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

Specimens from 300 patients were studied using five to nine aerobic and anaerobic culture media, including five that were hypertonic, Groups studied included fever of unknown origin, suspected endocarditis, endocarditis during therapy, bacteremia during therapy, abscess and cellulitis, presumed infectious arthritis, renal transplantation during rejection, collagen disease, sarcoidosis, lymphoma, and colitis. Isolates in hypertonic media were reverted to parent form by agar passage. In only 5% of these selected cases were organisms found in hypertonic, but not conventional, media that appeared on the basis of repeated isolation and/or serological studies to come from the patient. Nine of the 16 appeared to be of major significance. The two groups in which use of highly enriched, hypertonic media seemed most helpful were suspected endocarditis and undefined meningitis with negative cultures using standard media. The most effective of the hypertonic media used was 0.3 M sucrose in brain heart infusion with 20% horse serum. In most instances, the organism grew only in the hypertonic sucrose, and in most cases it appeared in conventional rather than aberrant form. Hypertonic media, especially 0.3 M sucrose, are of substantial helpin a small number of carefully selected cases.
J Clin Microbiol 1976 Sep
PMID:Study on the usefulness of hypertonic culture media. 97 87

Clinical and morphologic features are described in 22 necropsy patients with endocarditis involving rigid-framed prosthetic valves: aortic in 15 patients and mitral in 7. The interval from valve replacement to onset of symptoms of prosthetic valve endocarditis was less than 2 months in 8 patients and longer than 2 months in 14 patients. The most frequent infecting organism was the Staphylococcus (13 patients). In each of the 22 patients the infection was located behind the site of attachment of the prosthesis to the valve ring, and the infection spread to adjacent structures in 13 patients, 11 of whom had aortic prostheses. Prosthetic detachment causing severe regurgitation occurred in 12 of the 15 patients with an infected aortic valve prosthesis, and in 2 of the 7 with an infected mitral valve prosthesis. Prosthetic obstruction by vegetative material occurred in 5 of 7 patients with prosthetic mitral infection and in only 1 of 15 with prosthetic aortic infection. High degrees of conduction defects developed in seven patients with aortic prosthetic valve endocarditis: complete heart block in five, and complete left bundle branch block in two. Comparison of observations in the 22 patients with prosthetic valve endocarditis with those in 74 patients with active infective endocarditis involving natural left-sided cardiac valves revealed significant (P less than 0.05) differences in the percent with ring abscess, hemodynamic consequences of the endocarditis (valve stenosis), frequency of Staphylococcus as the causative organism and percent with complete heart block or left bundle branch block. No significant differences were observed between the two groups when comparing age, sex, type of underlying valve disease or frequency of organ infarcts of splenomegaly.
Am J Cardiol 1976 Sep
PMID:Prosthetic valve endocarditis: clinicopathologic analysis of 22 necropsy patients with comparison observations in 74 necropsy patients with active infective endocarditis involving natural left-sided cardiac valves. 98 58

Twenty-nine patients with bacteremia due to Corynebacterium vaginale, an inhabitant of the female genital tract, are described. Four were newborn babies. Nineteen were healthy young women delivered at full term by an operative procedure, cesarean section, or episiotomy. Within 48 hours fever and bacteremia developed. While receiving antibiotics the fever returned to normal, usually within 48 hours. The remaining cases were associated with septic abortion, tubal pregnancy, an intrauterine device, hydatidiform mole, and cellulitis. None of the adults showed evidence of brain abscess, meningitis, or endocarditis. Corynebacterium vaginale is an opportunistic minor pathogen that apparently gains access to the blood stream via an exposed vascular bed rather than as the result of immunosupression.
Johns Hopkins Med J 1976 Sep
PMID:Corynebacterium vaginale (Hemophilus vaginalis) bacteremia: clinical study of 29 cases. 108 32

A brief account of the aims sought by multiple antibiotic management is followed by an assessment of the antagonism and synergism displayed by associations of two bactericidal antibiotics, two bacteriostatic antibiotics, and one bactericidal and one bacteriostatic antibiotic. Instances of synergism between bactericides (particularly penicillins and aminosides) are mentioned. Stress is laid on recent studies on the mechanism of action of antibacterial drugs showing unmistakeable synergism between trimethoprim and sulphamethoxazol and between chloramphenicol and tetracycline. The antagonism between bactericides and bacteriostatics noted by Jawetz et Al. has not been confirmed clinically in a number of reported series. The main indications for combined antiobiotic therapy are reviewed: endocarditis, purulent meningitis, staphylococcia, brucellosis, salmonellosis, shigellosis, other Gram-negative infections and fever in the course of blood diseases. References is made to personal experience in the management of 35 cases of bacterial endocarditis, 15 cases of purulent meningitis and various forms of serious Gram-negative infection. Leaving aside exceptional cases, the clinical effects of antibiotic associations are uncertain and influenced by too many variables. The technique is still of importance, however, despite the introduction of many new antibiotics. It must not be thought of as a handy method for indiscriminate use, however; its indications (which are summarised) are quite clear.
Minerva Med 1975 Sep 05
PMID:[Further aspects of combination antibiotic therapy. Critical review and personal case studies]. 116 Nov 72

