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 1,639 records · Page 91Linked to original sources
PubMed2003

Iris abscess as an unusual presentation of endogenous endophthalmitis in a patient with bacterial endocarditis.

PURPOSE: To report the clinical findings and management of a case of endogenous endophthalmitis in a patient with bacterial endocarditis presenting with a septic metastasis to the iris. DESIGN: Observational case report. METHODS: Review of clinical findings and treatment. RESULTS: A 37-year-old intravenous drug user hospitalized with bacterial endocarditis secondary to methicillin-sensitive Staphylococcus aureus bacteremia presented with a painful red left eye, hypopyon, and iris abscess. Roth spots were noted in the fundus of the right eye. Aqueous culture was positive for methicillin-sensitive S aureus. The patient was treated with intravitreal, topical, and intravenous antibiotics. The hypopyon and iris abscess resolved within 2 weeks, and the patient achieved a final visual acuity of 20/25 in the left eye. CONCLUSIONS: Septic metastasis to the iris is a rare occurrence. To our knowledge this is the first reported case of an iris abscess secondary to bacterial endocarditis.

Abscess↗
PubMed1997

Candida tropicalis multifocal endophthalmitis as the only initial manifestation of pacemaker endocarditis.

PURPOSE: To document a case of Candida tropicalis endophthalmitis as the only manifestation of pacemaker endocarditis. METHODS: We examined a 75-year-old man with diabetes mellitus who was initially examined for bilateral multifocal endophthalmitis complicating endocarditis 2 years after a permanent pacemaker for sick sinus syndrome was implanted. RESULTS: Transesophageal echocardiography showed a large vegetation with a 3-cm diameter attached to the pacing electrode in the right ventricle. Six consecutive blood cultures grew C tropicalis. CONCLUSIONS: Ocular involvement, including multifocal endophthalmitis, may occur as the only manifestation of C tropicalis endocarditis, complicating an intravenous permanent pacemaker.

Aged↗
PubMed1995

Premacular hemorrhage as a sign of subacute bacterial endocarditis.

PURPOSE/METHODS: We examined a patient with mitral valve insufficiency, a sudden decrease in vision in the right eye, and premacular hemorrhage, which was a sign of subacute bacterial endocarditis. RESULTS/CONCLUSION: The patient was hospitalized and treated with intravenous antibiotics. Blood cultures grew Streptococcus viridans. Ocular symptoms and signs improved over two months. Premacular hemorrhage may be a sign of subacute bacterial endocarditis and may obscure other classic signs. Subacute bacterial endocarditis should be included in the differential diagnosis of premacular hemorrhage.

Acute Disease↗
PubMed2003

[Mitral regurgitation in infective endocarditis].

Endocarditis affecting the mitral valve is frequent and is associated with specific features. Mitral prolapse is the most frequent underlying disease and the mechanism of mitral regurgitation secondary to infective endocarditis is frequently complex and multiple. Echocardiography plays a key-role in both the diagnosis, the prognostic assessment and the choice of the best therapeutic option in patients with mitral valve endocarditis. Surgery is frequently necessary, and must be performed early in the course of the disease. Mitral valve repair is the best therapeutic option, when technically possible.

Abscess↗
PubMed2001

Double valve endocarditis.

BACKGROUND: There are little data concerning surgical outcomes in patients with native valve endocarditis affecting both the aortic and mitral valves. METHODS: From 1977 to 1998, 54 patients had simultaneous aortic and mitral valve grafting for native valve endocarditis. In 78%, mitral valve involvement was limited to the anterior leaflet, suggesting a jet lesion from the aortic valve. Surgical strategies included 31 valve repairs and valve replacement with mechanical (34), bioprosthetic (34), or allograft (9) prostheses. Three hundred twenty-five patient-years of follow-up were available for analysis (mean 6.0 +/- 4.8 years). RESULTS: There were no hospital deaths. Ten-year survival was 73%. Ten-year freedom from recurrent endocarditis was 84%, with risk peaking at 3 months, followed by a constant risk of 1.3%/yr. Choice of valvar procedure did not influence mortality or reinfection risk. CONCLUSIONS: The most common pattern of double valve infection was a jet lesion on the anterior mitral leaflet. Surgical treatment has late survival and freedom from reinfection similar to those of patients with single heart valve infection.

