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PubMedDate not supplied

[Bacterial endocarditis from the stimulatory unit of a cardiac pacemaker].

Cardiac device endocarditis is an infrequent complication of permanent pacemaker and implantable cardioverter-defibrillator. A personal observation had been valued noteworthy in relation to the relatively low rates and clinical features. An old man presented recurrent fevers throughout 17 months before transesophageal echocardiography detection of intracardiac vegetations. The removal and replacement of the infected device via open thoracotomy had been successful, and subsequently confirmed in a prolonged follow-up.

Aged↗
PubMed2006

Antibiotic prophylaxis for bacterial endocarditis--a study of knowledge and application of guidelines among dentists and cardiologists.

UNLABELLED: Antibiotic prophylaxis and infective endocarditis is a controversial topic. The compliance with available guidelines among dentists is poor. The dental health education of patients by their cardiologists is inadequate. OBJECTIVE: The objective of this study was to investigate the knowledge and application of available guidelines on antibiotic prophylaxis to prevent infective endocarditis among general dental practitioners and cardiologists. DESIGN: Structured postal questionnaire SUBJECTS AND METHODS: A list of 515 dentists was obtained from a register held by the Postgraduate Medical and Dental Board. A list of 85 cardiologists was obtained from a national register held by the Cardiothoracic Society of Ireland. RESULTS: A 31% response rate was obtained from the cardiologists and 37% from the dentists. The majority of the cardiologists (84%) were in hospital practice and 64% of dentists were in private general practice. Cardiologists showed a preference for the AHA guidelines (50%) and more dentists use the BSAC guidelines (56%). The cardiologists were very familiar with the cardiac conditions that pose a risk for dental patients but weak at educating their patients on the importance of good dental health. The dentists were good at identifying procedures that could place their patients at risk but less informed about which cardiac conditions warranted prophylaxis. Decision-making among the dentists with regard to choice of prophylaxis and appropriate treatment intervals was poor. CONCLUSIONS: The knowledge of and compliance with the available guidelines is poor. Dental health education of at-risk patients by their cardiologists and dentists is inadequate. Further regular education of patients, dentists and medical practitioners is required.

Amoxicillin↗
PubMed1991

[Septic pulmonary embolism, bacterial endocarditis and endocavitary pacemaker].

The number of patients carrying an endocavitary pacemaker is increasing every day. The presence of a foreign body in right cavities predisposes to the formation of thrombi that can be over infected from distal septic focci usually silent. When a pulmonary embolism is diagnosed in these patients, the initial study must include an echocardiographic exam in order to rule out the presence of an intracardiac thrombosis as the origin of the emboli. We present the case of a patient with and endocardiac pacemaker who was admitted with fever and repeated episodes of pulmonary embolism. Hemocultures were positive for proteus mirabilis and a electrocatheter thrombosis was demonstrated in bidimensional echocardiography. Proteus mirabilis was positive in cultures from the material obtained by cardiothomy and clinical evolution after surgery was satisfactory.

Aged↗
PubMed1991

[Unusually large vegetation on the mitral valve in a patient with bacterial endocarditis].

We present a case history of 29-year old female with infective endocarditis, who was admitted 15 months after neurosurgical treatment of disruption of cerebral aneurysm. The diagnosis of organic heart disease had been established in her childhood. 6 months after discharge from neurosurgery she developed marked dyspnoea on exertion and became febrile (up to 39.0 C). The presumptive diagnosis of infective endocarditis was established 6 months later, when she developed the symptoms and signs of severe anaemia with ESR 170 mm/hr although blood cultures were negative. The patient underwent treatment with Penicillin and Debecillin. On admission to our Institute echocardiography showed a very large, mobile vegetation in the left ventricle, connected to the anterior leaflet of mitral valve. Decision of mitral valve replacement was made, but rupture of the next cerebral aneurysm was the reason of unexpected, sudden death of the patient. The postmortem examination revealed 7 x 4 cm large vegetation, with the mass of 7.0 g. Histologically the vegetation consisted of mass of fibrin strands, platelets and blood cell with inflammatory cells. On its base the signs of the process of organization were marked. This vegetation was the largest one that we found in literature on this subject.

Adult↗
PubMed1991

[Bacterial endocarditis after treatment by a natural healer].

We describe a case of endocarditis caused by Propionibacterium acnes after a series of 'vitamin' injections and semipermanent acupuncture needle maneuvers by a natural healer. The patient had prosthetic heart valves. We found that the most probable source of infection was the treatment by the natural healer and therefore wish to warn against invasive treatment of such high-risk patients by laymen. If such treatment is insisted upon in spite of such warnings, antibiotic prophylaxis should be considered.

Acupuncture Therapy↗