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

Bacillus cereus is a rare cause of endocarditis, typically associated with intravenous drug abuse, rheumatic heart disease, prosthetic heart valves, pacemakers, or immunodeficiency. We present the first case of native valve Bacillus cereus endocarditis with no apparent risk factors. The patient had a fulminant course requiring emergent valve replacement.
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PMID:Native valve Bacillus cereus endocarditis in a non-intravenous-drug-abusing patient. 2211 59

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: in patients with isolated right-sided infective endocarditis (RSE) is the outcome of surgical management the same as in patients with or without left-sided involvement? Altogether, 419 papers were found using the reported search, six of which represented the best evidence to answer the clinical question. Two studies point towards better outcomes with isolated RSE. In one paper, mortality was significantly lower in isolated RSE patients (P = 0.0093) for the duration of the follow-up time (median 488 patient-years). Two studies reported early mortality (<30 days) for RSE patients at 3.6 and 3.8%, respectively. Combined right- and left-sided endocarditis (RLSE) patients were found to have a poorer pre-operative clinical presentation than isolated RSE patients with a greater requirement for inotropic support (P < 0.006) and the likelihood of an emergency operation (P < 0.001). They had a poorer intra-operative course with a higher incidence of cardiac abscess formation (P < 0.001). One study suggested that there is no significant difference in in-hospital and long-term mortality between intravenous drug abuse (IVDA) patients and non-IVDA patients. Left-heart involvement in the IVDA group was 61.5%. This was in-line with the published literature, demonstrating a rise in RLSE in IVDA compared with non-IVDA patients. Three articles looking at isolated left-sided endocarditis (LSE) gave mortality rates in the surgical group to be 27.1, 27.8 and 38%, respectively. In one study, the LSE mortality was not different for native vs. prosthetic valve infection (OR 0.65, 95% CI 0.23-1.87). After propensity matching and adjusting for hazards, the complication rate in the LSE group was higher and this translated to a higher mortality rate. We conclude from the literature that outcomes are more favourable with lower early and late mortality for isolated RSE patients over pure LSE or combined RLSE.
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PMID:What are the differences in outcomes between right-sided active infective endocarditis with and without left-sided infection? 2215 32

Gram-negative microorganisms are rarely implicated in causing infective endocarditis (IE). Although the traditionally identified risk factor for Gram-negative endocarditis has been intravenous drug abuse, recent studies have revealed that healthcare contact and the presence of prosthetic cardiac devices are primary risk factors for IE secondary to non-HACEK Gram-negative bacteria. We present a case of Enterobacter endocarditis in a patient with no prior history of valvular heart disease, implanted endovascular device, or intravenous drug abuse. The patient was treated successfully with carbapenem monotherapy. We have reviewed 43 cases of Enterobacter endocarditis reported in the literature to date. Clinical summary and management of IE secondary to Enterobacter based on all the published cases is outlined.
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PMID:An unusual etiology of infective endocarditis: Enterobacter cloacae. 2232 17

Major causes of morbidity in intravenous drug users are infections. In infective endocarditis, the tricuspid valve is mainly involved. Masses can cause septic embolisms and, in rare cases, they are associated with mycotic aneurysms of pulmonary arteries that lead to severe haemorrhage. We report the case of a young woman with a history of intravenous drug abuse and prolonged infective tricuspid valve endocarditis. Initially, echocardiography showed large masses on the anterior leaflet of the tricuspid valve and severe tricuspid regurgitation; blood cultures revealed staphylococcus and streptococcus species. Eight months after initial diagnosis, she presented with severe haemoptysis and fever. CT revealed a ruptured mycotic aneurysm of the right pulmonary artery. Lobectomy was performed immediately. Postoperatively, the patient fully recovered. After continued antibiotic treatment, follow-up examinations showed negative echocardiographic findings and blood cultures results.
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PMID:Massive haemoptysis in an intravenous drug user with infective tricuspid valve endocarditis. 2276 69

