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

Thirteen histologically-proven cases of endocarditis confined to the right side of the heart were found in 9406 consecutive autopsies. Eleven cases involved the tricuspid valve and two the atrial endocardium. Nine cases were in males and 4 in females. Only one case showed underlying valvular/endocardial disease. Eight cases were infective, with Staphylococcus aureus being the predominant organism, and 5 non-infective. For the infective cases, intravenous drug abuse was the commonest predisposing factor, and malignancy the commonest association for the non-infective. The commonest overall complication was lung abscess due to septic emboli in the 3 drug addicts, a common association in other reported series. These latter cases are particularly important to recognize, being generally more responsive to treatment than left-sided infective endocarditis.
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PMID:Isolated right-sided endocarditis in Hong Kong Chinese. 830

Endocarditis caused by Fusobacterium nucleatum is exceedingly rare. We report a case of F. nucleatum right-sided endocarditis in a patient with no known intravenous drug abuse. A detailed computer and manual search of the literature using Med-Line and Index Medicus, respectively, revealed a total of five cases of endocarditis due to this species. The clinical characteristics and the patient's hospital course are summarized and reviewed.
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PMID:Infective endocarditis due to Fusobacterium nucleatum: case report and review of the literature. 841 66

We report a case of gamma-streptococcal tricuspid valve endocarditis in a patient with no history of intravenous drug abuse. Echocardiography revealed large vegetations on the anterior and septal cusps. The patient had persistent fever and recurrent septic pulmonary embolism despite prolonged antibiotic therapy. However tricuspid valve replacement was successful.
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PMID:Tricuspid valve endocarditis with large vegetations in a non-drug addict without underlying cardiac disease. 878 54

The mortality of IE remains fairly high despite the aggressive use of intravenous antibiotics. Oral treatment of IE is an intriguing concept with many potential advantages over conventional intravenous therapy. Unfortunately, there are insufficient data to justify predominantly oral regimens for the treatment of IE. Trials have shown that oral therapy may have a role in follow-up to short courses of parenteral antibiotics, but these trials are limited by the small number of patients studied. It is important to note that most data for oral treatment of IE have been obtained from studies in patients with histories of IVDA and right-sided S. aureus endocarditis. As mentioned previously, the course of IE in this patient population tends to be less severe, which makes extrapolation of these data to the general population difficult. A need exist for the development of oral antimicrobials with the properties previously mentioned, making them appropriate for use in IE. Currently available oral agents require further study before general recommendations regarding their use in patients with IE can be made. Although successful oral treatment of prosthetic valve endocarditis has been reported, such patients in general should not be considered as appropriate candidates for oral therapy. For now, oral antimicrobial therapy may be appropriate only as follow-up to short-course intravenous therapy, or use in combination with intravenous therapy for IE in select populations whose disease course is less severe or in whom prolonged intravenous therapy is impractical (i.e., intravenous drug users).
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PMID:Oral antibiotic therapy in infective endocarditis. 879 56

A 36-old-woman was admitted with an infectious syndrome, respiratory insufficiency and vasculitis. There was a history of chronic intravenous drug abuse, sexual promiscuity and rheumatic heart disease. She had HIV positive tests. The vasculitis and heart failure worsened and the patient died of stroke. At autopsy it was found histologic evidence of AIDS, rheumatic heart disease with Aschoff nodes, infective endocarditis with cerebral abscesses and thalamic infarction.
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PMID:[Rheumatic heart disease and infective endocarditis in a patient with acquired immunodeficiency syndrome]. 918 24

A 31-year-old woman was admitted because of persistent remittent fever. Tricuspid valve endocarditis due to Staphylococcus aureus was identified as the cause of fever. The patient had no history of intravenous drug abuse, oral contraceptives or predisposing cardiac disease. Huge hepatomegaly was found without any signs of congestive heart failure. Liver enzyme abnormalities were not detected throughout the entire course of therapy. The liver biopsy specimen revealed peliosis hepatis. Treatment with panipenem/betamipron was successful, although recurrent septic pulmonary embolism occurred. The cause of the huge hepatomegaly encountered in the present case may be attributable to peliosis due to severe infection.
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PMID:Tricuspid valve endocarditis in a non-drug addict associated with peliosis hepatis. 939 42

