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

In this paper demographic characteristics, etiology, pathology and clinical features of infective endocarditis are reviewed simultaneous presentation of the data from our series of 50 cases with infective endocarditis. The peak incidence of infective endocarditis is between 11 and 15 years. Both sexes are equally affected. Patients with congenital or acquired heart disease tend to have hemodynamic trauma to the endocardium and vascular endothelium. These sites form the nidus for circulating bacteria of either spontaneous origin or the result of any oro-dental, genitourinary or other surgery or procedures and produce vegetations characteristic of infective endocarditis. The location of the vegetation is dependent upon the predisposing cardiac lesion. Embolic phenomenon is another cardinal feature of endocarditis and may occur in any organ system. Although a large variety of microbes have been known to cause endocarditis, streptococci and staphylococci remain the most frequent offenders. Clinical diagnosis of infective endocarditis is difficult because of the insidious onset and varied clinical features. A high degree of suspicion is essential for early diagnosis. Any patient with known heart disease and unexplained fever should be suspect for endocarditis. Splenomegaly, petechiae and embolic phenomena support this diagnosis. New or changing murmurs, splinter hemorrhages, Osler's nodes. Janeway's lesions and Roth's spots may be present. Elevated sedimentation rate, microscopic hematuria, leukocytosis with a shift-to-the-left and anemia may further support the diagnosis. Congenital or acquired heart disease and fever are all that will be present in many cases. Only isolation of the causative agent from the blood can confirm the diagnosis.
 ...
PMID:Infective endocarditis: a review. I. Incidence, etiology, pathology and clinical features. 72 71

Four patients in whom endocarditis had been verified at autopsy had the pathogenic organism isolated from aspirates of Osler's nodes. In three cases the responsible organism was identified in Gram stains made from aspirates. The etiologic agent was Staphylococcus aureus in three cases and Candida albicans in one case. Histologic examination of an Osler's node from one of the patients with S. aureus endocarditis showed a microabscess in the papillary dermis together with microemboli in nearby dermal arterioles. Workers previously have interpreted similar histologic findings as consistent with perivasculitis resulting from an immunologic reaction to the pathogenic organism. The present findings support Osler's original contention that the skin lesions that bear his name are "in all of probability caused by minute emboli".
 ...
PMID:Pathogenesis of Osler's nodes. 78 82

Infective endocarditis may have different clinical manifestations that result from involvement of different organ systems. These include heart murmur, valvular bacterial vegetation, arterial emboli induced hematuria, conjunctival petechiae, subcutaneous Janeway's spots and Osler's nodes. Musculoskeletal manifestation yields arthralgia, arthritis, low back pain and myalgia, etc. Early recognition of these manifestations can lead to earlier treatment and recovery without delay. We report three cases of infective endocarditis who first presented low back pain. Their clinical features resolved with treatment. The pathogenesis of low back pain in infective endocarditis is not well-known. However, vertebral arterial embolization, vertebral septic necrosis or immune complex deposition is elucidated.
 ...
PMID:[Low back pain as a presenting symptom in patients with infective endocarditis report of three cases and literature review]. 131 89

A 27 weeks' pregnant women exhibited infective endocarditis due to alpha-streptococcus. As echocardiography showed vegetations on both mitral leaflets, cesarean section was performed at 35 weeks' gestation and a healthy male infant weighing 2,430 g was delivered. Antibiotic therapy was continued for fever after the cesarean section but macrohematuria and Osler's nodes developed. Emergency mitral valve replacement was performed successfully despite the presence of active infective endocarditis. She was discharged after completion of a 10-week course of antibiotic therapy.
 ...
PMID:[Successful mitral valve replacement for infective endocarditis in pregnancy]. 220 63

A 34-year-old man, a heavy drinker, was admitted with a high fever and hematuria two months previously. Surgery was performed for acute sever pancreatitis and postoperatively antibiotics were administered with intravenous hyperalimentation. After discharge he was readmitted and infective endocarditis was strongly suspected because of high fever, hematuria, Osler's nodes, Janeway's lesions, splinter hemorrhages and mitral regurgitation. Penicillin G in combination with Gentamycine therapy was started on the first hospital day. On the second hospital day, blood culture revealed Candida tropicalis so Miconazole therapy was commenced. On the forth hospital day, he underwent surgery for replacement of a mitral prosthesis with a prosthetic valve because he had embolus in the radial artery. Despite intensive antifungal therapy, he showed no improvement in clinical symptoms. Then we changed the antifungal drug from Miconazole to Amphotericin B and 5-fluorocytosine. On the 109th hospital day, his clinical symptoms improved. Antifungal therapy was halted and at present 10 months later, he is healthy.
 ...
PMID:[A successfully treated case of infective endocarditis due to Candida tropicalis]. 221 59

