Gene/Protein Disease Symptom Drug Enzyme Compound
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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 late prosthetic endocarditis resulting from Moraxella non-liquefaciens is reported. Correct laboratory indentification is of therapeutic importance as Moraxella is often highly sensitive to penicillin. Because of suspected penicillin sensitivity, antibiotics other than penicillin were used, but failed to control the endocarditis. Prompt response occurred when penicillin was given. Penicillin remains by far the most effective antibiotic for the treatment of endocarditis, particularly when affecting prosthetic valves, and caused by organisms sensitive to penicillin.
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PMID:Penicillin-sensitive Moraxella prosthetic endocarditis. Near disaster caused by failure to treat with penicillin. 705 5

Etiology and clinical course of infective endocarditis were analyzed in 31 patients seen at this institution between 1971 and 1980. The follow-up period averaged 60 (1-180) months. The infection relapsed 9 times (relapse rate 31-38%). The etiologic agent isolated from blood cultures in 26/42 infective episodes. Penicillin-sensitive streptococci were by far the most frequent cause of infective endocarditis (46%), followed by Staphylococcus aureus in 23%. A predisposing cardiac lesion existed in 26/31 patients (84%), aortic valve disease and a prolapsing mitral valve being the most frequent. In the 31 patients there were 5 deaths, 2 of which occurred acutely within a few days following the onset of endocarditis (mortality rate 6%), 2 suddenly after completion of antimicrobial therapy and 1 from another cause during the observation period. Surgery was necessary in 18 patients, emergency valve replacement being required in 3 cases (10%). In 15 patients (52%) cardiac surgery was performed electively after healing of the endocarditis. The indication for surgery was onset of heart failure due to valvular incompetence in 16 patients and recurrent systemic embolization in 2 patients. All patients survived surgery. At restudy no difference was observed in overall cardiac function, physical working capacity and employment activities among the surviving patients whether operated upon or not.
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PMID:[Etiology and clinical course of bacterial endocarditis, 1971-1980]. 715 54

A case of infective endocarditis (IE) caused by a rare pathogen, Gemella morbillorum, is presented. Because of persistent low-grade fever after dental treatment, the patient was given oral antibiotics. Whereas he was diagnosed as having aortic regurgitation by a cardiologist, and IE was not suggested unfortunately. After long-term chemotherapy over five months, he was aware of nocturnal dyspnea and Gemella morbillorum was detected by blood culture. Then, he was treated with intravenous administration of Penicillin-G, and underwent surgical operation for valve replacement. No cases of IE due to this organism have been reported in Japan.
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PMID:Infective endocarditis caused by an indigenous bacterium (Gemella morbillorum). 782 81

A clinical case of streptococcal endocarditis in which the isolate proved susceptible to third- but not first-generation cephalosporins prompted us to examine the susceptibility of 44 alpha-haemolytic streptococci from cases of endocarditis to ten cephalosporins and benzylpenicillin. Twenty per cent of strains were resistant to penicillin, and 20% were tolerant. Cefazolin, cefuroxime and cefpirome were the most active first-, second- and third-generation cephalosporins tested. Other first-generation cephalosporins tested compared poorly to cefazolin. Cefotaxime and cefpirome were moderately active against some penicillin-resistant strains. Penicillin tolerance was common in Streptococcus gordonii, but a correlation between tolerance and dextran production could not be confirmed.
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PMID:Susceptibility of alpha-haemolytic streptococci causing endocarditis to benzylpenicillin and ten cephalosporins. 822 18

Endocarditis due to Actinomyces species for which a portal of entry cannot be identified is extremely rare. We present a case of primary endocarditis due to Actinomyces israelii with an unknown portal of entry and review seven similar cases reported in the literature since 1939. The disease predominantly affects males. Clinical features are similar to those of bacterial endocarditis due to other organisms. Penicillin remains the drug of choice for treatment of this condition. The optimal duration of treatment has not yet been determined; however, with early diagnosis and appropriate antimicrobial therapy, the prognosis is good.
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PMID:Primary actinomycotic endocarditis: case report and review. 851 51

Clostridial endocarditis is rare. We describe, to our knowledge, the first case of Clostridium innocuum endocarditis. The fatal case involved the tricuspid and pulmonary valves and was associated with multiple pulmonary emboli. We review the literature, which suggests the varied presentations and outcomes of clostridial endocarditis. Penicillin is the treatment of choice for this disease.
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PMID:Clostridium innocuum endocarditis. 858 63

