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Results for “ENDOCARDITIS, INFECTIOUS”

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At least 775 records · Page 43Linked to original sources
PubMed1981

[Changes in infectious endocarditis in 3 decades].

The course, clinical picture and outcome were compared in 101 patients with infective endocarditis (1975-79, phase III) with our earlier investigations 1947-57 (phase I) and 1961-74 (phase II). An impressive change in this disease was found: - The average age of the patients is higher. - Acute cases and postoperative courses (after valve replacement) are more common and the outcome in these cases is better. Subacute courses are on the decrease. The clinical picture often is oligosymptomatic: - Fever is absent in a quarter, cardiac murmur in nearly a fifth and splenomegaly in four fifths of the patients. - For the first time 5 patients with right-heart endocarditis were observed in phase III. Three of these patients were intravenous drug abusers. The initial clinical picture was misinterpreted as pneumonia or pulmonary embolism. - The most common infective agents were streptococci, followed by staphylococci. The portion of negative blood cultures was strikingly high (35%). - Despite the higher frequency of acute courses, mortality has decreased. Urgent cardiac valve replacement, which has been performed in a fifth of our patients, can prevent irreversible congestive heart failure.

Adult↗
PubMed1995

[Several mechanisms of immunological adaptation in the etiology of subacute infectious endocarditis].

The paper deals with the possibility of identifying the persons predisposed to the development of subacute septic endocarditis (SSE), with the prediction of the course of the disease and the clarification of reasons for the inefficiency of antibacterial therapy. The studies performed revealed the impairment of cooperative interaction of the immune system, which prevents it from fulfilling its main task, i.e. to make an immunological surveillance over the maintenance of internal constancy. Imperfection of this function in SSE patients and rheumatic heart diseases is based on the body's sharply limited adaptation which results from the genetically determined low values of the immune functional reserve realizable by the level of intracellular energy processes which are substantially lower in SSE patients, as evidenced by the studies conducted. This is very important for predicting whether it may develop in some patients with rheumatic diseases. The necessity of using large doses of antibiotics decreases the activity of intracellular processes to a greater extent, aggravating primarily phagocytic function, as reflected in the efficiency of antibiotic therapy.

Adult↗
PubMed1995

[Dental care and prevention of infectious endocarditis].

Infective endocarditis causes substantial morbidity and mortality despite adequate antimicrobial, medical and surgical treatment. The rationale for antibiotic prophylaxis against endocarditis is derived from the etiology and pathogenesis of the disease. Endocarditis usually follows bacteremia with certain endocarditis-prone bacteria in a patient with a predisposing heart condition. Protection by antibiotic prophylaxis is estimated to reach only 50% for a lot of reasons (transient bacteremia without dental or surgical intervention, predisposing heart disease not diagnosed previously, etc). Most authorities in the field of infective endocarditis strongly advocate the use of antibiotic prophylaxis for patients at risk. Clear guidelines are published by various highly qualified scientific committees. Recent schemes allow orally administered antibiotic prophylaxis because of a better doctor and patient compliance.

Administration, Oral↗
PubMed1995

[The acquired immunodeficiency syndrome, hypertrophic myocardiopathy and multivalvular infectious endocarditis. Apropos a clinical case].

We present a clinical case of a 33 years old young male, gypsy, intravenous drug abuser with heroine and cocaine and AIDS diagnosis. The clinical anamnesis was mainly fever and systolic heart murmur in a clinical scenario of AIDS. The two-dimensional echocardiographic study was clearly diagnostic of an hypertrophic obstructive cardiomyopathy of the left ventricle. This study showed also the presence of multiple vegetations of the mitral, aortic and pulmonic valves in a clinical setting of an acute Streptococcus Viridans infective endocarditis. In this case report we discuss the incidence of this type of multiple cardiac lesions and particularly the presence of this specific pathogenic agent in this high risk group of patients with intravenous drug abuse and systemic immunosuppression. We pointed out the rarity of these findings of left side valvular vegetations associated with this type of cardiomyopathy and the different factors related to infective endocarditis.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Infectious endocarditis in dentistry practice: recent controversies and modes of the use of antibiotic prophylaxis].

A survey by questionnaire to assess the daily practice of the antibiotic prophylaxis of infective endocarditis by physicians attending post-graduate schools of the Institutes of Oral Surgery and Stomatology (Group A n = 83) and Cardiology (Group B n = 46) of the Second University of Naples has been conducted. They were asked about dental procedure and cardiopathies that require prophylaxis for infective endocarditis, the relationship between infective endocarditis and rheumatic disease and the provision of antibiotic. Extraction of tooth and dental and oral surgery have been reported as the most risky procedures. Moreover provision of antibiotic prophylaxis was suggested to patients not at risk (pacemaker or coronary artery bypass), and was not suggested in high risk conditions (mitral valve prolapse with regurgitation and hypertrophic cardiomyopathy). Most of the 50-60% practitioners usually start the prophylaxis 24-48 hours before the procedure and prolong it for 48-72 hours. These results underline the need for improvement of the knowledge for the antibiotic prophylaxis of infective endocarditis.

Anti-Bacterial Agents↗