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Query: UMLS:C0014118 (
endocarditis
)
15,629
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Nine patients examined by arteriography were shown to have mycotic aneurysms involving the thoracic aorta, subclavian artery, renal artery, middle cerebral artery, hepatic artery, and splenic artery. Patients presented with
sepsis
, chest pain, mediastinal mass, headache, hypertension, and intraperitoneal bleeding. Etiologic factors included
endocarditis
, septicemia, drug abuse, and poorly controlled soft-tissue infection. Most mycotic aneurysms were virulent processes with rapid progression and only three of the nine patients (33%) survived. Since mycotic aneurysms may be associated with rapid progression and poor prognosis, early recognition is mandatory.
...
PMID:Protean manifestations of mycotic aneurysms. 10 65
Ninety-five cultures of group JK bacteria isolated from clinical specimens were characterized morphologically and biochemically. The microorganisms were isolated primarily from blood cultures. The bacterial cultures produced positive reactions when tested for catalase, Tween hydrolysis, and carbohydrate fermentation. Glucose and galactose were fermented by more than 90% of the organisms. Gas-liquid chromatography of trimethylsilyl derivatives of whole-cell hydrolysates of some of the group JK cultures yielded nearly identical elution profiles. The group JK microorganisms were susceptible to vancomycin but were resistant to most of the other 17 antimicrobial agents tested. A method is presented for differentiating the group JK microorganisms from other similar bacteria encountered in clinical specimens. Although these bacteria rarely occur in clinical specimens, they are capable of producing fatal infections (
endocarditis
and
sepsis
) in humans.
...
PMID:Characterization and identification of 95 diphtheroid (group JK) cultures isolated from clinical specimens. 11 Aug 26
To examine the role of circulating immune complexes (CIC) in infective
endocarditis
, we studied 64 patients with infective
endocarditis
for the presence of CIC by the polyethylene-glycol (PEG)-precipitation test and the Clq binding test. This study was repeated during the course of the disease in 23 patients. CIC were found in 84 per cent of patients (66 per cent with acute infective
endocarditis
, 89 per cent with subacute infective
endocarditis
) during the active phase of the disease. Higer PEG precipitates were associated with typical cutaneous signs, cryoglobulins and nonstreptococcic culture-positive infective
endocarditis
. Under appropriate antibiotic treatment, the PEG precipitate levels of 17 patients fell within 1 month to the normal range, with a concomitant drop in cryoglobulinemia and rheumatoid factor. Conversely, uncontrolled
sepsis
always (six of six) yielded a rising level of CIC. These findings support the hypothesis that CIC may be important in the pathogenesis of peripheral lesions in infective
endocarditis
.
...
PMID:Fate of circulating immune complexes in infective endocarditis. 15 40
A case of Escherichia coli septicemia with associated metastatic en dophthalmitis and
endocarditis
is presented. The ocular signs and symptoms were the initial manifestations of
sepsis
. Irreversible damage to the eye occurred in less than 24 hours. The pattern of metastatic bacterial endophthalmitis has changed since the introduction of potent antimicrobial agents, with an increased incidence of Gram-negative bacillemia. E. coli endophthalmitis carries a poor prognosis. Early diagnosis and systemic treatment will prevent the life-threatening complications of
sepsis
.
...
PMID:Endogenous E. coli endophthalmitis. 32 73
Our patient, with cirrhosis and chronic renal failure, represents an example of the susceptibility of a compromised host to Aeromonas infections. This patient, however, differs from previously reported cases in at least two important aspects. First, it is possible that her portal of entry was a fresh A-V fistula puncture site rather than an intestinal site. The temporal relationship of exposure to flood water prior to the onset of
sepsis
lends support to this possibility. Epidemiologic investigation of the dialysis center failed to reveal Aeromonas isolates from cultures of the water supply, machinery, or other patients. Second, this case is unique in that our patient developed a destructive aortic valve
endocarditis
resulting in valvular perforations and acute aortic insufficiency. Furthermore, this infection was initiated on what appears to have been a previously normal valve. Based on a review of the literature and the virulence demonstrated by A. hydrophila in our patient, we conclude that organisms of the genus Aeromonas are capable of inducing serious human infection. Such infections are more likely to occur in compromised hosts. A. hydrophila has accounted for the majority of reported infections.
...
PMID:Human aeromonas infections: a review of the literature and a case report of endocarditis. 34 23
The abdominal left ventricular assist device (ALVAD) is an order of magnitude more effective than conventional intra-aortic balloon pumping (IABP) in unloading and providing circulatory support to the failing left ventricle. This is a report of a unique case which demonstrates that in the absence of pulmonary vascular obstruction or constriction, the ALVAD can substitute for both left and right heart function. A 21-year-old patient with a congenital bicuspid aortic valve developed acute valvular
endocarditis
which rapidly progressed to congestive heart failure. An operation was undertaken, the mitral and aortic valves were excised and replaced by porcine heterografts, and a fistula from the right sinus of Valsalva to the right ventricle was closed. When coronary circulation was restored, irreversible ischemic contracture of the left ventricle, or "stone heart" syndrome, developed and emergency ALVAD or partial artificial heart implantation was effected. This device functioned as a total artificial heart for nearly six days, while a donor heart was sought. The patient then underwent removal of the ALVAD and cardiac and renal allografting. The transplanted heart functioned well, but the patient expired fifteen days later from gram-negative
sepsis
.
