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

The bacteriological spectrum of infective endocarditis is very different when the disease occurs spontaneously from when it follows shortly after cardiac surgery or is associated with narcotic abuse or haemodialysis. It is therefore suggested that two categories of the illness, naturally occurring and extraneous, are recognized. The great majority of cases of naturally occurring infective endocarditis are caused by organisms highly sensitive to penicillin. Oral therapy is nearly always effective in such cases and amoxycillin given with probenecid is recommended as the regime of choice. Extraneous infective endocarditis is most often caused by staphylococci, with Gram-negative bacilli and fungi also quite frequent infecting agents. Intravenous and oral therapy with a variety of antibiotics is discussed in the management of this group.
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PMID:The choice of antibiotic for treating infective endocarditis. 124 38

We have reported a case of high-level gentamicin-resistant enterococcal endocarditis as a complication of intravenous narcotic abuse. Because routine screening of enterococcal blood isolates for high-level aminoglycoside resistance was not done, the patient possibly received suboptimal therapy. This case amplifies the necessity of a systematic screening program for enterococcal blood isolates to detect high-level resistance to gentamicin and streptomycin in clinical laboratories.
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PMID:Gentamicin-resistant enterococcal endocarditis: the need for routine screening for high-level resistance to aminoglycosides. 210 3

Three cases of Staphylococcus aureus tricuspid valve endocarditis are reported; each was preceded by a gynaecological event. In 2 cases there was no overt pelvic sepsis and there had been no operative or instrumental intervention, but in the 3rd pelvic inflammatory disease was present, probably not as a result of interference. There are few reports in the recent literature of gynaecological events precipitating this condition; in contrast, intravenous narcotic abuse is well documented. In the literature there is insufficient stress laid on the fact that non-septic gynaecological events may cause the endocarditis. The difficulties in diagnosing tricuspid endocarditis, especially in a milieu where intravenous narcotic abuse is virtually unknown, are noted. When endocarditis is present in women known not to abuse narcotics, the absence of signs of pelvic inflammation may also cause difficulties in diagnosis.
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PMID:Staphylococcus aureus tricuspid valve endocarditis in young women after gynaecological events. A report of 3 cases. 650 98

Ninety-three episodes of culture-positive endocarditis occurred in 88 patients in the years 1970 to 1979. Streptococci caused two-thirds of the cases, with Streptococcus mitior and Streptococcus sanguis most common. Among the Group D streptococci, Streptococcus bovis was much more common than Streptococcus faecalis. Staphylococci accounted for a quarter of the episodes. Streptococcal endocarditis was commonest in the elderly, whereas staphylococcal endocarditis occurred at all ages. Degenerative heart disease was the underlying cardiac factor in nearly half the streptococcal cases, but staphylococci most often affected normal heart valves. When prosthetic valves were infected endocarditis of early onset was staphylococcal but that of late onset was streptococcal. Narcotic abuse was a common cause of staphylococcal endocarditis, second only to surgical wound infection following valve replacement. Streptococci affected the mitral and aortic valves equally but the staphylococci more usually involved mitral or tricuspid valves. The overall mortality was 36 per cent but was much higher for staphylococcal than streptococcal endocarditis.
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PMID:Infective endocarditis, 1970-1979. A study of culture-positive cases in St. Thomas' Hospital. 746 64

Gram-negative endocarditis was uncommon in the past, accounting for 1% to 3% of cases. With the advent of antibiotics, immunosuppressive agents and narcotic abuse, the number has increased to 5% to 10% in the native valves and as high as 17% in the prosthetic valves, with Haemophilus species as the commonest aetiological agent, accounting for about 1% of the cases. We report a case of Haemophilus parainfluenzae endocarditis in a 39-year-old man who presented with heart failure and persistent fever. Echocardiography showed bi-leaflet mitral valve prolapse and severe mitral regurgitation. A small vegetation was seen at the flail anterior valve leaflet. He responded well to 4 weeks of intravenous ampicillin at 9 g/day and 2 weeks of gentamicin at 4 mg/kg/day, and subsequently underwent valve replacement.
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PMID:Haemophilus parainfluenzae infective endocarditis. 892 25