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

Identification of beta hemolytic streptococci (BHS) as group A or non-group A on the basis of bacitracin sensitivity rather than Lancefield serogrouping may lead to misidentification of the pathogen. In four recent cases of endocarditis due to BHS, the pathogens initially were identified as group A; Lancefield serogrouping showed all four to be group G. All four patients presented with a syndrome characteristic of acute bacterial endocarditis. Review of all cases of endocarditis at our institution for the past five years showed none due to group A BHS. In 166 previously reported cases of endocarditis due to BHS, 68 pathogens were serogrouped: 53 belonged to groups B, C, G, or H; only five were group A. Our four cases and review of the literature demonstrate the need for Lancefield serogrouping in serious beta hemolytic streptococcal infections, rather than reliance on bacitracin sensitivity.
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PMID:Beta hemolytic streptococcal endocarditis: predominance of non-group A organisms. 3 54

Although a common cause of infection in animals, group C streptococci are rarely noted to be pathogenic in man. A total of 150,000 blood cultures obtained at the Mayo Clinic from 1968 to 1977 revealed group C streptococci in only eight patients. Acute bacterial endocarditis, meningitis, pheumonia, cellulitis and bacteremia due to group C streptococci are described in a host who had undergone immunosuppression (immunosuppressed host), and the relatively few cases previously reported are reviewed. Although severe, these infections may respond favorably to penicillin therapy. Endocarditis caused by group D streptococci is acute and destructive, and associated with early cardiac decompensation. The manifestations of cellulitis and pneumonia are similar to those when group A streptococci are causative organisms. Meningitis due to group C streptococci is acute and severe, and responds slowly to antimicrobial therapy. Colonization also occurs.
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PMID:Infections due to group C streptococci in man. 43 51

In the past six years, 35 patients with thermal injuries have died with a diagnosis of endocarditis. The cause of death in 21 of the 22 patients with acute bacterial endocarditis (ABE) was directly related to complications arising from the ongoing sepsis. In only three cases was the diagnosis considered pre-mortem. The endocarditis was located in the right heart in 18, left heart in 9, and both sides in 8 cases. Associated venous thrombi were present in 14 instances, and 10 of these were septic thrombi. Staphylococcus was the primary organism in the blood in 17 of 22 patients with ABE. Clinically audible murmurs were present in only two patients. In no instance was ABE superimposed upon previously existing valvular disease. ABE can serve as a silent source of sepsis in the burn patient. The diagnosis should be suspected with persistantly positive blood cultures, especially for Staphylococcus aureus, in any burn patient in whom no other foci of sepsis can be identified. Vigorous methods of diagnosis and specific treatment are recommended.
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PMID:Acute bacterial endocarditis: a silent source of sepsis in the burn patient. 98 31

The adhesion to fibrin-platelet clots in vitro of 21 strains of streptococci isolated from the blood of patients with sub-acute bacterial endocarditis (SABE) was measured. The species, in order of greatest adhesion, were Streptococcus faecalis, Streptococcus mutans, Streptococcus milleri, Streptococcus sanguis, dextran-positive Streptococcus mitior, dextran-negative Streptococcus mitior and Streptococcus salivarius. Individual strains within species, however, cannot be assumed to be representative of their species and may exhibit unusually high or low adhesion. Adhesion depended upon both bacterial concentration and period of contact. There was no simple relationship between ability to adhere and liability to cause endocarditis. Formation of dextran did not increase adhesion. The streptococci were more adhesive than strains of Escherichia coli and Neisseria sicca and less adhesive than strains of Staphylococcus aureus and Streptococcus pyogenes.
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PMID:Comparative adhesion of seven species of streptococci isolated from the blood of patients with sub-acute bacterial endocarditis to fibrin-platelet clots in vitro. 242 50

Clinical observations are described in 13 cases of pyomyositis with various cardiovascular complications: (a) pyogenic pericarditis (10 cases) with tamponade in 7 and myopericarditis in 1 case, and (b) acute bacterial endocarditis (3 cases). Blood cultures grew Staphylococcus aureus in all 3 with endocarditis and in 5 of 10 with pericarditis. These complications probably resulted from the bacteraemia which sometimes complicates pyomyositis. Enhanced susceptibility of cardiac muscles to infection in pyomyositis however remains another possibility.
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PMID:Cardiovascular complications of tropical pyomyositis. 343 41