In a demographic study, the black Ohio residents were characterized by those born in Ohio and those born in other regions of the United States, and comparisons were made of rates for all deaths (1960-1967) for coronary heart disease (420), endocarditis and myocardial degeneration (421-422), hypertensive cardiovascular diseases (440-447), cerebrovascular diseases (300-334), cardiovascular diseases (400-468), and total diseases of the cardiovascular system (300-334) (400-468). The division of the total United States-born Ohio residents by region of birth provided marked differences in the age-adjusted rates in the relative comparisons. The black males and females born in the South had a markedly higher age-adjusted death rate (ages 45 to 64) than those born in Ohio in each of the categories of cardiovascular diseases studied. For coronary heart disease, the age-adjusted death rate for the black males showed a marked excess over the black females, for each region of birth, whereas for hypertensive cardiovascular diseases the black males and females had similar age-adjusted rates for each region of birth. The findings indicate a carry-over among the black of a higher cardiovascular risk among those born in the South and lend support to the concept of the influence of the endemic factors in the early years of life. In the prospective study of black steelworkers, it was observed that migrant and nonmigrant workers had approximately the same mortality for cardiovascular disease overall, and when specific work areas were considered. Selective factors of employment, of medical screening, and capability of continued employment in strenuous environments, were considered the most likely basis for the similar mortality experience.
Am Heart J 1975 Sep
PMID:Heart disease mortality among black migrants: a study of Ohio residents (1960-1967). 116 30

Homograft aortic valve replacement was performed in 311 patients at the tnational Heart thospital, London, between 1964 and 1973. Valve failure has occurred in 61 patients (20%), 32 of whom survived reoperation. From 1963 through 1967, 156 valves were freeze-dried and account for 56 of the valve failures. From 1968 to 1973, 118 fresh or fresh-frozen valves resulted in only 5 failures. Six general types of failure have been identified: calcification (13), dehiscence (15), infective endocarditis (17), prolapse (6), cusp degeneration (5), and tear or perforation (5). Valve failure may be due to surgical technical error resulting in dehiscence or valve incompetence, or it may be related to degenerative changes in the homograft. The clinical results, supported by gross and histological examination and viability testing, enable us to conclude that fresh or fresh-frozen valves are superior to freeze-dried valves, having resulted in only 4% valve failure over the past five years.
Ann Thorac Surg 1975 Sep
PMID:Analysis of homograft valve failure in 311 patients followed up to 10 years. 116 72

A patient had delayed spontaneous rupture of the spleen complicating infective endocarditis. In 20 other cases reported through 1973, the most common presentation was found to be left upper quadrant pain followed by signs of peritoneal irritation and cardiovascular collapse. Abdominal paracentesis consistently yields free blood or pus in the peritoneal cavity; blood replacement and emergency splenectomy may be lifesaving. The basic pathological mechanisms may be (1) rupture of a mycotic aneurysm into the splenic substance (2) rupture of a splenic abscess, and (3) rupture of a suppurating intrasplenic vessel with hematoma formation, subcapsular dissection, and delayed capsular tear.
Arch Intern Med 1975 Sep
PMID:Rupture of the spleen in infective endocarditis. 116 28

Sixteen cases of infective endocarditis requiring valve replacement with a prosthesis are described. The indication for surgery was intractable congestive heart failure in all. Fourteen patients underwent aortic valve replacement, with five hospital deaths secondary to cardiac decompensation and one late death related to recurrent periprosthetic insufficiency. Two patients who required mitral valve replacement did well, with no early or late deaths. A collected review of 293 cases of left-sided primary infective endocarditis reported in the English literature confirms the feasibility, advisability, and life-saving potential of urgent surgical intervention in patients with persistent or progressive congestive heart failure, irrespective of the activity of the infective process or the duration of antibiotic therapy. All infected tissue should be resected, and Teflon bolsters should be used to minimize the incidence of periprosthetic leaks. The incidence of prosthetic infection is minimal, contrasted with the fatal potential of procrastination to achieve microbial cure.
J Thorac Cardiovasc Surg 1975 Sep
PMID:The case for early surgical treatment of left-sided primary infective endocarditis. A collective review. 116 41

Cardiobacterium hominis, a recently recognized Gram-negative pathogen, was recovered in blood cultures from a 65-year-old man with indolent endocarditis of previously normal heart valves. Despite the low virulence of the organism, major cardiac damage required valvular replacement, and there were multiple cerebral emboli with development of a mycotic aneurysm. After bacteriological cure, he died of a ruptured aneurysm.
Arch Neurol 1975 Sep
PMID:Cardiobacterium hominis endocarditis with cerebral mycotic aneurysm. 117 12

Anaerobic infections are reviewed with emphasis on management. Most anaerobic pulmonary infections respond to penicillin G, even when Bacteroides fragilis (penicillin-resistant) is present. Clindamycin is suitable in penicillin-sensitive patients. Intraabdominal infections have a complex flora usually involving anaerobes, especially B. fragilis. It is desirable to use antimicrobial therapy to cover potential pathogens of all types. Surgical drainage and debridement are extremely important considerations. Anaerobic bacteria were found in 72% of 200 patients with female genital tract infections and were the exclusive isolates in 30%. Surgical therapy is primary, but antimicrobial and anticoagulant therapy are also important. A variety of soft-tissue infections involve anaerobes. Surgery is the major therapeutic approach. Anaerobic endocarditis is uncommon but may be difficult to manage. Chloramphenicol is ordinarily the drug of choice for brain abscess. New antimicrobial agents, which are under investigation and are promising, include new penicillins, new cephalosporins, new tetracyclines, and metronidazole.
Ann Intern Med 1975 Sep
PMID:Management of anaerobic infections. 119 Jun 33


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