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

A patient in a blastic phase of chronic myelocytic leukemia developed multiple arterial emboli that originated from mitral valve vegetation. The diagnosis of infective endocarditis was not confirmed because blood cultures, serological assays and other examinations detected no pathogens. He died of intracranial hemorrhage after thrombolytic manipulation for embolization of the abdominal aorta and an autopsy was performed. Polymerase chain reaction analysis and Southern blot analysis of tissues from the mitral valve revealed Aspergillus species as the cause of the endocarditis, although none of the tissue specimens were culture-positive. These molecular analyses will be useful in the diagnosis of various types of Aspergillus infections.
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PMID:Aspergillus endocarditis in a leukemia patient diagnosed by a PCR assay. 912 14

Bartonella species are now considered emerging pathogens. Of the 11 currently recognized species, four have been implicated in human disease, although only two have been encountered in Europe. Bartonella quintana infections are now being diagnosed among the urban homeless and deprived, manifesting as trench fever, and Bartonella henselae has been shown to be the causative agent of cat scratch disease. Both species also cause a variety of HIV-associated infections, including bacillary anglomatosis. However, perhaps the most significant presentation of bartonellae infection is culture-negative endocarditis. The epidemiologies of Bartonella infections are poorly understood; most Bartonella henselae infections are probably acquired from infected cats, either directly by contact with a cat or indirectly via fleas. No animal reservoir has been implicated for Bartonella quintana; however, infection can be transmitted via the human body louse. Diagnosis of Bartonella infections can be made using histological or microbiological methods. The demonstration of specific antibodies may be useful in some instances, although certainly not in all. Cultivation of Bartonella is difficult, as the bacteria are extremely fastidious. Polymerase chain reaction-based or immunological methods for the detection of bartonella in infected tissues have proven useful. Clinical relapse is often associated with Bartonella infections despite a wide range of prescribed regimens. Only aminoglycosides display in vitro bactericidal activity against intracellular Bartonella species; therefore, they are recommended for treatment of Bartonella infections.
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PMID:Current knowledge of Bartonella species. 927 84

In vitro collagen binding of 216 Staphylococcus aureus isolates from patients with various diagnoses was studied. Polymerase chain reaction was used to examine these isolates regarding the existence of the corresponding cna gene. Distribution of capsular polysaccharide (CP) types was examined. Fifty-six (57%) of 99 S. aureus isolates from patients with endocarditis or bacteremic bone or joint infection were cna-positive compared with 65 (56%) of 117 isolates from bacteremic patients without signs of bone or joint infection (P = .99). There was a good correlation between in vitro collagen binding and presence of the cna gene. These data suggest that collagen binding is not a prerequisite for the development of endocarditis, osteomyelitis, or septic arthritis. There was no significant difference in the distribution of CP types among various patient groups, although there was a strong association between CP type 8 and the existence of the cna gene.
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PMID:Expression of collagen-binding protein and types 5 and 8 capsular polysaccharide in clinical isolates of Staphylococcus aureus. 984 60

Chronic Q fever is most commonly associated with culture-negative endocarditis and less frequently with infection of vascular grafts, infection of aneurysms, hepatitis, pulmonary disease, osteomyelitis, and neurological abnormalities. We report a case of chronic sternal wound infection, polyclonal gammopathy, and mixed cryoglobulinemia in which Q fever endocarditis was subsequently diagnosed. Polymerase chain reaction analysis of the wound tissue was positive for Coxiella burnetii DNA, and treatment of the endocarditis resulted in prompt healing of the wound. Chronic Q fever can occur without epidemiological risk factors for C. burnetii exposure and can produce multisystem inflammatory dysfunction, aberrations of the immune system, and persistent wound infections.
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PMID:Chronic sternal wound infection and endocarditis with Coxiella burnetii. 1045 Nov 61

We report the case of a Cardiobacterium hominis endocarditis causing an acute mitral insufficiency complicated of left heart failure. The patient has been treated after a few days by surgical valvuloplasty. Cardiobacterium hominis is a bacteria of the HACCEK group, bacille gram-negative, sometimes anaerobic, difficult to isolate. Recently, Polymerase Chain Reaction analysis appears to be effective for the the diagnosis in the identification of fastidious micro-organisms like Cardiobacterium hominis. We have reviewed in the literature 71 cases of Cardiobacterium hominis endocarditis; clinical presentation is often sub-acute, the bacteriological diagnosis is based on hemocultures for which the culture is slow and require enriched environments. Hemodynamic and thrombo-embolic complications are frequent because of the high pathogenicity of the bacteria which provides big and friable vegetations. Despite a high sensibility to antibiotherapy, surgical intervention is often required.
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PMID:[Cardiobacterium hominis endocarditis. A case report]. 1457 48

