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 1,441 records · Page 80Linked to original sources
PubMed1997

[Mitral endocarditis secondary to Streptococcus mitis bacteremic pneumonia].

Streptococcus viridans usually are an etiologic agent in odontogenic infection and endocarditis and only in some cases have been acknowledged as a respiratory pathogens. We present two cases of Streptococcus mitis bacteremic pneumonia with secondary mitral endocarditis in two patients that were been admitted by a respiratory infection (pneumonia), and later diagnosticated of mitral endocarditis. We dismiss the fisiopathogenic possibility of pneumonia with secondary pulmonary septic embolisms. With this description we help to prove the S. mitis respiratory system pathogenicity and show the known risk of endocarditis in any case of Streptococcus viridans bacteremic infection.

Bacteremia↗
PubMed1997

[Non-bacterial thrombosing endocarditis. Apropos of 2 cases].

The diagnosis of nonbacterial thrombosing endocarditis or marasmic endocarditis must be considered in patients presenting with a combination of cancer and systemic embolism. The pathophysiological mechanisms of this entity are unclear and purely hypothetical. However, hypercoagulability appears to play an essential role in the pathogenesis of this endocarditis, which could be the cardiac expression of a coagulopathy involving the entire vascular system. The authors report two cases of marasmic endocarditis which emphasize the value of transthoracic and transoesophageal echocardiography in the difficult diagnosis of this disease.

Aged↗
PubMed1997

Fever, C-reactive protein, and other acute-phase reactants during treatment of infective endocarditis.

BACKGROUND: Fever and sustained elevations of levels of C-reactive protein, erythrocyte sedimentation rate, and other inflammatory markers are common problems during treatment of infective endocarditis. We studied the value of these measurements during an 8-year period in all episodes of infective endocarditis treated in 1 university-affiliated institution. METHODS: A total of 193 consecutive episodes that fulfilled the criteria for infective endocarditis were prospectively enrolled during 2 periods, 1984 through 1988 and 1993 through 1995. Fever and results of serial measurements of C-reactive protein, erythrocyte sedimentation rate, white blood cell counts, and platelet counts were related to the clinical course of infective endocarditis. RESULTS: Fever persisted or recurred in 108 episodes (57%) despite appropriate antibiotic treatment. The causes of persistent fever and recurrent fever were different. Persistent fever that lasted 7 days or longer was caused by a complicating cardiac infection in 56% of these episodes. Recurrent fever, noted in 31% of all episodes and the major cause of fever during the third and fourth treatment weeks, was caused most often by hypersensitivity reactions to beta-lactams. Elevations in C-reactive protein levels were significantly prolonged in the episodes with complicated courses compared with the episodes with uncomplicated courses, while mean erythrocyte sedimentation rate remained unchanged during treatment, not differentiating between complicated and uncomplicated episodes. CONCLUSIONS: Fever during treatment must be analyzed in terms of persistence and recurrence to provide a basis for clinical decisions. Serial measurements of C-reactive protein are useful to monitor the response to antimicrobial therapy and to detect complications, while serial determinations of erythrocyte sedimentation rate are of no value.

Acute-Phase Proteins↗
PubMed1997

The role of transesophageal echocardiography in patients with chronic renal failure at low and high risk of endocarditis.

BACKGROUND AND AIMS OF THE STUDY: The benefits of transesophageal echocardiography (TEE) may depend on the clinical likelihood of infective endocarditis, but little data exist on patients at low risk. METHODS AND RESULTS: We studied 32 patients with renal failure with either a low (n = 21) or high (n = 11) level of clinical suspicion for infective endocarditis. In the low-risk cases, TEE provided no new information whether the transthoracic echo was normal or abnormal, although it did confirm that an echogenic mass was more likely to be a calcific deposit than a vegetation. In the high-risk cases, transthoracic echocardiography was always abnormal but TEE added new information in seven out of 11 cases-positively in six, and by exclusion in one. TEE detected signs of complications of infective endocarditis in one case. CONCLUSIONS: We conclude that, when the clinical suspicion of endocarditis is low, TEE is rarely necessary.

Echocardiography↗
PubMed1997

[A patient with mitral stenosis due to infective endocarditis].

