Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ENDOCARDITIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,135 records · Page 63Linked to original sources
PubMedDate not supplied

Viridans streptococcal endocarditis: the role of various species, including pyridoxal-dependent streptococci.

The viridans streptococci are a heterogeneous group of organisms frequently associated with microbial endocarditis. Isolates from consecutive patients with endocarditis due to viridans streptococci who were seen at The New York Hospital from 1944 to 1955 and from 1970 to 1978 were speciated, and the relative frequencies and patterns of sus ceptibility to penicillin were determined. Vitamin B6-dependent streptococci, classified as Streptococcus mitior, accounted for 5%-6% of microbial endocarditis in both time periods. Since these nutritional variants require the active forms of vitamin B6 for growth in routein media, they can be responsible for culture-negative endocarditis. Media must be supplemented with either pyridoxal hydrochloride or pyridoxamine dihydrochloride (the active forms of vitamin B6) for isolation, identification, and subsequent testing of susceptibility to antimirobial agents. Pyridoxine hydrochloride does not support the growth of these organisms in vitro.

Endocarditis, Bacterial↗
PubMedDate not supplied

Unusual pathogens in narcotic-associated endocarditis.

We report the cases of three adults with a history of intravenous drug abuse who developed endocarditis caused by Corynebacterium xerosis, Neisseria subflava, and Neisseria flavescens, respectively. No cases of endocarditis caused by C. xerosis or N. flavescens and only one case caused by N. subflava have previously been reported in association with narcotic addiction. The prominent clinical features in all patients included poor response to antibiotic therapy, persistent fever, and major embolic events. Stigmata of infection with human immunodeficiency virus, as manifested by oral candidiasis, cervical lymphadenopathy, and serologic evidence, were present in two of the three patients. At our institution, where Staphylococcus aureus remains the most frequent etiologic agent of narcotic-associated endocarditis, the occurrence of these three cases in a 9-month period is striking. We speculate that infection with human immunodeficiency virus may play a role in the pathogenesis of endocarditis caused by these unusual organisms.

Adult↗
PubMedDate not supplied

Endocarditis due to Corynebacterium pseudodiphtheriticum: five case reports, review, and antibiotic susceptibilities of nine strains.

Five cases of endocarditis due to Corynebacterium pseudodiphtheriticum are described. Two patients died, two patients with prosthetic valve endocarditis were successfully treated with antibiotics and valve replacement, and one patient with native valve endocarditis was successfully treated with penicillin alone. We also review 12 previously reported cases of C. pseudodiphtheriticum endocarditis. In vitro susceptibilities to 15 antibiotics were determined for nine isolates. The minimum inhibitory concentrations (MICs) of penicillin, amoxicillin, cefamandole, cephalexin, and rifampicin were all less than or equal to 0.12 mg/L. The MICs of vancomycin and ciprofloxacin for all strains were less than or equal to 0.5 mg/L. Tobramycin was the most active aminoglycoside, with MICs for all strains that were less than or equal to 0.12 mg/L. On the basis of in vitro data and the results of previous reports, penicillin alone or in combination with an aminoglycoside should achieve bacteriologic cure. Vancomycin should be used in patients who are allergic to penicillin.

Adolescent↗
PubMed1992

Mitral valve endocarditis caused by a serum-resistant strain of Escherichia coli.

Endocarditis due to Escherichia coli is rare. The case of a 79-year-old woman with E. coli bacteremia and multiple hemorrhagic cerebral infarcts is reported. A two-dimensional echocardiogram showed no evidence of a vegetation. While she was receiving antimicrobial therapy, bacteremia, hematuria, conjunctival petechiae, and a mitral regurgitant murmur occurred. The patient died, and at autopsy a large (2.2 x 2.0 x 0.7 cm) necrotic vegetation on the anterior leaflet of the mitral valve and several hemorrhagic infarcts of the brain were noted. An in vitro study with use of pooled human serum was performed and demonstrated that the patient's infecting strain of E. coli was serum resistant, in contrast to a serum-sensitive control strain of E. coli that was isolated from the cultures of blood from a patient with pyelonephritis. Including our case, 19 well-described cases of E. coli endocarditis from 1945 to 1990 have been reported. E. coli can cause endocarditis of both sides of the heart. More cases of endocarditis of host valves than of prosthetic valves have been documented.

Aged↗
PubMed1992

Infective endocarditis of a native valve due to Acinetobacter: case report and review.

