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Results for “ENDOCARDITIS, BACTERIAL”

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At least 19 recordsLinked to original sources
PubMed1979

Extracardiac manifestations of bacterial endocarditis.

Bacterial endocarditis is an elusive disease that challenges clinicians' diagnostic capabilities. Because it can present with various combinations of extravalvular signs and symptoms, the underlying primary disease can go unnoticed.A review of the various extracardiac manifestations of bacterial endocarditis suggests three main patterns by which the valvular infection can be obscured. (1) A major clinical event may be so dramatic that subtle evidence of endocarditis is overlooked. The rupture of a mycotic aneurysm may simulate a subarachnoid hemorrhage from a congenital aneurysm. (2) The symptoms of bacterial endocarditis may be constitutional complaints easily attributable to a routine, trivial illness. Symptoms of low-grade fever, myalgias, back pain and anorexia may mimic a viral syndrome. (3) Endocarditis poses a difficult diagnostic dilemma when it generates constellations of findings that are classic for other disorders. Complaints of arthritis and arthralgias accompanied by hematuria and antinuclear antibody may suggest systemic lupus erythematosus; a renal biopsy study showing diffuse proliferative glomerulonephritis may support this diagnosis. The combination of fever, petechiae, altered mental status, thrombocytopenia, azotemia and anemia may promote the diagnosis of thrombotic thrombocytopenic purpura. When the protean guises of bacterial endocarditis create these clinical difficulties, errors in diagnosis occur and appropriate therapy is delayed. Keen awareness of the varied disease presentations will improve success in managing endocarditis by fostering rapid diagnosis and prompt therapy.

Bone Diseases↗
PubMed1984

[Etiology of cerebral infarcts caused by emboli--subacute bacterial endocarditis].

Bacterial endocarditis is a rare cause of brain infarction. Prediposing factors are frequently valvular defects secondary to rheumatic conditions. A slowly progressive course and atypical symptoms of the disease can mask the condition to such an extent that the correct diagnosis is obtained only through the work up of secondary embolic complications. Modern antibiotic combinations therapy yields a cure in 98% of the cases. The problems obtaining the diagnosis and the course of the disease with antibiotic therapy will be demonstrated in a case of embolic brain infarction secondary to bacterial endocarditis.

Adult↗
PubMed1997

Profile of HIV patients with and without bacterial endocarditis.

Bacterial endocarditis (BE) is a serious medical condition seen in the injecting drug users (IDU) with or without HIV. Studies report a low prevalence of BE in HIV/AIDS patients and the clinical manifestations have been considered non-specific making early diagnosis difficult. The HIV Registry in our Center has recruited 1500 HIV/AIDS cases since May 1992. We decided to review and compare the clinical and epidemiological variables of patients admitted to the Registry with BE (23 pts) and without. Fever, sweats and weight loss were seen most frequent in BE patients as well as meningitis and pneumonia. The majority of the patients were IDU. Staphylococcus aureus was the most common pathogen. The tricuspid valve was the most affected valve. Mild insufficiency was the rule. The mortality in BE patients was higher than in the total group. The triad of IDU, the described constitutional signs and symptoms and coexisting meningitis and/or pneumonia, in the HIV/AIDS patient, should alert the physician to the presence of BE particularly in the outpatient setting were a more aggressive diagnostic approach should probably be attempted.

Adult↗
PubMed1995

[Contribution of the experimental model of bacterial endocarditis].

Bacterial endocarditis is a difficult to cure infection, due to poor penetration of antibiotics into infected vegetations, altered metabolic state of bacteria within the lesion, and absence of adequate host-defense cellular response which could cooperate with antibiotic action. The contribution of animal models to a better understanding of the pathophysiology of the infection and to definition and improvement of therapeutic regimens of endocarditis in humans, remains of great importance due to the difficulties encountered in clinical trials. The advantage of the experimental model is that besides the fact that is closely simulates the characteristics of the infection in humans, it provides clear endpoints which allow statistical comparisons among different therapeutic regimens. The animal model has definitively established that bactericidal therapy is warranted and that in vitro susceptibility tests, especially those evaluating the killing rate, have a good predictive value on therapeutic outcome. Two main aspects are discussed for their relevance to human therapy and represent our recent contribution: (i) the kinetics of antibiotic diffusion into vegetations, with special reference to data obtained with autoradiography; and (ii) the specificity of some pharmacodynamic aspects of antibiotics in endocarditis. This animal model has also helped to define the importance of antibiotic dosing strategies to achieve in vivo synergism and to outline the predictive value of some drug pharmacokinetic and dynamic properties on the in vivo response to therapy.

Animals↗
PubMed1976

Cerebral bacterial aneurysms in subacute bacterial endocarditis.

Bacterial aneurysms are aneurysms which develop on a vascular wall weakened as a result of a bacterial infection. They can develop anywhere. This paper describes a female patient with subacute bacterial endocarditis and multiple cerebral aneurysms. Conservative treatment followed.

Adult↗
PubMed1992

[Antibiotic prevention of bacterial endocarditis].

