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

We describe in detail 14 children (age, less than or equal to 19 years) who underwent operative intervention during active infection of the heart and/or great vessels. The series included five children less than 6 years old, who constitute 10% of all such cases reported in this age group to date. We also review the 132 published reports in which children underwent operative intervention during active endocarditis. We found the following: (1) The survival rate for all cases was 77%. (2) Persistent infection, embolic phenomena, and increasing congestive heart failure were the most frequent indications for operative intervention. (3) Survival rates were independent of the duration of preoperative antibiotic treatment. (4) Survival rates were independent of positive results of cultures of blood or tissue obtained at operation. (5) The perioperative mortality in our series was 14%. (6) Only 67% of patients had conditions thought to predispose to endocarditis. (7) Except for removal of catheter-associated cardiac masses from neonates, operative intervention in active endocarditis was uncommon among children less than 4 years old. (8) Staphylococcus aureus and viridans streptococci were the etiologic agents in the majority of cases of endocarditis requiring operation during active infection in children.
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PMID:Operative intervention in active endocarditis in children: report of a series of cases and review. 157 80

We report the cases of two patients with septic pulmonary embolism and respiratory failure after septic abortion. Hysterectomy was performed in both patients after unsuccessful uterine curettage and antibiotic therapy for treatment of the infection. The first patient (27 years-old) remained feverish. The blood cultures yielded Staphylococcus aureus. Tricuspid valve endocarditis was identified as the reason for persistent infection. Antibiotic treatment properly planned was administered and the patient was discharged. The second patient (23 years-old) apparently recovered after hysterectomy. Nevertheless, one month later, infection and septic pulmonary embolism recurred. The diagnosis of Staphylococcus aureus tricuspid valve endocarditis was made. Persistent infection unresponsive to medical treatment led to surgical treatment. The patient died after valve replacement. Thus the persistence or recurrence of infection and septic abortion may be due to tricuspid valve endocarditis.
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PMID:[Septic pulmonary embolism and endocarditis caused by Staphylococcus aureus in the tricuspid valve after infectious abortion. Report of 2 cases]. 260 82

Sixteen patients with tricuspid valve endocarditis were studied to define (1) what clinical or echocardiographic subsets are at risk for complications or need for tricuspid valve surgery, and (2) the long-term two dimensional echocardiographic course of tricuspid vegetations. There were 18 episodes of tricuspid endocarditis in the 16 patients; 12 patients had a history of intravenous drug abuse. Staphylococcus aureus was the most common infecting organism (11 patients). Persistent infection, cardiomegaly or radiography and right-sided heart failure were present in all patients undergoing tricuspid valve surgery and in none of the medically treated patients. Echocardiographic studies demonstrated tricuspid vegetations in 10 patients by M mode and in all 16 by two dimensional technique. Vegetation size, right ventricular enlargement and abnormal septal motion were not of prognostic significance. Two dimensional echocardiographic measurements of vegetation size correlated with surgical pathologic measurements in the four patients who underwent surgery. Serial two dimensional echocardiographic studies were available in eight patients a mean of 10.6 (range 2 to 19.5) months after the initial study: Vegetations had decreased in size or disappeared in seven patients and were essentially unchanged in one patient. It is concluded that (1) two dimensional echocardiography increases the detection of tricuspid valve vegetations and accurately estimates their size; (2) persistent infection, cardiomegaly and right-sided heart failure identify a subgroup of patients with tricuspid endocarditis who may have increased risk; (3) no M mode or two dimensional echocardiographic feature is a predictor of outcome; and (4) tricuspid valve vegetations tend to resolve with time.
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PMID:Natural history of tricuspid valve endocarditis: a two dimensional echocardiographic study. 621 Oct 79

Recently advances in early diagnosis of infective endocarditis (IE) by echocardiography provide for IE as a target disorder for valve repair. Valvulectomy without replacement might be still better operation of choice for some cases of intractable right-sided endocarditis. For our experience in 11 cases of valve repair or valvulectomy without replacement for IE, actuarial survival and reoperation-free rate at 6.8 years of mean follow-up after surgery was 81.8% and 90.9%. Persistent infection and intraoperative evaluation of the residual regurgitation was the point for postoperative management after these procedures. Although an elaborative valve repair should be applied for right-sided endocarditis, total pulmonary valvulectomy or regional tricuspid valvulectomy without prosthesis was available for destructive endocarditis.
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PMID:[Valve repair or valvulectomy without replacement for infective endocarditis: a report of 11 cases]. 756 11

Donors not meeting standard criteria, such as those with bacteremia, are now being used in response to the increasing need for organs for transplantation. Recommended strategies to prevent the occurrence of donor-derived bacteremia include the use of directed antibiotic prophylaxis. However, this approach does not eliminate the risk of infection transmission. Similarly, the management of organ recipients from donors with infective endocarditis (IE) remains uncharacterized. We report 2 cases of donor-derived bacterial infections in liver transplant recipients despite pathogen-specific antibiotic prophylaxis. In both instances, the donors had documented IE treated with appropriate antimicrobial therapy and clearance of bacteremia. Recipients had very distinctive clinical outcomes likely related to pathogen virulence and the extent of donor infection. Persistent infection in the transplanted liver should be suspected in organ recipients of a liver from donors with IE, despite the absence of bacteremia at the time of death and organ procurement. For eradication, recipients may require prolonged pathogen-directed antimicrobial therapy, such as is used for endovascular infections. Prompt recognition of donors with IE, appropriate notification, and prolonged antibiotic prophylaxis are key to reducing the risk of such donor-derived infections.
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PMID:Transmission of infection to liver transplant recipients from donors with infective endocarditis: lessons learned. 2558 91