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At least 19 recordsLinked to original sources
PubMed1992

[Surgical treatment of active infective endocarditis and prosthetic valve endocarditis].

Fifteen patients with active native valve endocarditis (NVE) and 5 with prosthetic valve endocarditis (PVE) were subjected to this study. Among the patients with NVE, one of 10 with simple destruction of leaflets and 2 of 5 with annular infection died postoperatively of cerebral bleeding and persistent infection. Five patients with annular infection, whose microorganisms were Streptococcus faecalis, Staphylococcus epidermidis and gram-negative coccus, had a shorter duration from onset to operation (mean 38 days) compared with the others (mean 85 days). A patient with NVE requires an urgent operation, especially when these microorganisms are identified. Among those with PVE, 3 underwent operation at the active phase and one at the chronic phase. Two patients with mechanical valve endocarditis by Staphylococcus and Candida died, but the other 2 with bioprosthetic valve endocarditis by alpha-Streptococcus survived, because infection was localized in the leaflets. Another patient with mechanical valve endocarditis by alpha-Streptococcus survived with conservative management. While a patient with bioprosthetic valve endocarditis requires an early operation as well as NVE, a patient with mechanical valve endocarditis requires selected management considering the microorganism and general condition.

Adult↗
PubMed1976

Prosthetic valve endocarditis: clinicopathologic analysis of 22 necropsy patients with comparison observations in 74 necropsy patients with active infective endocarditis involving natural left-sided cardiac valves.

Clinical and morphologic features are described in 22 necropsy patients with endocarditis involving rigid-framed prosthetic valves: aortic in 15 patients and mitral in 7. The interval from valve replacement to onset of symptoms of prosthetic valve endocarditis was less than 2 months in 8 patients and longer than 2 months in 14 patients. The most frequent infecting organism was the Staphylococcus (13 patients). In each of the 22 patients the infection was located behind the site of attachment of the prosthesis to the valve ring, and the infection spread to adjacent structures in 13 patients, 11 of whom had aortic prostheses. Prosthetic detachment causing severe regurgitation occurred in 12 of the 15 patients with an infected aortic valve prosthesis, and in 2 of the 7 with an infected mitral valve prosthesis. Prosthetic obstruction by vegetative material occurred in 5 of 7 patients with prosthetic mitral infection and in only 1 of 15 with prosthetic aortic infection. High degrees of conduction defects developed in seven patients with aortic prosthetic valve endocarditis: complete heart block in five, and complete left bundle branch block in two. Comparison of observations in the 22 patients with prosthetic valve endocarditis with those in 74 patients with active infective endocarditis involving natural left-sided cardiac valves revealed significant (P less than 0.05) differences in the percent with ring abscess, hemodynamic consequences of the endocarditis (valve stenosis), frequency of Staphylococcus as the causative organism and percent with complete heart block or left bundle branch block. No significant differences were observed between the two groups when comparing age, sex, type of underlying valve disease or frequency of organ infarcts of splenomegaly.

Abscess↗
PubMed1987

Fungal endocarditis complicating treatment of prosthetic valve bacterial endocarditis: value of prophylactic oral nystatin.

We describe two patients in whom fungal endocarditis occurred during antibiotic therapy for prosthetic valve bacterial endocarditis. Successful management of both patients was eventually achieved with antifungal therapy and replacement of the prosthetic valves. These cases and review of the literature suggest that (1) high-dose antibacterial therapy predisposes to fungal endocarditis; (2) during prolonged antibiotic therapy in patients predisposed to endocarditis, clinicians should consider the use of oral nystatin as prophylaxis against fungemia and possible fungal endocarditis; and (3) early replacement of prosthetic valves infected with fungi is indicated because chemotherapy alone is predictably inadequate to effect a cure.

Adult↗
PubMed1990

A comparison of Q fever endocarditis with native valve endocarditis.

We compared 10 episodes (8 patients) of Q fever endocarditis with 27 episodes (27 patients) of native valve endocarditis. Patients with Q fever endocarditis were more likely to have weight loss (p less than 0.003), experience fatigue (p less than 0.07), have clubbing of the fingers (p less than 0.005), have a diastolic murmur at the time of admission (p less than 0.03), be anemic (p less than 0.05), have a normal white blood cell count (p less than 0.005), and have a higher serum globulin concentration (p less than 0.007). While valve replacement was required for 50% of the episodes in both groups of patients, it was required later--mean 107 days following the onset of treatment--for the Q fever patients than for the native valve patients--mean 27 days. The mortality rates for these two diseases were not significantly different (30% for native endocarditis vs. 12.5% for Q fever endocarditis), but the Q fever patients experienced significantly fewer complications.

