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Results for “ENDOCARDITIS, INFECTIOUS”

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PubMed2004

Aspirin treatment for neonatal infectious endocarditis.

We describe a term female neonate with Serratia marcescens endocarditis. Despite adequate antibiotic therapy for 8 days, the bacteremia persisted and there was an increase in vegetation size. Treatment with aspirin was initiated, with resolution of the bacteremia and a gradual decrease in vegetation size. We conclude that in neonatal endocarditis, aspirin may be beneficial additional treatment.

Anti-Bacterial Agents↗
PubMed2004

Peroneal neuropathy due to a popliteal aneurysm in a patient with infectious endocarditis.

We present an 18-year-old young man with the diagnosis of infective endocarditis who also suffered from concomitant knee pain. The clinical examination revealed right homonymous hemianopsia and left peroneal neuropathy. Magnetic resonance imaging studies of the knee demonstrated a lobulated saccular aneurysm in the left popliteal fossa. We diagnosed this patient as having peripheral mononeuropathy due to an aneurysm compressing the peroneal nerve in the left poplitea.

Adolescent↗
PubMed2004

Mitral valve repair in a child with infectious endocarditis followed by meningitis.

A one-year-old boy without congenital cardiac anomaly suffered from meningitis and subsequent acute infective endocarditis that resulted in mitral regurgitation. During antibiotic therapy and management of congestive heart failure, he suddenly developed an acute subdural hematoma, and an aneurysm of the cerebral artery was detected by brain computed tomography. Clipping of the aneurysm was performed by neurosurgery, and 9 days after clipping, we performed mitral valve repair. Kay-Reed annuloplasty was performed and annulus size was reduced from 20 to 16 mm, and edge to edge repair of anterior and posterior leaflets near the commissure to reconstruct ruptured anterior leaflet chordae. This method is easy and useful to control mitral regurgitation when mitral chordae are detached from near commissure especially in child case.

Cardiac Surgical Procedures↗
PubMed1999

Vancomycin-Resistant Enterococcus: Infectious Endocarditis Treatment.

Vancomycin-resistant Enterococcus species represent serious gram-positive pathogens for which there is currently no recommended therapy. There are a number of new antibiotics with activity against these pathogens in development. Although there is a great deal of experience with some of these agents for skin and soft tissue infections, bacteremia, pneumonia, and intra-abdominal infections, there is currently little information available for the treatment of endocarditis. Animal and limited human data thus far suggest that new agents such as quinuprisitin-dalfopristin, LY333328 (a new glycopeptide antibiotic), and daptomycin (a lipopeptide antibiotic) may prove useful for this indication. Additional information, and especially combination treatment, are warranted to improve success and limit the emergence of resistance to these new antibiotics.

Journal Article↗
PubMed1995

Early identification of patients with native valve infectious endocarditis at risk for major complications by initial clinical presentation and baseline echocardiography.

Early identification of a high risk patient subgroup with infective endocarditis which develops a major complication (emboli, congestive heart failure, surgery for valve replacement, or death) during hospitalization would reduce morbidity, mortality and cost. Thus, for 74 patients with native valve infective endocarditis with documented vegetation by transthoracic two-dimensional echocardiogram, we reviewed 67 variables: history (15), physical examination (9), hematology/miscellaneous (7), chest X-ray (2), electrocardiogram (4), transthoracic two-dimensional echocardiograms (15) and hospital course (15). There were 48 men and 26 women, ages 45 +/- 19 years: 35 intravenous drug abusers and 39 non-users. There were 32 mitral, 21 tricuspid, 20 aortic, and 1 pulmonic valve vegetations; mean vegetation size was 1.4 +/- 0.9 cm2. Over the course of their hospitalization, 14 patients died (19%), 27 developed congestive heart failure (36%), 27 had systemic emboli (36%), and 22 required surgery (30%). The incidence of complications (death, heart failure or embolic events) did not differ between the drug abusers and non-users. Initial complaint of dyspnea on admission predicted the subsequent development of heart failure (P < 0.001), and a pre-admission embolus predicted a second in-hospital embolus (P < 0.001). Left atrial size, ventricular systolic or diastolic dimension did not effect prognosis. Importantly, a vegetation > 1.8 cm2 was 100% specific but only 30% sensitive for predicting the development of a complication. Vegetation mobility, shape, and number of cusps involved were not predictive. However, aortic valve vegetations had significantly more complications than those on the mitral valve (P < 0.03). By discriminant function analysis, 87% of major complications were predicted with the patient profile of having aortic valve vegetation, dyspnea on admission, prolonged preadmission fever, and no history of drug abuse; 75% of patients who developed heart failure were predicted by their having aortic valve vegetation, dyspnea, hypotension (systolic < 90 mm Hg), and no history of drug abuse; and 77% of patients requiring surgery were predicted by their having larger vegetation size, rales, and leftward shift of white blood cells. Thus, in native valve bacterial endocarditis with transthoracic echocardiographic documented vegetations, non-drug abusers with aortic vegetations, preadmission prolonged fevers, dyspnea, emboli and larger sized vegetations are at high risk for developing a major complication during their hospitalization.

