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

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

A 26-year-old male with fungal aortic endocarditis is presented in whom unique M-mode and two-dimensional echocardiographic findings permitted a diagnosis of mycotic aneurysm of right sinus of Valsalva and ventricular septal abscess preoperatively. The aneurysm was excised, and the affected aortic and tricuspid valves were replaced with valve prostheses.
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PMID:Fungal endocarditis complicated by mycotic aneurysm of sinus of Valsalva, interventricular septal abscess, and infectious pericarditis: unique M-mode and two-dimensional echocardiographic findings. 689 13

A case of common iliac mycotic aneurysm that presumably developed secondary to Klebsiella endocarditis was described. Recently, reports on gram negative septicemia and endocarditis have been on the increase. However, mycotic aneurysms secondary to bacterial endocarditis and particularly to Klebsiella endocarditis are rare. Inadequately treated serious gram negative septicemias have a high mortality rate. Early diagnosis and adequate combination chemotherapy with prompt surgical intervention were proven to be important factors in the successful management of such a complication.
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PMID:Successful management of iliac mycotic aneurysm secondary to Klebsiella endocarditis--report of a case. 689 92

One hundred and thirty patients at our Heart Institute with infectious endocarditis during the past 5 years were reviewed to provide an overview of the spectrum of infective endocarditis and to assess the accuracy of echocardiography in detecting the infective valvular and endocardial lesions. Of the 130 patients, 36 (28%) had the previous cardiovascular surgery. The mean age of the patients was 34 years, and only 11% of the patients were over 50 years of age. Of the 94 patients who had no cardiovascular surgery before developing infective endocarditis, 6 underwent urgent surgery, 49 had elective surgery and the remaining 39 were followed up with medical treatment. The mortality rate of the 55 patients who were operated on was 5.5% as against 18.0% in 39 without surgery. Half of the 36 patients who had been operated on before developing endocarditis had prosthetic valves inserted. Of the 5 patients with bioprosthetic valve endocarditis, only one survived as a result of prompt medical and surgical treatment. Streptococci were still commonly found, about 75% in the group without surgery and 50% in the group with surgery. Gram-negative bacilli and fungi were found in patients with prosthetic valve endocarditis. In 61 patients, morphologic abnormalities confirmed at surgery or necropsy were compared with the preoperative echocardiograms. Vegetations were identified preoperatively in 50 (95%) of the 53 valves involved, and valve destruction was correctly predicted in all 23 cases. Mycotic aneurysm was detected preoperatively in only 3 of the 12 patients in whom it occurred. Thirteen patients, in whom vegetation was recorded, were treated successfully with antibiotics alone and they needed no surgical intervention during the 2-year follow up period. The presence of a vegetation in an echocardiography does not necessarily require surgical intervention in itself or predict the ultimate course.
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PMID:Spectrum of the infective endocarditis in the past five years. 689 50

This is a case report of management of a delayed mycotic superior mesenteric artery aneurysm occurring in a patient 2 years after aortic valve replacement for endocarditis. A chronic ulcer history, anticoagulation therapy, episodic gastrointestinal bleeding associated with negative gastrointestinal series, and gastritis seen at endoscopy delayed the ultimate diagnosis. An episode of massive hemorrhage precipitated angiography with subsequent surgical confirmation of the diagnosis. Management included debridement and extirpation of the major part of the aneurysm, Doppler assessment of the inadequacy of collateral mesenteric arterial blood flow, and restoration of flow with a bypassing saphenous vein graft segment. Although this technique of reconstruction has been suggested, we can find no other report of such a similar case among the few reported surgical successes with superior mesenteric artery mycotic aneurysm.
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PMID:Gastrointestinal bleeding and mycotic superior mesenteric aneurysm. 697 9

A man with stenosis of the aortic valve acquired endocarditis after abdominal surgery. Klebsiella pneumoniae and Acinetobacter calcoaceticus were cultured from his blood. The blood cultures remained positive despite intravenous gentamicin and cephalothin to which the organisms were sensitive in vitro. Ultimately, the blood was sterilized by a combination of gentamicin and trimethoprim-sulfamethoxazole taken orally. The course of the patient was complicated by cardiac arrest and pericardial tamponade caused by a valve ring abscess and a dissecting mycotic aneurysm of the coronary sinus of Valsalva. Aortic valve replacement and right coronary artery bypass were performed. A prolonged course of trimethoprim-sulfamethoxazole was given postoperatively, and the patient has had no evidence of recurrent infection after five years. Trimethoprim-sulfamethoxazole, in combination with other antibiotics, has been successfully used to treat other patients with bacterial endocarditis and thus may be an alternative for patients in whom conventional therapy has failed.
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PMID:Trimethoprim-sulfamethoxazole therapy for infective endocarditis. 702 18

