[Demographic aging is unavoidable].
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Biomedical subjects
S Legrain
Publications and source records attributed to S Legrain.
[Subacute infectious endocarditis in the elderly. Retrospective study of 33 cases].
The authors reviewed 33 cases of infectious endocarditis in patients over 65 years of age and classified according to Von Reyn's diagnostic criteria. Twenty-four patients had organic valvular disease, 4 had a prosthetic valve, and in 4 cases the diagnosis of the murmur was uncertain. Positive blood cultures were obtained in 79 p. 100 of cases. The commonest infecting organism was the streptococcus (21 out of 26). In 11 patients, it was a Group D streptococcus and a recto-sigmoid colonic tumour was found in 3 cases. A dental portal of entry was suspected in 55 p. 100 of patients and this should guide the choice of prophylactic antibiotic therapy. The initial choice of antibiotic had to be changed in 19 patients, usually because of poor tolerance. Eight patients died and one underwent valve replacement within two months of hospital admission.
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Systemic polyarteritis nodosa diagnosed at hysterectomy.
A 61-year-woman was referred because of declining general health. A diagnosis of uterine malignancy was suspected on the basis of uterine enlargement and an elevated erythrocyte sedimentation rate. Hysterectomy was performed, and histologic examination revealed necrotizing vasculitis affecting the ovaries, fallopian tube, and uterus. Muscle biopsy showed typical periarteritis nodosa lesions. Despite the scarcity of such cases, the incidental finding of necrotizing arteritis in a surgical uterine specimen warrants further investigation to determine if the vasculitic process is localized.
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