Echocardiography↗
PubMed2004

[Clinical study and analysis of risk factors for mortality in 86 cases of infectious endocarditis in children and adolescents in Argentina: 1988-2000].

INTRODUCTION: IE is a rare infection in children. Scarce reports with large number of patients are published. METHODS: Between January 1988 to December 2000 we analyzed all cases of IE cases admitted to our hospital. RESULTS: 86 cases of IE (4.9/10,000 admissions) in 86 children were diagnosed. The median age was 7.6 years. In 77% of patient previous cardiac disease was detected, interventricular defects and Tetralogy of Fallot were the more frequent. Three percent of children had rheumatic heart disease. Thirty-six percent of children had previous heart surgery. Fifty-seven percent have been received previous antibiotics. Eighty-seven percent had positive blood cultures, being the S. aureus and S. viridans the predominantly. Forty-eight percent of children had complications. The metabolic disorders and the nosocomial infections were the most frequent. Twenty-four percent required surgery, 24% of them in the first week of the diagnosis. The mortality in operated children was 19%. In the multivariate analysis we could observe that children with more than 7 years and S. aureus isolation in blood cultures had more incidence of complications and posterior surgery (p < 0.05). Children with S. aureus IE had longer duration of fever, more incidence of complications than patients with S. viridans IE (p < 0.05). Ten percent of children were treated as outpatients. The global mortality was 12,8%. Previous surgery (OR = 6.89; IC 95% 1.54-30.7) and previous antibiotic treatment (OR = 9.98; IC 95% 1.12-88.8) were the factors related with higher mortality in the multivariate analysis. S. aureus was the predominat pathogen and caused more morbidity and mortality than S. viridans IE. CONCLUSION: Children with IE with previous surgery and previous antibiotic treatment died with more frequency.

Adolescent↗
PubMed2002

[Aseptic meningitis ornidazole-induced in the course of infectious endocarditis].

INTRODUCTION: Drug-induced aseptic meningitis (DIAM) has been reported as an uncommon adverse reaction to treatment, nonsteroidal anti-inflammatory drugs (NAIDS) stand for most of the published cases. EXEGIS: Our observation reports the first case of a meningeal syndrome with fever, after the administration of ornidazole, with biological aseptic meningitis with lymphocyte prodominance. Spontaneous recovery occurred within a few days and without sequelae. It involved a patient with endocarditis and revealing an intramucous sigmoid adenocarcinoma. The rest of the infection tests was negative. CONCLUSION: We concluded that we were in the presence of a DIAM, with ornidazole as the most probable implicated agent. This diagnosis is suggested in front of a recurring meningeal syndrome without any other apparent etiology, hence the importance of the questioning of the patient. Pending objective evidence usually provided by rechallenge, an antibiotic therapy is necessary, because it is, above all, a diagnosis of exclusion.

Aged↗
PubMed1985

[Actinobacillus actinomycetemcomitans infectious endocarditis. Apropos of 2 cases and review of the literature].

This work reports two cases of endocarditis caused by Actinobacillus actinomycetemcomitans. As noted in the medical literature, the mean clinical features are a subacute infection without know source of bacteremia, in a male patient aged 40 years or older and who is suffering from a heart disease. In our two presentations, the good response to single antibiotic treatment, although the optimal therapeutic approach is not yet defined, and the lack of embolism phenomena are of special interest. Spectrum of bacteria which can be responsible of infective endocarditis is widening rapidly; this study is an example of this trend.

Actinobacillus Infections↗