Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report on a 45-year-old man with bacterial mitral valve endocarditis and valve-ring abscess following a staphylococcus aureus sepsis with septic shock and respiratory insufficiency. A thrombosis of the marginal branch of the left circumflex coronary artery with a myocardial infarction occurred as a consequence of the unusual location of the abscess which spread to the left ventricular lateral wall with an encasement of this blood vessel, and with destruction of the arterial wall. The patient died of biventricular heart failure because of septic shock and myocardial infarction. We discuss entrance spots of infection, predisposing diseases, and complications of valve-ring and myocardial abscesses.
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PMID:[An unusual cause of myocardial infarct. Bacterial mitral valve endocarditis, valve ring and myocardial abscess with direct coronary lesion]. 832 78

Thirty-five patients were operated in the acute phase of mitral valve endocarditis between 1986 and 1991. The surgical indications were hemodynamic (22), echocardiographic (9), embolic (2) and infectious (2). There were pre-existing valve lesions in 45% of cases. The causal organism was identified in 90% of cases: streptococcus (19), staphylococcus (9) and Gram negative bacilli (4). Preoperative antibiotic therapy was prescribed for an average of 18 days. The aortic valve was infected in 9 patients and tricuspid valve in 1 patient. The mitral lesions were: abscess (11), vegetations (11), perforations (16), and ruptured chordae tendinae (22). All patients underwent Carpentier's mitral valvuloplasty. The operative mortality was 5.7% (2 patients). Early reoperation was required in 1 case. Follow-up was possible in 96% of cases for an average of 23 months. No recurrences of endocarditis were observed. One patient was reoperated and 3 died. All the others were in Classes I and II of the NYHA. None had significant mitral regurgitation or stenosis. These results show that mitral valvuloplasty is possible in the acute phase of endocarditis in 90% of cases. The mortality and morbidity are low and long-term results are stable.
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PMID:[Mitral valvuloplasty during the acute phase of endocarditis]. 836 20

Between 1983 and 1991, 104 patients (average age: 52 +/- 13 years) with aortic endocarditis (94 on native and 10 on prosthetic valves), were operated, 81 before the end of antibiotic therapy. Blood cultures were negative in 17 patients, identified a streptococcus in 49 patients, a staphylococcus in 16 patients, and a Gram negative or other organism in 22 patients. The following complications were observed before surgery: severe cardiac failure in 67 patients, renal failure in 24 patients, conduction defects in 13 patients, neurological complications in 13 patients, systemic or coronary embolism in 12 patients. Aortic valve replacement was performed in all patients, associated with mitral valve replacement in 25 patients and tricuspid valve replacement in 1 patient. Twelve patients died after surgery (11/81 of early operations, 1/23 operated later; NS). During a follow up of 3.5 +/- 2.8 years, there were 24 late deaths, 12 of non cardiovascular causes. Of the 20 variables tested, 3 were related to perioperative and late mortality (age, cardiac and renal failure). The 5 year survival (58.1 +/- 5.7%) is identical to that of the period 1970-1982 despite a very significant drop in perioperative mortality. Some of the causes of late mortality (older age of patients, changes in the infecting organisms) provide little hope of improving the prognosis in the near future. Others suggest that earlier surgery could improve the long term prognosis.
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PMID:[Has life expectancy of patients after surgery for aortic valve endocarditis improved over the last twelve years?]. 874 92

A 43-year-old orthotopic heart transplant recipient had coagulase-negative staphylococcus endocarditis 26 weeks after the operation. A diagnosis of endocarditis was confirmed and followed up by serial transoesophageal echocardiography. Treatment with intravenous gentamycin and vancomycin cured her endocarditis, and a 2.5 cm vegetation regressed significantly. She has been well since and, at 14 months after transplantation, was back to her normal activities. Although repeated blood culture yielded only intermittent light growths of coagulase-negative staphylococci, there were several positive samples. In a setting of infective features, light growths of coagulase-negative staphylococcus should be taken seriously if repeatedly positive in heart transplant recipients or other immunocompromised patients. Transesophageal echocardiography offers significant advantages over the transthoracic modality in suspected endocarditis.
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PMID:Infective endocarditis of the tricuspid valve in an orthotopic heart transplant recipient. 879 29

We describe the prompt diagnosis and successful treatment of mitral valve endocarditis in a 52-year-old woman due to a recently described coagulase negative staphylococcus, Staphylococcus lugdunensis. Endocarditis due to this organism has a high mortality rate with 8 out of 12 published cases ending in fatality. Review of the literature revealed that use of commercial identification systems can lead to misidentification of Staphylococcus lugdunensis and consequently delay appropriate treatment. It is clinically important to distinguish Staphylococcus lugdunensis from other coagulase negative staphylococci by detailed microbiological testing. The awareness of this from of endocarditis and its natural history is important since it differs significantly from other coagulase negative staphylococci. It highlights the need for early surgical intervention not only for haemodynamic complications but also for recurrent emboli. Multiple emboli appears to be a frequent finding on review of the literature.
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PMID:Successful treatment of Staphylococcus lugdunensis endocarditis complicated by multiple emboli: a case report and review of the literature. 884 90

