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At least 685 records · Page 38Linked to original sources
PubMed1997

Bacterial endocarditis in hemodialysis patients.

Infective endocarditis (IE) is one of the most serious complications of bacteremia. Hemodialysis patients with prosthetic vascular access devices such as dual-lumen cuffed venous catheters and polytetrafluoroethylene (PTFE) grafts are at increased risk for bacteremia compared with patients with primary arteriovenous fistulae (PAVF). We present 20 cases of IE in hemodialysis patients seen at our institution over a 7-year period. Eight patients had PTFE grafts, 11 had dual-lumen cuffed catheters, and one had a PAVF. All patients underwent transthoracic echocardiography (TTE) and 16 patients also received transesophageal echocardiography (TEE). The Duke Criteria were used to characterize patients as definite or possible IE. Organisms were Staphylococcus aureus (55%), Staphylococcus epidermidis (25%), and Enterococcus sp (10%). The mitral valve (50%) was the most commonly affected valve, followed by aortic (30%) and right-sided IE (25%). Valve replacement was performed in five patients, of whom three survived hospitalization. The overall mortality rate for the series was 30%. All the dual-lumen cuffed catheters were removed, while only two of the eight PTFE grafts were removed. Four of the six patients who died had PTFE grafts, of which one was judged to be infected and removed. Echocardiography was essential to the diagnosis of IE. Vegetations were found in 50% by TTE and 81% by TEE. Six patients with no vegetations on TTE were found to have vegetations on TEE.

Arteriovenous Shunt, Surgical↗
PubMed1999

Inverse paradoxical embolism in a patient on chronic hemodialysis with aortic bacterial endocarditis.

We present a 45-year-old patient on chronic hemodialysis who suffered aortic endocarditis by Staphylococcus haemolyticus after bacteremia associated with a venous catheter, which was used temporarily during the maturing phase of a Cimino-Brescia arteriovenous fistula in the left forearm. Three weeks after starting antibiotic therapy, the patient suffered a septic pulmonary embolism. The catheter had been removed 4 weeks before the embolism. Thrombophlebitis of lower limbs, infection or thrombosis of the vascular access, and the involvement of right-sided cardiac structures were all discarded. We assumed that the pulmonary episode was probably a consequence of the paradoxical passage of embolic material, detached from the aortic valve, from arterial to venous circulation through the arteriovenous fistula.

Aortic Valve↗
PubMed1998

[Bacterial endocarditis in the aortic valve of a three month old infant. Correction with an aortic homograft].

We report the case of a three-month-old infant with an infective endocarditis of the aortic valve, showing perforation of two valve leaflets and a perivalvular abscess. The patient was operated on using a cryopreservated homograft with anastomosis of both coronary arteries. The outcome is good two years after surgery. This is the youngest patient operated on using this technique in our country.

Aortic Valve↗
PubMed1998

Common coronary ostium mimicking an aortic abscess in a case of bacterial endocarditis.

A patient with aortic valve endocarditis presented with severe aortic regurgitation, large vegetation, and a periannular cavity at transesophageal echocardiography consistent with an abscess. At surgery a common coronary ostium was found, which was responsible for the abnormal periannular image. Such congenital abnormality, although unusual, is an echocardiographic pitfall in the case of endocarditis.

Abscess↗
PubMedDate not supplied

Calcific cerebral arterial embolization in the setting of bacterial endocarditis superimposed on prior rheumatic aortic valvular disease.

Stroke from a calcific cerebral artery embolus demonstrated by noncontrast computed tomography (CT) is rare. Although the ability of CT to demonstrate early acute cerebral emboli is limited, in the uncommon event of a calcific cerebral embolus, CT can easily visualize the embolized material. We present an unusual case of calcific cerebral arterial embolization to the proximal middle cerebral artery and illustrate the usefulness of CT in diagnosing this rare entity in conjunction with important predisposing clinical factors.

Aortic Valve Insufficiency↗
PubMed2001

Bacterial endocarditis: a rare complication following orthotopic cardiac transplantation.

We describe a 46-year-old man who developed infective endocarditis, meningitis, sternal abscess, and infective cerebral emboli after cardiac transplantation. Staphylococcus aureus was the infective organism. We successfully managed the patient with flucloxacillin and fusidic acid to treat infection, and with prostacyclin for systemic embolization.

Cyclosporine↗
PubMed1997

Bacterial endocarditis: results of a survey in a children's hospital in France.

OBJECTIVE: To identify and analyse the risk factors for infective endocarditis. DESIGN: Retrospective survey over a 12-year period. SETTING: Department of Paediatric Cardiology, Nancy, France. SUBJECTS: 43 children attending during 1970-1992 who were diagnosed with infective endocarditis in accordance with Von Reyn's classification. RESULTS: 45 episodes of infective endocarditis were recorded (2 children had 2 episodes). Congenital cardiac disease was the most frequent predisposing factor for infective endocarditis. The causes of bacteraemia found were frequently, but not exclusively, of dental origin (30.5%). Among the dental causes were: poor oral health, inappropriate treatments and lack of antibiotic prophylaxis. CONCLUSIONS: Children diagnosed with a cardiac disorder should be examined by a dentist. Modern principles of antibiotic therapy and accepted dental procedures must be performed as soon as possible and parents informed of the current preventive recommendations.

Adolescent↗