The activity of penicillin, alone and in combination with sulbactam, against a heterogeneously methicillin-resistant, penicillinase-producing clinical isolate of Staphylococcus aureus and its penicillinase-negative derivative was investigated in vitro and in a rabbit experimental endocarditis model. Penicillin was significantly more effective than vancomycin against the penicillinase-negative derivative in vivo (P < 0.001), and it sterilized 25% of the vegetations. The combination of penicillin and sulbactam exhibited an in vivo synergistic effect on the penicillinase-producing strain (P < 0.01) but did not produce any advantage over treatment with vancomycin, even when a high dose of sulbactam was used (100 mg/kg of body weight every 6 h). This combination was significantly less effective against the penicillinase-producing strain than was penicillin alone against the penicillinase-negative derivative (P < 0.03). In addition, the most resistant subpopulation of the surviving bacteria, which grew on agar containing 16 micrograms of methicillin per ml, was detected in 5 of 6 animals treated with penicillin and a high dose of sulbactam against the penicillinase-producing strain compared with only 1 of 12 animals treated with penicillin alone against the penicillinase-negative derivative (P < 0.01). We conclude that penicillin is highly effective against penicillinase-negative methicillin-resistant S. aureus and that penicillinase production, rather than methicillin resistance, appears to be the limiting factor for the activity of the penicillin-sulbactam combination against penicillinase-producing, methicillin-resistant S. aureus.
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PMID:Importance of penicillinase production for activity of penicillin alone or in combination with sulbactam in experimental endocarditis due to methicillin-resistant Staphylococcus aureus. 872 70

Two cases of Aerococcus urinae endocarditis are reported. The organism is not included in any database of commercial identification systems at this time. Formation of tetrades and positive reactions for leucine arylamidase and beta-glucuronidase pointed strongly to A. urinae. The cellular fatty acid pattern was similar to that of Aerococcus viridans, with predominantly C16:0, C18:1 omega 9c and C18:0; the presence of C18:1 omega 7t differentiated our isolates from A. viridans and can support the diagnosis of A. urinae. Furthermore, susceptibility to penicillin but resistance to cotrimoxazole represents a pattern opposite to that of A. viridans. Minimal inhibition concentrations of gentamicin and netilmicin were < or = 64 mg/l but those of tobramycin were > or = 256 mg/l. Penicillin combined with either gentamicin or netilmicin showed distinct synergy in killing kinetics. These combinations seem to be the appropriate regimen to treat A. urinae endocarditis.
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PMID:Endocarditis due to Aerococcus urinae: diagnostic tests, fatty acid composition and killing kinetics. 1021 43

Three cases of serious infection caused by Aerococcus urinae are presented: a patient with endocarditis and two patients with soft-tissue infection (phlegmon and balanitis respectively). The literature on Aerococcus urinae infections is reviewed and the antibiotic therapy discussed. Aerococcus urinae is a pathogen isolated primarily from urine specimens of elderly patients with local or systemic predisposing conditions. Most infections are mild, but serious infections such as endocarditis and septicemia/urosepsis have been described. Penicillin or ampicillin in combination with an aminoglycoside and close monitoring of the patient's clinical status and laboratory results would seem to be the best strategy for management of cases of serious infection.
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PMID:Three cases of serious infection caused by Aerococcus urinae. 1042 Oct 47

The activity of trovafloxacin was compared with those of vancomycin and penicillin in a model of Streptococcus sanguis species group (trovafloxacin MIC, 0.125 microg/ml) and Streptococcus mitis species group (trovafloxacin MIC, 0.125 microg/ml) experimental endocarditis. Rabbits with catheter-induced aortic valve vegetations were given no treatment, trovafloxacin at 15 mg/kg of body weight three times a day (t.i.d.), vancomycin at 15 mg/kg twice a day, or penicillin at 1. 2 x 10(6) IU t.i.d. After 3 days of treatment, the animals were sacrificed; cardiac valve vegetations were aseptically removed and cultured quantitatively. Penicillin was as active as vancomycin as measured by in vivo clearance of bacteria. Trovafloxacin was less active (P < 0.05) than vancomycin or penicillin against S. sanguis species group infection but had similar efficacy against S. mitis species group infection. Quinolones, despite MICs in the susceptible range, may not be active for serious infections caused by some viridans group streptococci.
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PMID:Trovafloxacin treatment of viridans group Streptococcus experimental endocarditis. 1095 16


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