One of the rarest complications of endocarditis, infected (mycotic) aneurysms result from haematogenous dissemination of septic emboli and occur more frequently in patients with cardiac valvular abnormalities or prosthetic valves, intravenous drug abuse, diabetes and immunosuppression conditions such as HIV infection. Although often clinically unsuspected, mycotic aneurysms are potentially life-threatening because of disseminated sepsis and propensity to rupture. Contrast-enhanced multidetector CT provides prompt detection, characterization and vascular mapping of these lesions, allowing correct planning of surgical or interventional therapies and reproducible follow-up. Because of their characteristically unpredictable behaviour, mycotic aneurysms may undergo spontaneous thrombosis, size reduction, rapid enlargement or rupture, therefore strict imaging surveillance with CT and/or color Doppler ultrasound is necessary.
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PMID:Mycotic visceral aneurysm complicating infectious endocarditis: Imaging diagnosis and follow-up. 2278 57

Isolated pulmonary valve endocarditis is a very rare entity, usually associated with intravenous drug abuse. We describe a case of isolated pulmonary valve endocarditis in a diabetic patient with no apparent precipitating factors besides a lesion on the right hallux. The clinical course was favorable and he was discharged home after a six-week course of antibiotic therapy.
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PMID:Isolated pulmonary valve endocarditis in a normal heart. 2285 15

A case of tricuspid valve infective endocarditis is presented. Since this was not the first episode, the patient had not undergone invasive procedures and there was no history of intravenous drug abuse, the possibility of congenital heart disease was considered, a hypothesis that was confirmed.
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PMID:[Tricuspid valve endocarditis in a patient with congenital heart disease]. 2323 44

Isolated pulmonary valve endocarditis (IPE) is an uncommon clinical entity. We reported 4 cases of IPE without underlying heart diseases that required surgical interventions. Two of the present patients had predisposing factors that included a history of abdominal surgery in Case 1 and intravenous drug abuse in Case 3. All four patients presented with persistent fever together with pulmonary symptoms despite appropriate antibiotic management. Three of the patients underwent elective pulmonary valve repair, but Case 3 underwent an urgent surgical intervention due to uncontrolled septic shock. Pulmonary valve repair was performed using autologous pericardial patch in all 4 patients. All of them had immediate postoperative recovery and satisfactory outcomes in the follow-up.
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PMID:Surgical valve repair of isolated pulmonary valve endocarditis. 2324 38

Endocarditis is a serious infection of the innermost muscle layer of the heart and can lead to significant mortality and morbidity. Echocardiography is instrumental to the timely diagnosis of this disease entity. We discuss the case of a patient presenting to the emergency department (ED) with fever of unclear etiology. The diagnosis of right-sided endocarditis was made using focused cardiac ultrasound. A 46-year-old man with a history of intravenous drug abuse presented to the ED complaining of fevers and headaches. Focused cardiac ultrasound demonstrated a tricuspid vegetation. The patient was promptly treated for right-sided endocarditis. This case illustrates the use of focused cardiac ultrasound to facilitate the early diagnosis and management of endocarditis in the ED.
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PMID:Focused cardiac ultrasound diagnosis of right-sided endocarditis. 2347 5

We report a 30-year-old male intravenous drug abuser presenting with persistent pacemaker lead thrombosis with superimposed pacemaker lead endocarditis. He underwent urgent surgery, but expired due to refractory sepsis. This case confirms that patients with pacemakers are at risk of developing pacemaker lead thrombosis. In addition, they are at high risk of developing pacemaker lead endocarditis if additional risk factors for endocarditis are present. We believe this case report is unusual on account of pacemaker lead thrombosis as well as endocarditis occurring in a patient with history of intravenous drug abuse. Whether pacemaker patients with multiple leads need to be on long-term antiplatelet or anticoagulation therapy necessitates further studies.
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PMID:Pacemaker lead thrombo-endocarditis in an intravenous drug abuser. 2414 31


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