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

We have reviewed 107 cases of staphylococcal bacteraemia in order to assess the current clinical spectrum of serious staphylococcal sepsis in Zimbabwe, where staphylococcal bacteraemia is common. Infection was hospital-acquired in 35 cases and community-acquired in 72 cases. The mortality rate was 28%. Most patients were young, with predisposing conditions such as prematurity, protein-caloric malnutrition and measles. The length of the prodromal illness tended to be short and a primary site of infection, usually the lungs or skin, was obvious in 66% of patients. In 30% there was evidence of metastatic spread, usually to meninges, bone, joint and muscle, but endocarditis was uncommon. Metastatic infection was rare when infection was acquired in hospital. Death appeared to be associated with measles, protein-caloric malnutrition, acquisition of infection in hospital, absence of an obvious focus of infection and with inappropriate antibiotic therapy. Aggressive treatment with antibiotics intravenously was the rule. A combination of penicillin and an aminoglycoside was favoured until the nature of the infecting organism was established. Of those patients who died, 38% had received less than 72 h antibiotic therapy. Multiple antibiotic resistance is now widespread in Zimbabwe.
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PMID:Staphylococcal bacteraemia in Zimbabwe 1983. 403 14

In a man aged 62 years with a 14-year-history of polycythaemia vera progressing into a myelofibrotic stage symptoms and signs of an intracranial tumour with increased intracranial pressure developed. CT scan as well as angiography of the right internal carotid artery revealed richly vascularized masses within the meninges. The patient died in endocarditis and progressive heart failure and at autopsy the intracranial masses were shown to be due to meningeal myeloid metaplasia. The literature is reviewed and it appears that myeloid metaplasia within the central nervous system might be more common than has been hitherto anticipated. A CT scan is to be recommended in myelofibrosis whenever symptoms and signs suggesting intracranial disease are present.
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PMID:Intracranial myeloid metaplasia in myelofibrosis. 707 20

Of 2030 consecutive patients with bacteremia, only 102 were free from underlying disorders. 43 were males, and the median age was 66 years. The sources of infection were the urinary tract (in 48%), lower respiratory tract (13%), endocarditis (7%), biliary tract (6%) and the meninges (5%). The most common pathogens were Escherichia coli (in 45% of patients), Streptococcus pneumoniae (21%), Staphylococcus aureus (9%) and hemolytic streptococci (9%). Overall mortality rate was 13%, 4% in patients with urinary tract infection and 19% in patients with other sources. Half of the deaths occurred within 2 days of hospitalization, and 75% of them within 4 days. All patients with septic shock and all patients with meningitis died. Other factors related to mortality were residence in a nursing home, low functional capacity, advanced age, high blood urea nitrogen and creatinine and low albumin, and infections caused by Staphylococcus aureus, Neisseria meningitidis and polymicrobial infections. A protective effect of appropriate antimicrobial antibiotic therapy could not be demonstrated. In conclusion, bacteremic patients with no known underlying disorder and source of their infection other than the urinary tract should be given maximum supportive treatment and should be closely watched.
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PMID:Bacteremia in patients without known underlying disorders. 785 58

Nonbacterial thrombotic endocarditis (NBTE) is characterized by the deposition of thrombi on undamaged heart valves and by the increased frequency of associated arterial embolic events in patients with chronic debilitating diseases. Fifteen subjects diagnosed by necropsy of nonbacterial thrombotic endocarditis (NBTE) were studied to evaluate the general features, associated diseases, arterial embolic events, distribution and characteristics of histologic lesions. The most common underlying disease was neoplasm, which was present in 10 cases. Of these, 6 were adenocarcinomas, 3 hematological, and the remaining case was a bladder carcinoma. Other associated diseases included amyloidosis, MELAS syndrome, and sepsis. In most cases peripheral arterial embolic events were detected (9 cases). The central nervous system and the lung were involved in 7 cases (78%), heart and kidneys in 5 cases (56%), and spleen in 4 cases (44%). Other involved organs included pancreas, thyroid gland, testicles, meninges, liver and adrenal glands. The left valves were predominantly involved. The mitral valve in eight cases and the aortic valve in six cases. All cases with right involvement had the antecedent of central venous catheterization. Subendothelial fibrosis was a common histological finding which revealed the chronicity of the disease.
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PMID:[Nonbacterial thrombotic endocarditis: a review of a necropsy series]. 910 84

