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

A case of right-sided Pseudomonas cepacia endocarditis in a heroin addict is presented in which septic cutaneous vasculitis (ecthyma gangrenosum) is a prominent feature. Ecthyma gangrenosum, most commonly associated with sepsis due to P aeruginosa, has not been previously described with P cepacia septicemia.
Arch Dermatol 1977 Feb
PMID:Pseudomonas cepacia endocarditis and ecthyma gangrenosum. 83 96

Hereditary hemorrhagic telangiectasia is an inherited disorder in which patients may have multiple telangiectases and arteriovenous fistulas in the skin and internal organs. Patients can suffer from a variety of serious clinical complications, including abscess formation. We report two patients in whom neurologic symptoms developed from embolic abscesses, one for whom this complication was fatal. The reported incidence and microbiologic features of this complication are similar to that of endocarditis in patients with valvular heart disease. We believe that patients with hereditary hemorrhagic telangiectasia should receive similar antibacterial prophylaxis for procedures placing them at risk for bacteremia.
J Am Acad Dermatol 1991 Apr
PMID:Embolic abscesses in hereditary hemorrhagic telangiectasia. 155 83

The normal microflora of skin vary significantly between sebaceous rich, wet, and dry areas. This would be expected to influence the likelihood of developing transient bacteremia while undergoing skin surgery on these different areas, thereby affecting the risk of infective endocarditis from such procedures. We evaluated the incidence of transient bacteremia in 45 patients undergoing skin surgery on the sebaceous rich areas of the head and neck. After surveillance skin cultures, aerobic and anaerobic blood culture samples were taken at 0, 1, 5, and 15 minutes after the start of the procedure. All baseline blood culture results were negative. Three of the 45 patients developed transient bacteremia within the first 15 minutes after the start of the procedures. Samples from two patients grew pure cultures of Propionibacterium acnes and that from one patient grew a pure culture of Staphylococcus hominis, yielding a 7% incidence of bacteremia in the 45 patients studied. These data support the use of perioperative prophylactic antibiotics for surgery involving clinically uninfected skin of the head and neck only in patients with prosthetic heart valves. This is in keeping with the current recommendations of the American Heart Association against the need for antibiotic prophylaxis for nonprosthetic valve endocarditis in patients undergoing cutaneous surgery on clinically uninfected skin.
J Am Acad Dermatol 1988 Jul
PMID:The incidence of bacteremia in skin surgery of the head and neck. 340 31

A 30-year-old woman developed cutaneous proliferating angioendotheliomatosis without endocarditis. She was treated with local excision and radiotherapy 42 months ago. There is no recurrence eight years after clinical onset of the lesion, making this one of the longest documented cases of survival. A literature review of the disease, including its controversial histiogenesis, treatment, and survival, is presented. In view of the rarity of the disease, only by studying more patients can we better understand the disease. Since more than one disease process may be included under this diagnosis, clearer clinical and histogenetic separation is required, with immunohistochemical techniques potentially helping to provide a more precise diagnosis.
Arch Dermatol 1986 Mar
PMID:Proliferating angioendotheliomatosis. Case with long survival and review of literature. 351 10

The development of transient bacteremia during simple surgical excision of cutaneous neoplasms was studied. Of 35 patients undergoing surgery on eroded, but not clinically infected, cutaneous tumors, one developed a transient bacteremia, whereas none of 15 patients developed bacteremia during surgery on cutaneous neoplasms with intact skin surfaces. The low incidence of bacteremia associated with surgery on eroded skin neoplasms suggests that, for this commonly performed surgery, prophylactic antibiotics be administered perioperatively only to patients with prosthetic heart valves and not to other patients at risk for endocarditis. This recommendation would be in keeping with the American Heart Association guidelines for prophylaxis for other surgical procedures associated with low incidences of transient bacteremia.
Arch Dermatol 1987 Feb
PMID:The incidence of bacteremia during skin surgery. 381 94

Antibiotic prophylaxis is generally administered either to prevent wound infection or to hinder the development of endocarditis. Although the use of antibiotics in certain circumstances to prevent wound infection can be straightforward, there are other circumstances in which the decision to use antibiotics is much less clear. Endocarditis prophylaxis has traditionally been based on the American Heart Association's guidelines, which do not cover dermatologic surgery. This article discusses the rationale and controversies surrounding the use of antibiotic prophylaxis for prevention of both wound infection and endocarditis, reviews the few studies that pertain to dermatology, and provides recommendations for antibiotic prophylaxis on a case-by-case basis for those who perform dermatologic surgery.
J Am Acad Dermatol 1995 Feb
PMID:Antibiotic prophylaxis in dermatologic surgery. 854 90

