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

The clinical findings relating to 11 patients in Hong Kong (HK) and to 43 patients described elsewhere, all with Streptococcus zooepidemicus septicaemia, are reviewed. There was a particular association with cardiovascular disease (27%) with seven cases of endocarditis, three of abdominal aortic aneurysm and two of deep venous thrombosis. Associations not previously reported included two cases of pharyngitis and two patients with persistent post-operative fever. The overall mortality was 22%. Both human and porcine strains of S. zooepidemicus from HK did not hydrolyse aesculin in contrast to the aesculin-positive biotypes reported previously. HK strains also had very mucoid colonies and capsules of hyaluronic acid were seen in electron micrographs. Samples of chromosomal DNA, extracted by means of HindIII restriction endonuclease, of strains from human beings and pigs were identical. The MIC of penicillin for all strains was less than or equal to 0.03 mg/l but the MBC for all was greater than 32 mg/l. Penicillin alone is generally sufficient for cure but combination with an aminoglycoside may be indicated in seriously ill patients. In our locality, pigs were incriminated as a possible source of human infection whereas consumption of contaminated dairy products is important elsewhere.
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PMID:Streptococcus zooepidemicus (Lancefield group C) septicaemia in Hong Kong. 227 71

Coxiella burnetii, the etiologic agent of Q fever, is mainly responsible for endocarditis with negative blood culture results, but only a few cases of C. burnetii infections of aortic aneurysms have been published. We report three cases of abdominal aortic aneurysms treated in patients with Q fever infection with simultaneous endocarditis (n = 1) and previous history of cardiac valve replacement for endocarditis (n = 1). A coeliac aortic aneurysm was diagnosed in one patient treated for acute Q fever with persistent serologic results showing chronic infection despite adequate antibiotic therapy and without endocarditis. Resection of the aneurysm cured the chronic infection, and C. burnetii was identified by culture of the aneurysmal wall. In the two other cases, chronic infection of C. burnetii was diagnosed by serologic examination after surgery for an abdominal aortic aneurysm. One patient with negative blood culture results had amaurosis fugax due to endocarditis and required aortic valve replacement; recurrent fever without evidence of valve dysfunction or infection developed in one patient who had had prosthetic cardiac valve replacement 6 months earlier for endocarditis. Aortic aneurysms were treated with in situ prosthetic grafts and long-term antibiotic therapy. At a mean follow-up of 12 years, no septic aortic complications occurred, and serologic test results have remained negative. The presence of an aortic aneurysm and cardiac valve disease seems to be a predisposing factor for chronic C. burnetii infection. Diagnosis particularly relies on the physician's awareness of this condition and is confirmed by serologic examination. Aortic aneurysm resection is mandatory to cure the chronic infection and must be associated with long-term antibiotic therapy.
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PMID:Abdominal aortic aneurysm and Coxiella burnetii infection: report of three cases and review of the literature. 1601 65

Staphylococci can cause a wide spectrum of infections, including endocarditis, osteomyelitis, and sepsis, which is reflected by the numerous virulence factors they produce, among them a recently identified new class of adhesins, namely, the multifunctional autolysins/adhesins. Here we report the identification and molecular characterization of Aaa, a novel autolysin/adhesin from Staphylococcus aureus. The gene encoding Aaa was cloned from the clinical isolate Staphylococcus aureus 4074. DNA sequence analysis revealed that aaa encodes a deduced protein of 334 amino acids with a predicted molecular mass of 35.8 kDa. Aaa contains three N-terminal repetitive sequences that comprise features of a peptidoglycan-binding domain, the LysM domain. The expression of aaa by Escherichia coli and its subsequent characterization revealed that Aaa possesses bacteriolytic activity as well as adhesive properties, such as binding to extracellular matrix proteins. Real-time biomolecular interaction analysis demonstrated that the interaction of Aaa with fibrinogen, fibronectin, and vitronectin is dose dependent and saturable and occurs with a high affinity. Furthermore, we demonstrate that Aaa binds to the Aalpha and Bbeta chains of fragment D of fibrinogen. Immunofluorescence microscopy revealed that Aaa is located at the cell surface. Finally, an aaa knockout mutant showed reduced adherence to surface-adsorbed fibrinogen and fibronectin, strongly suggesting a role for Aaa in the colonization of host factor-coated polymer surfaces and/or host tissue.
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PMID:The multifunctional Staphylococcus aureus autolysin aaa mediates adherence to immobilized fibrinogen and fibronectin. 1604 Sep 92

A 12-year-old girl with a high fever underwent echocardiography and was found to have a myxoma that arose from the atrial side of the anterior mitral valve leaflet. The tumor was successfully excised. Histologic examination of the tumor showed myxoma cells and an organized thrombus with bacterial colonization. The patient was discharged from the hospital on antibiotic treatment. After remaining asymptomatic for 3 weeks, she was readmitted with acute abdomen. Ultrasonography and magnetic resonance angiography detected intra-abdominal hemorrhaging and a saccular aneurysm of the abdominal aorta. The patient underwent successful emergency surgery. To our knowledge, no other report has been published concerning an abdominal aortic aneurysm secondary to bacterial infection of a cardiac myxoma. Although complications this severe are rarely observed in patients who have endocarditis, early recognition and treatment can be life-saving.
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PMID:Ruptured abdominal aortic aneurysm after resection of an infected cardiac myxoma. 1762 77

