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

Although infection by Corynebacterium diphtheriae is a model of extracellular mucosal pathogenesis, and diphtheria is one of the most worried diseases, this microorganism can be associated also with invasive infections such as endocarditis, septic arthritis, and osteomyelitis. Invasive infections are usually caused by non-toxigenic C. diphtheriae strains. Over the last years severe pharyngitis/tonsillitis associated with the isolation of non-toxigenic C. diphtheriae have been described. Penicillin treatment failure of these infections could only partially be explained by penicillin tolerance of the causing strain. Thus, we examined the in vitro ability of non-toxigenic C. diphtheriae throat clinical isolates to adhere to, and enter human respiratory epithelial cells. Trasmission and scanning electron microscopy demonstrated intracellular C. diphtheriae in laryngeal (HEp-2 cells) and pharyngeal (Detroit D562 cells) tissue culture. Live intracellular bacteria were detectable up to 48 h post-infection. Using a variety of compound that act on eukariotic cell structures, the internalization of C. diphtheriae seems to occur via a zipper-like mechanism. It is likely that internalization of C. diphtheriae can be involved in throat colonization contributing to bacterial eradication failure and asymptomatic carriage.
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PMID:Internalization of non-toxigenic Corynebacterium diphtheriae by cultured human respiratory epithelial cells. 1535 Oct 33

Transient bacteremia associated with various endoscopic procedures is a well-documented phenomenon. Clinically important bacteremias are very rarely seen, however, this malady has significant morbidity in susceptible patients with valvular heart disease, liver cirrhosis, malignancy and immune deficiency. This bacteremia is a complication that is generally observed secondary to upper endoscopy and other associated invasive procedures in at risk patients, and the more serious manifestations include spontaneous bacterial peritonitis, septic arthritis, meningitis, brain abscess and infective endocarditis. Infective endocarditis is an extremely rare complication of gastrointestinal endoscopy, and it has been convincingly documented in only seven cases. We report a case of native valve endocarditis due to Streptococcus intermedius in a patient with valvular heart disease as a consequence of routine upper endoscopy.
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PMID:Subacute bacterial endocarditis associated with upper endoscopy. 1551 8

In recent years, Kingella kingae has emerged as an important pediatric pathogen but the antigenicity of the organism and the host immune response have not been studied. Outer membrane proteins (OMPs) of 57 K. kingae isolates were characterized and the immune response of 19 children with invasive infections was studied by immunoblotting. Kingella kingae OMPs were remarkably similar disregarding place and time of isolation and associated clinical condition (asymptomatic carriage, bacteremia, endocarditis, septic arthritis or osteomyelitis). Most OMPs were immunogenic but the specific bands that reacted in each strain and the intensity of the reactions varied substantially. When convalescent sera were reacted with heterologous strains, bands that either were not recognized by the homologous serum or were not present in the homologous strain were visualized. These results demonstrate that OMPs of K. kingae are highly conserved but suggest that some epitopes are polymorphic, resulting in a variable pattern of immune response.
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PMID:Characterization and immunogenicity of Kingella kingae outer-membrane proteins. 1560 35

Invasive pneumococcal infection (IPI) is a re-emerging complication of Streptococcus pneumoniae infection, particularly in patients with human immunodeficiency virus (HIV) infection. We report a case of a patient who presented with pneumococcal septicaemia, meningitis and septic arthritis, which initially responded to antibiotics, but where the patient eventually succumbed to infective endocarditis of the tricuspid valve. We discuss the spectrum of clinical manifestations of IPI, focusing especially on the Austrian syndrome (defined as pneumococcal endocarditis with rupture of the aortic valve and meningitis), its association with HIV infection, and its management in light of the emergence of penicillin-resistant strains of Streptococcus pneumonia.
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PMID:Invasive pneumococcal infection presenting as septic arthritis and Austrian-like syndrome involving the tricuspid valve in a patient with underlying HIV infection. 1568 Dec 57

A 61-year-old man with no known cardiac history presented with septic arthritis of the right knee secondary to group B Streptococcus. During follow-up, echocardiography revealed a 1.8 cm x 1.2 cm mobile vegetation on the pulmonary valve. Despite parenteral antimicrobial therapy, the patient developed recurrent pulmonary emboli with enlargement of the vegetative mass, necessitating surgical debridement and replacement of the pulmonary valve. A diagnosis of pulmonic valve endocarditis should be considered in the differential diagnosis of any febrile patient with multiple pulmonary emboli.
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PMID:Isolated pulmonic valve endocarditis. 1583 65