The appropriate use of antibiotic prophylaxis is confusing for all surgeons and it is certainly not straight-forward for dermatologists. There are no set guidelines which encompass skin surgery. This article reviews antibiotic prophylaxis both to prevent wound infections and to prevent endocarditis. Some of the issues and controversies surrounding the use of antibiotic prophylaxis are discussed, and guidelines are provided which should be of assistance to those who perform dermatologic surgery.
Semin Dermatol 1994 Mar
PMID:Antibiotic prophylaxis. 815 9

We review the medical issues and emergencies potentially encountered in the practice of general or surgical dermatology. Traditional guidelines have largely consisted of dated extrapolations from the nondermatologic literature concerning procedures that are primarily irrelevant to dermatology. This article outlines a rational approach to organizing an office emergency plan for anaphylaxis, stroke, status epilepticus, myocardial infarction, and hypertensive crisis. We discuss the literature that has influenced current office behavior regarding endocarditis prophylaxis, the use of electrosurgery with pacemakers, arrhythmogenic drug interactions, vasovagal syncope, lidocaine "allergy," and bleeding complications from oral anticoagulants. Recommendations for managing these issues in a dermatologic context are provided.
J Am Acad Dermatol 1997 Jan
PMID:Medical issues and emergencies in the dermatology office. 948 99

We report the first case of livedo reticularis revealing a latent infective endocarditis due to Coxiella burnetti. The patient, a 54-year-old woman, also had chronic thrombocytopenia and mixed cryoglobulinemia. Chronic Q fever was confirmed by serodiagnosis and livedo regressed totally with doxycycline and hydroxychloroquine.
J Am Acad Dermatol 1999 Nov
PMID:Livedo reticularis revealing a latent infective endocarditis due to Coxiella burnetti. 1053 65

A 70-year-old patient with a history of hypertension and hypercholesterolemia was referred for evaluation of necrotic toes. The patient had a history of several cerebrovascular accidents during the previous month. Initially, she developed sudden-onset left upper extremity weakness which, over the ensuing 4 days, progressed to complete left-sided weakness. This was followed by the development of acute dysarthria. A transesophageal echocardiogram revealed moderate left ventricular hypertrophy, several vegetations on her tri-leaflet aortic valve associated with moderate aortic regurgitation, and a large right atrial thrombus with a mobile component. Bubble studies failed to reveal any septal defects. The patient's electrocardiogram was nonspecific. As serial blood cultures were negative despite fevers of up to 39.8 degrees C, the patient was treated with a 6-week course of intravenous ceftriaxone, ampicillin, gentamicin, and ciprofloxacin for a presumed diagnosis of culture-negative endocarditis. Fungal cultures of the blood were negative. The patient, however, progressed and developed several necrotic toes. Physical examination was significant for ischemic changes of the left first, second, third, and fifth toes, as well as the right first and second toes. Diffuse subungual splinter hemorrhages in the toenails, numerous 2-4-mm palpable purpuric papules on the lower extremities, and nontender hemorrhagic lesions of the soles were also noted. Peripheral and carotid pulses were intact and no carotid bruits were heard. Cardiopulmonary and abdominal examinations were unremarkable. Neurologic examination revealed a disoriented, dysarthric patient with left central facial nerve paralysis, as well as spasticity, hyperactive reflexes, and diminished strength and sensation in the left upper and lower extremities. A left visual field defect and left hemineglect were also present. The patient's last brain computerized tomogram revealed areas of low attenuation consistent with cerebral infarctions in three distinct areas of the brain. These included the left occipitotemporal area, the right parieto-occipital area, and the right posterior frontal region. The regions affected were in the distribution of both the anterior and posterior circulation. No evidence of hemorrhage was noted. The patient subsequently complained of abdominal discomfort. A computerized tomogram of the abdomen with oral and intravenous contrast revealed a 4-cm x 3-cm irregular mass in the tail of the pancreas with several low-attenuation lesions throughout the liver which were consistent with infarctions or metastases. Several splenic infarctions were also present. A biopsy of the tumor revealed pancreatic adenocarcinoma. The patient's carcinoembryonic antigen level was 18. 4 ng/mL (0-3) and the CA 19-9 antigen level was 207,000 U/mL (0-36). The alpha-fetoprotein level was normal. Other significant laboratory findings included a prothrombin time of 16.7 (international normalized ratio, 1.4), an activated partial thromboplastin time of 32 (ratio, 1.3), and a platelet count of 85,000/mm3. The Russell viper venom time, sedimentation rate, and C3 levels were normal, and the patient was negative for antinuclear antibodies, anticardiolipin antibodies, and antibodies to extractable nuclear antigens. Of note, the patient was not receiving any anticoagulation. Blood cultures for mycobacteria and fungi, human immunodeficiency virus serology, and urinalysis and culture were negative. The patient subsequently developed an inferior wall myocardial infarction and was transferred to the coronary care unit. In line with the family's request, aggressive care was ceased and the patient expired. The patient's family refused an autopsy.
Int J Dermatol 2000 Apr
PMID:Cutaneous manifestations of marantic endocarditis. 1080 80


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