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

A patient with Staphylococcus aureus bacteremia associated with an infected intravenous catheter was treated with oxacillin for two weeks. During that period all blood cultures were sterile, he rapidly became afebrile, and there were no signs of endocarditis or metastatic abscesses. However, serum antibodies against staphylococcal teichoic acid, initially undetectable by the agar gel immunodiffusion technic, became positive during the second week of treatment. Three weeks after discharge, the patient was readmitted to the hospital because of back pain and weakness in the lower extremities. Vertebral osteomyelitis and a spinal epidural abscess caused by Staph. aureus of the same phage type as the bacteremic isolate were demonstrated. This case illustrates the importance of careful follow-up of patients with Staph. aureus bacteremia and the potential value of serial measurement of teichoic acid antibodies in detecting clinically inapparent complications of infection.
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PMID:Association of teichoic acid antibody with metastatic sequelae of catheter-associated Staphylococcus aureus bacteremia: a failure of the two-week antibiotic treatment. 42 75

Bacterial endocarditis caused by Actinobacillus actinomycetemcomitans is a rare disease. A 48-year-old man who had a Starr-Edwards aortic valve prosthesis inserted in 1972 was admitted for evaluation of confusion, headaches, anorexia, weight loss, diarrhea and weakness. Six blood cultures yielded gram-negative organisms which were subsequently identified as A. actinomycetemcomitans. Treatment with ampicillin and gentamicin resulted in cure which has been maintained after an observation period of eleven months. This represents the second report of A. actinomycetemcomitans endocarditis in a patient with a prosthetic valve.
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PMID:Actinobacillus actinomycetemcomitans endocarditis in a patient with a prosthetic aortic valve. 88 Dec 58

Strains of Streptococcus mutans were isolated from blood cultures of ten patients with endocarditis. Nine of these patients had a typical clinical picture of subacute bacterial endocarditis, with fever, weakness, heart murmur and multiple positive blood cultures. All the patients had previous valvular heart diseases; only in three cases the initiating event involved some type of dental manipulations which where supposed as the source of infection. The major criteria for recognizing S. mutans were colony morphology on blood agar, characteristic extracellular polysaccharide production in 5% sucrose broth, acid formation in mannitol and sorbitol broth, and the failure of antigenic extracts of S. mutans to react with streptococcal group antisera. The susceptibility to antimicrobial agents was tested by the diffusimetric method with susceptibility disks. All the strains were susceptible to penicillin G, erythromycin, pristinamycin, lincomycin and tetracycline, and resistant to streptomycin and gentamicine.
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PMID:[Characteristics of "Streptococcus mutans" from endocarditis and susceptibility to antimicrobial agents (author's transl)]. 90 Jun 95

A 6-year-old male blue-and-gold macaw (Ara ararauna) was presented with severe weakness, anorexia, and weight loss of 2 weeks duration. Cardiac auscultation revealed a soft systolic murmur. Blood cultures collected both antemortem and postmortem yielded pure isolates of Enterobacter cloacae. At necropsy, vegetative endocarditis was found involving the left atrioventricular valve. Microscopically, the lesion on the valve was characterized by a mixture of necrotic material, colonies of gram-negative bacteria, fibrosis, and inflammatory infiltrate consisting primarily of heterophils.
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PMID:Bacteremia and vegetative endocarditis associated with a heart murmur in a blue-and-gold macaw. 148 68

A diagnosis of endocarditis was made in 37 patients (three days to 21 years old) on the basis of the following: histology in 11; at least two positive blood cultures in patients with underlying cardiac disease in 22; less than two positive blood cultures, vegetations seen at echocardiography and a suggestive clinical syndrome in four. Twenty-six patients had primary endocarditis (17 with pre-existing cardiopathy, nine with normal hearts). The 11 others developed secondary endocarditis following heart surgery (early onset in six, late onset in five). The mean delay before diagnosis was prolonged 35.8 days. The clinical and laboratory findings included weakness in 36 patients, fever in 35, new or modified heart murmur in 14, positive blood cultures in 30, anemia in 12, high white blood cell count in 15, increased sedimentation rate in 14, and positive echocardiogram in 11. Etiologic agents isolated were: streptococci in 17, staphylococci in seven, miscellaneous germs in eight, and aspergillus in two. Mortality was greater in patients less than one year old, infected with aspergillus or without underlying heart disease. The present study suggests that childhood endocarditis remains uncommon but presents a poor prognosis with a mortality of 27% and a morbidity of 85.7%.
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PMID:The evolving pattern of pediatric endocarditis from 1960 to 1985. 234 61

A 49 year-old woman was hospitalized with headache and left-sided weakness. Computed tomographic scan and carotid angiogram revealed mycotic aneurysms of the bilateral middle cerebral artery with intracranial bleeding. Although all blood cultures were sterile, her physical examination suspected mitral regurgitation due to infective endocarditis and mycotic cerebral aneurysms. Severe congestive heart failure developed immediately after successful clipping for ruptured mycotic aneurysm of the right middle cerebral artery and then mitral valve replacement with prosthetic valve was performed 3 months after craniotomy. At operation, infective endocarditis on the mitral valve was confirmed. Her postoperative course was uneventful and the second craniotomy for aneurysm of the left middle cerebral artery has been planning.
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PMID:[Valve replacement in infective endocarditis with mycotic cerebral aneurysm. Report of a case with successful operation]. 305 69