Diagnosis of Whipple's disease is difficult, and thus its frequency is probably underestimated, particularly in culture-negative infective endocarditis. However, it must be systematically searched for in such a situation, first because it is associated with a poor natural outcome, and second because Tropheryma whipplei is not covered by the conventional empirical therapy recommended for culture-negative infective endocarditis. Whipple's disease endocarditis is usually associated with weight loss, intestinal and joint involvement. Nevertheless, it is sometimes the only manifestation of the disease, which makes the diagnosis much more difficult. We report the case of a 66-year-old patient with Barlow's disease, who underwent mitral valve replacement for severe mitral regurgitation. Vegetations were observed on the resected valve, both macroscopically and histologically. No microorganism was found at first. The diagnosis of Whipple's disease endocarditis was finally obtained by Polymerase Chain Reaction on valve tissue, and later confirmed by Periodic Acid Schiff staining. The outcome was favorable after a prolonged antibiotic therapy including doxycycline and hydroxychloroquine.
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PMID:[Infective endocarditis as the only manifestation of Whipple's disease: an atypical presentation]. 2127 53

Q fever is a worldwide zoonosis caused by Coxiella burnetii. The clinical manifestations of Q fever include endocarditis, pneumonitis and hepatitis. Disease awareness and evolving diagnostic tests have enabled the recognition of unusual manifestations of Q fever. We report a case of Q fever osteomyelitis. A 51-year-old patient was admitted to hospital because of fever, leg weakness, and asthenia. His past medical history included surgery and a bone graft for the treatment of a giant cell tumor on the distal part of the femur. Blood and bone biopsy cultures were negative. Bone histological examination was consistent with a sub-acute or chronic inflammatory reaction that involved foci of epithelioid and gigantocellular infiltrates and necrosis. Serology testing revealed high antibody titers to C. burnetii antigens (phase I: IgG 3200; IgA 200; phase II: IgG 6400; IgA 400), which is indicative of chronic Q fever. The specific Polymerase Chain Reaction (PCR) of the abscess sample from the femoral region was positive for C. burnetii. The patient was treated for chronic Q fever with doxycycline and hydroxychloroquine for 18 months and recovered gradually without recurrence of pain or functional impairment. Q fever osteomyelitis is a rare and most likely underestimated disease. Epithelioid and gigantocellular granulomatous osteomyelitis in the context of culture-negative bone specimens should raise suspicion of Q fever. Serological tests, specific PCR and cell culture can provide evidence of a C. burnetii infection. Although bone diffusion may be a concern, the currently recommended treatment for Q fever was effective in this case.
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PMID:Q fever osteomyelitis: a case report and literature review. 2228 90

Bartonella henselae infection is typically associated with cat scratch disease. This microorganism can also lead to culture-negative infective endocarditis in immunocompromised patients. We present a rare case of a previously healthy 65-year-old man with B. henselae-associated endocarditis of a prosthetic aortic root. All blood cultures, as well as cultures of the resected aortic valve vegetations, remained negative. Polymerase chain reaction with specific bacterial primers with DNA sequencing was used to identify B. henselae as the etiologic agent. This was successfully managed by an aortic root re-replacement using a mechanical conduit, reimplantation of coronaries ostia, and antibiotic therapy.
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PMID:Bartonella as a cause of mechanical prosthetic aortic root endocarditis. 2245 Jan 12

Brucellosis is a worldwide zoonosis caused by Brucella species. The disease remains a significant economic and public health problem particularly in the Mediterranean countries. Clinical manifestations of brucellosis are variable and often nonspecific, simulating infectious and noninfectious diseases. Osteoarticular involvement is the most common focal complication of brucellosis and morbidity. Mortality rate due to brucellosis is low, mostly secondary to endocarditis and central nerve involvement of disease. The diagnosis of brucellosis depends on the clinical presentations and laboratory tests. Detection of Brucella species by culture method is sometimes unsuccessful; therefore, serological tests are preferred. These tests are easy to perform, and results can be obtained within a short span of time. Several serologic tests have been developed for the diagnosis of human brucellosis, including the standard agglutination tube (SAT) test, anti-human globulin (Coombs) test, indirect fluorescence antibody (IFA) test, and enzyme-linked immunosorbent assay (ELISA). SAT is the primary test used in many clinical laboratories. IFA and ELISA are simple and reliable for the detection of immunoglobulin classes especially in complicated cases. Polymerase chain reaction (PCR) technique is highly sensitive and specific for the determination of Brucella spp. from peripheral blood and other tissues. Recent patents are especially based on molecular assays in the diagnosis of brucellosis. However, PCR is still expensive and may not be appropriate for daily practice.
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PMID:Clinical presentations and diagnosis of brucellosis. 2287 52

A 65 year-old woman was admitted for acute heart failure and severe sepsis revealing definite mitral infective endocarditis with severe regurgitation, complicated by multiple embolisms. Three blood cultures yielded a group G Streptococcus canis strain. Urgent surgery was performed with bioprosthetic valve replacement. Polymerase chain reaction analysis of the valve found S canis DNA. Amoxicillin and gentamicin were given for 2 weeks followed by 4 weeks of amoxicillin alone. She reported contact with a dog without bite. S canis has been reported to cause zoonotic septicemia but to our knowledge, this is the first human case of native valve infective endocarditis.
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PMID:First reported human case of native mitral infective endocarditis caused by Streptococcus canis. 2544 53


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