the tad genes are involved in secretion of factors required for tight adherence of A. actinomycetemcomitans. Remarkably, complete and highly conserved tad gene clusters are present in the genomes of the bubonic plague bacillus Yersinia pestis and the human and animal pathogen Pasteurella multocida. Partial tad loci also occur in strikingly diverse Bacteria and Archaea. Our results show that the tad genes are required for tight adherence of A. actinomycetemcomitans to surfaces and are therefore likely to be essential for colonization and pathogenesis. The occurrence of similar genes in a wide array of microorganisms indicates that they have important functions. We propose that tad-like genes have a significant role in microbial colonization.
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PMID:Nonspecific adherence by Actinobacillus actinomycetemcomitans requires genes widespread in bacteria and archaea. 1102 39

The etiologic diagnosis of infective endocarditis is easily made in the presence of continuous bacteremia with gram-positive cocci. However, the blood culture may contain a bacterium rarely associated with endocarditis, such as Lactobacillus spp., Klebsiella spp., or nontoxigenic Corynebacterium, Salmonella, Gemella, Campylobacter, Aeromonas, Yersinia, Nocardia, Pasteurella, Listeria, or Erysipelothrix spp., that requires further investigation to establish the relationship with endocarditis, or the blood culture may be uninformative despite a supportive clinical evaluation. In the latter case, the etiologic agents are either fastidious extracellular or intracellular bacteria. Fastidious extracellular bacteria such as Abiotrophia, HACEK group bacteria, Clostridium, Brucella, Legionella, Mycobacterium, and Bartonella spp. need supplemented media, prolonged incubation time, and special culture conditions. Intracellular bacteria such as Coxiella burnetii cannot be isolated routinely. The two most prevalent etiologic agents of culture-negative endocarditis are C. burnetti and Bartonella spp. Their diagnosis is usually carried out serologically. A systemic pathologic examination of excised heart valves including periodic acid-Schiff (PAS) staining and molecular methods has allowed the identification of Whipple's bacillus endocarditis. Pathologic examination of the valve using special staining, such as Warthin-Starry, Gimenez, and PAS, and broad-spectrum PCR should be performed systematically when no etiologic diagnosis is evident through routine laboratory evaluation.
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PMID:Endocarditis due to rare and fastidious bacteria. 1114 9

Intermittent fever is rare during the course of infectious diseases but it represents a diagnostic and therapeutic challenge. The most frequent infectious causes of intermittent fever are focal bacterial infections, mainly infections localised to canals like urinary or biliary ducts or the colon and also infections of a foreign material. Other causes are less frequent, like infective endocarditis, tuberculosis, infections due to Yersinia enterocolitica or malaria, or exceptional like borreliosis, ratbite fever, chronic meningococcemia or chronic Epstein-Barr Virus infection. Careful anamnesis and clinical examination as well as a few simple complementary investigations, preferably performed during a febrile episode, are often sufficient to set the limits of possible further more complex investigations.
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PMID:[Intermittent fever of infectious origin]. 1191 56


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