A case of community-acquired infective endocarditis of a native valve that was caused by Acinetobacter calcoaceticus subspecies anitratus is presented. The previously reported cases are reviewed, and therapy for this disorder is discussed. The presence of a transient maculopapular rash involving the palms and soles but sparing the face is suggested as a possible early clinical clue to the diagnosis. Native valve endocarditis caused by Acinetobacter species is an acute, aggressive illness that is more likely to be fatal than the prosthetic valve form; of the previously described patients, five of 15 with native valve endocarditis and one of six with prosthetic valve endocarditis died. In the appropriate clinical setting, we recommend therapy with an antimicrobial agent known to be active against Acinetobacter organisms when blood cultures are reported to yield oxidase-negative, gram-negative coccobacilli until the final identification of the microorganism is known.

Acinetobacter Infections↗
PubMed1992

Endocarditis due to Neisseria mucosa: two case reports and review.

Two cases of endocarditis caused by Neisseria mucosa are reported, and the literature on N. mucosa endocarditis is reviewed. N. mucosa is a rare but serious cause of endocarditis that is associated with a high rate of embolic complications and high mortality and is not always highly sensitive to benzylpenicillin. Most patients with N. mucosa endocarditis have been treated with combined therapy with penicillin and an aminoglycoside, although the optimal regimen has not been defined.

Adult↗
PubMed1994

Campylobacter fetus endocarditis: two case reports and review.

We report two cases of Campylobacter fetus endocarditis. The first case involved a bicuspid native aortic valve in a 60-year-old woman, and the second involved a prosthetic aortic valve in a 76-year-old woman. No source of infection was identified in either case. Despite antibiotic therapy, hemodynamic deterioration necessitated valve replacement; both patients recovered completely. C. fetus is an uncommon cause of human infection but may be responsible for severe illnesses such as endocarditis and thrombophlebitis because of its tendency to attack the vascular endothelium. Review of the literature revealed 21 cases of endocarditis caused by this organism, usually involving the aortic valve. To our knowledge, there are only two reported cases of prosthetic valve endocarditis. Our second patient is the oldest one encountered so far with this condition.

Aged↗
PubMed1995

Haemophilus paraphrophilus endocarditis: case report and review.

Endocarditis due to Haemophilus paraphrophilus is an uncommon disease. We report a case of H. paraphrophilus endocarditis with embolic complications in which the causative organism was resistant to beta-lactam antibiotics. Before April 1994, 16 cases of H. paraphrophilus endocarditis had been reported. Infection by this organism usually affects a previously damaged mitral valve. We emphasize the fastidiousness of the organism and the high incidence of embolic complications, which determine the outcome. To our knowledge we describe the first patient with endocarditis due to beta-lactam-resistant H. paraphrophilus.

Adult↗
PubMed1996

Infectious endocarditis due to non-typhi Salmonella in patients infected with human immunodeficiency virus: report of two cases and review.

Endocarditis is not usually considered a complication of AIDS. Because salmonellal bacteremia is common in HIV-infected patients and because salmonellae have a propensity to adhere to endothelial cells, these patients are at risk of endocarditis and endarteritis. We report two cases of endocarditis due to Salmonella enteritidis and review three previously reported cases. All five patients had underlying heart valve disease and developed fever, breakthrough or relapsing bacteremia, heart murmurs, and cardiac failure; four of five patients were older than 45 years. One patient died, but the other four were successfully treated with beta-lactam agents alone or in combination with aminoglycosides or with ofloxacin (valve replacement was not required). As AIDS patients get older, the number of cases of endocarditis or endarteritis due to Salmonella species may increase, particularly in geographic areas where Salmonella species are prevalent.

AIDS-Related Opportunistic Infections↗
PubMed1995

The prophylaxis of infective endocarditis: current practices in France. French Federation of Cardiology.

Over the last 10 years, the French Federation of Cardiology has circulated recommendations regarding the use of chemoprophylaxis in patients at risk for infective endocarditis. A national survey conducted in 1991, however, showed that the vast majority of both general practitioners and dentists were unaware of these recommendations. Therefore, a Consensus Conference was convened in 1992, with the object of defining and circulating new guidelines which were to be as practical as possible, for the prophylaxis of infective endocarditis. The Consensus Conference first defined which categories of subjects were at risk for infective endocarditis and which types of procedures were potential causes of endocarditis. The second task of the Conference was to determine recommendations for chemoprophylaxis before procedures at risk. For ambulatory dental procedures, a single oral dose of 3 g of amoxicillin administered in the hour preceding the procedure was recommended. Additional recommendations were made for subjects with an allergy to penicillin, for procedures requiring general anaesthesia or for urologic or digestive tract procedures. These recommendations were printed on credit-card format cards and distributed to all practising cardiologists, who were encouraged to give each of their patients at risk a personal card bearing his/her name and the type of heart condition at risk. It is hoped that these measures to both simplify the prophylactic antibiotic regimen and circulate the recommendations from the Consensus Conference may reduce the incidence of this still severe disease.

Anti-Bacterial Agents↗
PubMed1995

Q fever endocarditis.

