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

Brucellosis is a multisystemic disease. The most common cause of death from the disease is endocarditis. The aortic valve is most commonly affected. The disease rarely involves the mitral valve. A 30 year-old woman presented with complaints of chills and fever up to 38 degrees C at night, fatigue, palpitations, and dyspnea for the previous 3 weeks. Cardiac auscultation revealed a diastolic murmur in the mitral area. Her temperature was 38.3 degrees C. On echocardiographic examination, the mitral valve area was 0.62 cm (2) and an isoechoic mass thought to be a vegetation was detected on the anterior mitral leaflet. A diagnosis of infective endocarditis was made and vancomycin administration was commenced. Brucella melitensis was isolated in all three blood samples, however, the patient remained seronegative with Brucella agglutination titers of up to 1/160. The antibiotic therapy was then shifted to doxycycline (200 mg/day), rifampicin (600 mg/day), and ciprofloxacin (1000 mg/day). After 30 days of treatment, surgery was performed for the severely stenotic mitral valve and to remove the vegetation. The operation was successful. The postoperative period was uneventful. On the follow-up she had no complaints. In cases with Brucella endocarditis, after diagnosis, antibiotic therapy must be started immediately and when the clinical condition improves, surgical intervention should be performed when indicated.
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PMID:A case of mitral stenosis complicated with seronegative Brucella endocarditis. 1509 Jul 14

A 33-year-old man with a known bicuspid aortic valve presented with fever, chills, progressive fatigue, anorexia, and night sweats. Echocardiography confirmed aortic-valve endocarditis, but blood cultures remained negative. Bartonella henselae endocarditis was ultimately confirmed by serology as well as by immunohistochemistry and PCR testing of the excised valve. The patient recovered with appropriate antibiotic therapy. B henselae is a common cause of culture-negative endocarditis. It predominantly affects men with underlying valvular disease, and has a predilection for aortic valves. Diagnosis is usually made serologically and with either tissue culture, immunohistochemistry, or PCR. Treatment of this destructive endocarditis consists of a combination of long-term antibiotic therapy and surgical valve repair. This case is used to discuss the approach towards the treatment of patients with endocarditis that is blood-culture negative.
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PMID:A mechanic with a bad valve: blood-culture-negative endocarditis. 1556 27

Human brucellosis has become a rare disease in Germany since the eradication of bovine and ovine/caprine brucellosis in this country. Therefore, most physicians are unfamiliar with the illnesses clinical presentation, diagnostic tools, and therapeutic strategies. This retrospective study was carried out to evaluate the epidemiological, clinical, and laboratory features of human brucellosis in Germany in the years 2002 and 2003. Thirty-one bacterial isolates from 30 patients sent to the German national reference laboratory were characterized using the genus-specific bcsp31 real-time PCR, the species-specific AMOS-PCR, and standard microbiological methods for the detection and identification of Brucella spp. The medical records of all patients with bacteriologically confirmed brucellosis were evaluated. All 31 isolates proved to be Brucella (30 Brucella melitensis and 1 Brucella suis). Most of the brucellosis patients were infected in endemic countries while visiting friends and relatives during their summer holidays. One case of laboratory-acquired infection was identified. Brucellosis was transmitted mainly by the consumption of contaminated unpasteurized milk or cheese from goats and sheep. The patients presented primarily with flu-like symptoms, i.e. fever, chills, sweating, headaches, arthralgia, and myalgia. In most cases, however, symptoms and signs of focal complications, e.g. spondylitis, endocarditis, and meningoencephalitis, predominated. The rate of complications was much higher than that in endemic countries, presumably as a result of diagnostic delay due to a low index of suspicion. In summary, physicians in nonendemic countries such as Germany must be aware of brucellosis being a possible cause of fever of unknown origin in immigrants and tourists travelling from endemic countries.
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PMID:Human brucellosis in a nonendemic country: a report from Germany, 2002 and 2003. 1595 15

As far as we are aware, right-sided bacterial endocarditis has not previously been described as presenting with systemic illness and testicular swelling. We report a teenager who presented with this unusual combination as a consequence of right-sided endocarditis. He presented with high fever, with chills and rigor, along with painful enlargement of the left testicle, a productive cough with progressive breathlessness, and joint pains. His blood culture was positive for Staphylococcus aureus, and a computerised tomographic scan of the chest revealed multiple pulmonary emboluses. Ultrasound of the testicles showed features of inflammation, and an echocardiogram revealed a vegetation on the tricuspid valve.
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PMID:Testicular swelling with pneumonia and septicaemia: a rare presentation of right-sided endocarditis. 1616 97

Infective endocarditis related to pacemaker is a rare but serious condition in permanent venous tracing. A 65-year-old man was admitted to the hospital with high fever and chills. A DDD pacemaker had been implanted via the right subclavian vein because of sick sinus syndrome 6 years earlier. Transesophageal echocardiogram identified an oscillating round hyperechoic mass with a stalk near the tricuspid valve. Blood cultures grew Staphylococcus hominis. The patient was treated with antibiotics and operated on after the acute phase of the illness had subsided. We hereby report a case of lead endocarditis caused by S. hominis in a patient with pacemaker, which has been rarely reported in the English literature.
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PMID:Pacemaker lead endocarditis caused by Staphylococcus hominis. 1668 53