Adolescent↗
PubMed2003

Infectious endocarditis of a Chiari network.

We present the case of a 62-year-old man with infectious endocarditis in a Chiari network. Chiari networks are present in 1.5% to 3% of the population. Although Chiari networks are usually clinically insignificant, they are associated with a number of conditions, including patent foramen ovale, thromboembolism, atrial aneurysm, and cardiac arrhythmias. Although there are rare reports of patients with a Chiari network who had endocarditis develop, this is the first report of a patient who had endocarditis develop solely within a Chiari network.

Endocarditis, Bacterial↗
PubMed1986

Successful management of aortic valve endocarditis with associated periannular abscess and aneurysm.

Aortic valve endocarditis extending beyond the aortic root presents a particularly difficult management problem. During a four-year period we have seen four patients with extensive annular abscesses involving the native valve (in 1 patient) and prosthetic valves (in 3). In all these patients the aortic roots were debrided and valved conduits were replaced with coronary artery grafts while appropriate antibiotics were administered. Postoperative complications included conduction abnormalities, hemorrhage, and low cardiac output, but all 4 patients were discharged from the hospital. Two patients died, 1 of an unrelated disease at 13 months postoperatively and 1 of endocarditis at 16 months postoperatively. The two remaining patients are alive and well at 11 and 46 months postoperatively. We conclude that, in spite of the prosthetic material required, this procedure permits adequate debridement and safe reconstruction for the rare patient in whom endocarditis has resulted in aortic-ventricular discontinuity.

Abscess↗
PubMed1985

Late Mycobacterium chelonei bioprosthetic valve endocarditis: activation of implanted contaminant?

Mycobacterium chelonei contamination of the Hancock porcine heart valve prosthesis occurred in a few lots manufactured between October, 1975, and August, 1976. The unimplanted valves were recalled, but a number of valves in their cohort had already been implanted. This report describes a patient with Mycobacterium chelonei endocarditis of a Hancock bioprosthetic heart valve belonging to this cohort that occurred three years after implantation. We are aware of four similar instances of mycobacterial endocarditis and believe that these latent infections originated either from surgical inoculation or from implantation of a contaminated valve prosthesis. Other Hancock valves manufactured between October, 1975, and August, 1976, may harbor latent M. chelonei. We believe early valve replacement with aggressive combination antibacterial and antituberculosis therapy is essential for control of atypical mycobacterial valve endocarditis.

Adult↗
PubMed1977

Bacteremia, endocarditis, and the Hancock valve.

Among 373 patients with porcine xenografts, there were 27 instances of exposure of the xenograft to bloodstream or endocardial infection in 22 patients. Nine patients underwent 10 separate insertions of xenografts for active infective endocarditis. There were no early infections or valve failures. Three patients returned with a late prosthetic valve endocarditis (PVE) due to a new infection. There were 6 instances of bacteremia early after xenograft valve insertion with no early infection, no valve dysfunction, and 1 instance of late PVE. Eleven patients had PVE on a porcine xenograft. Blood cultures in the 10 patients treated with antibiotics promptly became negative. There were 3 valve-related deaths: 2 from valve incompetence and 1 from mitral and aortic xenograft stenosis. Our experience suggests that the Hancock porcine xenograft is: (1) as resistant to infection as are rigid prostheses in active infective endocarditis; (2) resistant to early postoperative bacteremias; and (3) easier to sterilize than rigid prostheses and more durable than other tissue valves in the face of PVE.

Adult↗
PubMed1986

Management of vascular complications of bacterial endocarditis.

