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

Haemophilus influenzae is an aerobic pleomorphic gram-negative coccobacillus that requires both X and V factors for growth. It grows poorly, if at all, on ordinary blood agar unless streaked with Staph. aureus. It grows well on chocolate agar. Because this medium is often not used in culturing specimens from adults and because the organism may be overgrown by other bacteria, the frequency of H. influenzae infections has undoubtedly been seriously underestimated. This is aggravated by the failure of many physicians to obtain blood cultures in suspected bacterial infections and the failure of many laboratories to subculture them routinely onto chocolate agar. H. influenzae, along with Streptococcus pneumoniae, is a major factor in acute sinusitis. It is probably the most frequent etiologic agent of acute epiglottitis. It is probably a common, but commonly unrecognized, cause of bacterial pneumonia, where it has a distinctive appearance on Gram stain. It is unusual in adult meningitis, but should particularly be considered in alcoholics; in those with recent or remote head trauma, especially with cerebrospinal fluid rhinorrhea; in patients with splenectomies and those with primary or secondary hypogammaglobulinemia. It may rarely cause a wide variety of other infections in adults, including purulent pericarditis, endocarditis, septic arthritis, obstetrical and gynecologic infections, urinary and biliary tract infections, and cellulitis. Antimicrobial susceptibility testing is somewhat capricious in part from the marked effect of inoculum size in some circumstances. In vitro and in vivo results support the use of ampicillin, unless the organism produces beta-lactamase. Alternatives in minor infections include tetracycline, erythromycin, and sulfamethoxazole-trimethoprim. For serious infections chloramphenicol is the best choice if the organism is ampicillin-resistant or the patient is penicillin-allergic.
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PMID:Haemophilus influenzae infections in adults: report of nine cases and a review of the literature. 31 Sep 43

Two cases of bacterial endocarditis caused by Haemophilus parainfluenzae are reported with a review of 33 other cases of H. parainfluenzae endocarditis and 5 cases of H. influenzae endocarditis. Although H. parainfluenzae is usually considered a non-pathogenic microorganism, this review firmly establishes its role as a causative agent in endocarditis. Furthermore, several clinical features were noted which were atypical when compared to findings usually present in patients with bacterial endocarditis. The mean age of the patients was only 27 years. Over 60% of the patients had no identifiable predisposing illness, an unexpected finding in view of the low degree of pathogenicity associated with this microorganism. Polymicrobial bacteremia, usually with viridans streptococci, was found in 11% of patients. Major arterial emboli were documented in 57% of patients, an incidence unchanged from the pre-antibiotic era. Diagnosis of the disease is dependent upon an awareness of the fastidious cultural requirements necessary for isolation of Haemophilus species. Culture media must contain a source of X and V factors. Mortality from H. parainfluenzae endocarditis has been reduced from 100 per cent prior to 1940 to about 12 per cent by use of appropriate antimicrobial agents. Awareness that Haemophilus species can cause bacterial endocarditis is important because the diagnosis is dependent upon utilization of special culture methods and the patient may not respond to some of the empiric regimens used for treating bacterial endocarditis. It should be especially considered as a possible cause of "culture-negative" or "abacteremic" endocarditis.
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PMID:Haemophilus parainfluenzae and influenzae endocarditis: a review of forty cases. 32 16

Nine Haemophilus species strains, all beta-lactamase negative, isolated from patients with endocarditis were tested in killing curve experiments. Antibiotics used were penicillin, amoxicillin, aztreonam alone and in combination with tobramycin, as well as ciprofloxacin alone. Synergism between beta-lactams and tobramycin with reduction of colony counts to zero was seen after 24 h for H. influenzae, H. parainfluenzae and H. segnis strains. Ciprofloxacin was as effective as beta-lactam-tobramycin combinations. The H. aphrophilus strain was not killed as effectively as other strains by any of the antibiotics.
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PMID:Killing curve activity of ciprofloxacin is comparable to synergistic effect of beta-lactam-tobramycin combinations against Haemophilus species endocarditis strains. 138 4

In a five-year prospective study of blood culture-positive septicaemia in a Hong Kong teaching hospital there were 2211 clinically-significant episodes, of which 16% occurred in children less than 15 years old. The microbiology and clinical features were broadly similar to those seen in Europe and North America, but with some important differences. Two-thirds of episodes were community-acquired. The most common organism isolated from community-acquired septicaemias was Escherichia coli and the source, most commonly, the urinary tract. However, the biliary tract was the second most common source of community-acquired infection (25%), reflecting the frequency of liver disease in Hong Kong. Three per cent of community-acquired septicaemias were associated with endocarditis; half of these were with viridans streptococci, usually in patients with rheumatic heart disease, and 40% were in drug addicts with methicillin-sensitive Staphylococcus aureus. The commonest organisms causing community-acquired childhood infections were Salmonella spp. (27%) and Streptococcus pneumoniae (22%), whereas pneumococci accounted for only 3% of adult community-acquired micro-organisms. Haemophilus influenzae infections were uncommon and there was no case of meningococcal or gonococcal septicaemia. The commonest cause of hospital-acquired septicaemia was Staph. aureus (24%), of which 46% were methicillin-resistant. The characteristics of septicaemia in Hong Kong are influenced by the patient population structure, endemic disease patterns, local medical practice and socio-economic factors, but the rarity of Str. pneumoniae in adults and of H. influenzae and Neisseria meningitidis in children is unexplained.
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PMID:Septicaemia in Hong Kong. 234 72

