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[Auriculo-ventricular perforation in bacterial endocarditis. Surgical treatment].

The authors report a case of bacterial endocarditis during which the precise nature of the heart lesions were only discovered at operation. There left ventricle and right atrium. The characteristics of the systolic murmur and the findings on phonocardiography together with left ventricular angiography had suggested mitral incompetence. There were no conduction disorders in this patient which might have helped in preoperative diagnosis. In connection with this case, the authors recall the characteristics of aneuryms of the membranous septum and congenital or acquired communications between the left venticle and the right atrium.

Aortic Valve Stenosis↗

Gram-negative bacterial endocarditis in narcotic addicts.

The number of cases of bacterial endocarditis in drug addicts seen at UCLA and Wadsworth Veterans Administration hospitals increased sharply in 1971 over the average of the four preceding years. Enteric Gram-negative bacilli were the infecting organism in three of the seven cases seen in 1971 but were not found in any cases of endocarditis in the 1967-70 period. Medical treatment of the patients was, in general, unsuccessful in spite of the intensive use of newer antimicrobials active against enteric Gram-negative bacilli. One patient died with fulminant Pseudomonas endocarditis and two others (Pseudomonas and Serratia endocarditis) eventually required operations on the heart before a cure was achieved.

Adult↗

Bacterial endocarditis due to Kingella kingae.

A case of infective bacterial endocarditis due to Kingella kingae in a 26 year old male involving a prosthetic mitral valve is described. Microbiological features of this organism are outlined, and the treatment of this endocarditis is discussed with reference to the four previously reported cases.

Adult↗

Acute bacterial endocarditis in pregnancy. A report of three cases.

Acute bacterial endocarditis, a fulminating disorder most often caused by Staphylococcus aureus, is uncommon in pregnancy. However, the frequency of this disease may be increasing due to the prevalence of intravenous drug abuse. Three cases occurred during pregnancy at Charity Hospital, New Orleans; all three patients were intravenous drug abusers. One patient had polymicrobial disease.

Acute Disease↗

[Bacterial endocarditis and mitral valve prolapse].

The suspected diagnosis of bacterial endocarditis is based on a presumption. Over the last few years, ultrasound, which can identify valvular lesions and their repercussions, has established itself as a supplementary diagnostic tool in the early stages of this disease. The existence of false negatives should not be underestimated, but one must also be aware of the possibility of false positives. These false positives are mostly due to mitral valve prolapse. An unusual cas serves as an illustration of the potential diagnostic difficulties of this association and confirms the value of the ultrasound examination, provided it is performed under optimal conditions and repeatedly. However, the abnormalities of ventricular kinetics in the course of mitral valve prolapse limit the evaluation of the haemodynamic repercussions of the regurgitation. The authors stress the supplementary contribution of phonomechanographic examinations. In this particular case, they gave an idea of the severity of the mitral leak and of its recent onset and they strongly suggested the integrity of left ventricular function and the presence of major valvular dysplasia.

Aged↗

Subacute bacterial endocarditis presenting with necrotic skin lesions.

Classical lesions associated with subacute bacterial endocarditis include petechiae, splinter hemorrhages, Osler's modes and Janaway lesions. We describe a patient with subacute bacterial endocarditis, whose sole cutaneous findings were bullous necrotic lesions of the lower extremities. The superficial vessels were occluded by acidophilic material and coccal bacteria were identified in the vessels. Immunofluorescent studies revealed Igm and C3 in the vessel walls.

Adolescent↗