The genus Ruminococcus which are anaerobe Gram positive cocci, previously classified as Peptostreptococcus, may colonize the upper respiratory tract, gastrointestinal tract, vagina and skin of humans and animals. In this report a case of liver abscess and a case of infective endocarditis caused by Ruminoccocus productus, which is very rarely encountered in the clinical practice were presented. The first case was a 32 years old male who was admitted to the hospital in 2002, with the complaints of fever lasting for 20 days and pain while breathing. The abdominal ultrasonography revealed the presence of a liver abscess, and the drainage material from the abscess yielded Ruminococcus productus, identified in BACTEC 9200 (Becton Dickinson, Sparks, Md) anaerobe system. As the isolate was found to be sensitive to penicilin, the empirical gentamicin and ampicillin/sulbactam therapy was continued. The second case was a 25 years old male who was admitted to the hospital in 2005, with the signs of fever lasting for 3-4 months, chills, bone and joint pains. As multiple vegetations were detected in echocardiography, blood cultures were collected and empirical therapy with ceftriaxone and gentamicin was initiated with the preliminary diagnosis of infective endocarditis. Bacteria which were isolated from blood cultures by BACTEC 9200 system have been identified as R. productus. As this strain was also sensitive to penicillin, the empirical therapy was changed to penicilin and gentamicin. These two cases indicated that R. productus should be considered in complicated infections even if it is a rarely isolated species from the clinical samples.
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PMID:[Liver abscess and infective endocarditis cases caused by Ruminococcus productus]. 1720 98

We report a case of a 51-year-old diabetic male who presented with a complaint of intermittent chills and fever that he had experienced for 10 days. No obvious respiratory tract, genitourinary tract, gastrointestinal tract, or skin lesions were observed. Blood culture data were positive for group B beta-streptococcus. Transthoracic and transesophageal echocardiography revealed vegetation in the anterior leaflet of the mitral valve. The patient was diagnosed with infective endocarditis (IE) and prescribed a parenteral antibiotic. Three days after admission, the patient complained of progressively blurred vision. Slit lamp examination found fine keratic precipitates and aqueous cells in the anterior chambers in both eyes, implying that the patient had uveitis. He was then prescribed a topical steroid for 4 months, and his vision improved gradually. This case is an important reminder that uveitis, not only endophthalmitis, can occur with IE. Treatment for one condition, if misapplied, may worsen the other.
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PMID:Infective endocarditis with uveitis: a rare case report. 1728 85

Chiari network is a rare vestigial remnant of the right valve of the sinus venosus, located in the right atrium. We report the case of a 41-year-old woman who presented with fever and chills. She had a history of infective endocarditis caused by methicillin-sensitive Staphylococcus aureus a year ago. Echocardiography did not reveal the presence of any vegetation on any of the cardiac valves. She was found to have a mass attached to Chiari network in her right atrium. This was removed surgically and revealed the presence of infective endocarditis on the papillary fibroelastoma attached to the Chiari network. This is the first report of such a case and illustrates that not all endocarditis occurs on cardiac valves.
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PMID:Infective endocarditis of a papillary fibroelastoma on Chiari network of right atrium: a case report. 1792 93

After several weeks of fever and chills, a 31-year-old logger developed pain in his right thigh. Upon examination a tender, pulsating upper thigh mass was found with a long loud bruit arising from it. Severe aortic insufficiency was present; however, blood cultures were negative. An angiogram, captured blood with contrast spewing from the profunda femoral artery to fill a 5 x 10 cm sac. A false aneurysm was diagnosed and resected; numerous gram positive cocci were present in cut sections, but cultures from the cavity grew the gram negative bacteria Salmonella and Alcaligenes. After one month of intravenous ampicillin the aortic valve was replaced after being destroyed by endocarditis. Ampicillin was continued and recovery was uneventful. Mycotic aneurysms are commonly caused by Salmonella (10%), which was second only to Staphylococcus (30%). The femoral artery accounts for 38% of all mycotic aneurysms. They typically present with a pulsatile mass (52%), bruit (50%), and fever (48%). This diagnosis can be supported by leukocytosis (64-71%), positive blood cultures (50-85%), and a history of arterial trauma (51%) (injection drug use, intravascular procedure, or trauma) or endocarditis (10%).
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PMID:Mycotic femoral aneurysm. 1794 Dec 49

We describe the first pediatric case of Gemella bergeriae endocarditis in a 15-year-old boy with tetralogy of Fallot and pulmonary atresia who presented with weight loss, chills, and cold intolerance. Blood cultures revealed Gram-positive cocci that failed to type with Lancefield group antiserum. The identification of the organism was confirmed by 16S rRNA gene sequencing.
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PMID:Gemella bergeriae endocarditis in a boy. 1817 61


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