A 51-year-old woman presented with mild stenosis of the mitral valve which had become thickened and rigid due to infective endocarditis, manifesting as persistent fever of up to 40 degrees C and general fatigue of a few days' duration. A harsh systolic murmur was heard. Multiple blood cultures revealed alpha-streptococcus. Echocardiography disclosed asymmetric septal hypertrophy (interventricular septal thickness/posterior wall thickness, 19/14 mm) and systolic anterior wall motion of the mitral valve. Continuous wave Doppler ultrasonography showed a peak left ventricular outflow tract pressure gradient of 170 mmHg. Transesophageal echocardiography revealed vegetations on the anterior mitral leaflet, aortic valve and interventricular septum along the left ventricular outflow tract. In particular, the anterior mitral leaflet was thickened and moved poorly. The calculated mitral valve areas was 1.5 cm2 and peak diastolic left atrium-left ventricle pressure gradient was 7 mmHg. A specimen of the mitral valve did not reveal commissural adhesion, but the anterior mitral leaflet showed marked fibrous thickening caused by scarred vegetation. Based on these findings, the diagnosis was hypertrophic obstructive cardiomyopathy complicated by infective endocarditis and "mitral stenosis". Valvular regurgitation is a common complication of active and healed infective endocarditis. In contrast, infective endocarditis rarely causes valvular stenosis except for stenosis caused by large fungus vegetation.

Cardiomyopathy, Hypertrophic↗
PubMed1997

[Surgical treatment of infective endocarditis associated with cerebral mycotic aneurysm].

We experienced two cases of infective endocarditis associated with cerebral mycotic aneurysm. Case 1: 58 year-old man underwent emergency aortic and mitral valve replacement due to active infective endocarditis and congestive heart failure diagnosed by transesophageal echocardiography. After the operation, he did not wake up and his bilateral pupils were dilated. Computed tomography demonstrated massive intracranial hemorrhage and severe brain edema. He died from multiple organ failure 22th postoperative day. Rupture of cerebral mycotic aneurysm was strongly suspected. Case 2: 56 year-old man was admitted with severe headache and high grade fever. Computed tomography demonstrated intracranial hemorrhage. Cerebral mycotic aneurysm was detected at left distal middle cerebral artery by cerebral angiography. Infective endocarditis and mitral regurgitation were also diagnosed by echocardiography. He underwent cerebral mycotic aneurysmectomy after intensive antibiotics therapy, followed by successful mitral valve replacement. We review the literatures and discuss the problems of surgical management of infective endocarditis with cerebral mycotic aneurysm.

Aneurysm, Infected↗
PubMed1997

[Polymicrobial endocarditis: a clinical and evolutive study of 12 cases diagnosed during a 10-year period].

Polymicrobial endocarditis (PE) is uncommon, whether in series of cases of polymicrobial bacteriemia or of endocarditis. Among the 201 cases of infective endocarditis seen between 1986 and 1995 by an infectious diseases service, 12 patients had PE (6%). Nine were males, mean age was 28 years and ten were active intravenous drug users. All of them were HIV (+) and 50% had AIDS. Eleven subjects had infection of the tricuspid valve and 58% developed septic pulmonary emboli. The most common organism encountered was Staphylococcus aureus in 8 patients followed by Streptococcus viridans and S. pneumoniae in three. The most common combinations of organisms were S. aureus and S. pneumoniae in 3 cases and S. aureus and Pseudomonas aeruginosa in two. Two patients died, one with Xantomona maltophilia and another with Candida albicans. The symptoms of PE were usually indistinguishable from endocarditis caused by a single organism and the prognosis depended on the species rather than the number of organisms isolated.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Clinical analysis of infective endocarditis with aneurysmal formation of the mitral or aortic valve].

Echocardiographic findings, clinical features, and pathophysiology of mitral and aortic valve aneurysms were evaluated in four patients with pathologically proven aneurysms of the mitral and/or aortic valves associated with infective endocarditis. These four were selected from 20 patients hospitalized in our institute from April 1990 to May 1995 because of infective endocarditis. All four patients had received repeated, inadequate antibiotic treatments at other medical institutions prior to admission, and underwent surgical repair because of acute hemodynamic exacerbation associated with aneurysmal perforation. Six aneurysms (three mitral and three aortic valve aneurysms) were detected before surgery, including two by transthoracic echocardiography and four by transesophageal echocardiography. The echocardiographic findings typical of aortic valve aneurysm were: ringed echo at the level of the aortic annulus in the short-axis view; turbulent flow within the ringed echo; and dome formation of the aortic valve that persisted throughout the cardiac cycle. All mitral valve aneurysms were true aneurysms without active inflammatory changes or significant destructive lesions, and were associated with severe infective aortic regurgitation. Histologic examination of the aortic valve in these patients showed active inflammation and extensive destruction, suggesting that these valves were the primary focus of infection. One patient had an aortic valve aneurysm without apparent mitral involvement, indicating that another mechanism had mediated aneurysmal formation. We conclude that: diagnosis of mitral or aortic valve aneurysms in patients with infective endocarditis has important therapeutic implications, and therefore, transesophageal echocardiographic examination should be done in such patients: there are three key echocardiographically diagnostic findings of aortic valve aneurysm as mentioned above; and several unknown factors may contribute to aneurysmal formation of the mitral or aortic valve in patients with infective endocarditis.

