Biomedical subjects

Rosa Francavilla

Publications and source records attributed to Rosa Francavilla.

5 recordsLinked to original sources

PubMed2003

[Infective endocarditis as predisposing factor to recurrence].

In this paper we communicate our experience with 60 patients who suffered two or more episodes of infectious endocarditis (IE), selected from 1053 cases of IE defined in accordance with Duke's Hospital criteria. Relapsing IE was diagnosed when episodes occurred with at least a 6 month interval between them or when, even if the time distance was shorter, they were caused by different microorganisms. Sixty-four cases of relapsing IE were observed. In each patient we considered age, sex, presence of risk-factors for IE, time laps from the onset of symptomatic disease to diagnosis, time interval between the two or more IE episodes, aetiology, endocarditic location, echocardiographic elements, therapy, complications and final outcome were considered. We conclude, agreeing with other authors, that infectious endocarditis may rightfully be considered a risk factor for further IE episodes and that, for this reason, an adequate prophylactic therapy must be given.

Adult↗

PubMed2003

[Streptococcus bovis infectious endocarditis: clinical and epidemiological characteristics].

This paper shows our experience concerning the study of Streptococcus bovis infectious endocarditis (EI): 47 patients, with no prior history of IV drug abuse (NTD), who suffered EI caused by Streptococcus bovis were excerpted from a case record of 1053 cases with diagnosis of EI defined in accordance with Duke's Hospital criteria. For each patient we considered age, sex, complications, echocardiographic findings, antibiotic therapy, eventual heart-surgery and final outcome of the disease. We then compared the parameters of our patients, with the ones of 216 NTD patients suffering non Streptococcus bovis EI, selected according to age correspondence and concomitant onset of the disease. The characteristics of Streptococcus bovis EI are analogous to the ones of EIs caused by other micro-organisms in NTD patients, except for a non statistically significant trend of higher frequency in old age and in males. Concerning possible predisposing conditions, we considered the association extensively described in the literature between Streptococcus bovis EI and gastroenteric pathology (above all colon neoplasms): this association was not frequently observed in our study because appropriate instrumental investigations of the digestive tract were carried out only in a minority of patients.

Adult↗

PubMed2003

[Factors associated with the time to clinical diagnosis of infectious endocarditis. Analysis of a multicentre case-record].

The authors demonstrate that time necessary for diagnosis in 902 patients with validated infectious endocarditis was significantly shorter in 249 drug addicts confronted with 653 non-addicted patients. With regard to the latter category we noticed a significant tendency in diagnostic time reduction in the last five years of observation and this is probably due to the improved knowledge on infectivologists regarding the clinical presentation of infectious endocarditis rather than the application of validating protocols

Comorbidity↗

PubMed2002

[Polymicrobial infective endocarditis in Italy].

In our series, including 1053 cases of infective endocarditis (IE) collected from 86 Infectious Diseases Centres in Italy between 1984 and 1999, we identified 34 cases (3.2%) with a polymicrobial etiology. Intravenous drug abuse was the most important risk factor for the development of polymicrobial IE. Twenty three patients had a left sided-IE and 6 patients had a right-sided IE. The most commonly encountered microorganisms were Staphylococci and Streptococci and the most frequently observed associations of microorganisms were those between Staphylococci and Gram-negative bacteria and between Staphylococci and fungi. Twelve patients (35.3%) underwent surgery, and 5 patients (16.7%) died. Polymicrobial endocarditis did not differ clinically from IE caused by a single microorganism, and the prognosis seems to be related to the site of infection and to some specific pathogens.

Adult↗

PubMed2002

[Signs and symptoms that lead to clinical hypothesis of infective endocarditis].

We studied clinical presentations on admission in Infectious Disease Wards of 1053 patients (308 i.v. drug abusers and 745 non drug abusers) with IE validated according to the Duke Hospitals' criteria, from a total of 1164 patients observed from 1984 to 1999. We divided the patients in three five-year span groups (1984-89, 1990-94 and 1995-99) and we examined signs and symptoms on presentation that led us to suspect I.E. (sepsis, valvulopathy, peripheric vascular damage and predisposing conditions including i.v. drug abuse). Our study confirms that clinical diagnosis of I-E. nowadays is reliable if history and physical examination are carried out correctly.

Diagnosis, Differential↗