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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Haemophilus parainfluenzae endocarditis is characterized by great variation in the acuteness of presentation, difficulty in isolation of the pathogen, a 50% to 60% incidence of major arterial emboli, and variability of response to therapy. Prosthetic valve endocarditis (PVE) due to H parainfluenzae biotype II occurred in a 14-year-old girl with congenital heart disease and a Starr-Edwards mitral valve prosthesis. Management was complicated by a prolonged culture-negative period (eight days), intermittent bacteremia (only five of 15 positive blood cultures), an embolus to the right femoral artery, progressive congestive heart failure, and urgent prosthestic valve replacement. Cure was achieved with 44 days of ampicillin sodium-gentamicin sulfate therapy monitored by serum bactericidal titers.
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PMID:Prosthetic valve endocarditis due to Haemophilus parainfluenzae biotype II. 44 17

We reviewed fourty-six patients who had undergone surgery for infective endocarditis in the past fifteen years and identified risk factors affecting the outcome. Twenty-nine patients had infection of the native valve only, 11 had infective endocarditis associated with congenital heart disease, and 6 had prosthetic valve endocarditis. Overall hospital mortality was 6.5%. Prosthetic valve endocarditis carried a higher mortality (33%) than native valve endocarditis (3.4% or congenital heart disease with infective endocarditis (0%). For the patients with active endocarditis, the early mortality rate was higher (13%) than with inactive endocarditis (3.2%). Staphylococcal infections were more likely to cause severe valve destruction and residual infection than streptococcal infection. Our results indicated that surgical management of infective endocarditis should be done after the completion of adequate antibiotic therapy. Early diagnosis should reduce the mortality, prevent fatal complications, and lead to qualitative improvement of infective endocarditis.
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PMID:[Surgical management of infective endocarditis]. 274 10

This retrospective study describes 100 cases of infective endocarditis (IE), collected between 1980 and 2004. Patients were subdivided into 2 groups, according to the use of trans-esophageal echocardiography (TOE) in the institution where the study was performed: group A (GA=55 patients, between 1980 and 1991) and group B (GB=45 patients, between 1992 and 2004). The IE cases of 59 men and 41 women were analyzed. Patients had a mean age of 33 years (range 15-75 years). An underlying heart disease was involved in all cases, mainly rheumatic heart disease (93% of cases). Native valve endocarditis (NVE) was seen in a majority of cases (93%), and the localization of IE was aortic in 36 cases, mitral in 36 cases, mitro-aortic in 26 cases and mitro-aortic-tricuspid in 2 cases. Prosthetic valve endocarditis (PVE) occurred in 12 cases. Blood cultures were positive in 31 cases, with 14 staphylococcal infections (3 in GA and 11 in GB) (p < 0.05), of which 6 were coagulase-negative; 13 were streptococci and 4 were Gram negative bacilli. All patients had a transthoracic echocardiography (TTE), and patients in group B also had a TOE. Seventeen patients had a favorable outcome without need of a surgical intervention. Early surgery was necessary in 71 cases (85.5%), and elective surgery in 12 cases (14.5%). Mortality while awaiting surgery was 27%, and has been decreasing for the past decade (41.8% in GA and 8.9% in GB) [p < 0.05]. Postoperative mortality after early surgery intervention was 13.6% (6 among 44 patients), and it was 8.3% (1 among 12 patients) after elective surgery intervention. Overall mortality was 34%: 27 deaths with NVE (30.7% [27/88]), and 7 deaths with PVE (58.3% [7/12]) [NS]. Predictors of mortality in this observational study were positive blood cultures involving staphylococci, the presence of valve mutilations, unstable prostheses, and heart failure.
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PMID:[Retrospective study on 100 cases of infective endocarditis, Rabta University Hospital, Tunis, from 1980 to 2004]. 1629 41

Propionibacterium species are occasionally associated with serious systemic infections such as infective endocarditis. In this study, we examined the clinical features, complications and outcome of 15 patients with Propionibacterium endocarditis using the International Collaboration on Endocarditis Merged Database (ICE-MD) and Prospective Cohort Study (ICE-PCS), and compared the results to 28 cases previously reported in the literature. In the ICE database, 11 of 15 patients were male with a mean age of 52 y. Prosthetic valve endocarditis occurred in 13 of 15 cases and 3 patients had a history of congenital heart disease. Clinical findings included valvular vegetations (9 patients), cardiac abscesses (3 patients), congestive heart failure (2 patients), and central nervous system emboli (2 patients). Most patients were treated with beta-lactam antibiotics alone or in combination for 4 to 6 weeks. 10 of the 15 patients underwent valve replacement surgery and 2 patients died. Similar findings were noted on review of the literature. The results of this paper suggest that risk factors for Propionibacterium endocarditis include male gender, presence of prosthetic valves and congenital heart disease. The clinical course is characterized by complications such as valvular dehiscence, cardiac abscesses and congestive heart failure. Treatment may require a combination of medical and surgical therapy.
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PMID:Propionibacterium endocarditis: a case series from the International Collaboration on Endocarditis Merged Database and Prospective Cohort Study. 1785 87