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At least 469 records · Page 26Linked to original sources
PubMed1989

[Infectious endocarditis in patients with liver cirrhosis].

To evaluate the clinical and microbiological features of infective endocarditis in patients with cirrhosis we compared 18 episodes of endocarditis in these patients with a control group of patients without liver disease. In 61% of patients with cirrhosis the origin of infection was unknown. Four patients developed endocarditis as a consequence of bladder catheterizations and two after hepatic biopsy. None of the four with previously known valvular heart disease had received antibiotic prophylaxis during these procedures. As compared with the control group, the patients with cirrhosis had more infections by enterococci (38.8% vs 11%; p less than 0.007) and non-viridans streptococci (38.8% vs 7.4%; p less than 0.001) and significantly less infections by viridans streptococci (11% vs 42.5%; p less than 0.01). The mortality rate associated with endocarditis was 38.8% and 22% in patients with and without cirrhosis, respectively (less than 0.1; NS). Infective endocarditis in patients with cirrhosis is often a complication of diagnostic or therapeutic procedures and has distinctive microbiological features.

Adult↗
PubMed1989

[Current problems of infectious endocarditis. Clinico-diagnostic considerations on 17 cases].

Seventeen cases of Infective Endocarditis diagnosed over a seven-year period by clinical-echocardiographic criteria in a Division of General Medicine are reviewed. More significant aspects regard the observation of the disease in some subjects at risk (elderly persons, patients with normal native valves affected by cirrhosis, by intravenous drugs abuse, by haematological neoplasms), the diagnostic difficulties in cases with oligosymptomatic or atypical beginning, and the frequent negative blood cultures. The value and the limitations of echocardiography and some aspects of therapy are discussed.

Adult↗
PubMed1989

[Heart valve replacement in active infectious endocarditis].

A material of 87 patients who underwent cardiac surgery for active infective endocarditis from 1975 to 1987 is analyzed retrospectively. 91 emergency operations were performed in 19 women and 68 men with a mean age of 48 years. 72 native valves and 19 prosthetic valves were involved. Streptococci (41%) and staphylococci (27%) were the most frequent bacteriological isolates, whereas 19% of the cultures remained negative. Heart failure (52%), embolism (21%), uncontrolled infection (11%), prosthetic valve endocarditis (10%), atrioventricular block (4%) and ventricular septal defect (2%) were the indications for surgery an average of 22 days after diagnosis. 17 patients (19%) died, 9 during hospitalization from heart failure or septicemia and 8 in the later course. 16 patients required reoperation for valvular incompetence (5), paravalvular leak (4) or prosthesis infection (7). Five relapses (5.5%) and two reinfections (2.5%) were treated surgically while two reinfections responded to medical therapy alone. Postoperatively, 34 patients (39%) suffered severe complications such as neurological deficits, prosthetic valve endocarditis or anticoagulant haemorrhage. After a mean observation period of 52 months (range 1-147 months) 64 (91%) of the surviving patients were in NYHA classes I + II and 6 (9%) in NYHA classes III + IV.

Adolescent↗
PubMed1987

[Infectious endocarditis caused by Streptococcus bovis and alcoholic cirrhosis complicated by hepatoma].

The case is reported of a 66-year old man who developed Streptococcus bovis endocarditis on a fairly loose aortic stenosis and who also presented with alcoholic cirrhosis complicated by an ultimately lethal hepatoma. On this occasion, comments are made on the following points: -Str. bovis is increasingly responsible for bacterial endocarditis. This micro-organism is now rapidly and reliably identified. -Str. bovis endocarditis has some clinical features of its own. -Patients in whom the usual portals of entry of bacterial infection (i.e. benign or malignant tumours of the colon or rectum) cannot be identified should be investigated systematically for hepatic cirrhosis. -Drug sterilization of the gut is useful to prevent bacteremia of intestinal origin in cirrhotic patients.

Aged↗
PubMed1985

[Bacteriological diagnosis of infectious endocarditis. Evaluation of a system for eliminating antibiotics in the blood].

We carried out 310 blood-cultures on samples from patients receiving antibiotics for either known or suspected infective endocarditis or suspected septicaemia. The culture bottles were inoculated either directly or after the antibiotics had been removed from the blood sample by the Antimicrobial Removal Device System. Out of 63 bacterial isolates from 21 patients (15 infective endocarditis and 6 septicaemias), 45 were made by both methods, 16 only after treatment with the Antimicrobial Removal Device System and two only after conventional culture. Of the 45 paired isolates, eight were cultured more rapidly after Antimicrobial Removal Device System treatment compared with none by conventional culture. The Antimicrobial Removal Device System thus significantly increased the number of positive cultures and the speed of their isolation. In practice, Antimicrobial Removal Device System treatment proved useful in five of the 21 cases, but delayed culture in one. Its greatest value was in showing persistent bacteraemia in patients being treated for prosthetic valve endocarditis.

Anti-Bacterial Agents↗