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

The clinical, pathomorphological and microbiological findings during meat inspection in 599 pigs with endocarditis at slaughter were studied. Clinical signs were observed in 41 per cent of the pigs on ante-mortem inspection. Lameness was the most common sign. However, this symptom is not very specific of endocarditis. This is also true of various other symptoms. Only dyspnoea and drowsiness were indicative of endocarditis to some extent, but occurred only sporadically. Extracardial lesions were observed in 66 per cent of the pigs with endocarditis on post-mortem inspection. Metastatic processes (infarction or inflammatory foci) were most frequently detected in the kidneys. These were highly specific of endocarditis. In addition, the following changes were observed in decreasing incidence: signs of sepsis (hyperplastic splenitis, petechiae and degradation of organs), inflammatory lesions of the joints and legs, metastatic pneumonia and inflammation of the tail. Bacteriological examination was positive in 62 per cent of the cases. Streptococci were the organisms most frequently isolated (36 per cent), followed by Corynebacterium pyogenes (19 per cent) and Erysipelothrix rhusiopathiae (14 per cent). The discussion is concerned with the significance of these bacteria to meat-consumers.
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PMID:[Endocarditis and meat inspection in slaughtering pigs. 1. Clinical, pathological and microbiological aspects]. 368 3

The characteristics features of right-sided endocarditis are summarized in this case report of a 30-year-old female admitted with a history of high grade, continuous, fever, breathlessness, and dry cough over a 10-day period. The patient had had an incomplete abortion 15 days earlier for which dilatation and curettage was performed. On examination, the patient was toxic, febrile with a pulse of 118/minute and respiration 36/minute. Her blood pressure was 110/70 mm Hg. There was soft, tender hepatomegaly and soft splenomegely. There also were scattered coarse crepitations over both lungs. The vaginal examination revealed posterior fornicial bogginess and tenderness. Urine and cervical pus swab showed growth of klebsiella. The blood culture was negative. A plan chest X-ray revealed multiple, small, basal, pulmonary infiltrates. Posterior colopuncture revealed a small quantity of clear, yellowish fluid. Abdominopelvic ultrasonography revealed an ill-defined haziness in the parauterine region. The patient was treated with ampicillin, gentamycin, and metronidazole, but she continued to deteriorate. An urgent exploratory laparotomy was performed. The patient died on the 2nd postoperative day. The autopsy findings revealed that the heart was normal in size and shape. The tricuspid valve showed a large vegetation projecting into the ventricle. Microscopic examination revealed polymorphonuclear infiltration with clumps of gram-negative bacillifocal areas of myocarditis also were seen. In lungs the right lower lobe showed a small, hemorrhagic infarct. Both the liver and spleen were congested. Kidneys showed multiple petechiae on the external surface and on the cut section. Endocarditis during pregnancy may be because of perinatal infections, urinary tract infection, or septic thrombophlebitis of pelvi veins. Septic abortion of pelvic infection secondary to IUD also can provide portal of entry for bacteria. The common organisms are streptococcus, staphylococci, and occasionally bacteroides and gram negative bacilli. Clinical suspicion of right-sided endocarditis is justified in any patient with prolonged fever, cough, pleuritic pain, tachycardia, and multiple pulmonary infiltrates. Heart murmurs are usually absent and if present are soft and may be heard at atypical sites.
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PMID:Tricuspid valve endocarditis following septic abortion. 371 Oct 12

A young intravenous drug user presented with Staphylococcus aureus endocarditis involving the tricuspid valve, which was replaced with a Hancock bioprosthesis. She presented again with fever and dyspnea five months later and was found to be cyanotic. Recurrent endocarditis involving the prosthesis with right-to-left shunting through a patent foramen ovale was documented by echo and confirmed at autopsy.
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PMID:Endocarditis of a tricuspid prosthesis causing valvular stenosis and shunting through a patent foramen ovale. 373 7

