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

A descriptive term nonbacterial thrombotic endocarditis (NBTE) is used currently instead of the former name marantic endocarditis. The study describes 171 cases of NBTE encountered in autopsies over a period of 22 years (an incidence of 0.93% in adults). Malignancy was present in 59% of cases. Tumors relatively most frequently associated with NBTE were carcinomas of the ovaries, biliary system, pancreas, lung, and stomach. The vegetations were located mostly on the left-sided valves (mitral 64%, aortic 24%, both 9%). The involved valves were otherwise normal in 82%, and they were previously damaged in 18%. Systemic emboli from valvular vegetations occurred in 41% of patients, with splenic, cerebral, and renal circulations being most frequently affected. Pulmonary embolism was noted in 43%. The state of nutrition at autopsy was within normal limits in 35%; there was undernourishment or cachexia in 40%, and overweight or obesity in 22% of patients. The main pathogenetic factor in NBTE seems to be a state of hypercoagulation.
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PMID:[Nonbacterial thrombotic endocarditis--a study of 171 case reports]. 833 26

Clinical features of 43 cases of invasive Eikenella corrodens infections diagnosed at National Taiwan University Hospital during a 6-year period (1993-1998) were analyzed. The clinical syndromes included head and neck infection (56%), pulmonary infection (23%), intra-abdominal infection (14%), cutaneous infection (5%), skeletal infection (2%), endocarditis (2%), and pelvic abscess (2%). Nearly two-thirds of the patients (63%) had pre-existing diseases. Malignancy (35%), especially of the head and neck, was the most common underlying illness. More than half of the patients (56%) had associated factors predisposing to invasive Eikenella corrodens infection. Polymicrobial infections occurred in 28 (65%) patients, with two-thirds of the concurrent isolates being streptococci (66%). Five cases were fatal, with four deaths directly attributable to invasive Eikenella corrodens infection. Antimicrobial susceptibility testing and molecular typing were performed on 23 preserved Eikenella corrodens isolates. Antimicrobial susceptibility testing showed that Eikenella corrodens isolates were susceptible to penicillin, amoxicillin, cefoxitin, cefotaxime, cefepime, ciprofloxacin, and imipenem. The isolates were resistant to clindamycin, metronidazole, cephalothin, and cefuroxime. None of the 23 isolates produced beta-lactamase. Random amplified polymorphic DNA patterns of the 23 isolates were different, suggesting that different clones of Eikenella corrodens caused these infections.
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PMID:Clinical features of patients with invasive Eikenella corrodens infections and microbiological characteristics of the causative isolates. 1139 11

Malignancy-related thromboembolism, so-called Trousseau's syndrome, can present as acute cerebral infarction, non-bacterial thrombotic endocarditis (NBTE) and migratory thrombophlebitis. It is usually attributed to a cancer-related hypercoagulable state, chronic disseminated intravascular coagulopathy (DIC), or tumour embolism. We report on two patients with adenocarcinoma of the colon and cholangiocarcinoma who developed widespread thromboembolism during disease progression. Both did poorly despite aggressive institution of anticoagulation therapy. These cases emphasize that cerebral infarction or refractory thromboembolism in cancer-treated patients should prompt investigation for recurrent or metastatic disease or progression of the underlying malignancy. Optimal treatment remains to be established.
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PMID:Trousseau's syndrome related to adenocarcinoma of the colon and cholangiocarcinoma. 1525 90

In rare instances, stroke may precede a diagnosis of cancer and be the first clinical evidence of an underlying malignancy.Cerebral infarction mostly complicates lymphomas, carcinomas, and solid tumors. Malignancy-related thromboembolism can present as acute cerebral infarction, nonbacterial thrombotic endocarditis and migratory thrombophlebitis. It is generally attributed to a cancer-related hypercoagulable period, chronic disseminated intravascular coagulopathy (DIC), or tumor embolism. We reported a case of malignancy-related thromboembolism from an undiagnosed pancreatic adenocarcinoma in a 54-year-old man, who presented with recurrent ischemic stroke due to chronic DIC. He died of the underlying malignancy despite the appropriate institution of anticoagulation therapy.This case emphasizes that cerebral infarction may be the first manifestation of an undiagnosed cancer. If there is laboratory or clinical evidence associated with DIC, patients with a cerebral infarct of an unknown etiology should be investigated for a malignant process. The optimal method of anticoagulation in cancer patients with thromboembolic disease (TED) remains unclear.
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PMID:Recurrent ischemic stroke as an initial manifestation of an concealed pancreatic adenocarcinoma: Trousseau's syndrome. 2136 97