The range of microorganisms that may cause bacterial endocarditis is extensive. Increasingly recognised is the frequency with which Haemophilus species may be associated with this condition, although they account for less than 1% of cases. Haemophilus influenze, however, is very rarely implicated. We report a fatal case of H. influenzae endocarditis in a 55-year-old man.
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PMID:Fatal Haemophilus influenzae endocarditis. 267 94

The efficacy of sulbactam/ampicillin in the treatment of mice with fatal systemic infections produced by ampicillin-resistant Staphylococcus aureus, Haemophilus influenzae, Klebsiella pneumoniae, or Proteus vulgaris strains is well established. In this paper the demonstrations of efficacy for sulbactam/ampicillin have been extended to a number of clinically relevant models, including bacteremia and meningitis produced by H. influenzae in infant rats, experimental staphylococcal endocarditis in rabbits, localized lesions in mice, urinary tract infections in rats, and prophylaxis in a surgical wound model in mice. In these models, in which ampicillin-resistant organisms were used, sulbactam/ampicillin was either more effective than or as effective as appropriate control agents. Neither sulbactam nor ampicillin used separately displayed significant activity. The results of supportive pharmacokinetic studies, in which differential bioassays were used, demonstrated that sulbactam and ampicillin generally were delivered with equal efficiency to plasma and to extravascular fluids obtained by sampling the contents of implanted cylinders.
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PMID:Activity of sulbactam/ampicillin in screening and discriminative animal models of infection. 302 2

From 1976 to 1985, 27 adult invasive Haemophilus infections were observed at the University Medical Center in Lausanne. Only 5 cases (19%) were caused by Haemophilus influenzae type b, while 12 cases (44%) were due to Haemophilus species other than H. influenzae. Two out of 24 strains tested were ampicillin-resistant. The infections were meningitis in 8, pneumonia in 7, endocarditis in 5, sepsis of unknown origin in 4, epiglottitis in 2, and one gynecological infection. Except for the latter three patients, each case was associated with one or more underlying conditions. Seven patients died (26%), in three of whom death was directly related to the infectious process. This report and a review of the literature show that adult invasive Haemophilus infections are not uncommon and may be serious. Associated underlying diseases and advanced age are generally present. In contrast to infections occurring in children, invasive Haemophilus infections in adults are not restricted to encapsulated Haemophilus influenzae type b strains.
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PMID:[Invasive Haemophilus infections in adults]. 349 62

In a retrospective study covering a 13-year period and a population of 817,900 inhabitants, 13 cases of invasive infection caused by Haemophilus species other than Haemophilus influenzae were found. Ten of the infectious episodes were caused by Haemophilus parainfluenzae and three by Haemophilus aphrophilus. The clinical manifestations comprised endocarditis, meningitis, pleuropneumonia, epiglottitis and septicaemia from an unknown focus. These 13 infectious episodes caused by uncommon Haemophilus species constituted less than 3% of the total number (473) of invasive Haemophilus infections registered during the same period of time. Invasive H. influenzae infections were more common in all age groups than infections caused by other Haemophilus species. In contrast to H. influenzae infections, which predominate in childhood, invasive infections due to uncommon Haemophilus species had no predilection for any age group.
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PMID:Invasive infections caused by Haemophilus species other than Haemophilus influenzae. 387 45

A 79-year-old female developed endocarditis and meningitis due to an ampicillin-resistant, non-beta-lactamase-producing strain of Haemophilus influenzae. Carbenicillin and gentamicin therapy resulted in bacteriological and clinical cure. The mechanism of resistance of ampicillin-resistant, non-beta-lactamase-producing strains of H. influenzae is unknown.
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PMID:Isolation of an ampicillin-resistant, non-beta-lactamase-producing strain of Haemophilus influenzae. 696 43

Two cases are presented of Haemophilus endocarditis in patients with presumed normal valves. One case was due to H. influenzae presenting as a typical case of infective endocarditis and the other was due to H. para-influenzae presenting as an acute pyrexia of unknown origin. The difficulties in making the diagnosis and the optimal treatment are discussed.
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PMID:Haemophilus endocarditis. 697 55


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