Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 40-year-old woman in whom the mitral valve had to be replaced with a prosthetic one (St. Jude's) had to be reoperated 8 months later because of endocarditis on the second prosthetic valve (Carbo-Medics). Four months later her general condition deteriorated progressively with cough and dyspnoea, requiring hospitalization. Auscultation revealed moist rales over both lung bases; heart sounds were distant but otherwise normal. The "international normalized ratio" was 2.5, while erythrocyte sedimentation rate, white cell count and C-reactive protein were normal. Transthoracic echocardiography demonstrated a hardly moving mitral valve prosthesis with an opening area of 0.8 cm. Subsequently this decreased further and measurement of the anticardiolipin antibody titre revealed an IgG fraction of 37.9 U/ml (normal up to 12 U/ml). Within 48 hours thrombolysis with streptokinase had increased the valve's opening area to 1.8 cm. The patient made an uneventful recovery under strict anticoagulation. This case illustrates that the anticardiolipin syndrome can be a cause of an otherwise unclear genesis.
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PMID:[Thrombosis of a prosthetic mitral valve in the anticardiolipin syndrome]. 778 11

Although the literature on subacute bacterial endocarditis from both the preantibiotic and antibiotic eras mentions cough as a symptom, neither bacteremia nor endocarditis is listed in reviews on chronic cough. Herein we describe a 74-year-old man who underwent an extensive workup as an outpatient because of chronic cough of 7 months' duration. Chest roentgenography, chest and sinus computed tomography, fiberoptic bronchoscopy, gallium scan, transthoracic echocardiography, and other studies revealed no apparent cause for his nonproductive cough. Because of a persistently increased erythrocyte sedimentation rate and associated weight loss, blood cultures were obtained, all of which grew Streptococcus constellatus. A transesophageal echocardiogram revealed mitral valve vegetation. After antibiotic therapy was administered, the patient's cough completely resolved. He has experienced no coughing for more than 14 months. Bacteremia in conjunction with endocarditis should be added to the list of uncommon causes of chronic cough. The mechanism of cough is unknown.
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PMID:Chronic cough associated with subacute bacterial endocarditis. 779 89

A 63-year-old man with cough and shortness of breath was diagnosed to have active infective endocarditis resulting in acute pulmonary edema with aortic regurgitation caused by a huge vegetation on the noncoronary cusp and left ventricular-right atrial (LV-RA) communication which were demonstrated by the echocardiogram and color doppler method. The LV-RA communication located at the atrioventricular portion of the membranous septum was closed with GoreTex patch through the right atrium combined with the aortic valve replacement with a bileaflet mechanical valve in emergency. The bacteriological studies demonstrated staphylococcus epidermidis. The postoperative course was uneventful and the patient is now on regular duty two years after surgery.
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PMID:[A case of left ventricular-right atrial communication complicated with aortic regurgitation caused by active infective endocarditis]. 783 20

The demographics and natural clinical history of canine congenital subaortic stenosis (SAS) were evaluated by retrospective analysis of 195 confirmed cases (1967 to 1991), 96 of which were untreated and available for follow-up evaluation. Of these, 58 dogs had left ventricular outflow systolic pressure gradients available for assessment of severity. All 195 dogs were used for demographic analysis. Breeds found to be at increased relative risk included the Newfoundland (odds ratio, 88.1; P < .001), Rottweiler (odds ratio, 19.3; P < .001), Boxer (odds ratio, 8.6; P < .001), and Golden Retriever (odds ratio, 5.5; P < .001). Dogs with mild gradients (16 to 35 mm Hg) and those that developed infective endocarditis or left heart failure were diagnosed at older ages than those with moderate (36 to 80 mm Hg) and severe (> 80 mm Hg) gradients. Of 96 untreated dogs, 32 (33.3%) had signs of illness varying from fatigue to syncope; 11 dogs (11.3%) developed infective endocarditis or left heart failure. Exercise intolerance or fatigue was reported in 22 dogs, syncope in 11 dogs, and respiratory signs (cough, dyspnea, tachypnea) in 9 dogs. In addition, 21 dogs (21.9%) died suddenly. Sudden death occurred mainly in the first 3 years of life, primarily but not exclusively, in dogs with severe obstructions (gradient, > 80 mm Hg; odds ratio, 16.0; P < .001). Infective endocarditis (6.3%) and left heart failure (7.3%) tended to occur later in life and in dogs with mild to moderate obstructions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The natural clinical history of canine congenital subaortic stenosis. 788 29

A 57-year-old man with a cough and increasing exertional dyspnoea for the past 6 weeks was found on examination to have a loud systolic murmur and cardiomegaly with pulmonary congestion. Echocardiography revealed congenitally corrected transposition of the great arteries (cTGA: atrioventricular and ventriculoarterial discordance): a morphologically right ventricle with a tricuspid valve on the left, a morphologically left ventricle with bicuspid a-v valve on the right, the aorta arising ventrally from the left-sided (morphologically right) ventricle. The tricuspid valve showed an Ebstein-like anomaly with obvious regurgitation. Transoesophageal and contrast echocardiography defined valvar anatomy, attachment of the great arteries and cardiac chambers to the venous and arterial circulations, as well as absence of a left to right shunt. Angiography revealed a coronary anatomy typical for cTGA. The exertional dyspnoea responded to diuretics and low doses of ACE inhibitor. Follow-up monitoring of the valvar regurgitation and appropriate endocarditis prophylaxis were recommended. As the haemodynamics in cTGA is normal, in the absence of additional anomalies, it is a congenital cardiac defect which can, though rarely, present first in adulthood. Life expectancy depends on the nature of any additional defects and the degree of commonly associated tricuspid valve regurgitation. As this case demonstrates, echocardiography can largely define the anomalies.
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PMID:[Congenitally corrected transposition of the great vessels in adulthood. The value of noninvasive study methods]. 807 3