Peripheral arterial emboli that result from bacterial endocarditis may be silent or catastrophic. Cardiac surgical intervention may prevent embolism, but the guidelines for timing of intervention are unclear. An accepted approach is to intervene only if two episodes of peripheral embolism occur. Our recent experience suggests a more refined approach is in order. Eight children with active bacterial endocarditis have been treated with embolic complications. One patient with abdominal pain and GI bleeding was treated with heparin for multiple peripheral mesenteric emboli. Four patients had femoral embolectomies, one twice. Three patients developed embolomycotic aneurysms of the aorta in two cases and the common iliac in one; all were ruptured and two survived with staged reconstruction in one and extra-anatomic bypass in the other. Staph aureus and Strep viridans were the organisms involved most often. A review of the details of care in these patients leads to the following conclusions: angiographic survey reveals that most patients have multiple emboli; early embolectomy may prevent formation of infected aneurysms; Staph aureus infected patients are at risk for development of infected aneurysms; patients with large floppy vegetations in the left heart on echocardiography are at high risk for embolism; and 2 to 3 weeks from onset of endocarditis is the peak time for embolic risk.

Adolescent↗
PubMed1998

Culture-negative endocarditis caused by Bartonella henselae.

A 4-year-old girl presented with clinical evidence of infective endocarditis involving her aortic valve, but blood cultures were sterile. Serologic studies and analysis of resected valve by immunohistochemistry and polymerase chain reaction established the diagnosis of Bartonella henselae endocarditis. Clinicians should be aware that B. henselae can cause apparent culture-negative endocarditis in children.

Antibodies, Bacterial↗
PubMed1984

Aerococcus viridans endocarditis.

Aerococcus viridans organisms are gram-positive cocci with a strong tendency to form tetrads. These bacteria have infrequently been encountered as a human pathogen, particularly in bacterial endocarditis. A review of the literature suggests that treatment of A. viridans endocarditis should be similar to that for endocarditis caused by penicillin-susceptible streptococci.

Adult↗
PubMed1986

Infective endocarditis: a challenging disease.

Enhanced clinical awareness of infective endocarditis, along with improved microbiologic methodology and more aggressive surgical intervention, has favorably influenced the outcome of the disease. The evolving nature of infective endocarditis over the past decade is described, as are the changing epidemiologic factors, microbiologic techniques, and echocardiographic contributions in the clinical management of patients with infective endocarditis.

Adult↗
PubMed1978

Infective endocarditis associated with cell wall-deficient bacteria. Electron microscopic findings in four cases.

Although cell wall-deficient bacteria have been isolated in vitro from cases of endocarditis, no pathogenic role has been established for these forms in human disease. One criterion difficult to satisfy is the demonstration of these variants in human tissue, and electron microscopic documentation has not been reported. Cardiac valvular vegetations from four cases of endocarditis were examined by electron microscopy because of unusual histologic features of minimal inflammation and organization and small organisms that stained poorly by Gram stain. Although cell wall-complete bacteria were identified in the specimens, each showed the presence of cell wall-deficient forms within the vegetations; these variants predominated in three cases. Since manifestations of infective endocarditis were present in three cases and conventional cultures were negative, the evidence indirectly suggests a pathogenic role for these aberrant bacteria in human disease.

Adult↗
PubMed1997

Candida endocarditis in a child with hyperimmunoglobulinemia E syndrome.

Hyperimmunoglobulin E syndrome (HIE) is a disorder characterized by extremely elevated serum levels of IgE and recurrent infections. Patients are particularly predisposed to have staphylococcal abscesses, usually involving skin, lungs, and joints; but they are also at risk for infections with other bacteria and fungi. We report the case of a 46-month-old boy with HIE who had Candida endocarditis and sepsis with a large fungal mass extending through the tricuspid valve and into the surrounding heart tissue, requiring surgical excision and replacement with a prosthetic valve. He had an indwelling central line for previous antibiotic therapy and had oral thrush for a month before presentation, which had been treated with oral nystatin. He was first seen with very dark urine, a new murmur, petechial rash, in shock, and disseminated intravascular coagulation. The white blood cell count was 38,700 with 70% segmented neutrophils, 9% banded neutrophils, 15% lymphocytes, 4% monocytes, and 2% eosinophils. Hemoglobin was 7.1, and platelet count was 14,000. Prothrombin time was 15.5, and partial thromboplastin time was 31; fibrinogen level was 110 mg/ml, and fibrin degradation products were greater than 40 mg/ml. Serum IgE was 38,664 and 44,510 on repeat measurement. He has had recurrent staphylococcal pneumonias with pneumatoceles, twice requiring segmental lung resection. Blood and tricuspid valve cultures grew Candida albicans. He was treated with amphotericin and flucytosine, and later switched to fluconazole, with good response to therapy. A literature search revealed no other reported case of Candida endocarditis in patients with HIE. Fungai endocarditis is a rare complication, which may occur in patients with HIE and indwelling central catheters.

