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

Fifteen bacterial isolates (12 streptococcal and 3 staphylococcal strains) from patients with bacterial endocarditis were screened for a variety of surface receptors, in an attempt to identify a common feature that might contribute to their ability to attach to and colonize damaged heart tissue. The bacterial receptors screened for, using a dot-blot autoradiographic procedure, included those for the Fc region of human IgG, fibrinogen, fibronectin and human C1q. Bacteria with receptors for each of the probes used could be identified, but no common receptor was present on all endocarditis-causing strains.
J Gen Microbiol 1986 Jul
PMID:Analysis of surface receptor expression on bacteria isolated from patients with endocarditis. 294 70

Chromosomal and plasmid DNA have been extracted from six isolates of Coxiella burnetii, the aetiological agent of Q fever. Restriction fragment length polymorphisms detected after HaeIII digestions of chromosomal DNA revealed four different patterns that distinguished the American from the European isolates, and the Nine Mile phase I prototype strain from a spontaneously derived, isogenic phase II nonrevertant variant. At least one of the HaeIII fragments visible in the pattern from Nine Mile phase I and not in that from Nine Mile phase II could not be detected by DNA-DNA hybridization, and thus may have been deleted during the phase transition. Comparison of Nine Mile phase II, which does not survive animal passage, with Grita M44 phase II, which does, indicated that the HaeIII fragment was present in the Grita strain. These results suggest that this HaeIII fragment may be concerned with functions necessary to survive the cellular immune response in vivo. Isolates from two human endocarditis cases showed the greatest divergence from all the other isolates, having at least five fragments of unique mobility in the HaeIII digestion pattern of their chromosomal DNA. Also, a plasmid obtained from these two isolates was 2 to 3 kb larger than the plasmid present in the other five isolates, and its restriction pattern could be distinguished from that of the other plasmids by several endonucleases. Detection of chromosomal and plasmid restriction fragment length polymorphisms among strains of phase I or phase II C. burnetii from various geographical locations and environmental sources will facilitate Q fever diagnosis and strain identification.
J Gen Microbiol 1986 Feb
PMID:Genetic heterogeneity among isolates of Coxiella burnetii. 301 63

Intravenous drug abusers with endocarditis present difficult problems in both medical and psychiatric management. A retrospective chart survey revealed that eight of nine such patients with endocarditis signed out against medical advice before antibiotic therapy was completed. Reasons for premature discharge included the patient's underlying psychopathology as well as the emotional response of the staff to these patients. Understanding both of these factors may help to prevent these premature discharges.
Gen Hosp Psychiatry 1988 May
PMID:Noncompliance in the treatment of endocarditis. The medical staff as co-conspirators. 337 98

Mild mitral valve prolapse, hypoglycemia, irritable colon, and premenstrual syndrome are examples of anatomico-physiologic phenomena that largely overlap with normal. Such "overlap syndromes" become labeled disease entities by the medical community through a process called medicalization. This report uses mitral valve prolapse (MVP) to exemplify the effects of medicalization on patients, physicians, and society. Ascertainment bias and insufficient controlled clinical studies have led to the description of a clinical entity replete with false associations (e.g., mitral valve prolapse syndrome) and overly pessimistic prognostication (e.g., risk of sudden death or endocarditis), leading to clinical overreaction, overtreatment, and unnecessary induction of disability. Though some physical complications may be prevented by recognizing severe MVP, there is substantial risk of iatrogenic harm by attributing complex symptoms and illness behavior to mild MVP, which is probably a normal variant. A three-dimensional analysis of illness experience is presented that may be of use in conceptualizing the clinical approach to overlap syndromes such as mild MVP. Conservative criteria for the diagnosis of significant MVP have been developed at the National Institutes of Health. Treatment of patients with mild MVP must emphasize that it is a normal variant without serious consequences. Because the risks of overmedicalization are so substantial, the impact of diagnostic labels on individual patients and society must be analyzed continually.
J Gen Intern Med
PMID:The medicalization of normal variants: the case of mitral valve prolapse. 337 94

Although clinical information provided to the interpreter of imaging tests may improve disease detection, it may also bias the interpreter towards certain diagnoses, increasing the chance of false positives. To determine the possibility of this bias, the authors studied patients who were referred for echocardiography with a clinical suspicion of endocarditis. Hospital charts from a two-year period were reviewed to determine clinical data available to the echocardiographer, echocardiogram results, and the final diagnosis. Four clinical features, when present at the time of echocardiography, were associated with increased numbers of false-positive results. Test specificity was 97% (34/35) for patients without any of these features, but dropped to 80% (16/20) when two or more features were present. The authors conclude that clinical information may bias echocardiogram interpretations such that both test specificity and the posttest probability of disease may be overestimated when tests are used in clinical practice.
J Gen Intern Med
PMID:Echocardiography, endocarditis, and clinical information bias. 377 19