This retrospective study was performed to determine the range, occurrence and incidence of spontaneously arising histopathological findings of the cardiovascular system in purpose-bred laboratory nonhuman primates. Data were collected from 84 controlled toxicological studies with equal numbers of male and female animals and full tissue lists. Attempts were also made to standardize pathological terms used by various original pathologists. Tissue sections from 2464 animals, which included 2050 cynomolgus monkeys (Macaca fascicularis), 284 common marmosets (Callithrix jacchus) and 130 rhesus monkeys (Macaca mulatta) were examined. The most common cardiac finding was focal myocardial inflammation, subcategorized as either "inflammatory cell infiltration" (339) or "focal myocarditis" (131). Other cardiac findings included mineralization (29), endocarditis (16), pericarditis (10), squamous cysts (6) and ectopic thyroid tissue (5). Perivasculitis/vasculitis in the kidney, lung, meninges, sciatic nerve, and other tissues (206) was the most common vascular lesion. Focal myocarditis was more common in male (60%) than female (40%) animals. Cardiac mineralization and extramedullary hematopoiesis were more common in marmosets than other species while ectopic thyroid tissue was present in marmosets and cynomolgus monkeys. To our knowledge, this is the first study to demonstrate the range and incidence of spontaneous cardiovascular lesions in laboratory nonhuman primates.
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PMID:Spontaneous lesions of the cardiovascular system in purpose-bred laboratory nonhuman primates. 1684 63

Of the two postmortem examinations on rat-bite fever previously reported, the patient of Miura and Toriyama, a woman, aged 32 years, died on the 70th day after the onset of the disease. Anatomically there were no marked changes. Histological examinations were not made. Macroscopically, the following findings are reported: increase of cerebrospinal fluid, hyperemia of the meninges, inflammatory edema of the lungs, cloudy swelling of the liver, etc. The other, Blake's case, was a woman of 67, who died 1 month after the bite of a rat. The anatomical findings were acute ulcerative endocarditis, subacute myocarditis, interstitial hepatitis, glomerular and interstitial nephritis. The suprarenals contained a large amount of perivascular fluid. There were infarcts in the spleen and kidney. In general, the organs were hyperemic; the lung showed hemorrhages and edema, Histologically, Blake found marked degeneration, necrosis, and infiltration in the cardiac muscles, infiltration of polynuclear cells, and increase in the interstices of the liver, also marked polynuclear infiltration of the shrunken kidney.
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PMID:A CONTRIBUTION TO THE ETIOLOGY AND PATHOLOGY OF RAT-BITE FEVER. 1986 55

To identify demographics, clinical manifestations, and outcomes of patients with Coccidioides fungemia, we searched our institutional medical records to identify patients with Coccidioides fungemia treated between 1998 and 2008 and conducted a comprehensive search of the medical literature to identify previously reported cases. Coccidioides fungemia is an uncommon manifestation of coccidioidomycosis, a fungal infection caused by Coccidioides sp. endemic to the southwestern United States. Six Coccidioides fungemia patients were treated at our institution during the 10-year period. All 6 had underlying comorbid disease; three were receiving immunosuppressants. Three patients survived longer than 2 years. The literature review identified 107 patients, bringing the total cohort to 113 (mean age, 42 years). Forty-three patients (38%) had infection with the human immunodeficiency virus, 20 (18%) were receiving corticosteroids, 11 (10%) had solid organ transplants, and 5 (4%) were pregnant. Sites of extrapulmonary dissemination were reported for 97 (86%); the most common sites were liver (26/97 [27%]), spleen (21/97 [22%]), and meninges/central nervous system (17/97 [18%]). No patient showed evidence of endocarditis. At least 1 serologic test was positive in 45 (87%) of 52 patients for whom results were available. Overall mortality at 30 days was 62% (70/113; mean survival, 11.4 days). Survival was significantly worse in immunocompromised versus immunocompetent patients (22/72 [31%] vs. 19/36 [53%], respectively; P = .04). Lack of antifungal therapy predicted poor survival (8/38 [21%] vs. 32/65 [49%], respectively; P = .004). Coccidioides fungemia is an uncommon manifestation of fulminant, disseminated coccidioidomycosis. Survival is poorest in immunocompromised patients or those not receiving antifungal therapy.
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PMID:Coccidioides fungemia in six patients, with a review of the literature. 2033 78

The authors report the case of an immunocompetent man who presented with acute impairment of the neurological system, hypertensive crisis and renal failure. The patient was eventually diagnosed with Rhodotorula mucilaginosa meningitis and infective endocarditis. To the best of our knowledge, this is the first description of simultaneous infection of the meninges and endothelium caused by Rhodotorula in a non-immunocompromised patient.
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PMID:Meningitis and infective endocarditis caused by Rhodotorula mucilaginosa in an immunocompetent patient. 2394 66

Systemic infection caused by G. haemolysans has rarely been reported. We herein describe the case of a 69-year-old woman with recurrent G. haemolysans meningitis that led to abducens nerve palsy. Osteomyelitis of the clivus was likely present at the first admission, which led to reinfection of the meninges because the course of antibiotic treatment was too short. The patient has remained free of relapse for one year after undergoing a second round of treatment that lasted 63 days. In cases of G. haemolysans meningitis, coexisting infectious diseases, such as endocarditis and/or osteomyelitis, should therefore be investigated to prevent recurrence.
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PMID:Recurrent Gemella haemolysans meningitis in a patient with osteomyelitis of the clivus. 2404 30