Endocarditis↗
PubMed1977

Echocardiographic observations in opiate addicts with active infective endocarditis. Frequency of involvement of the various values and comparison of echocardiographic features of right- and left-sided cardiac valve endocarditis.

Echocardiographic observations are described in 25 opiate addicts with active infective endocarditis involving apparently previously normal valves. Infective endocarditis was isolated to the tricuspid valve in 11 patients, involved both right- (tricuspid valve) and left-sided valves in 7 and was isolated to the left-sided valves in 7 (mitral valve in 6). Twenty patients (80%) had tricuspid valve regurgitation, 12 had mitral regurgitation, 3 had aortic regurgitation and none had pulmonary valve regurgitation. Considering the 75 cardiac valves (excluding the pulmonary) in the 25 patients, echocardiographic abnormalities consistent with active infective endocarditis were detected in 26 (74%) of the 35 clinically incompetent valves but in none of the 40 competent valves. Comparison of the 20 incompetent tricuspid valves with the 12 incompetent mitral valves indicated that (1) the echocardiogram was less sensitive in detecting tricuspid valve lesions, (2) rupture of tricuspid valve chordae tendineae was absent or not detectable, and (3) tricuspid valve vegetations tended to be larger.

Adult↗
PubMed1971

Experimental bacterial endocarditis in the opossum (Didelphis virginiana). 3. Comparison of spontaneously occurring endocarditis with that induced experimentally by pyogenic bacteria and fungi.

It was possible to induce bacterial endocarditis in opossums with single intravenous injections of Streptococcus viridans or Staphylococcus aureus. Fiftyeight percent of those animals given Streptococcus viridans developed bacterial endocarditis in which most of the lesions were on the left side of the heart. The experimentally induced streptococcal disease was similar to that which may occur spontaneously in opossums, both with respect to the distribution and structure of the vegetations. Single injections of Staphylococcus aureus resulted in endocarditis in 100% of the test animals. These lesions differed from those due to streptococci by having a relatively high frequency of right- as well as left-sided valvular disease and by being somewhat smaller than those due to streptococci.Endocarditis could not be successfully induced with injection of three different fungi.

Animals↗
PubMed1978

Experimental endocarditis in rabbits. I. Technique and spontaneous course of non-bacterial thrombotic endocarditis.

Insertion of a polyethylene catheter into the heart was used for regular establishment of sterile endocarditis in 52 rabbits. The catheter was inserted with the aid of guide wire, and distance marking on the catheter was used to obtain precise positioning, so that the catheter was retained with the curved distal end inside the left ventricle of the heart. The results showed that the catheterization procedure could be carried out with a high degree of accuracy. Uniform localization of the vegetations was obtained, these reaching a suitable size of development in all rabbits after insertion of the catheter for 3 days. Histological examination of the sterile vegetation showed that catheter withdrawal at this time would still permit the regular development of an infection. After withdrawal of the catheter, the sterile vegetations rapidly decreased in size and disappeared almost completely by 10 days. Sterile endocarditis in rabbits induced by a catheter for a period of 3 days proved to be a harmless and self-limiting disease. The model presented seems to be suitable for futher investigations on experimental bacterial endocarditis.

Animals↗
PubMed1992

[Indium-111 or Tc-99m-HMPAO marked granulocytes as specific markers of florid stage endocarditis--results comparing clinical, histological and scintigraphic findings in 30 patients with suspected endocarditis].

Thirty patients with clinically suspected infective endocarditis were scanned with Indium-111- or Tc-99m-HM-PAO-labeled granulocytes. The scans were correlated with the clinical course, and in 20 cases with the results from histologic examination of the valves. In six cases the scintigraphic examination gave correct positive results, in three cases false negative, in one case a false positive, and in 20 cases correct negative results. If we limit the analysis to only the histologically proven cases, our data suggest a specificity of the method of 86% and a sensitivity of about 67%.

Abscess↗