The authors report a case of bacterial intracranial aneurysm associated with infective endocarditis. A 48-year-old male was admitted on March 26, 1994, with complaints of difficulty in speaking and mild swelling of the right leg following mild fever. On examination he showed motor aphasia and mild weakness of the right upper and lower limbs. Cardiac auscultation revealed a grade 3/6 holosystolic murmur. Laboratory data revealed signs of infection through white blood cell count and CRP. Enterococcus faecalis was isolated from the blood culture at the time of admission. A computerized tomographic (CT) scan and magnetic resonance (MR) imaging showed a round mass with perifocal edema. Angiography revealed an aneurysm from the precentral artery of the left middle cerebral artery. A mycotic aneurysm due to bacterial endocarditis was diagnosed. The patient was treated with high doses of antibiotics. However, angiography 2 weeks after the initial study demonstrated the enlargement of the aneurysm and severe narrowing of the angular artery. On April 19, excision of the aneurysm was performed. Operative findings showed degeneration and thickening of the walls of the aneurysm. After the operation, antibiotic therapy was continued. The patient was asymptomatic upon discharge and has continued to do well. Repeated angiography on September 12 showed no further aneurysm. There is a danger of rupture in mycotic aneurysm due to bacterial endocarditis. It is important to repeat angiography and to manage the primary disease. If an aneurysm enlarges with serial angiography, it should be treated surgically without further delay.
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PMID:[Bacterial intracranial aneurysm associated with infective endocarditis: a case showing enlargement of aneurysm size]. 747 21

A 11 years-old male child, with supravalvar aortic stenosis who had as complications aortic endarteritis and mycotic aneurysm formation in the ascending aorta. The aneurysms were diagnosed by a control echocardiogram at the end of an apparently successful clinical treatment of endocarditis. Angiography confirmed the diagnosis and the aneurysms were surgically resected. Six months after surgery the patient is doing well.
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PMID:[Supravalvar aortic stenosis complicated by aortic endarteritis and formation of mycotic aneurysm]. 761 16

Prosthetic valve endocarditis is still a very serious complication, carrying an incidence of death between 30 and 70% in some series. Therefore early and accurate diagnosis is crucial. Early (less than 60 days post surgery) endocarditis is usually a fulminant disease, where staphylococcal infection is most common. Late prosthetic endocarditis resembles more closely other forms of the disease. Conventional echocardiography is useful in the evaluation of prosthetic valve function, but it is very limited in the demonstration of infective lesions, primarily because of acoustic shadowing. Transoesophageal echocardiography (TE) enables high resolution imaging of the heart without chest wall interference, and viewing of the heart from the posterior (atrial, low pressure) side, where most of the vegetations are expected to be found in both mitral and tricuspid positions. It also enables better visualization of the left ventricular outflow tract, where aortic prosthetic vegetations tend to be present. Furthermore, transoesophageal echocardiography allows accurate diagnosis of some of the common complications of endocarditis: abscess/cavity formation; mycotic aneurysm; prosthetic valve dehiscence and regurgitation. In spite of these advantages, limitations should be recognized. Struts are commonly seen on transoesophageal echocardiography following surgery and should not be confused with vegetations. Similarly, normal prosthetic regurgitation should not be confused with paravalvar leakage. Nevertheless, transoesophageal echocardiography, when expertly used, changes the possibility for early and more accurate diagnosis of prosthetic valve endocarditis dramatically. Transoesophageal echocardiography should be included among the major criteria in the diagnosis and follow-up of prosthetic valve endocarditis.
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PMID:Echocardiographic assessment of prosthetic valve endocarditis. 767 26

Acute valvular obstruction caused by vegetation is a rare complication infective endocarditis. To our knowledge, only 9 cases and an autopsy case by Roberts have been reported since 1967. A 46-year-old man admitted with a chief complaint of pyrexia for 2 months duration. Within 24 hours of admission, the patient noticed of increased shortness of breath. Physical examination and the chest X-ray confirmed the pulmonary edema. An echocardiogram revealed a huge echogenic mass that was adherent to the mitral leaflet and obstructed the orifice completely. Soon after the patient fell into cardiogenic shock, an emergency mitral valve replacement was undertaken. At operation, multiple verrucae arising from the entire mitral leaflet was seen to occlude the orifice. The vegetation was excised and replaced with a # 25 Omnicarbon prosthesis. Postoperatively, the patient developed multiple organ failure caused by cardiogenic and septic shock which responded well to intensive medical treatment consisting of hemodialysis and continuous arteriovenous hemofiltration. Angiographically, a mycotic aneurysm in the left radial artery was found on the 18th postoperative day. After extirpation of the infective focuses, the postoperative course had stabilized. Mitral obstruction due to infective endocarditis is a fatal disease. Prompt diagnosis with echocardiogram and an emergency surgery should be undertaken to save the patient.
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PMID:[Mitral obstruction due to infective endocarditis: a case report]. 771 14


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