Q fever is a widespread disease caused by the rickettsia Coxiella burnetii, an obligate intracellular bacteria which man usually acquires through the inhalation of infected dust from subclinically infected animals. Q fever may be acute or chronic. The chronic form mostly presents as endocarditis, which is difficult to diagnose and may ultimately be fatal. Immunocompromised conditions and underlying heart disease are the most important risk factors to consider in cases of Q fever endocarditis. The ultimate diagnosis is based on specific diagnostic tests which include serology, demonstration of C. burnetii in valvular material, isolation of C. burnetii from blood and tissue samples by cell-culture techniques as well as amplification and detection of the bacterial DNA by polymerase chain reaction. Treatment of chronic Q fever endocarditis is complex and requires long-term antibiotic therapy, sometimes associated with heart valve replacement. At the present time neither an optimal antibiotic combination nor the duration of treatment is known and patients with Q fever endocarditis require prolonged follow-up because of the possibility of later relapses.

Coxiella burnetii↗
PubMed1995

Late prosthetic valve endocarditis.

Prosthetic valve endocarditis remains an extremely serious complication, with a low but increasing incidence. 'Late' endocarditis, occurring more than 60 days after surgery, is relatively infrequently associated with staphylococci, Gram-negative bacteria and fungi so characteristic of the endocarditis that occurs earlier. A probable source of infection can be found in 25%-80% of patients, the most frequent causes being dental procedures, urological infections and interventions, and indwelling catheters. The most common organisms are S. epidermidis, S. aureus, viridans streptococci and enterococci. The general principles of antibiotic treatment are similar to those for native valve endocarditis, but antibiotic treatment needs to be more prolonged and dosages should be used which result in maximal, nontoxic concentrations. Oral anticoagulants should be stopped and replaced by intravenous heparins. Surgical reintervention is called for if there are large highly mobile vegetations in the mitral position or within 72 h if there are cerebral thrombo-embolic episodes.

Endocarditis, Bacterial↗
PubMed1984

Late prosthetic valve endocarditis. Bacteriological findings and prognosis in 29 cases.

Of 296 incidences of infectious endocarditis seen between 1971 and 1980, 29 cases of late prosthetic valve endocarditis (10%) occurred in 26 patients who had undergone valve replacement more than two months previously. The prosthesis was mitral in 8 cases, aortic in 9 cases, and multiple in 12 cases. The clinical picture consistently associated fever together with a regurgitation murmur in 12 cases (41%), a splenomegaly in 7 cases, a neurologic accident in 13 cases and other signs of endocarditis in 10 cases. Blood cultures were positive in 28 cases. The diagnosis was confirmed anatomically in 11 cases. Thirty-one causative agents were identified: 15 streptococci (48%), most of them were group D (11/15), 11 staphylococci (35%) 6 Staphylococcus aureus, 5 Staphylococcus coagulase negative and 5 other species. Two relapses and 3 recurrent infections were noted. The death rate was 58% with some factors being associated with a higher death rate: non-streptococcal micro-organism (87%) regurgitation murmur (83%) cardiac failure with dysfunction of the prosthesis (89%) neurologic complication (91%). Eight valve replacements were performed within a mean period of 32 days after the onset of the antibiotherapy with a death rate of 75%. It decreased to 50% for patients treated with antibiotic alone, and as low as 23% for Streptococcal endocarditis. These results suggest that earlier and more frequent indications for cardiac valve replacement could be an alternative to improve the prognosis.

Endocarditis, Bacterial↗
PubMed1984

Correlation of echocardiographic and surgical findings in acute bacterial endocarditis.

From January 1979 to April 1983, 72 patients (pts) with bacterial endocarditis were treated. During their first stay in hospital 36 of them (age range: 23-67 years) underwent cardiac surgery because of severe congestive heart failure, unsuccessful antibiotic treatment of the infection and/or embolic events. In all these cases cardiac surgery was performed without preoperative catheterization. Surgery was recommended on the basis of clinical as well as M-mode and 2D echocardiographic findings. In 32 of the 36 pts the echocardiographic study completely predicted the surgical findings (23x the aortic valve, 1x the mitral valve, 1x the tricuspid valve, 5x the mitral and aortic valve, 1x the aortic valve and a VSD and 1x the triscuspid valve and a VSD were involved). The preoperative echocardiographic diagnosis was incomplete in 4 of the 36 pts. One aortic aneurysm, one aortic root abscess and 2x vegetations on the mitral valve were not detected by echocardiography. Surgery was recommended in these 4 pts because of additional aortic valve endocarditis proven by echocardiography. We conclude that combined M-mode and 2D echocardiography allows the accurate prediction of morphological alterations of the heart in the setting of acute bacterial endocarditis. Thus cardiac surgery can be recommended in pts with acute bacterial endocarditis without preoperative heart catheterization and coronary angiography.

