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

A case of community-acquired infective endocarditis of a native valve that was caused by Acinetobacter calcoaceticus subspecies anitratus is presented. The previously reported cases are reviewed, and therapy for this disorder is discussed. The presence of a transient maculopapular rash involving the palms and soles but sparing the face is suggested as a possible early clinical clue to the diagnosis. Native valve endocarditis caused by Acinetobacter species is an acute, aggressive illness that is more likely to be fatal than the prosthetic valve form; of the previously described patients, five of 15 with native valve endocarditis and one of six with prosthetic valve endocarditis died. In the appropriate clinical setting, we recommend therapy with an antimicrobial agent known to be active against Acinetobacter organisms when blood cultures are reported to yield oxidase-negative, gram-negative coccobacilli until the final identification of the microorganism is known.
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PMID:Infective endocarditis of a native valve due to Acinetobacter: case report and review. 142 Jul 4

Thirty one patients underwent early valve replacement for infective endocarditis during a 10-year period (between September 1973 and December 1983). Intractable heart failure, persistent infection and systemic emboli were the indications for urgent surgical intervention. Native valve endocarditis had been present in 22 patients (71%) and surgery was performed 14-105 (mean 51) days after the onset of symptoms. Nine patients (29%) had prosthetic valve endocarditis and surgery was performed within 6 to 51 (mean 28) days. The aortic valve was replaced in 22 patients (71%), the mitral valve in 5 patients (16%) and both valves in 4 patients (13%). Four patients (12.9%) died during hospitalization. There were no late deaths or reinfection in this series. The remaining 27 patients were discharged and after a mean follow-up period of 36 months, 25 patients were in NYHA functional class I or II. Only 9 patients (29%) underwent cardiac catheterization prior to surgery and the other patients were operated upon on the basis of echocardiographic data alone. The post-operative results with a survival rate of 87%, justify an aggressive surgical approach in order to prevent serious complications and cardiovascular deterioration. It appears that surgical decision-making can be made on the basis of echocardiography. The risk of cardiac catheterization can be avoided with the newer generation of echocardiographic equipment which allows a detailed and complete analysis of cardiac abnormalities and function.
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PMID:Early cardiac valve replacement in infective endocarditis: a 10-year experience. 360 41

Antibiotic therapy for staphylococcal endocarditis is based on in vitro susceptibility, antibiotic efficacy in experimental endocarditis, and clinical experience. Native valve endocarditis due to Staphylococcus aureus in non-addicts is treated with four to six weeks of a penicillinase-resistant penicillin, a cephalosporin, or vancomycin. An aminoglycoside can be added for the initial three to five days, but longer-term multiple-drug therapy (adding an aminoglycoside and rifampin) is reserved for unresponsive infection. Right-sided native valve endocarditis in addicts usually responds to less vigorous therapy than that for native valve endocarditis in non-addicts. Vancomycin is the drug of choice for endocarditis due to methicillin-resistant S. aureus. Intrinsic methicillin-resistance in Staphylococcus epidermidis is often cryptic, requiring special tests for detection. Methicillin-resistant S. epidermidis is the major cause of prosthetic valve endocarditis. Vancomycin, rifampin, and gentamicin therapy for two weeks, followed by vancomycin plus rifampin, is recommended for treating this infection. Despite potent antimicrobial therapy, surgery is important in the therapy of complicated endocarditis, particularly prosthetic valve endocarditis.
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PMID:Staphylococcal endocarditis. Laboratory and clinical basis for antibiotic therapy. 389 13

In a population of 930,000 inhabitants all records of native valve infective endocarditis diagnosed in the decade 1980-89 were reviewed. One hundred and thirty-two cases were found, of whom 23 were not diagnosed until postmortem. Median prehospital duration of symptoms was 20 days (range 0-180) and median in-hospital diagnostic delay five days (range 0-54). Known cardiac disease was found in 42%, possible portal of entry in 33%, but in 36% no predisposing factors were found. During the clinical course 55% experienced cardiac failure and 17% embolic episodes. Surgery was required in 19 patients. Of 111 culture positive cases, streptococci were found in 61 and staphylococci in 45 cases. Overall mortality was 33% with a mortality of clinically diagnosed cases of 18%. Native valve endocarditis is thus associated with a significant mortality in part due to significant diagnostic delays and a large number of post-mortem diagnosed cases. Only by securing a high level of alertness towards endocarditis can we expect a reduced mortality.
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PMID:[Endocarditis--clinical picture of native valve infection]. 799 92

Native valve endocarditis normally presents with fever and only later in its course demonstrates dysfunction of the affected valve. We describe a case of endocarditis due to Neisseria subflava, a Gram-negative diplococcal saprophyte of the oral cavity, which was unsuspected clinically and found unexpectedly during a mitral valve operation performed for symptomatic prolapse with regurgitation.
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PMID:Nonfebrile mitral valve endocarditis due to Neisseria subflava. 854