Adult↗
PubMed1997

Tricuspid valve repair in right-sided endocarditis.

BACKGROUND AND AIMS OF THE STUDY: Tricuspid valve endocarditis traditionally has been treated with either valve resection or valve replacement. To avoid implantation of foreign material in an infected area and to circumvent anticoagulation, tricuspid valve repair was applied and the results assessed. METHODS: Tricuspid valve repair was performed in five patients with right-sided endocarditis. All patients had tricuspid regurgitation grade 3-4 on preoperative transesophageal echocardiography, and developed progressive deterioration associated with heart failure. The indications for surgery were congestive heart failure, persistent sepsis, recurrent emboli, concomitant left-sided endocarditis, and fungal infection. Surgical procedures included cusp resection, annular plication and annuloplasty, pericardial patch replacement, and construction of artificial chordae. RESULTS: There were no hospital deaths and major associated morbidity. Follow up is complete at a mean of 20.4 months. There were no reoperations or cases of recurrent infections. All patients are in NYHA class I-II. Postoperative echocardiography revealed no signs of major valvular dysfunction. CONCLUSIONS: Valve repair in right-sided endocarditis is a relatively new application for repair techniques, but may become an attractive alternative to tricuspid valve excision or prosthetic valve replacement.

Adult↗
PubMed1997

[Infectious endocarditis: prognostic factors of mortality in 131 cases].

BACKGROUND: Global hospital mortality for infective endocarditis ranges from 13 to 40%. AIM: To compare clinical, microbiological, echocardiographic factors and complications between patients that died during an episode of infective endocarditis and those who survived. PATIENTS AND METHODS: We followed during their hospital stay, 129 patients, aged 14 to 74 years old, who had 131 episodes of infective endocarditis. Clinical assessment, echocardiography and microbiological study was done to all patients. Surgical indications were those derived from complications. RESULTS: Thirty three patients died during hospital stay (25.2%). There were no differences between survivors and deceased patients in the lapse between onset of symptoms and hospital admission, presence of fever, dyspnea or heart murmurs. Skin and mucosal septic manifestations occurred with higher frequency in deceased patients (57.1 and 24.3% respectively). Blood cultures were positive in 55% in survivors and 48% in those who died. The most frequent infecting organisms were staphilococci and streptococci. Vegetations were found with greater frequency in aortic position in both groups of patients. Deceased patients had a higher frequency of cardiac failure (84 and 65% respectively) and embolic episodes (77 and 46% respectively) than survivors. Antimicrobial treatment was successful in 94% of survivors and 15% of those who died. Forty percent of survivors and 54% of deceased patients were subjected to surgical procedures. CONCLUSIONS: The most important predictor of hospital mortality in this series of patients with infective endocarditis was antimicrobial treatment failure.

Adolescent↗
PubMed1997

[A case of isolated tricuspid valve endocarditis caused by Campylobacter fetus].

We reported a rare case of isolated tricuspid valve endocarditis in a non-addict with no underlying cardiac disease. A 48-year-old man was presented with high fever and newly developed leg edema. The diagnosis of tricuspid endocarditis was established following detection of a large vegetation (3.0 cm) on the tricuspid valve on echocardiography. One blood culture showed positive for Campylobacter fetus. At operation, a large and a small vegetation were found attached to the anterior leaflet of the tricuspid valve, and the septal leaflet was also found to be involved by the infective endocarditis. These leaflets were therefore removed and the tricuspid valve was replaced with CarboMedics valve. He has remained free of endocarditis for nineteen months after surgery.

Campylobacter Infections↗
PubMed1997

[Tricuspid endocarditis caused by Chlamydia pneumoniae. Apropos of a case].

The authors report a case of tricuspid blood culture-negative endocarditis where serologic investigations showed high titers of antibodies against. Chlamydia pneumoniae, thus suggesting its possible role as the causal agent. The treatment consisted of polymicrobial therapy using ciprofloxacine and doxycycline with favorable response thus avoiding surgical intervention. In all cases of culture-negative endocarditis not responding to classic empiric antibiotics, Chlamydia infection should be suspected. Although rare cases of endocarditis due to Chlamydia pneumoniae have been reported in the literature, to our knowledge, this is the first case of isolated tricuspid valve endocarditis due to this agent to be reported.

Anti-Bacterial Agents↗
PubMed1993

Dental procedures and infective endocarditis: current approaches of cardio-vascular surgery departments from different centres (Part 1).