Forty three year-old male who had cough and easy fatigability since three weeks prior to admission was diagnosed to have acute pulmonary edema with severe mitral regurgitation caused by active infective endocarditis. Transesophageal echocardiograms under the endotracheal intubation for controlled respiration suggested rupture of the posterior papillary muscle of the mitral valve and the emergency surgical treatment was performed. Intraoperatively the total rupture of the posterior papillary muscle was confirmed and mitral valve replacement was carried out with a SJM prosthetic valve. Histological examination of the ruptured papillary muscle revealed hemorrhage, muscle necrosis and small cell infiltration suggesting the presence of active inflammation with bacteria on it. Staphylococcus epidermidis was demonstrated by the bacteriological studies of the ruptured papillary muscle.
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PMID:[Successful surgical treatment in a case of complete rupture of the posterior papillary muscle of the mitral valve caused by infective endocarditis]. 808 83

Three weeks following a toothache, a 56-year-old man developed cough, sputum, fever, and pleuritic chest pain. He had mild periodontal disease and his chest radiographs and chest computed tomographic (CT) scans showed multiple pulmonary nodules. The CT scan strongly suggested septic pulmonary embolism. Aspirated pus from one of the nodules yielded pure growth of Streptococcus intermedius. Lesions resolved with antimicrobial therapy. The usual predisposing factors for septic pulmonary embolism were absent, and, the isolation of S intermedius from the pus, the antecedent toothache, and periodontal disease all suggested the gingiva as the source. We hypothesize that periodontal infection led to bacteremia, seeding of the lungs, and multiple anaerobic pulmonary abscesses, akin to reported instances of infective endocarditis from dental foci without any prior dental procedures. To our knowledge, this presentation of septic pulmonary embolism is unprecedented.
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PMID:Septic pulmonary embolism due to periodontal disease. 825 94

Brucella endocarditis was diagnosed in a 21-year-old itinerant farm worker hospitalized for acute pulmonary edema. History taking revealed cough, fever and sweating one month earlier which had been treated with antibiotics. At admission, echography showed lesions on the aortic valve and hemocultures identified Brucella meltensis. On day 7 of specific treatment with doxycycline (200 mg/day) and rifamycine (1200 mg/day), and despite digitalics and diuretics, left ventricular failure rapidly worsened, leading to cardiac arrest and death before emergency surgery could be performed. Autopsy showed occlusive vegetations on the aortic valves facing the right coronary ostium, deep ulceration of the valsava sinus with abscess formation and fibrino-hemorragic pericarditis involving both the anterior and posterior walls of the epicardium. Gram negative germs were evidenced in the abscess alone. This case emphasizes the potentially rapid destructive effect of Brucella melitensis and confirms that surgery is the safest therapeutic alternative for aortic valve localizations. Surgery should be performed without delay.
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PMID:[Brucella pancarditis with fatal outcome]. 866 92

A 26-year-old man had a total repair of tetralogy of Fallot at 1 year of age, and had redo surgery for restenosis of the right ventricular outflow tract and small residual VSD at 11 years of age. After the second operation, AV block developed and an endocardial pacemaker system was implanted. For the last 3 years, he had mild febrile episodes, cough, occasional hemoptysis and paroxysmal ventricular tachycardia. Because of his refractory tachycardia and suspected infective endocarditis, he was admitted for further study. Blood culture revealed Peptostreptococcus, echocardiogram showed vegetation around intravenous pacing lead, and electrophysiological study demonstrated delayed potential on the left side of the right ventricular outflow tract. He underwent scartectomy and cryoablation of the focus of the tachycardia which was reconfirmed by epicardial and endocardial mapping during the operation, which involved removal of the endocardial lead and new outflow tract patch repair. His postoperative course was uneventful without any antiarrhythmic drugs. Pathological examination of the scar showed myocardial fibrosis and replacement by fatty tissue which was different from the pathological characters of the arrythmogenic right ventricular dysplasia.
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PMID:[Successful scartectomy and cryoablation for ventricular tachycardia occurring late after correction of tetralogy of Fallot]. 896 97

A 38-year-old man was admitted to our hospital for detailed examination of fever, cough and yellow sputum. At the age of 32, be had mitral prosthesis for the first time, because of mitral regurgitation due to mitral valve prolapse. Four years previously, he had again undergone mitral prosthetic valve replacement due to prosthetic valve endocarditis due to staphylococcus epidemidis. This occasion, staphylococcus aureus was isolated by arterial blood culture. Transesophageal echocardiography detected vegetation attached to the mitral prosthetic valve and paravalvular leakage. The diagnosis was prosthetic valve endocarditis. He underwent a third mitral prosthetic valve replacement. Detection of the source of infection was difficult only by transthoracic echocardiography, and immediate transesophageal echocardiography seemed mandatory to diagnose bacterial endocarditis.
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PMID:[Mitral prosthetic valve replaced twice due to repeated prosthetic valve endocarditis: a case report]. 921 Nov 15


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