In a retrospective study of 39 patients with infective endocarditis (IE) all had elevated concentrations of C reactive protein (CRP) at presentation, patients with the acute variety having significantly higher values than patients with the subacute variety. In addition, the majority of patients with subacute bacterial endocarditis had elevated concentrations of circulating immune complexes (CICs) and rheumatoid factor (RF), both of which were absent in all but one of nine patients with acute bacterial endocarditis. Two patients with subacute and one with acute bacterial endocarditis had low values of C3 and C4. Measurement of CRP, CICs, and RF did not distinguish between patients with and without extracardiac manifestations. Sequential analysis of patients revealed that a successful response to antimicrobial treatment was indicated by a striking and rapid decline in CRP, with less striking declines in CICs, RF, and IgM. Antibiotic failure was indicated by the persistence of high concentrations of CRP and CICs. We conclude that the measurement of C reactive protein is of some value in the diagnosis and management of infective endocarditis. A normal CRP concentration excludes this diagnosis. The measurement of CRP alone appears sufficient for monitoring most cases of infective endocarditis with the sequential measurement of rheumatoid factor and circulating immune complexes adding no useful information except where the CRP remains elevated despite treatment. In this latter instance, persisting high levels of CRP and circulating immune complexes together herald an ominous course.
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PMID:Serological investigations in the diagnosis and management of infective endocarditis. 347 Nov 92

In 40 patients with acute bacterial endocarditis, the indication for cardiac valve replacement was established exclusively on the basis of the echocardiographic and clinical findings. The patients had an average age of 42 years and were under followup observation for an average of 2.2 years. The endocarditis involved the aortic valve 32 times, the mitral valve once, the tricuspid valve in two cases and the aortic and mitral valve together in five cases. In addition to the valve replacement, a ventricular septum defect and aneurysm of the ascending aorta had to be dealt with surgically in two cases each. The intraoperative and perioperative lethality was 2.5% (n = 1). The postoperative lethality was 12.5% (n = 5). In the surviving 34 patients, a recurrence of the endocarditis has not occurred up to now in any case. According to the NYHA classification, six of the surviving patients were to be classified as stage II and 28 as stage I, whereas stage III or IV had been present preoperatively in all cases. The postoperative echocardiographic investigation revealed a significant decrease of the left ventricular enddiastolic diameter (from 61 +/- 8 mm to 51 +/- 5 mm; P less than 0.001). In four cases, a slight insufficiency of the artificial valve could be detected. Reoperation was not necessary in any of these patients.
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PMID:[Heart surgery in acute bacterial endocarditis without preoperative heart catheterization. Long-term observation of 40 patients]. 382 28

Although bacterial endocarditis in women at risk because of endocardial lesions frequently follows pregnancy-related pelvic surgery, endometrial biopsy with or without brushing for cytology was not known to be associated with bacteremia or endocarditis risk. Because a patient who developed acute bacterial endocarditis as a result of endometrial biopsy performed without antibiotic prophylaxis was encountered, 50 subsequent patients undergoing endometrial brushing and biopsy were studied and postprocedure bacteremia was found in four, all of whom were premenopausal.
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PMID:Endometrial biopsy, bacteremia, and endocarditis risk. 398 45

The introduction of antibiotic therapy and changing epidemiologic patterns have altered the nature of glomerulonephritis as it occurs during the course of bacterial endocarditis. Observations made predominantly in the pre-antibiotic era suggested that infections with less virulent organisms, by virtue of their indolent subacute course, favored an antibody response predisposing to immune complex glomerulonephritis. Although antibiotic prophylaxis and therapy have reduced the incidence of both Streptococcus viridans bacterial endocarditis and concomitant glomerulonephritis, Staphylococcus aureus has become a major cause of acute bacterial endocarditis with a high incidence of glomerulonephritis. Parenteral drug abuse itself, which has emerged as a major factor predisposing to endocarditis, may also favor the development of glomerulonephritis. The course of glomerulonephritis has been altered in association with these changes in etiology and epidemiology. This review summarizes the clinical and morphologic features of glomerulonephritis as it currently occurs during the course of bacterial endocarditis.
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PMID:Glomerulonephritis in bacterial endocarditis. 638 Feb 88

From January 1979 to April 1983, 72 patients (pts) with bacterial endocarditis were treated. During their first stay in hospital 36 of them (age range: 23-67 years) underwent cardiac surgery because of severe congestive heart failure, unsuccessful antibiotic treatment of the infection and/or embolic events. In all these cases cardiac surgery was performed without preoperative catheterization. Surgery was recommended on the basis of clinical as well as M-mode and 2D echocardiographic findings. In 32 of the 36 pts the echocardiographic study completely predicted the surgical findings (23x the aortic valve, 1x the mitral valve, 1x the tricuspid valve, 5x the mitral and aortic valve, 1x the aortic valve and a VSD and 1x the triscuspid valve and a VSD were involved). The preoperative echocardiographic diagnosis was incomplete in 4 of the 36 pts. One aortic aneurysm, one aortic root abscess and 2x vegetations on the mitral valve were not detected by echocardiography. Surgery was recommended in these 4 pts because of additional aortic valve endocarditis proven by echocardiography. We conclude that combined M-mode and 2D echocardiography allows the accurate prediction of morphological alterations of the heart in the setting of acute bacterial endocarditis. Thus cardiac surgery can be recommended in pts with acute bacterial endocarditis without preoperative heart catheterization and coronary angiography.
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PMID:Correlation of echocardiographic and surgical findings in acute bacterial endocarditis. 651 89


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