Imipenem, a potent new beta-lactam antibiotic, which is bactericidal against most pathogenic bacteria, and cilastatin, a dehydropeptidase inhibitor combined with imipenem to prevent the metabolism of imipenem in the kidney, were evaluated in the treatment of bacterial endocarditis. Seventeen patients, including 14 who used intravenous drugs, were treated with imipenem/cilastatin in a dose of 500 mg each infused over 30 minutes every six hours. The mean duration of treatment was 29 days with a range of 21 to 56 days. Causative bacteria were Staphylococcus aureus in 10 patients, S. aureus plus group B Streptococcus in one, viridans group Streptococcus in two, Neisseria subflava, Eikenella corrodens, and group G Streptococcus in one patient, and Staphylococcus epidermidis, Hemophilus aphrophilus, and Enterobacter aerogenes in one patient each. The minimal bactericidal concentration of imipenem against 16 of 18 isolates tested was 0.04 micrograms/ml, 1 microgram/ml against H. aphrophilus, and 0.4 micrograms/ml against E. aerogenes. The site of infection was the right side of the heart in 11 patients, the left side in five, and both sides in one. The mean number of days to defervescence was 9.7. All patients were cured, and none required cardiac surgery. Adverse effects were few and interrupted treatment occurred in only one patient who had acute dyspnea during an infusion on Day 26 of therapy. Imipenem/cilastatin appears to be a relatively safe and highly effective treatment of staphylococcal endocarditis in intravenous drug users; too few patients with endocarditis caused by other bacteria were treated to allow a firm statement about efficacy in non-staphylococcal endocarditis.
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PMID:Efficacy of imipenem/cilastatin in endocarditis. 385 10

The clinical relevance of the echocardiographic finding of mitral valve prolapse (MVP) is largely unclear. Therefore we made a prospective study of 470 patients with MVP established by M-mode echocardiography (63.7% holosystolic, 36.3% late systolic) over an average period of 2.7 years, corresponding to an observation period of 1,269 patient years. Patients with hemodynamically relevant mitral insufficiency were excluded from the study, as were patients with additional cardiac disorders. Three patients died, two of non-cardiac causes, but one probably in sudden cardiac death. 54.8% complained of angina pectoris, 15.6% of dyspnea. 14.4% suffered from non-orthostatic vertigo. 23.3% had one or more syncopes, 14.9% for the first time during the period of observation. 43.4% suffered from rhythm disturbances, 10.2% for the first time during the period of observation. Patients with rhythm disturbances experienced non-orthostatic vertigo (p less than 0.01) and syncopes (p less than 0.01) more frequently than patients without rhythm disturbances. During the study none of the patients developed endocarditis and none had an arterial embolism. Patients with late systolic MVP and a click experienced syncopes more frequently than those with holosystolic MVP without a click (p less than 0.05). Further correlations between the echocardiographic picture, auscultatory findings, age, sex and weight on the one hand and clinical progress on the other hand, were not found. Thus prognosis for MVP with regard to survival seems to be good. Nonetheless, complaints, even potentially threatening syncopes, are frequent. Neither clinical nor echocardiographic findings permit a prognostic statement.
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PMID:[Clinical course of 470 patients with mitral valve prolapse]. 396 12

The early and late results were retrospectively evaluated in 57 cases of double or triple valve replacement or repair performed in 1970-1983. The causes of the valvular lesions were rheumatic fever (43 cases), bacterial endocarditis (6), syphilis (1) and unknown (7 cases). The preoperative NYHA classification was III in 29 patients and IV in 28, due mainly to dyspnea of effort. Cardiomegaly (mean radiologic volume 880 cm3/m2) and atrial fibrillation were the dominant clinical findings. Surgery was on emergency indications in five cases. Cold cardioplegia combined with external cardiac cooling has been used for myocardial protection since 1977. The valve replacements were 56 aortic, 50 mitral and 2 tricuspid. In addition there were three closed and two open mitral commissurotomies, two mitral plastic repairs, three tricuspid valve anuloplasties (DeVega) and one aortic anuloplasty. Follow-up (0.3-13, mean 3.5 years) was supplemented with a check-up including two-dimensional echophonocardiography and hematologic tests. The operative mortality (10/57 patients) fell from 26% in 1970-1976 to 12% in 1977-1983. The causes of death were low cardiac output in preoperatively ill patients (5), myocardial infarction (2), technical failure (2) and sepsis (1 case). There were 11 late deaths (6.7/100 patient-years of observation), the commonest cause (5 patients) being congestive heart failure. The respective incidences of thromboembolism, paravalvular leak and postoperative endocarditis were 2.1, 4.2 and 2.1 episodes/100 patient-years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Combined multiple-valve procedures. Factors influencing the early and late results. 401 39