Acute Disease↗
PubMed1977

Perihepatitis and hepatitis as complications of experimental endocarditis due to Neisseria gonorrhoeae in the rabbit.

Seven strains of Neisseria gonorrhoeae (colony type 1 or 2) were tested for their ability to produce endocarditis in rabbits with transaortic valve catheters. The gonococci exhibited three auxotype patterns and a broad range of susceptibility to penicillin and to complement-mediated serum bactericidal activity. Only four strains produced endocarditis; infectivity appeared to be related to serum resistance. Neither arthritis nor skin lesions were observed in infected animals, but 40% had hepatitis, often with fibrinous perihepatitis. Hepatic lesions could be induced by the continuous infusion of gonococci without a transvalvular catheter. Suppurative hepatitis in the rabbit endocarditis model is of particular interest in light of the unusual hepatic involvement reported in association with gonococcal endocarditis in humans. Since perihepatitis also occurs as a complication of experimental gonococcal bacteremia, perhaps the Fitz-Hugh-Curtis (gonococcal perihepatitis) syndrome appearing in women occurs more often as a function of undiagnosed bacteremia than has heretofore been suspected.

Animals↗
PubMed1979

Synergy between carbenicillin and an aminoglycoside (gentamicin or tobramycin) against Pseudomonas aeruginosa isolated from patients with endocarditis and sensitivity of isolates to normal human serum.

Isolates from the blood of 30 patients with endocarditis due to Pseudomonas aeruginosa were tested for synergy between carbenicillin and an aminoglycoside, either gentamicin or tobramycin, by in vitro checkerboard methods in modified (cation-supplemented) Mueller-Hinton broth. Twenty-five of the 30 isolates were affected synergistically. Whether given low (2.5--5 mg/kg) or high (8 mg/kg) doses of aminoglycoside along with 30 g of carbenicillin daily, all of the five patients infected with pseudomonads that were not synergistically affected were refractory to treatment with pseudomonads that were not synergistically affected were refractory to treatment with the carbenicillin-gentamicin combination, whereas the finding of synergy of carbenicillin with gentamicin (or tobramycin) did not assure a medical cure. Tests for synergy between carbenicillin and gentamicin yielded different results in Mueller-Hinton agar than in modified Mueller-Hinton broth. The majority (28) of 30 isolates of endocarditis-producing P. aeruginosa were resistant to the bactericidal effects of 50% pooled normal serum that had been freshly separated. One of the endocarditis-producing strains that was sensitive to 50% serum was resistant to 10% serum. However, sensitivity or resistance to freshly separated, pooled normal human serum did not predict the outcome of antibacterial therapy for pseudomonas endocarditis.

Aminoglycosides↗
PubMed1982

Successful prophylaxis against experimental streptococcal endocarditis with bacteriostatic antibiotics.

Because bacteriostatic concentrations of vancomycin are effective in prophylaxis against endocarditis due to Streptococcus sanguis in rats, the efficacy of three other bacteriostatic antibiotics was investigated against three different streptococcal species that cause subacute endocarditis in humans: Streptococcus intermedius. S. sanguis, and Streptococcus mitior. Rats were challenged by intravenous injection of 2 x 10(5) colony-forming units of streptococci 24 hr after intracardiac insertion of a transaortic catheter and 30 min after intravenous injection of various doses of clindamycin, erythromycin, and doxycycline. Significant protection was achieved with all three antibiotics, but only clindamycin was fully effective against all three species at doses that simulated serum levels achievable in humans after oral administration. Endocarditis was prevented by antibiotic concentrations in serum far below minimal bactericidal concentrations for these streptococci. Furthermore, serum at the time of bacterial challenge was not bactericidal. Therefore, single doses of nonbactericidal antibiotics prevented endocarditis in rats by mechanisms other than bacterial killing.

Animals↗
PubMed1984

Production of experimental endocarditis by coagulase-negative staphylococci: variability in species virulence.

The abilities of 11 coagulase-negative staphylococcal isolates of human origin to establish infective endocarditis in a rat model were compared. Seven of the strains were Staphylococcus epidermidis, the species most commonly causing endocarditis in humans. The other four strains were Staphylococcus hominis, an infrequent cause of endocarditis. Four of the seven strains of S. epidermidis and two of the four strains of S. hominis elaborated surface slime. With an inoculum of 10(7) colony-forming units, endocarditis was established in all of 77 rats injected with S. epidermidis but in only five (12.5%) of 40 animals injected with S. hominis (P less than .001). Strains of S. epidermidis were significantly more resistant to phagocytic killing in vitro than were strains of S. hominis. These data indicate that there are major differences in the virulence of various species of coagulase-negative staphylococci, both in vivo and in vitro, and that these differences are reflected in the observed incidence of disease caused in humans by the respective species.

Animals↗