Native valve endocarditis due to Staphylococcus capitis is uncommon and is usually managed conservatively with good outcome. Of the nine previously reported cases there has been only one mortality. We report a case of native aortic valve endocarditis due to S capitis in an elderly diabetic that had a fatal outcome despite appropriate therapy with antibiotics. A review the literature is also presented.
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PMID:Aortic valve endocarditis due to Staphylococcus capitis. 1110 6

This retrospective study describes 100 cases of infective endocarditis (IE), collected between 1980 and 2004. Patients were subdivided into 2 groups, according to the use of trans-esophageal echocardiography (TOE) in the institution where the study was performed: group A (GA=55 patients, between 1980 and 1991) and group B (GB=45 patients, between 1992 and 2004). The IE cases of 59 men and 41 women were analyzed. Patients had a mean age of 33 years (range 15-75 years). An underlying heart disease was involved in all cases, mainly rheumatic heart disease (93% of cases). Native valve endocarditis (NVE) was seen in a majority of cases (93%), and the localization of IE was aortic in 36 cases, mitral in 36 cases, mitro-aortic in 26 cases and mitro-aortic-tricuspid in 2 cases. Prosthetic valve endocarditis (PVE) occurred in 12 cases. Blood cultures were positive in 31 cases, with 14 staphylococcal infections (3 in GA and 11 in GB) (p < 0.05), of which 6 were coagulase-negative; 13 were streptococci and 4 were Gram negative bacilli. All patients had a transthoracic echocardiography (TTE), and patients in group B also had a TOE. Seventeen patients had a favorable outcome without need of a surgical intervention. Early surgery was necessary in 71 cases (85.5%), and elective surgery in 12 cases (14.5%). Mortality while awaiting surgery was 27%, and has been decreasing for the past decade (41.8% in GA and 8.9% in GB) [p < 0.05]. Postoperative mortality after early surgery intervention was 13.6% (6 among 44 patients), and it was 8.3% (1 among 12 patients) after elective surgery intervention. Overall mortality was 34%: 27 deaths with NVE (30.7% [27/88]), and 7 deaths with PVE (58.3% [7/12]) [NS]. Predictors of mortality in this observational study were positive blood cultures involving staphylococci, the presence of valve mutilations, unstable prostheses, and heart failure.
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PMID:[Retrospective study on 100 cases of infective endocarditis, Rabta University Hospital, Tunis, from 1980 to 2004]. 1629 41

Native valve endocarditis caused by Aspergillus spp. is an uncommon disease with a high mortality rate. Generally, Aspergillus is isolated from affected valve in post-mortem or biopsy specimens. However, its isolation from blood cultures is exceedingly rare. We report a case of fungal endocarditis in a native mitral valve with the isolation of Aspergillus fumigatus both in valve vegetation and in blood culture bottles. The patient underwent valve replacement and antifungal treatment with voriconazole and caspofungin, but he died on post-operative day 45 with disseminated aspergillosis confirmed by necropsy. Paradoxically, galactomannan antigen detection in serum was negative. This is the third case of Aspergillus endocarditis with positive blood culture reported in the literature.
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PMID:[Native valve Aspergillus fumigatus endocarditis with blood culture positive and negative for galactomannan antigen. Case report and literature review]. 1760 38

The yeast Kodamaea (Pichia) ohmeri is a rare human pathogen with infrequent report of neonatal infection. Native valve endocarditis by Kodamaea ohmeri is extremely rare. The current case report describes a case of fatal nosocomial native valve endocarditis without any structural heart defects in a 40dayold baby. The patient was referred to our institute after having ICU stay of 18 days in another hospital for necrotizing enterocolitis and was found to have obstructive tricuspid valve mass and fungemia with Kodamaea ohmeri. In spite of the treatment, patient developed sepsis with disseminated intravascular coagulation and could not be revived.
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PMID:Kodamaea ohmeri tricuspid valve endocarditis with right ventricular inflow obstruction in a neonate with structurally normal heart. 2167 14

We present a case of aortic and tricuspid native valve endocarditis in which Cardiobacterium valvarum was isolated from the blood culture of a 65-year-old man. Cardiobacterium valvarum is a fastidious, Gram-negative bacillus. The genus Cardiobacterium encompasses two species - Cardiobacterium valvarum and Cardiobacterium hominis. Although both species rarely feature as the aetiological agent of endocarditis, Cardiobacterium hominis has a higher incidence than Cardiobacterium valvarum. For this causative organism, we believe this is the first report of fatality prior to surgical intervention and the first clinical course to be complicated by cerebral vasculitis. Native valve endocarditis caused by Gram-negative bacilli is extremely rare and identification of isolates may require the use of reference laboratories with molecular identification techniques.
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PMID:Cerebral vasculitis and Cardiobacterium valvarum endocarditis. 2287 49


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