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

Intracranial mycotic aneurysm is a rare complication in patients with infective endocarditis occurring in about 2% to 10% of cases. Although the risk of rupture is about 1.7%, it is usually a catastrophic event with a fatality rate of 80%. Neurological deficits secondary to cortical involvement are common, given the frequency of intralobar hemorrhage. We report two cases of intracerebral hemorrhage caused by ruptured intracranial mycotic aneurysms. Both had involvement of the right frontoparietal lobes with resultant left hemiparesis, left homonymous hemianopia, and impairments of cognition and perceptual function. Despite intensive rehabilitation, their functional outcomes were less than satisfactory as they needed assistance in self-care activities and mobility on discharge.
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PMID:Ruptured intracranial mycotic aneurysm: a rare cause of intracranial hemorrhage. 771 25

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 51-year-old woman was referred to our institute for surgical treatment from an other hospital where she was diagnosed as having a mycotic aneurysm located at the aortic annulus due to infective endocarditis. The aneurysm communicated with the left ventricle, with aortic stenosis and regurgitation, mitral stenosis and tricuspid regurgitation caused by rheumatic fever. On admission to our institute, the infective endocarditis was at the healed stage. The mycotic aneurysm was located at the aortic annulus of the right coronary cusp, and was closed using a prosthetic patch with mattress sutures. Aortic valve replacement with a 19-mm St. Jude Medical prosthesis was then performed on this patch. The mitral and tricuspid valves were also replaced with 27-mm and 29-mm St. Jude Medical prostheses, respectively. The patient is doing well 1 year after surgery.
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PMID:[Surgical treatment of aortico-left ventricular communication due to infective endocarditis]. 776 44

Mycotic aneurysm is usually found in the middle cerebral artery associated with infective endocarditis. Previous reports we have identified include only 4 cases of vertebrobasilar aneurysm. We report on a 29-year-old female who had multiple mycotic aneurysms involving both the carotid and vertebrobasilar systems complicated by intracranial hemorrhage with infective endocarditis, in whom staged operations, mitral valve replacement and craniotomies, were successfully performed.
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PMID:Successful surgical management for multiple cerebral mycotic aneurysms involving both carotid and vertebrobasilar systems in active infective endocarditis. 781 87

An intracranial mycotic aneurysm developed in a 35-year-old woman with endocarditis, caused by Cardiobacterium hominis, around a prosthetic valve. This type of aneurysm is a rare, life-threatening entity, and C. hominis is extremely uncommon as the causative agent. The pathogenesis and monitoring of intracranial mycotic aneurysm are discussed.
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PMID:Intracranial mycotic aneurysm in a patient with endocarditis caused by Cardiobacterium hominis. 783 85

We report a case of mitral valve replacement after ruptured mycotic aneurysm resection in acute phase of bacterial endocarditis. We have experienced a 68-year-old man with vegetation at the anterior leaflet of mitral valve and multiple systemic embolization. He underwent aneurysmectomy of ruptured mycotic cerebral aneurysm and embolectomy of left femoral artery eight days after subarachnoid hemorrhage. Mitral valve was replaced three days after successfully. If there was no heart failure preoperatively, valve replacement operation is recommended in acute phase of infected endocarditis or few days after cerebral aneurysmectomy.
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PMID:[Mitral valve replacement secondary to resection of mycotic cerebral aneurysm in acute phase of bacterial endocarditis--a case report]. 796 40

This report concerns a 29-year-old man with recent Streptococcus viridans endocarditis on a bicuspid aortic valve who was found to have a mycotic aneurysm of the left anterior descending coronary artery and infective erosion and thinning of the posterior wall of the ascending aorta 1.5 to 3.5 cm above the origin of the left coronary artery, a combination of lesions not previously reported. Mycotic aneurysm of the coronary arteries affects less than 1% of patients with infective endocarditis, and there are few reports of the management of these rare lesions. The surgical management of this patient is presented with a brief review of the available literature.
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PMID:Mycotic aneurysm of the left anterior descending coronary artery after aortic endocarditis. A case report and brief review of the literature. 800 Feb 73

