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

A middle-aged patient with "brown bowel syndrome" or gastrointestinal ceroidosis manifested as malabsorption of undetermined cause is described. Autopsy revealed involvement of the entire gastrointestinal tract and unusual cardiac findings. Microscopically, the pigment responsible for the discoloration is a lipofuchsin that is deposited in the smooth muscle cells of the gastrointestinal tract. In all reported cases, ceroidosis was associated with some abnormality of the gastrointestinal tract--that is, malabsorption, steatorrhea, or gross local disease--with the possible exception of prolonged malnutrition. This case is also unusual because of the unexplained multifocal proliferative endocarditis. Vitamin E deficiency may be the common denominator of all these various disorders.
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PMID:Ceroidosis in the "brown bowel syndrome". 42 5

Candida albicans arthritis is uncommon. Although occasional instances of meningitis, osteomyelitis, endocarditis, pneumonia, and extensive visceral involvement due to Candida species have been reported, only 7 documented cases of arthritis caused by Candida albicans are found in the literature. The present case was an infant with a gastroschisis defect of the abdominal wall, who required multiple surgical procedures, prolonged antibiotic therapy, and parental intravenous hyperalimentation. Following a blood stream infection with Candida albicans, septic arthritis of the left knee developed. Treatment with intravenous Amphotericin-B over a 6-week period was successful in eridicating the infection. The child is completely well 9 months after discharge from the hospital. Factors which may predispose patients to infection by Candida albicans include prolonged antibiotic therapy. corticosteroids, generalized debilitation, malnutrition, parental hyperalimentation, and immunosuppressive therapy. Amphotericin-B therapy may be associated with considerable toxicity including azotemia, hepatic dysfunction, and hematologic abnormalities. The therapeutic regimen of Amphotericin-B is effective but a 6-week course of antifungal therapy may be necessary to eradicate septic arthritis of Candida albicans. Surgical drainage is probably indicated only for recent infections.
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PMID:Candida arthritis. A case report and review of the literature. 80 14

Histopathologic studies and isolation of virus and bacteria in culture were carried out for 71 children less than 5 years of age with fatal pneumonia. A potential microbial etiology was identified for 61 children (86%): bacteria for 19 (27%), virus for 16 (23%), and virus plus bacteria for 26 (37%). Staphylococcus was the most prevalent pathogen, alone or in combination with other organisms, followed by Pseudomonas aeruginosa. Viral infection may predispose to bacterial infection in some children. A correlation of clinical course, results of cultures, and morphologic changes revealed cofactors that may have contributed to a fatal outcome. Lung abscess, pericarditis, myocarditis, endocarditis, and meningitis were associated with bacterial infection. Many patients in this study had severe bronchopneumonia, with a high prevalence of complications such as abscess (62%), atelectasis (40%), pericarditis (28%), and empyema (7%). Such complications added to multiple infections, measles, and malnutrition contributed to the fatal outcome in these children.
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PMID:Etiology of infection and morphologic changes in the lungs of Filipino children who die of pneumonia. 212 58

34 cases of Listeria monocytogenes endocarditis reported in the literature from 1950-1986 were reviewed. The male to female ratio was 2: 1. The average age was 49 years, and 35% of patients were 60 years of age or older. A single case of polymicrobial endocarditis was identified. There were 8 cases of prosthetic valve endocarditis. Left-sided cardiac involvement predominated, with only a single case of right-sided endocarditis reported. Aortic and mitral valvular involvement accounted for 32 and 29% of cases respectively. Underlying cardiac disease was present in over half of the cases, with rheumatic heart disease being the most common underlying cardiac condition. Noncardiac underlying conditions were found in 38% of cases. These included chronic hemodialysis, alcoholism, pregnancy, malignancies, diabetes mellitus, steroid therapy and malnutrition. Onset of the disease was varied as was initial presentation. There was a high incidence of vascular phenomena (59%), with large vessel emboli seen late in the course of many cases. Many cases were diagnosed late. Overall mortality was 50%. Treatment of listeria endocarditis varied from case to case. A review of in vitro and in vivo studies as well as case reports suggests that ampicillin or penicillin plus an aminoglycoside may be the treatment of choice.
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PMID:Listeria monocytogenes endocarditis: a review of the literature 1950-1986. 305 15

The group B streptococcus has been shown to be a major cause of meningitis in the newborn and an occasional cause of endocarditis and sepsis in postpartum women. Little attention has been devoted to this organism as a cause of bacterial endocarditis. Twelve patients with group B streptococcal endocarditis were seen at The Presbyterian Hospital, New York, NY, between 1974 and 1985. There were seven women, five men. Ages ranged from 32 to 81 years. Serious underlying disease was present in all - diabetes mellitus in seven, carcinoma in three (bladder in two, and breast in one), alcoholism in three, malnutrition in two, heroin addiction in one, tuberculosis in one, serious prior valvular heart disease in two. The aortic valve was affected in four patients - mitral in two, mitral and aortic in one, tricuspid in four, unknown in one. The presentation was acute in seven patients. Metastatic infection occurred in seven, heart failure in six, major emboli in four, septic pericarditis in one, myocardial abscess in one. The group B streptococcus should be considered as a pathogen capable of causing acute endocarditis in certain patients with defects of host defense, particularly patients with diabetes mellitus, carcinoma or alcoholism. Cardiac surgery may be necessary in these patients due to the rapid destruction of the valves which occurs, in spite of the fact that the organisms are usually highly susceptible to penicillin.
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PMID:Streptococcus agalactiae (group B) endocarditis--a description of twelve cases and review of the literature. 330 82