The ability to aggregate human platelets was examined for five Lactobacillus rhamnosus strains and five Lactobacillus paracasei subsp. paracasei strains isolated from patients with infective endocarditis (IE), 25 laboratory isolates from the same two species, and 14 strains from five other oral species, namely Lactobacillus acidophilus, Lactobacillus fermentum, Lactobacillus oris, Lactobacillus plantarum and Lactobacillus salivarius. Amongst the L. rhamnosus strains, platelets were aggregated by all five IE strains and 8/16 laboratory strains. For the L. paracasei subsp. paracasei strains, the respective numbers were 2/5 and 2/9. Aggregation also occurred with 11/14 strains of the other five species; each species was represented. The optimal ratio of bacteria to platelets for aggregation was approximately 1:1, and there was considerable variation in the lag phase that preceded aggregation, depending on the source of the platelets. Overall, the lag phase varied between 0.25 +/- 0.1 and 20.4 +/- 3.2 min and the percentage aggregation ranged between 70 +/- 2.6 and 104 +/- 13.5%. Confirmation that aggregation was being observed came from studies with five strains on the inhibitory effects of EDTA, dipyridamole, apyrase, imipramine, acetylsalicylic acid and quinacrine. Inhibition of aggregation by L. rhamnosus strains by the peptide arginine-glycine-aspartic acid-serine (RGDS) further indicated a role for fibronectin and/or fibrinogen. Pronase treatment of cells for 1 h and extraction of bacterial surface components with 0.1 M-Tris/HCl (pH 8.5) at 37 degrees C for 1 h stopped aggregation in 8/9 IE strains. Extracted surface proteins (200 micrograms) completely inhibited platelet aggregation by 8/9 of the homologous strains.(ABSTRACT TRUNCATED AT 250 WORDS)
J Gen Microbiol 1993 Dec
PMID:The aggregation of human platelets by Lactobacillus species. 812 21

American Heart Association (AHA) guidelines to prevent infective endocarditis recommend the use of antibiotic prophylaxis to treat hypertrophic cardiomyopathy caused by mitral regurgitation. The syndrome of congestive heart failure is frequently seen with clinical findings similar to those of hypertrophic cardiomyopathy, but antibiotic prophylaxis is not specifically recommended in the current AHA guidelines for congestive heart failure. Clinicians should be aware of the incidence of valvular abnormalities in congestive heart failure, and other cardiomyopathies, and consider the use of infective endocarditis antibiotic prophylaxis per AHA guidelines.
Gen Dent
PMID:Clinical consideration for infective endocarditis antibiotic prophylaxis. 966 69

Endocarditis is a serious complication of injection drug use most commonly caused by Staphylococcus aureus. We report a case of tricuspid valve polymicrobial bacterial endocarditis in an injection drug user from 3 oral anaerobes: Actinomyces odontolytica, Veillonella species, and Prevotella melaninogenica. The patient was believed to have acquired these organisms from his habit of licking the needle in order to gauge the strength of the cocaine prior to injection. The patient was successfully treated with a 6-week course of penicillin G and metronidazole. This case demonstrates the importance of a detailed history in designing empiric therapy.
J Gen Intern Med 2005 Oct
PMID:A case of polymicrobial endocarditis caused by anaerobic organisms in an injection drug user. 1619 Nov 49

This study sought to determine the antimicrobial susceptibility of Staphylcoccus aureus and viridans group streptococci strains collected from the forearm skin and saliva of 30 patients at high risk of endocarditis. Agar susceptibility tests of antibiotics routinely utilized in dentistry were used to verify antimicrobial resistance of bacterial strains. Of the Staphylcoccus aureus strains, 50% were resistant to ampicillin, 53.3% to amoxicillin, 60.0% to penicillin G, 13.3% to amoxicillin/clavulanate, 20.0% to azithromycin, 27.6% to clarithromycin, 23.3% to erythromycin, 3.3% to cefazolin, and 6.7% to clindamycin. Regarding streptococci, 16.7% of the strains were resistant to ampicillin, 16.7% to amoxicillin, 23.3% to azithromycin, 23.3% to clarithromycin, 30.0% to erythromycin, 13.3% to cefazolin, 26.7% to clindamycin, 16.7% to penicillin G, and 3.3% to amoxicillin/clavulanate. Pathogens associated with bacterial endocarditis exhibited elevated resistance rates against the antibiotics used for prophylaxis in dentistry.
Gen Dent
PMID:Antimicrobial resistance of Staphylococcus aureus and oral streptococci strains from high-risk endocarditis patients. 1636 48

We describe the case of a 43-year-old woman with transient ischemic neurologic deficits and recurrent systemic and pulmonary emboli in whom infectious work-up and extensive thrombophilic evaluation were unremarkable. Transesophageal echocardiography (TEE) established the diagnosis of nonbacterial thrombotic endocarditis (NBTE). This is a rare condition often associated with hypercoagulable states or advanced malignancy such as adenocarcinomas, characterized by cardiac vegetations along valvular coaptation lines without destruction of leaflets. In our patient, we diagnosed an ovarian clear cell adenocarcinoma, a malignant disorder that has been rarely reported in association with NBTE. This case illustrates that NBTE can present as an atypical manifestation of malignancy and must be distinguished from infective endocarditis, which implies a different therapeutic strategy. When confronted with findings of NBTE without a clear etiology, an occult neoplasm must be excluded. Anticoagulant therapy is the mainstay of treatment. However, cardiac vegetations may require surgical intervention in rare instances.
J Gen Intern Med 2006 Dec
PMID:Nonbacterial thrombotic endocarditis with recurrent embolic events as manifestation of ovarian neoplasm. 1696 57


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