Two cases of tricuspid valve endocarditis due to staphylococcus epidermidis have been examined in patients with permanent transvenous pacemaker. While transthoracic echocardiography was unable to detect any tricuspidal abnormalities, large vegetations located on the tricuspidal leaflets and the electrocatheter were detected by transesophageal echocardiography. Both cases required surgical removal of the electrostimulation system and valve toilet.
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PMID:[Transesophageal echocardiographic evaluation of tricuspid endocarditis from implanted pacemaker: description of two cases]. 916 74

A 38-year-old man was admitted to our hospital for detailed examination of fever, cough and yellow sputum. At the age of 32, be had mitral prosthesis for the first time, because of mitral regurgitation due to mitral valve prolapse. Four years previously, he had again undergone mitral prosthetic valve replacement due to prosthetic valve endocarditis due to staphylococcus epidemidis. This occasion, staphylococcus aureus was isolated by arterial blood culture. Transesophageal echocardiography detected vegetation attached to the mitral prosthetic valve and paravalvular leakage. The diagnosis was prosthetic valve endocarditis. He underwent a third mitral prosthetic valve replacement. Detection of the source of infection was difficult only by transthoracic echocardiography, and immediate transesophageal echocardiography seemed mandatory to diagnose bacterial endocarditis.
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PMID:[Mitral prosthetic valve replaced twice due to repeated prosthetic valve endocarditis: a case report]. 921 Nov 15

Coagulase-negative staphylococcus (CNS) is the most frequent cause of nosocomial bacteremia and prosthetic valve endocarditis. CNS bacteremia can be polyclonal. No data exist on the clonality of CNS causing endocarditis. We present a case of CNS aortic homograft endocarditis in which at least five different genotypes of CNS were identified in initial blood-culture isolates by genomic macrorestriction enzyme analysis and pulsed field gel electrophoresis. Since the polyclonality was accompanied by differences in antibiotic susceptibility, this observation may have important consequences for the treatment of CNS endocarditis. Because of the parallels in the pathogenesis of CNS prosthetic valve endocarditis and CNS infections of a variety of other prosthetic devices, it might also have consequences for CNS prosthetic device infections in general. We suggest that antibiotic susceptibility testing of just one blood-culture isolate may be insufficient.
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PMID:Polyclonal staphylococcus endocarditis. 924 36

We successfully treated a case of active infective endocarditis in the remission phase of virus-associated hemophagocytic syndrome (VAHS). A 21-year-old man was admitted to our hospital for fever, arthralgia, and general fatigue. His blood cultures revealed staphylococcus epidermidis. He underwent urgent aortic valve replacement and closure of the abscess cavity because of an ineffective antibiotic therapy and a progressive left heart failure. Operative findings showed about 100 ml bloody pericardial effusion, fresh vegetation on the aortic left coronary and non-coronary leaflets, and aortic root abscess just below the left coronary ostium. The aortic root abscess extended to the left ventricular wall between the base of left atrial appendage and the base of main pulmonary artery and was in the state of impending rupture. The left main coronary artery was fully exposed after debridement in the abscess cavity. It was thought that left atrial appendage as a pedicle was useful for filling up the abscess cavity to protect infection.
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PMID:[A case of active infective endocarditis in the remission phase of virus-associated hemophagocytic syndrome]. 972 Mar 81

Infectious complications of pacemaker implantation are not common but may be particularly severe. Localised wound infections at the site of implantation have been reported in 0.5% of cases in the most recent series with an average of about 2%. The incidence of septicaemia and infectious endocarditis is lower, about 0.5% of cases. The operator's experience, the duration of the procedure and repeat procedures are considered to be predisposing factors. The main cause of these infections is though to be local contamination during the implantation. The commonest causal organism is the staphylococcus (75 to 92%), the staphylococcus aureus being the cause of acute infections whereas the staphylococcus epidermis is associated with cases of secondary infection. The usual clinical presentation is infection at the site of the pacemaker but other forms such as abscess, endocarditis, rejection of the implanted material, septic emboli and septic phlebitis have been described. The diagnosis is confirmed by local and systemic biological investigations and by echocardiography (especially transoesophageal echocardiography) in cases of right heart endocarditis. There are two axes of treatment: bactericidal double antibiotherapy and surgical ablation of the infected material either percutaneously or by cardiotomy. Though controversial, and unsupported by scientific evidence, the role of systematic, preoperative, prophylactic antibiotic therapy in the prevention of these complications seems to be increasing.
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PMID:[Infections secondary to implantation of cardiac pacemakers]. 974 92


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