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Biomedical subjects

V Vic-Dupont

Publications and source records attributed to V Vic-Dupont.

5 recordsLinked to original sources

Pseudomonas aeruginosa endocarditis. A report of nine cases.

9 cases of Pseudomonas aeruginosa endocarditis are reported and the results of this study are compared with the data of the literature. The source of infection was known in 8 patients: 7 were nosocomial infections (cardiac catheterization in 5 cases, cardiac surgery in 2 cases). The diagnosis was made in 8 patients with left-sided endocarditis. In 1 patient tricuspid endocarditis was diagnosed on postmortem examination. Carbenicillin associated with an aminoglycoside antibiotic appeared to be the most effective treatment when prescribed for several weeks. 6 of 9 patients died of uncontrolled septicemia, 3 of whom underwent surgery which was twice performed because of poor hemodynamic status. In the other 3 patients drug administration was effective at first. However, a relapse occurred in these three cases compelling another effective antibiotic therapy. Surgery was peformed in these three patients. Valve cultures were negative in two cases and positive in 1. These 3 patients survived. They are still alive after a follow-up period of 2 or 3 years.

Adult

[Acute bacterial endocarditis].

Acute endocarditides, defined by the intensity of the infectious syndrome, increase rapidly in incidence, both in absolute number and in relation with classical subacute endocarditides. 60 cases were studied out of a lot of 130 cases of bacterial endocarditides. They are characterized by the nature of the portals of entry, particularly in hospital, the nature of the causal germs (staphylococci and gram-negative germs essentially), their habitually primary character, the importance of embolic manifestations. Cardiac failure through valvular mutilation is common, but surgical valve replacement is not always possible in view of the visceral or infectious context. Their overall prognosis is a very bad one: lethality 67 percent as against 15 percent for subacute endocarditides. An important part of prevention lies in a better hospital hygiene.

Acute Disease

[Septic phlebitis. Its consequences and its treatment].

Septic phlebitis is characterized clinically by a local syndrome in an arm, the chest or a leg, by an irregular temperature (toothsaw curve), by blood cultures that are simultaneously or successively positive for one or several pathogenic microorganisms, by repeated, multiple infected embolism and by the possibility of endocarditis as a complication. Septic phlebitis occurs either spontaneously (staphylococcosis, syndrome of angina pectoris and infarction), or through secondary infection by secondary microbial colonization of a thrombosis of gynecological or obstetrical origin or, thirdly, as the consequence of venous catheterization (perfusion, pacemaker, explorations). Prevention is based on the selection of the material (silastic piercing catheters), the choice of the site of injection, the observation of strict surgical asepsis and of choice of the fluid injected (no corticoids, nor heparin which inactivates the oligosaccharides). As regards the curative treatment, no use should be made either of heparin or of anti-inflammatory agents (especially no corticoids); first of all, the material that has caused the thrombophlebitis should be withdrawn immediately; secondly, 24 to 36 hours later, a specific antibiotic treatment should be instituted and after two weeks, if still necessary, surgical ligation may be carried out of the inferior vena cava, the subclavian vein or the brachiocephalic venous trunk, depending on the localization of the phlebitis.

Anti-Bacterial Agents