A 5-year-old spayed female Doberman Pinscher was referred for clinical evaluation following two acute episodes of lameness, lethargy, and respiratory dyspnea. The femoral pulse had a bounding "water-hammer" quality. Arterial blood pressures were 280 mm of Hg to greater than 300 mm of Hg during systole and approximately 40 mm of Hg during diastole. Systolic blood pressure was lowered to 210 mm of Hg, using prazosin. Radiography revealed extensive pulmonary interstitial markings and smooth subperiosteal expansions of the long bones indicative of hypertrophic pulmonary osteopathy. Despite symptomatic treatment, the dog's health gradually deteriorated, and it died 9 days after referral. Necropsy revealed vegetative endocarditis of the aortic valve. Insufficiency of the aortic valve was believed to be responsible for the systolic hypertension and the hypertrophic pulmonary osteopathy.
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PMID:Arterial hypertension and hypertrophic pulmonary osteopathy associated with aortic valvular endocarditis in a dog. 744 Mar 32

We recently experienced a case of infective endocarditis with multiple embolic complications. The patient was a 21-year-old male who was admitted to our hospital with high fever and dyspnea. Echocardiography showed vegetation on the aortic valve, severe aortic regurgitation and mild mitral regurgitation. Abdominal echography revealed large splenic infarction. First we performed aortic valve replacement and splenectomy. But infective endocarditis developed after surgery, and echocardiography revealed severe mitral regurgitation, which has been a change for the worse. After treatment with antibiotics, mitral valve replacement (the second surgery) was performed. Intraoperative findings were confirmative of subtotal rupture of the posterior papillary muscle. Histological examination of the subtotal ruptured muscle revealed presence of coagulation necrosis. The patient is healthy without recurrence of infective endocarditis after the second surgery. It is exceedingly rare to experience a case of surgically treated subtotal papillary muscle rupture due to infective endocarditis.
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PMID:[A case of infective endocarditis with subtotal rupture of the posterior papillary muscle]. 760 64

From January 1986 through December 1993, 482 patients underwent aortic valve replacement with the Carpentier-Edwards pericardial bioprosthesis at our institution. Patients ranged in age from 26 to 87 years (mean, 72.5 +/- 7.1 years), and 59.8% of them were men. Pure or predominant aortic stenosis was the indication for operation in 80.1% of the patients. Most (75.4%) of the patients were in New York Heart Association functional class III or IV preoperatively because of dyspnea. Isolated aortic valve replacement was performed in 265 patients (55.0%). The most frequent concomitant procedure was aortocoronary bypass grafting (38.4%). All patients were followed up for as many as 7 years postoperatively (average, 1.7 +/- 1.7 years). Twenty-six patients (5.4%) died within 30 days postoperatively; 53 patients died during the remainder of the follow-up period. The actuarial survival rate was 74.0% +/- 3.6% at 5 years and 59.7% +/- 7.5% at 7 years postoperatively. There were 12 valve-related deaths, and these were due to endocarditis (n = 3), thromboembolism (n = 5), anticoagulant-related hemorrhage (n = 2), reoperation necessitated by structural deterioration (n = 1), and sudden death (n = 1). After 7 years, the freedom from thromboembolic events was 86.6% +/- 3.8%, the freedom from anticoagulant-related hemorrhage was 98.0% +/- 0.9%, and the freedom from reoperation was 90.9% +/- 8.3%. There was only one structural failure, and this occurred at 6 years postoperatively.
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PMID:Intermediate clinical results after aortic valve replacement with the Carpentier-Edwards pericardial bioprosthesis. 764 79

We reported an experience of successful aortic valve replacement due to active infective endocarditis complicated with Klippel-Trenaunay-Weber (KTW) syndrome which was characterized by limb hypertrophy, hemangioma, arteriovenous fistula and varicose veins. A 27-year-old man was admitted to our hospital because of severe dyspnea and high grade fever. Echocardiogram revealed severe aortic regurgitation and destruction of aortic valve due to active infective endocarditis. We performed aortic valve replacement and patch closure of annular abscess. As to vascular malformation of lower limb including arteriovenous fistula and varicose veins, surgical treatment was not undergone to avoid postoperative limb dysfunction. Although the origin of infective endocarditis was uncertain, the patient had peripheral vascular malformations. It was postulated that valvular endocardial injury might be occurred by cardiac volume overload due to arteriovenous fistula. The patients with KTW syndrome should be followed under careful observation since infective endocarditis may be one of the complications of the syndrome.
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PMID:[A case report of infective endocarditis complicated with Klippel-Trenaunay-Weber syndrome]. 771 95


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