Thirteen cases of infective endocarditis (IE) diagnosed for the first time at autopsy or, in those patients with a previous diagnosis of IE, not thought to be active at the time of death, are presented. Of the six patients who died within 24 h of the onset of symptoms, two died of obstruction of a valve orifice, two died of sepsis, one died of sepsis and alcoholic cardiomyopathy, and one died of a coronary artery embolus. Of the five patients with symptoms lasting more than 24 h, three died of sepsis and congestive heart failure. One died from sepsis alone and one died from congestive heart failure (CHF). In two patients whose duration of symptoms is unknown, one died of sepsis and CHF, and in the other the mechanism of death is unknown. Predisposing factors present in 11 of 13 patients included alcoholism (three), intravenous (IV) drug abuse (three), prosthetic valves (three), aortic stenosis (two), past rheumatic fever (one), and nonstenotic congenitally bicuspid valves (two). The reasons for no antemortem diagnosis were a missed or incorrect clinical diagnosis in three patients seen by a physician shortly before death, no signs or symptoms or found dead (four), non-specific signs and symptoms (three), refusal of medical treatment (one), and a solitary lifestyle (one); there was insufficient information about one patient. Individuals with needle tracks, generalized petechiae. Osler's nodes, splinter hemorrhages, intravenous catheters, pacemaker wires, and infected aortic-valve (A-V) shunts are at risk of IE. Blood and the vegetations should be cultured. The attending physician should be notified of the diagnosis in such cases.
 ...
PMID:Unexpected death as a result of infective endocarditis. 258 45

Osler's nodes developed on the dorsum of the left foot of a patient with enterococcal endocarditis and on the dorsum of the right foot of another patient with Staphylococcus aureus endocarditis. The lesions were erythematous, raised, and very painful, but they resolved completely. There was no evidence of other embolic phenomena at the time the Osler's node appeared.
 ...
PMID:Osler's nodes on the dorsum of the foot. 318 Aug 59

Osler's nodes are classic lesions strongly associated with infective endocarditis. Osler's original description placed them as a frequent finding (70%) in cases of endocarditis. Recent literature, however, has infrequently described these lesions, which in general are no longer found to be useful. We review the clinical syndromes of infective endocarditis and their association with these lesions. We also review the pathogenesis of the lesion that currently supports the embolic nature of Osler's nodes. Osler's nodes are helpful clues if they appear in patients with infective endocarditis, and biopsy and culture of the lesion may provide an etiologic diagnosis.
 ...
PMID:Osler's nodes and the recognition of infective endocarditis: a lesion of diagnostic importance. 329 28

The etiology of Osler's nodes remains controversial. We describe a patient with endocarditis in whom Streptococcus sanguis was grown from the biopsy of such a lesion. Bacterial embolic events are likely to be the major pathogenetic event in the development of Osler's nodes, and recognition of the etiology of infective endocarditis may be found through biopsy of them.
 ...
PMID:The utility of Osler's nodes in the diagnosis of infective endocarditis. 365 66

Two hundred patients (90 men and 110 women), mean age 36.2 years, admitted to a Department of Medicine, between 1961 and 1979 with subacute infective endocarditis (SIE) were studied. Rheumatic heart valve disease was the predisposing lesion in 94% and the mitral valve was involved in about 80% of the cases. Diagnosis of SIE was confirmed by blood cultures in 66 patients and at autopsy on another 57 patients. The rheumatic symptoms and signs (RSS) considered were: arthralgia, rachialgia, arthritis, myalgia and Osler's nodes. RSS showed up in 50 (25%) of the subjects and arthralgias were the most frequent (12.5%). There were no significant differences between the 50 RSS patients and the other patients, regarding bacteriological and other laboratory data, including immunoglobulins. RSS patients were significantly younger (P less than 0.001). Out of the 200 patients, 71 (35.5%) died. Eight (16%) of these were in RSS subgroup of 50 patients. Presence of RSS did not worsen prognosis in our patients. Septic bone metastasis was not identified.
 ...
PMID:Rheumatic symptoms and signs in subacute infective endocarditis. 633 88


1 2 Next >>