Clinical features and immune status have been studied in seven previously healthy children with disseminated staphylococcal disease. Six of seven patients had a history of a viral-type illness before developing disseminated staphylococcal disease. Five patients had a petechial rash. Endocarditis occurred in three patients, two of whom had a cerebral embolism. All seven patients had an abnormal urinary sediment, and in two it was suggestive of glomerulonephritis. Two had transient renal failure. Three patients had evidence of pneumonia, one of the three developed pneumatoceles and one developed a pleural effusion. Four had osteomyelitis and/or septic arthritis. All patients had a transient abnormality of intracellular bacterial killing by neutrophils. One patient died. Three patients have residual valvular heart disease; one of the three patients has weakness of one arm and another has a seizure disorder. Cellular and humoral immunity in all six surviving patients is normal. We speculate that an antecedent viral infection temporarily suppressed neutrophil function and predisposed these children to secondary and severe staphylococcal disease.
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PMID:Clinical features and abnormal neutrophil function in disseminated staphylococcal disease. 398 77

From 1973 to 1983 nine cases of Brucella melitensis infection were hospitalised at the Centre hospitalier universitaire vaudois (CHUV), Lausanne. In each case, the infection was acquired in a Mediterranean country (4 cases in Italy, 2 in Spain, 2 in Portugal and 1 in Greece). In 6 of the cases the disease was acquired by ingestion of dairy products and in 2 cases by direct animal contact. Despite classical initial symptomatology (fever, rigors, weakness), the time from first symptoms to diagnosis varied between 10 days and 5 months. This delay probably explains why 6 of 9 patients were admitted because of septic complications: orchi-epididymitis, arthritis, meningitis and endocarditis. With prolonged antibiotherapy, the evolution was favourable in all cases. The patient who presented with endocarditis required emergency aortic valve replacement. Culture of the valve showed the presence of 10(9) B. melitensis/g of tissue. Cure was achieved by the administration of streptomycin and tetracycline for 6 weeks, followed by cotrimoxazole for one year. These cases show that the diagnosis of Brucella infection is becoming rare in Switzerland. It is often not suspected, and prompt diagnosis is delayed until further complications occur. Serology and blood cultures should be done in every patient presenting with fever after a stay in endemic countries.
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PMID:[Brucellosis: a varied clinical presentation in 9 patients]. 633 95

It is well known that the incidence of mitral valve prolapse is increased in various hereditary and humoral disorders, particularly in diseases with abnormal collagene structure and metabolism. We consecutively investigated, both clinically and echocardiographically, 22 patients with Klinefelter's syndrome (Mean age: 35 +/- 15.8 years). On clinical examination one third (7 patients) showed clinical signs of connective tissue weakness, 9 patients were obese. In 3 patients without a history of rheumatic fever mitral regurgitation was present. A mid-systolic click was heard in 12 patients, in 8 of them a click-murmur syndrome. Mitral regurgitation has been found in 3 patients. Echocardiographic ally, 12 of 22 patients (55%) revealed mitral valve prolapse which was not correlated with the degree of the chromosomal aberration. The incidence of mitral valve prolapse in an otherwise healthy male population is reported to be approximately 6%. Thus, in Klinefelter's syndrome, the frequency of mitral valve prolapse is found to be markedly increased. Regarding the nosological implications of mitral valve prolapse, it is recommended to thoroughly examine patients cardiologically. Furthermore, since mitral valve prolapse bears a higher risk of malignant cardiac arrhythmias, chest pain and endocarditis, an antiarrhythmic treatment and--if indicated--antibiotic prophylaxis has to be instituted. Those patients also should be advised to adjust their life style appropriately.
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PMID:Klinefelter's syndrome and mitral valve prolapse. an echocardiographic study in twenty-two patients. 674 77

Fifty one cases of Pseudomonas aeruginosa bacteriaemia observed during the last 12 years are reported. Thirty five patients were over fifty years old; 92 p. cent were admitted for several days and about 50 p. cent were in post-operative period. A previous antibiotherapy and an impaired status are promotive factors. The respiratory or peritoneal origins are the most frequent. All patients were feverish; 24 have had an infectious shock which was inaugural in 12 cases. Seven pneumonitis, 3 endocarditis, one pericarditis and 2 osteitis were observed. An ecthyma gangrenosum was noted in three patients. Mortality was 70 p. cent. Comparison between recovered and died patients improved bad prognosis of old age, post operative period, neoplasic, previous organica weakness and pulmonary or peritoneal origins. Used alone, colimycin has seemed to be more effective than aminosid antibiotics; but their association with betalactamins was better. An in vitro study of the susceptibility of 100 Pseudomonas aeruginosa strains has proved the interest of piperacillin and cefsulodin; azlocillin, cefoperazone and ceftriaxone are just less effective.
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PMID:[Pseudomonas aeruginosa bacteriaemia: new clinical and therapeutic aspects ]. 681 7


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