Continuous infusion (CI) ticarcillin-clavulanate is a potential therapeutic improvement over conventional intermittent dosing because the major pharmacodynamic (PD) predictor of efficacy of beta-lactams is the time that free drug levels exceed the MIC. This study incorporated a 6-year retrospective arm evaluating efficacy and safety of CI ticarcillin-clavulanate in the home treatment of serious infections and a prospective arm additionally evaluating pharmacokinetics (PK) and PD. In the prospective arm, steady-state serum ticarcillin and clavulanate levels and MIC testing of significant pathogens were performed. One hundred and twelve patients (median age, 56 years) were treated with a CI dose of 9.3-12.4g/day and mean CI duration of 18.0 days. Infections treated included osteomyelitis (50 patients), septic arthritis (6), cellulitis (17), pulmonary infections (12), febrile neutropenia (7), vascular infections (7), intra-abdominal infections (2), and Gram-negative endocarditis (2); 91/112 (81%) of patients were cured, 14 (13%) had partial response and 7 (6%) failed therapy. Nine patients had PICC line complications and five patients had drug adverse events. Eighteen patients had prospective PK/PD assessment although only four patients had sufficient data for a full PK/PD evaluation (both serum steady-state drug levels and ticarcillin and clavulanate MICs from a bacteriological isolate), as this was difficult to obtain in home-based patients, particularly as serum clavulanate levels were found to deteriorate rapidly on storage. Three of four patients with matched PK/PD assessment had free drug levels exceeding the MIC of the pathogen. Home CI of ticarcillin-clavulanate is a safe, effective, convenient and practical therapy and is a therapeutic advance over traditional intermittent dosing when used in the home setting.
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PMID:Continuous infusion of ticarcillin-clavulanate for home treatment of serious infections: clinical efficacy, safety, pharmacokinetics and pharmacodynamics. 1587 64

Podagra is a term used to describe acute monoarthritis of the first metatarsophalangeal (1st MTP) joint. The most common diagnoses of arthritis in this joint are: crystal-induced synovitis, septic arthritis, traumatic conditions and reactive arthritis. When etiologies other than gout are involved this is frequently referred to as pseudopodagra. We report the case of a patient who presented with pain and swelling of the 1st MTP The absence of intraarticular crystals and hyperuricemia encouraged further evaluation of the patient. A cardiac murmur was investigated by echocardiography, which revealed valvular vegetations and the diagnosis of infective endocarditis (IE) was established. This is the first reported case of a podagra-like presentation of IE. As in this case, the diagnosis of gout should rest on findings beyond the presence at 1st MTP arthritis, with evaluation of all extraarticular signs in order to rule out other possible diagnoses.
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PMID:Pseudopodagra: A presenting manifestation of infective endocarditis. 1589

Serious infections can result from wounds that are caused by bites from animals and humans. Organisms recovered from bite wounds generally originate from the oral cavity of the biting animal, as well as from the patient's skin flora. Anaerobes have been isolated from animal and human bite wound infections, especially those associated with abscess formation. In addition to local wound infections, common complications, such as lymphangitis, septic arthritis, tenosynovitis, and osteomyelitis, and uncommon complications, such as endocarditis, meningitis, brain abscess, and sepsis, may occur. Wound management includes proper local care and, when needed, antimicrobial therapy.
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PMID:Management of human and animal bite wounds: an overview. 1592 Mar 71

Four cases are described of Aerococcus viridans endocarditis with favorable outcome, focusing on the clinical picture. Extracardiac findings (e.g. neurological, renal, musculoskeletal, intra-abdominal) in infective endocarditis (IE) have been recognized more frequently in recent years, and may delay the diagnosis and have a negative influence on the prognosis. Aerococcus viridans, a very rare microorganism causing invasive infections, has been associated with bacteremia, septic arthritis, and especially IE. As expected, the strains isolated were susceptible to penicillins, trimethoprim/sulfamethoxazole, and glycopeptides. Medical therapy was sufficient to cure IE in two patients, while two others required surgical intervention.
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PMID:An unusual bacterium, Aerococcus viridans, and four cases of infective endocarditis. 1597 24

We report a case of shoulder arthritis due to Haemophilus aphrophilus. The patient, a 56 year-old woman, was immunocompetent. She presented with a septic arthritis of the left shoulder without portal of entry. A synovial fluid sample was cultured and positive for a gram-negative bacillus after 8 days. It was identified as Haemophilus aphrophilus, in the HACCEK group, by PCR ARN 16S. We did not find any associated endocarditis. The patient recovered. As far as we know, this is only the 5th reported case of arthritis due to this microorganism.
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PMID:[Shoulder arthritis due to Haemophilus aphrophilus]. 1598 45


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