Inflammatory abdominal aortic aneurysm is a rare cause of abdominal pain in young adults that may be difficult to diagnose in the Emergency Department. This case highlights the significance of this condition as a possible diagnosis in young patients presenting with abdominal symptoms. A 32-year old woman presented with lower abdominal and back pain. She had four previous visits to the Emergency Department and one hospital admission with similar symptoms and had been discharged without a definite diagnosis. Her vascular risk factors included hypercholesterolemia and smoking. A computed tomography (CT) scan showed a non-leaking infrarenal saccular abdominal aortic aneurysm and para-aortic lymphadenopathy. A transthoracic echocardiogram excluded endocarditis. There was no evidence of bacterial, viral, or fungal infection on blood and serum assays, and her autoimmune screen was negative. She underwent urgent open repair using a synthetic graft. The aneurysmal wall and para-aortic lymph node histology confirmed the diagnosis of inflammatory aneurysm with periaortitis. She remained asymptomatic at 8 months after surgery with no evidence of additional aneurysmal disease. Inflammatory abdominal aortic aneurysm is an unusual cause of abdominal pain in young adults. It is more likely in patients with persistent or recurrent abdominal symptoms.
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PMID:Inflammatory infrarenal abdominal aortic aneurysm in a young woman. 1802 83

Concomitant valvular and abdominal aortic pathologies, both requiring urgent surgical interventions, are an uncommon entity. The ideal surgical management of such a scenario varies, depending on a host of variables. Due to its complexity and rarity, the ideal management approach remains an unknown. We describe a patient who presents with a delayed diagnosis of concomitant Salmonella species mitral valve (MV) endocarditis and mycotic abdominal aortic aneurysm (AAA). Though both clinical entities required urgent surgical intervention, the presence of one made intervening for the other high-risk and created a surgical dilemma. Following guarded conservative medical management, the patient underwent successful staged surgical interventions.
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PMID:Simultaneous Salmonella spp. endocarditis and mycotic abdominal aortic aneurysm presentation: a surgical dilemma. 1962 48

We report a rare case of multiple myeloma presenting with native aortic valve endocarditis with secondary embolic mycotic abdominal aortic aneurysm, contiguous paraspinal and iliopsoas abscesses, and pneumonia due to Streptococcus pneumoniae in a Chinese man. He was treated with aortic valve replacement, endovascular stenting of aneurysm, image-guided drainage of abscesses, and a 6-week course of endocarditic antibiotic therapy followed by chronic suppressive antibiotic therapy. Cases of multiple myeloma presenting with invasive pneumococcal infection were reviewed.
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PMID:Pneumococcal native aortic valve endocarditis with mycotic abdominal aortic aneurysm, paraspinal and iliopsoas abscesses and pneumonia revealing a multiple myeloma. 2137 85

This study reports on a contained rupture of mycotic abdominal aortic aneurysm secondary to coagulase negative staph successfully repaired with aorto bi-iliac polytetrafluoroethylene (PTFE) Gor-Tex graft. An 8-year-old Saudi male patient was found to have infective endocarditis by coagulase negative staph with mitral valve (MV) leaflet damage, which was repaired with mechanical MV. Post-cardiac surgery, he complained of intermittent abdominal and back pain, until he became more symptomatic and had a sudden abdominal pain. Ultrasound showed abdominal aortic aneurysm (AAA), as well as the CT scan showed contained posterior rupture of AAA. He was operated immediately and the aorta was repaired with bifurcated PTFE Gor-Tex graft. He tolerated the operation, and he was given antibiotic coverage according to sensitivity. Tissue culture of the aorta confirmed coagulase negative staph. The strong relation between infective endocarditis and mycotic aneurysm should make a high index of suspicion of developing abdominal aortic aneurysm in children. Utilizing the PTFE graft with an omental patch is safe and life saving.
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PMID:Successful repair of a contained rupture of mycotic aortic aneurysm in an 8-year-old child using polytetrafluoroethylene graft. 2282 15

Infected aortic aneurysms represent 0.85 to 1.3% of aortic aneurysms. Most often, the implicated bacteria species are Salmonella sp., Staphylococcus sp. and Streptococcus sp. Brucella-related infected aortic aneurysms are very rare. Most often, they result from endocarditis or from a local septic focus. Combined treatment by antibiotics and surgery is the standard for infectious aneurysms. In the absence of formal factual data, the surgical treatment is still discussed in the literature, especially since endovascular treatments have been in full expansion. We are reporting the case of a female patient presenting with a Brucella-related infra-renal abdominal aortic aneurysm, without primitive infectious source (area) or identified endocarditis. Surgical treatment with in situ prosthetic replacement and omentoplasty in association with adapted antibiotics allowed a favorable outcome with an excellent result after an 8-year follow up.
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PMID:In situ repair of a primary Brucella-infected abdominal aortic aneurysm: long-term follow-up. 2338 May 62

A 30-year-old woman with a more than 6-month history of fever, weight loss, general fatigue and dysesthesia of lower extremities was admitted to our hospital with a diagnosis of infective endocarditis. Blood cultures revealed Staphylococcus oralis. Echocardiography revealed severe mitral and moderate tricuspid regurgitation, as well as massive vegetations and aneurysms on the mitral valve. Computed tomography revealed an abdominal aortic aneurysm, left common and external iliac arterial aneurysms, and occlusion of the left common iliac, the deep femoral arteries and the bilateral tibioperoneal trunk. The ankle brachial pressure indices (ABI) were 0.94 (right) and 0.61 (left). She initially underwent mitral valve replacement and tricuspid annuloplasty. On postoperative day 24, the affected segments of the arteries were replaced with a woven Dacron bifurcated graft after resection of the mycotic abdominal and the iliac arterial aneurysms. We could not obtain a sufficient amount of omental pedicle to wrap the prosthesis. Her postoperative course was uneventful and mycotic arterial embolism and aneurysm did not recur.
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PMID:[Multiple mitral valve aneurysms, mycotic arterial embolism and aneurysms with infective endocarditis]. 2391 33


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