...
PMID:Partial artificial heart (ALVAD) use with subsequent cardiac and renal allografting in a patient with stone heart syndrome. 36 90
Septic thrombosis of central veins is rarely diagnosed during life and nearly always proves fatal. We have recently successfully treated a patient with a 75% body surface burn in whom septic thrombosis of the inferior vena cava developed associated with high-grade candidemia as a complication of parenteral nutrition. Signs of venous thrombosis and candidemia persisted after catheter removal. Prompt and intensive therapy with amphotericin B, monitored by fungicidal assays of serum, resulted in cure. Generous hydration and directed supplementation of sodium bicarbonate permitted us to administer a large total dose of amphotericin over a relatively brief period of time with no nephrototoxic effect whatsoever. Septic central venous thrombosis mandates a pharmacologic approach to therapy similar to that used for infective
endocarditis
, with the addition of anticoagulation. Should
sepsis
prove refractory to this program of it pulmonary embolization occurs, operative intervention is indicated despite the high risks involved.
...
PMID:Management of septic thrombosis of the inferior vena cava caused by Candida. 41
Distinguishing endocarditic from nonendocarditic septicemias is prognostically and therapeutically important. One hundred two patients with both valvular and nonvalvular
sepsis
were studied for the presence and quantitation of circulating immune complexes. Ninety per cent of the patients with infective
endocarditis
versus 50 per cent of septic patients without infective
endocarditis
had circulating immune complex levels (p less than 0.005). Mean circulating immune complex levels in patients with infective
endocarditis
were significantly higher than in those without infective
endocarditis
, 106 +/- 18.58 microgram/ml versus 31 +/- 7.4 microgram/ml (p less than 0.005). Only three of 52 patients without infective
endocarditis
had circulating immune complex levels greater than 100 microgram/ml, as opposed to 16 of 50 patients with infective
endocarditis
(p less than 0.005). Similarly, one of 52 patients without infective
endocarditis
has circulating immune complex levels greater than 200 microgram/ml, as opposed to eight of 50 patients with infective
endocarditis
(p less than 0.05). In 92 per cent of the patients without infective
endocarditis
and 76 per cent of those with infective
endocarditis
peak circulating immune complex levels developed within 14 days after their entry into the study, often on the initial sampling. In febrile, septicemic patients with clinical symdromes nonclassic for
endocarditis
, measurements of serial circulating immune complex levels may be of adjunctive diagnosis importance. If circulating immune complex levels are undetectable,
endocarditis
would appear less likely; alternatively, levels above 100 to 200 microgram/ml would suggest a valvular rather than nonvalvular septic focus.
...
PMID:Use of circulating immune complex levels in the serodifferentiation of endocarditic and nonendocarditic septicemias. 42 Feb 50
The experience with the cefamandole prophylaxis in 244 patients with open heart-surgery, and another 84 patients operated upon on prosthetic vascular reconstruction was evaluated. No case of
endocarditis
,
sepsis
or massive wound infection with infected prosthesis was found in the reviewed patients. Considering the fact that patients undergoing open heart-surgery and prosthetic vascular reconstruction are subjected to much more bacterial contamination than patients undergoing any other surgical procedure, the cephalosporin treatment (in our study cefamandole) should be considered the antibiotic of choice in preventing of infection during and after such surgical intervention.
...
PMID:[Infection prophylaxis with cefamandole. Clinical evaluation in the open heart-surgery and the prosthetic vascular reconstruction (author's transl)]. 44 Jan 93
Controversy persists concerning the role of early surgical intervention in severe infective
endocarditis
(IE). We therefore reviewed 163 episodes of well-documented IE in which 32 cardiac operations were performed during the active phase of IE. Congestive heart failure (CHF) was the principal indication for surgery in 88% (28/32); systemic emboli, 1/32; and persisting
sepsis
, 3/32. Staphylococcus and enterococcus were the most common infecting organisms in the operative group (44% and 16% respectively). Surgical mortality (11/32,37%) did not differ (p greater than 0.05) from medical mortality (26/131,20%). All 11 operative deaths occurred in patients moribund prior to surgery, including three with preoperative cardiac arrest. Surgical patients undergoing preoperative cardiac catheterization demonstrated marked CHF: a mean left ventricular end-diastolic pressure of 25.3 mm Hg. The mean cardiac index in 8/11 surgical deaths was lower (p less than 0.05) vs surgical survivors: 2.21/min/m2 vs. 3.21/min/m2. Postoperative complications were rare in the 21 surgical survivors. There were no episodes of continued infection, prosthetic dehiscence, or advanced heart block; only one paravalvular leak; and one systemic embolus. These findings emphasize the high medical and surgical mortality in patients with IE, suggest that delayed operative intervention may be a major causative factor resulting in a high surgical mortality, and justify an aggressive surgical approach in patients with valve dysfunction and heart failure. These data indicate that survivors of surgical intervention during active IE have eradication of infection and few postoperative complications.
...
PMID:Surgery in active infective endocarditis. 44 78
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