Bacterial vegetations involving the aortic valves of six patients were studied by scanning and transmission electron microscopy. The microorganisms isolated were Staphylococcus aureus--2, coagulase-negative staphylococcus--1, Streptococcus fecalis--2 and Streptococcus MG--1. The surface of the vegetations was usually amorphous. However, in areas where the surface of the vegetation was broken, myriads of microorganisms were seen. Transmission electron microscopy revealed bacteria embedded in an electron dense matrix in all vegetations despite the fact that they were negative on culture. Cell wall rupture was common. Thinning, and in some instances thickening, of the cell wall was also observed. The Streptococcus MG cells showed abnormal division with daughter cells being unable to separate. It is likely that the altered morphology of these bacterial cells is due to antibiotic treatment, however studies of an animal model of endocarditis are needed to dissect out the various possible contributions to these changes: host defenses; bacterial malnutrition in the depths of the vegetation; and antibiotic effect.
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PMID:Ultrastructure of cardiac bacterial vegetations on native valves with emphasis on alterations in bacterial morphology following antibiotic treatment. 342 27

Some particular features of the cardiomyopathies (CM) observed in the tropics, especially in Africa, are emphasized in this study. Chronic parietal endocarditis is excluded from the CM group. The author presents facts that justify the linking of that affection to endocardial diseases. Myocardiopathies are acute ailments presenting with congestive lesions, reversible under etiological therapy. Anemic and beri-beri myocardiopathies are not unusual in the tropics and present a hyperkinetic syndrome before the stage of advanced cardiac insufficiency. Infectious or parasitic myocarditis seem frequent in the tropics. The author recalls the characteristics of the myocarditis in the human african trypanosomiasis which he opposes, particularly, to the american trypanosomiasis. The reality of bilharzial myocarditis is more debatable while bilharzial pulmonary hypertension is well documented. Chronic congestive CM presents a few specific characteristics in the tropics. The features, well described in temperate regions, are found in the tropics with a particularly unfortunate prognosis. Some alcoholic myocardiopathies have been observed. The rare occurrence of hypertrophic CM in the tropics results, seemingly, from a lack of exploratory means. The author studies briefly a recent series of 31 cases in Abidjan. Post-partum myocardiopathy seems to be the clinical appearance of a latent myocardial insufficiency of the normal post-partum in women presenting with associated risks factors (anemia, malnutrition, overwork, excessive sodium intake, etc.). An early diagnosis enables a cure only by resting, but it is sometimes necessary to associate a medical treatment. Death by embolism or the passing to chronicity are however possible. Drepanocytic CM is debatable and in many cases, seems hardly differentiated from anemic myocardiopathy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cardiomyopathies in tropical areas]. 377 21

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

Sixty-seven patients were treated with moxalactam in a noncomparative trial of hospitalized patients; 32 had endometritis or chorioamnionitis, 12 had skin and soft tissue infections, 5 had osteomyelitis, 5 had pneumonia, 5 had urinary tract infections, 4 had arthritis, 2 had sepsis from an unknown source, 1 had endocarditis, and 1 had peritonitis. Bacteremia was present in 12 of these patients. Patients were given 3 to 12 g of moxalactam per day (mean, 6.24 g/day) in divided doses every 6 to 8 h. Seven patients were given intramuscular treatment for 3 to 20 days for part or all of their therapy. The rest were given intravenous treatment exclusively. Treatment was continued for 2 to 42 days (mean, 10 days). The dose and the duration of therapy were determined by the type of infection and the response of each patient. There were four treatment failures and one enterococcal-clostridial superinfection. Moxalactam was well tolerated. Allergic reactions led to the discontinuation of the antibiotic in three patients. Prolonged prothrombin and partial thromboplastin times were observed in 2 of 11 patients tested; in both instances in patients had severe underlying diseases, including malnutrition and alcoholism. Pain on intramuscular injection was noted in two patients receiving 1,500 mg, but not in five receiving a lower dose; in one case the pain forced the use of intravenous therapy after one dose, and in the other case the pain was mild and the patient was treated for 20 days. We concluded that moxalactam was effective in the treatment of the types of infections included in this study and produced few adverse reactions.
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PMID:Moxalactam in the therapy of serious infections. 621 Nov 40

A 26 year old female patient was admitted to our hospital because of septic temperatures and chills. In the patient's history renal insufficiency has been known for several years due to agenesia of the right and pyelonephritic renal congestion of the left kidney. Long lasting anorexia nervosa had been treated by psychotherapeutical interventions for years and when failing it necessitated repeated intravenous nutrition by central venous lines. The prominent symptom of the intravenously treated young woman was fever up to 39.7 degrees C and pneumonia, which was considered by the first treating clinic to be caused directly by diminished immunoreactivity in malnutrition and preuremia. The chest X-ray confirmed pneumonia and revealed multiple abscesses in both lungs (Figure 1). After being transferred to our intensive care unit the pathophysiological context became obvious. From inspection (positive jugular pulsation), from auscultation (holosystolic murmur at the left parasternal border) tricuspid incompetence due to infective endocarditis was suspected. This was confirmed immediately by TM and two-dimensional transthoracic echocardiography, which showed a large vegetation on the anterior tricuspid valve leaflet (Figures 2a and 2b). Tricuspid regurgitation was also ascertained by color flow echocardiography (Figure 2c). Several blood cultures were positive for staphylococcus aureus. Clinical and laboratory recovery was achieved by antibiotic therapy with vancomycin and cephtazidim for 3 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Fever and lung abscesses in anorexia nervosa after infusion therapy]. 792 23


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