Bacterial endocarditis is a serious condition with high lethality. The authors review the etiology of the disease and conditions and procedures associated with increased risk, and give recommendations on choice and dosage of effective antibiotics. Most cases of endocarditis are caused by gram-positive cocci of the genera Streptococcus, Enterococcus or Staphylococcus. The number of cases caused by staphylococci has increased in recent decades. Risk of acquiring endocarditis is higher, for example, in patients with prosthetic cardiac valves and in patients with a previous history of endocarditis. Interventions associated with increased risk include various procedures in the mouth, throat and upper airways, since this is where the bacteria most often causing endocarditis are to be found. A single oral dose of amoxycillin is recommended for standard prophylaxis, and ampicillin in combination with an aminoglycoside for parenteral use. In cases of penicillin allergy, a single oral dose of clindamycin is recommended in patients at risk of bacteriemia from the respiratory tract, with trimetoprim as an alternative for genito-urinary and gastrointestinal procedures. Vancomycin or vancomycin plus aminoglycoside is recommended as a parenteral regimen in cases of penicillin allergy.

Anti-Bacterial Agents↗
PubMed2001

Retroperitoneal suppurative lymphadenitis complicating Staphylococcus aureus acute bacterial endocarditis.

Acute bacterial endocarditis is commonly caused by Staphylococcus aureus. Acute bacterial endocarditis due to S. aureus is often complicated by metastatic infection to distant organs, i.e. the central nervous system, the heart, lungs, kidneys and joints. However, metastatic lymph node involvement has not been reported. This is a case report of S. aureus acute bacterial endocarditis complicated by metastatic suppurative lymphadenitis of retroperitoneal lymph nodes. We believe this is the first reported case of suppurative lymphadenitis of the mesenteric lymph nodes secondary to S. aureus acute bacterial endocarditis.

Acute Disease↗
PubMed1980

Skin manifestations of subacute bacterial endocarditis. Case report of subacute bacterial endocarditis mimicking Tappeiner's angioendotheliomatosis.

SBE manifests many skin findings including petechiae, splinter hemorrhages of the nails, Osler's and laneway lesions, clubbing of the fingers, and findings suggestive of angiitis. Another case with similar histopathologic findings to those originally described by Tappeiner and Pfleger is described, but with positive blood cultures to corroborate the clinical identification of SBE.

Adult↗
PubMedDate not supplied

Use of transesophageal echocardiography for improving detection of valvular vegetations in subacute bacterial endocarditis.

Subacute bacterial endocarditis is associated with significant morbidity and mortality. Valvular destruction, congestive heart failure, embolic phenomena, failure of medical therapy, and death are all more common in patients with echocardiographically discernible valvular lesions. Transthoracic echocardiography is often unsatisfactory for evaluation of vegetations in patients with chest wall deformities, lung disease, obesity, or prosthetic valves. The transesophageal approach affords uniformly high-quality images with excellent structural resolution. We present a case of suspected subacute bacterial endocarditis in a patient with equivocal diagnoses of vegetations on three separate transthoracic echocardiograms in whom transesophageal evaluation revealed obvious large vegetations that involved the aortic and mitral valves. Subsequent autopsy confirmed this diagnosis. The case illustrates the utility of a new imaging method for the detection of valvular vegetations. In view of the prognostic implications of detected vegetations, transesophageal echocardiography probably should be performed on all patients with suspected subacute bacterial endocarditis and equivocal results by transthoracic study.

Aged↗
PubMed2001

A complicated case of acute bacterial endocarditis.

Acute bacterial endocarditis continues to be a significant medical and surgical problem in the United States. The authors describe a complicated case of acute Staphylococcus aureus endocarditis in an 18-year-old man. The patient suffered multiple systemic emboli requiring aggressive medical and surgical intervention.

Adolescent↗
PubMed1987

In vitro correlation of platelet aggregation with occurrence of disseminated intravascular coagulation and subacute bacterial endocarditis.

Platelet-bacterial interactions were examined in vitro by incubating organisms isolated from patients with septicemia with normal platelet-rich plasma. The potency of various species of gram-positive and gram-negative bacteria to induce irreversible platelet aggregation was then determined in an aggregometer. The aggregation curves produced by the bacteria resembled the normal platelet response to collagen and were impeded by the presence of aspirin. Strains of Staphylococcus aureus and Pseudomonas aeruginosa isolated from 25 different patients produced maximum increases in light transmission and irreversible platelet aggregation with relatively rapid mean aggregation times; six of these patients had clinical and laboratory evidence of disseminated intravascular coagulation. In contrast, isolates of alpha streptococcus and Staphylococcus epidermidis induced irreversible platelet aggregation much less commonly and were associated with considerably longer mean aggregation times. None of the latter group of patients had evidence of disseminated intravascular coagulation. Isolates of bacteria from a small number of patients with subacute bacterial endocarditis uniformly induced irreversible platelet aggregation. Addition of paired bacterial isolates to normal platelet-rich plasma demonstrated a synergistic aggregation response. These data suggest that a relative hierarchy exists in bacterial strain potency to induce irreversible platelet aggregation. The rapidity and degree of aggregation in vitro correlated well with the clinical and laboratory evidence for subacute bacterial endocarditis and disseminated intravascular coagulation in vivo. These observations may provide useful adjunctive laboratory information to help establish the diagnosis of subacute bacterial endocarditis, especially in the clinical setting where the classical findings of endocarditis are not obvious during initial presentation.

Blood Platelets↗