Infective endocarditis remains an important problem and the means of prevention are still insufficient. The causal bacteria have changed very little, but the incidence of nosocomial infections and endocarditis complicating intravenous drug abuse are increasing. The distinction between subacute and acute clinical presentations remains appropriate. Cardiac and neurological complications are frequent and carry a high risk of mortality. The diagnosis is obtained by the integration of clinical data and the results of blood cultures. Echocardiography is extremely useful for detecting vegetations, and for assessing the haemodynamic consequences and specific cardiac complications. Risk stratification can be obtained by correct integration of multiple parameters. The causal agent should be identified before the initiation of antimicrobial therapy. Surgery is frequently required, and should be performed rapidly when indicated.
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PMID:Infective endocarditis: prevention, diagnosis and management. 942 48

Infective endocarditis caused by beta-hemolytic streptococci is infrequently seen. Members of the Infectious Diseases Society of America's Emerging Infections Network (EIN) were polled for cases of beta-hemolytic streptococcal endocarditis that were seen between 1 January 1994 and 31 December 1996. Thirty-one cases were submitted by 22 members. The patients' ages ranged from 4 months to 79 years, and 18 (58.1%) were males. Prosthetic valve infection occurred in six cases and intravenous drug abuse was noted in only one case. Diabetes mellitus was noted in 10 patients (32.3%). Group B beta-hemolytic streptococci accounted for over two-thirds of isolates (21 [67.7%] of 31). Twenty-five patients (80.7%) developed complications of infective endocarditis, and 15 (48.4%) underwent surgical intervention with valvular revision or excision. Sixty-one percent (19 of 31) received aqueous crystalline penicillin G either as monotherapy or in combination with gentamicin sulfate. In contrast to previously published data, the mortality rate (12.9%) among patients in this survey was remarkably low. There was no infection relapse documented in 16 of the remaining 27 patients for whom posttreatment follow-up information was available.
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PMID:Infective endocarditis caused by beta-hemolytic streptococci. The Infectious Diseases Society of America's Emerging Infections Network. 945 11

Fungal endocarditis has emerged as an important complication of patients undergoing cardiovascular surgery. Our patient had no past history of cardiac surgery, intravenous drug abuse or immunosuppressive therapy. He had received broad-spectrum antibiotics for varying periods, which might have predisposed him to this infection. The diagnosis was based on the demonstration of hyaline, septate branched fungal elements in the infected valvular tissue and isolation of Aspergillus flavus in culture. The delay in establishing the ante-mortem diagnosis because of repeatedly negative blood cultures, presence of disseminated intravascular coagulopathy and rapidly deteriorating kidney function were the major factors contributing to his poor prognosis and death, despite surgical removal of infected valves and antifungal therapy. This is the first report of endocarditis due to A. flavus from the Middle East.
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PMID:Endocarditis due to Aspergillus flavus. 947 91

Infective endocarditis (I.E.) is a common bacterial infection of the endocardium, which before the advent of antibiotics, had a high mortality rate. Endocarditis has been described as a serious and a potentially fatal condition in which the heart beats in a muffled march towards the grave, in quick time in the acute form and with a slower, but as deadly rhythm, in the subacute form. I.E. can occur at any period of life, but presently, there has been a shift towards younger individuals due to intravenous drug abuse. Thus the overall incidence since the pre-antibiotic era has remained constant. This has been the situation in spite of the periodic revisions made by the American Heart Association (AHA) for the guidelines for antibiotic prophylaxis. In India there are no guidelines issued by any professional organisations and hence the decision to use antibiotic prophylaxis depends on the dentist's awareness of the patient's predisposition, the standard regime learnt from a textbook, the patient's economic status and belief to comply with the advice and the choice of antibiotic, route of administration and dose. In this paper, an attempt is made to collect data on the incidence of I.E. from two large teaching hospitals and use it to decide whether antibiotic prophylaxis of patients predisposed to I.E. should be followed or not.
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PMID:Infective endocarditis, the conundrum of antibiotic prophylaxis. 949 12


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