The relationship between dental procedures and infective endocarditis is well known. Therefore, in order to prevent infective endocarditis, pre-operative antibiotic prophylaxis is recommended. However, a total agreement has not been achieved regarding which dental procedures and specific heart diseases require prophylaxis. The aim of the present study is to review the latest concepts dealing with heart diseases regarding the choice of appropriate antibiotic regimen, determination of patients at risk of infective endocarditis and dental procedures which require pre-operative prophylaxis. Our review revealed that there is still some disagreement regarding the above concepts. We believe that dentists, especially periodontists, can play a significant role in the prevention of infective endocarditis following dental procedures, by giving more attention to the subject and also by alerting the infectious diseases/microbiology departments and related medical staff.

Antibiotic Prophylaxis↗
PubMed1997

[Coxiella burnetti infectious endocarditis. Apropos of a case].

Chronic forms of Q fever (endocarditis) are rare, but are responsible for severe and desperately recurrent infections, resulting in multiple valve replacements with a reserved prognosis. The authors report the case of a 35-year-old patient with a known history of rheumatic fever, who developed blood culture negative infectious endocarditis on a mitral bioprosthesis. The diagnosis of Q fever was based on serological arguments. Despite long-term antibiotic therapy, serology remained strongly positive and was associated with repeated mitral valve disinsertion. The patient died immediately after the fourth operation in a context of haemodynamic failure. This clinical case emphasizes the importance of performing Q fever serology in any case of culture negative endocarditis and the therapeutic difficulties encountered in chronic recurrent endocarditis.

Adult↗
PubMed1998

[Clinical manifestations and therapeutic of isolated infective endocarditis of the tricuspid valve].

We reviewed the records of patients admitted to our centre with the diagnosis of isolated tricuspid valve infective endocarditis and analysed the clinical presentation, etiopathogenic agent, echocardiographic features and therapeutic approach, namely the indication for cardiac surgery. Between 1988 and 1996, 11 cases of confirmed tricuspid valve endocarditis were identified, corresponding to 5% of the cases of endocarditis admitted to our centre in the same period. A predisposing factor was found in ten of the patients, half of them intravenous drug addicts and Staphylococcus aureus was the most frequent agent isolated. Fever and pleuro-pulmonary manifestations were predominant clinical features. Transthoracic echocardiography had a crucial role in the diagnosis and transesophageal echocardiography was important to characterize vegetations. Four patients underwent cardiac surgery, for persistent infection. In two cases, excision of the vegetations and ring annuloplasty was performed. In two patients not addicted to drugs, the tricuspid valve was replaced with a bioprosthesis, since the extension of the damage to the valve did not allow repair. One patient, with early endocarditis of a tricuspid bioprosthesis died before surgery was attempted.

Endocarditis, Bacterial↗
PubMed1998

[Laboratory control in diagnosis and treatment of infective endocarditis].

Infectious endocarditis is caused by a wide variety of microorganisms. Etiological diagnosis depends either on direct methods, directed to the detection and isolation of the causative organisms, or serological methods. Blood cultures remain as the best method for the diagnosis of bacterial endocarditis. Blood culture technology has changed due to the appearance of new automatic continuous monitoring systems which shorten the detection time. Endocarditis with a negative blood culture has decreased below 5% because of new blood culture systems, new serological methods and molecular technology. The control of antimicrobial therapy in endocarditis must be performed by expert laboratories. A minimal bactericidal concentration, serum levels of antimicrobials and the serum bactericidal test are the most useful parameters. Their execution requires the use of strict protocols and interpretation must be carried out with an expert in clinical microbiology and infectious diseases.

Anti-Bacterial Agents↗
PubMed1998

[Pneumococcal endocarditis].

With the increasing frequency of pneumococcal bacteriaemia in Denmark during the last ten years, it is important to be aware of pneumococcal endocarditis. Two cases of pneumococcal endocarditis are described and an estimate is made of the incidence. The first case had endocarditis of the aortic valve with concomitant meningitis. Acute valve replacement was necessary and recovery was complete. The second case, which started with an embolic episode, also had endocarditis of the aortic valve. This patient recovered after treatment with antibiotics.

Adult↗
PubMed1998

[A case report of successful mitral valve replacement for infective endocarditis during pregnancy].

Infective endocarditis is an important but uncommon complication in obstetric or gynecologic practice. A 32 weeks' pregnant woman exhibited endocarditis due to Streptococcus oralis. The present case was successfully managed by means of aggressive antibiotic and diuretic treatments appropriate for endocarditis. The patient entered spontaneous labor at the estimated date of confinement and delivered of healthy 2.8 kg boy. After four weeks later scheduled mitral valve replacement with SJM valve was performed at the chronic stage of endocarditis. Her postoperative recovery was uneventful and she was discharged 40 days after the operation.

Adult↗