From January, 1978, through December, 1990, surgical treatment for active infective endocarditis was performed in 11 patients. There were 8 men and 3 women who ranged in age from 19 to 54 years with a mean age of 38.8 years. Two patients had ventricular septal defects and 1 patient had rheumatic valve disease. In all patients, the infecting organism was isolated from blood, including streptococcus in 7, staphylococcus in 2, and gram-negative rods in 2. The indication for operation at the active phase was uncontrolled infection in 7 and progressive heart failure in 4. The operation was performed at 7 to 150 days with a mean of 53 days after diagnosis. Operative findings showed vegetations in all cases and perforations of the valve in 6. There were no operative deaths. Perioperative complications developed in 5, whose indication for operation was uncontrolled infection. Complications consisted of 1 prosthetic valve endocarditis, 1 pulmonary suppuration, 1 ruptured mycotic aneurysm of the hepatic artery, 1 ruptured mycotic aneurysm of the popliteal artery, and 1 pyogenic spondylitis. All were successfully treated surgically or with antibiotic therapy. There were no complications in patients whose indication for operation was progressive heart failure. We conclude that the risk of embolism is high in patients undergoing surgery at the active phase of infective endocarditis because of uncontrolled infection; thus, such patients should be carefully monitored for emboli.
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PMID:[Surgical treatment of active infective endocarditis]. 803 71

Since 1976, 37 patients have undergone valve replacement for infective endocarditis at our institute. Twenty patients required surgery during the active stage and 17 in the inactive stage. The former group consisted of 17 native and three prosthetic valve endocarditis, and all patients in the latter group had native valve endocarditis. Eighteen patients had AVRs, 15 had MVRs and four had DVRs. Congestive heart failure was the indication for surgery in 80% of the active and 100% of the inactive group. There were nine early deaths (45%) and one late death in the active group, and one early (6%) and one late death in the inactive group. Operative mortality in the active group, however, has recently been reduced to 30% for the 10 patients operated upon in the past two years. Two patients with active endocarditis were complicated by rupture of cerebral mycotic aneurysms postoperatively and resulted in one early and one late death, respectively. It is suggested that timely surgical intervention according to the hemodynamic state of the patients is essential in reducing early mortality in infective endocarditis. Attention should be paid to cerebral mycotic aneurysm as one of the problems affecting on postoperative mortality and morbidity.
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PMID:[Surgical treatment of infective endocarditis]. 811 89

The average overall incidence of neurologic complications in patients with infective endocarditis is 30%, with the vast majority of these complications in patients with left-sided valvular disease. The incidence of central nervous system manifestations, particularly of embolic events, tends to be higher in cases of endocarditis caused by more virulent organisms, such as S. aureus and the Enterobacteriaceae. The clinical presentation is dependent on the area of the central nervous system involved. CT and MRI scanning are useful radiologic imaging techniques for the diagnosis of central nervous system complications in patients with infective endocarditis; cerebral angiography should be used in patients with suspected intracranial mycotic aneurysm. The cornerstone of management is appropriate antimicrobial therapy. Neurosurgical intervention may be required for certain patients with intracranial mycotic aneurysms that do not disappear after antimicrobial therapy or for aneurysms that enlarge or bleed. Anticoagulants should be continued in patients with prosthetic valve endocarditis who do not have evidence of intracranial hemorrhage. Anticoagulants should be avoided (unless thromboembolic events are from a site other than the vegetation) in patients with native valve endocarditis owing to the risk of hemorrhagic central nervous system complications. Case fatality rates tend to be higher in patients with neurologic complications of infective endocarditis. Earlier diagnostic and therapeutic interventions for patients with central nervous system complications of infective endocarditis will, it is hoped, improve the outcome in patients with this disorder.
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PMID:Neurologic complications of infective endocarditis. 831 94


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