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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gonococcal endocarditis, although extremely rare, is increasing in frequency, particularly among young exposed patients. It has a distinct predilection for aortic and mitral valve involvement and tends to cause rapid valvular destruction and acute heart failure. Blood cultures are often negative during the first (3 to 31) days. Echocardiography with Doppler is helpful in detecting valvular vegetations, regurgitation and signs of hemodynamic deterioration. Early antibiotic treatment may stabilize the hemodynamic situation only in mitral but not in aortic valve involvement, which necessitates prompt valvular replacement in the event of perforation and/or annulus abscess. Gonococcal endocarditis should be the first item to be excluded in cases of fever with systemic symptoms in young people with a history of sex-transmitted disease. We present a typical case.
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PMID:[Gonococcal endocarditis: an infection as rare as it dangerous. Apropos of a case: the importance of suspicion in diagnosis and of immediate treatment]. 212 29

A 47-year-old sexually active Japanese man was admitted with a persistent fever and weight loss. A physical examination revealed a cardiac murmur. A transthoracic echocardiogram was nondiagnostic, although blood cultures grew Neisseria gonorrhoeae. Gonococcal endocarditis was diagnosed based on the modified Duke criteria. The administration of antimicrobial therapy resulted in an adequate initial resolution; however, two months after completing the therapy, the patient developed cardiac failure. Severe aortic regurgitation was identified, and the patient underwent emergent aortic valve replacement. Despite the rarity of gonococcal endocarditis, this disease should nevertheless be considered in patients presenting with a fever, cardiac murmur and a consistent sexual history.
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PMID:Gonococcal endocarditis in a 47-year-old Japanese man. 2458 44

The incidence of severe complications of the Neisseria gonorrhoeae infection has presented variations over recent decades since the advent of penicillin. Gonococcal endocarditis (GE) still remains an ever-present threat afflicting the society's poor and sexually active young population. This entity frequently requires surgical intervention and usually exhibits a poor outcome. The interval between the onset of symptoms and the diagnosis does not usually exceed 4 weeks. One of the characteristics of GE is a proclivity for aortic valve involvement with large vegetation and valve ring abscess formation. The authors report the case of a young man with a 2-week history of fever, malaise, weakness, and progressive heart failure symptoms, who had no previous history of genital complaints or cardiopathy. The physical examination was consistent with acute aortic insufficiency, which was most probably of an infectious origin. The echocardiogram showed thickened aortic cusps and valve insufficiency. After hospital admission, the patient's clinical status worsened rapidly and he died on the second day. The autopsy findings disclosed aortic valve destruction with vegetation and a ring abscess besides signs of septic shock, such as diffuse alveolar damage, acute tubular necrosis, and zone 3 hepatocellular necrosis. The blood culture isolated N. gonorrhoeae resistant to penicillin and ciprofloxacin. The authors call attention to the pathogen of this particular infectious endocarditis, and the need for early diagnosis and evaluation by a cardiac surgery team.
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PMID:Gonococcal endocarditis: an ever-present threat. 2754 39