Candidiasis↗
PubMed1980

10 Years of infective endocarditis at St. Bartholomew's Hospital: analysis of clinical features and treatment in relation to prognosis and mortality.

A retrospective survey of patients with infective endocarditis at St. Bartholomew's Hospital in the decade 1966--75 showed a male/female ratio of 1.5/1. The commonest presenting features were malaise, fever, new cardiac symptoms, heart-failure, splenomegaly, and finger clubbing. The commonest problem during treatment was heart-failure. As in the two previous decades, viridans streptococci were the commonest causative organisms. Acute endocarditis was caused by Staphylococcus aureus. 6 patients' lives were saved by heart-valve replacement during medical treatment. Of 3 patients who relapsed, 1 died. The overall mortality at six months was 20%, compared with 40% in the two previous decades. Of the patients with proven subacute infective endocarditis thought to have received adequate antibiotic treatment, only 5 of 49 (10%) died; in a similar group of patients in the previous decade 19% died. Early surgical intervention probably accounts for the improved prognosis.

Acute Disease↗
PubMed2002

Infective endocarditis at a tertiary care centre in Lebanon: predominance of streptococcal infection.

OBJECTIVES: Infective endocarditis (IE) remains a disease associated with high morbidity and mortality. Many epidemiological studies have been reported worldwide; however, data from the Middle East is scarce. Most studies have recently shown a trend towards increasing incidence of Staphylococcus aureus endocarditis and decreasing prevalence of rheumatic heart disease as a predisposing condition. METHODS: We conducted a retrospective review of all recorded cases of IE in adult patients admitted between 1986 and 2001 to the American University of Beirut-Medical Centre. RESULTS: The total number of cases was 91. The mean age was 48 years. Fifty-nine percent of patients had a predisposing cardiac condition, rheumatic heart disease being the most common (33%). Blood cultures were positive in 77.5% of the cases: the most commonly isolated organisms were Streptococcus spp. (51%; of which 57% were viridans streptococci.) and Staphylococcus spp. (36%; of which 72% were S. aureus and 28% were coagulase-negative staphylococci). Transoesophageal echocardiography was performed in 36 patients (40%), of which 32 (89%) showed positive findings. When applying the revised Duke criteria, 82% of the patients were classified as definite and 16.5% as possible endocarditis. Surgery was performed in 32% of cases mostly for valvular regurgitation, followed by heart failure. The complication rate was 69% with congestive heart failure, drug-related toxicities, new valvular regurgitation and systemic embolisation being the most common. The in-hospital mortality rate was 18%. CONCLUSIONS: Unlike data reported from the United States and northern Europe, this study confirms that in Lebanon, a developing country, we continue to have a predominance of streptococci as aetiologic agents in IE, and rheumatic heart disease as the most common underlying heart condition. Application of the revised Duke criteria was useful in confirming the diagnosis of IE.

Academic Medical Centers↗
PubMed2004

Brucella endocarditis complicated with a mycotic aneurysm of the superior mesenteric artery: a case report.

Brucella endocarditis, although a rare complication of brucellosis, is the main cause of death attributable to this disease. Mycotic aneurysm is an important extracardiac complication of infective endocarditis. Mycotic aneurysm of the superior mesenteric artery is extremely rare. In the present case, we report a patient with Brucella melitensis endocarditis complicated with a superior mesenteric artery aneurysm. To our knowledge, this is the first such reported case.

Adult↗