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PubMed1986

[Echocardiographic diagnosis of infectious endocarditis on patent ductus arteriosus with involvement of the pulmonary artery and the pulmonary and aortic semilunar valves. Description of a case].

Infective endocarditis is one of the most rare complications of patent ductus arteriosus (PDA). Usually vegetations are localised at the level of the patent ductus and can involve the left branch and the trunk of the pulmonary artery. We report the case of a young woman with PDA, who was admitted to the hospital in severe congestive heart failure due to infective endocarditis. A 2D echocardiographic examination revealed vegetations into the ductus with extension to the pulmonary artery, pulmonary valve and aortic valve. The results of the echocardiographic study enabled us to evaluate the extension of the lesions, to avoid heart catheterization and to decide the most suitable surgical approach for repairing all the damage in one surgical operation.

Adult↗
PubMed1987

[Infectious endocarditis caused by rare germs. Review of the literature apropos of 2 cases].

The authors report two new cases of endocarditis secondary to exceptionnally encountered germs: one to Pasteurella pneumotropica, the other ascribed to Leptospira ictero-haemorragiae, on serologic criteria. Concerning these two cases, they propose to take a census of rare germs, from a detailed study of the literature. Among more than 5,000 cases of endocarditis published after 1944, are considered as rare germs those causing a disease in less than one p. cent of the cases. This purely "mathematical" definition enable to include 45 germs. A synthesis of all the cases reported attempts to demonstrate a few particular traits of these endocardites secondary to rare germs.

Adult↗
PubMed1985

[Cardiac insufficiency in infectious endocarditis].

The aim of this study of 101 cases of infective endocarditis was to determine the factors predisposing to cardiac failure, the prognostic factors of this complication and the therapeutic implications. A significant (p less than 0.05) Chi square test was the statistical reference. Fifty-two per cent of patients developed cardiac failure which was biventricular in 48 p. 100 of cases and the presenting symptom in 64 p. 100. The mean age of the patients with cardiac failure was 56.6 years with a clear male predominance. In 48 p. 100 of cases, cardiac failure complicated a pre-existing cardiac lesion which was usually acquired (84 p. 100). The commonest condition was valvular insufficiency of the aortic and mitral valves (70 p. 100 of cases with cardiac failure). Severe cardiac failure was observed more frequently and earlier in aortic than in mitral regurgitation. The commonest infecting organism was the streptococcus (53 p. 100 of cases with cardiac failure) and the most frequent presumed portal of entry was dental (25 p. 100). Arrhythmias were observed in 51 p. 100 of patients in cardiac failure, the commonest being atrial fibrillation (34 p. 100) complicating mitral valve disease in 56 p. 100 of cases; 17 p. 100 of arrhythmias were ventricular. Conduction defects were observed in 26 p. 100 of cases with cardiac failure, 55 p. 100 of which had aortic valve disease. Valvular vegetations were demonstrated by echocardiography in 43 p. 100 of cases with cardiac failure. Valve replacement had to be performed for resistant cardiac failure in 13 p. 100 of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Cardiac abscess in infectious endocarditis. Apropos of 25 anatomo-clinical cases].

Although rarely suspected clinically, cardiac abscesses are a serious and not uncommon complication of infective endocarditis (IE). Twenty-five cardiac abscesses were found at autopsy in 125 cases of IE on native valves. The anatomoclinical features of these cases are described. Cardiac abscesses usually occur in patients with previous valvular heart disease (21/25) and more commonly in aortic valve endocarditis (15/25) especially when complicating calcific aortic stenosis (9/25). The predominant infecting organism was staphylococcus aureus (9 cases). An iatrogenic portal on entry was confirmed in 9/25 cases. Conduction defects (14/25) commonly led on to sudden death (9 cases) despite attempts at temporary pacing (14/25) commonly led on to sudden death (9 cases) despite attempts at temporary pacing (2 cases%. The clinical history was shorter than 2 months in 4/5 cases. The average age of the patients was 53.3 years. The commonest site of infection was the aortic valve (16/25), affecting the posterior cusp in all cases. It is difficult to summarise the localisation of the abscesses as collection of pus extended in all directions. Involvement of the valve rings (aortic 10 cases--mitral 5 cas), of the interventricular septum (15 cases), of the LV free wall (17 cases), was common, sometimes in association, and fistula formation between two different cavities was observed in 4 cases. The abscess may communicate with a cardiac chamber or remain enclosed in the parietal structures (17 cas) reaching an average size of 2 cm diameter. Histological examination distinguished collected forms with an identifiable pyogenic membrane from the extensive, gangrenous, necrotic form with detectable microbial colonies in 9 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess↗