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At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Video-assisted cardioscopy for infectious endocarditis.

We successfully resected vegetation of infectious endocarditis in right ventricular outflow tract using a video-assisted cardioscopy without ventriculotomy. Video-assisted cardioscopy provided clear and precise visualization of vegetation on the anterior wall of right ventricular outflow. This technique is effective to visualize remote intra-cardiac structures, and to facilitate repairs, while avoiding the need for extended cardiac incisions.

Endocarditis, Bacterial↗
PubMedDate not supplied

[The clinico-morphological characteristics of glomerulonephritis in infectious endocarditis].

Clinicomorphological characteristics of glomerulonephritis in infectious endocarditis (IEGN) were studied in 62 patients (with samples of autopsy material being used in 52 instances). IEGN presents with dissaminated and focal proliferative alterations involving extracapillary and/or tubulointerstitial components, and is characterized by a broad variability of indices for proteinuria, hematuria and cylindruria. In diffuse prolipherative glomerulonephritis the degree of proteinuria and cylindruria appear to be significantly higher than in focal segmental proliferative glomerulonephritis, as is the incidence rate of development of renal insufficiency and its gravity.

Adolescent↗
PubMed1995

[Right-sided infectious endocarditis due to methicillin-resistant Staphylococcus aureus resulting in ruptured abscess of the ventricular septum and sinus of Valsalva].

A 24-year-old woman presented with right-sided infectious endocarditis due to methicillin-resistant Staphylococcus aureus (MRSA). This is the first report of right-sided infectious endocarditis caused by MRSA in Japan. The patient was admitted to the Jichi Medical School Hospital because of fever of unknown origin and disturbance of consciousness. Several months before, she had discontinued treatment for hyperthyroidism. Antibiotics effective against MRSA, vancomycin and flomoxef, were given intravenously, but a new heart murmur was detected. Echocardiographic study revealed vegetations attached to the tricuspid valve and abscess formation on the ventricular septum. The vancomycin dosage was increased and arbekacin sulfate was also given from the sixth hospital day. However, these antibiotics had very little effect and the abscess rapidly increased in size. Color flow mapping finally demonstrated intracardiac shunt flow through the ruptured abscess of the ventricular septum and sinus of Valsalva. She died suddenly, probably from heart failure. The prognosis of infectious endocarditis due to MRSA is poor and drug therapy often fails. Thus, surgery should be considered in the early stage.

Abscess↗
PubMed1988

[Possibilities of cardiac surgery in the treatment of active valvular infectious endocarditis].

The results of surgical treatment of 142 patients with active valvular infectious endocarditis are reviewed. Hospital mortality was 15.5% (22 patients died). Follow-up covered 6 months to 14 years (with an average of 3.5 years) in 108 patients. Ten (9.3%) patients died over this period, and 11 (10.2%) showed indifferent or poor results of surgery. Within 5 years, total survival rate was 74.4%, including hospital mortality, and good late results were seen in 76.8% of the discharged patients. Surgical treatment of active valvular infectious endocarditis is shown to be a fairly effective method and should be used on a larger scale in clinical practice.

Adolescent↗
PubMed1975

Cryoglobulinaemia in patients with infectious endocarditis.

Serum cryoglobulins were found in nineteen out of twenty patients with infectious endocarditis. The cryoglobulins were of the 'mixed type' consisting of IgG, IgM and IgA. C3 and fibrinogen were present in some specimens. The concentration of the cryoglobulins tended to fall with therapy and clinical improvement of the patients. Serum antibodies to the offending bacterial organism were not preferentially concentrated in the cryoglobulins. In contrast, IgM rheumatoid factor was present in the cryoglobulins, though undetectable in the corresponding serum. These findings are consistent with the view that cryoglobulins represent circulating immune complexes which may be important in the pathogenesis of immunological sequelae sometimes found in patients with infectious endocarditis.

Adult↗
PubMed1993

[Infectious endocarditis on permanent endocavitary pacemakers: value of echocardiography and review of the literature].

Infectious endocarditis around indwelling pacemakers is rare (0.15% of all implantations). They have a gloomy prognosis with a global mortality rate of nearly 34% as emerges from this review of the literature concerning 58 cases of infectious endocarditis published within the past 16 years. On the basis of the 6 cases which the authors report, they stress the importance and sometimes difficulty of using ultrasound in a positive diagnosis. Cardiographic ultrasound, which can determine the size and emboligenic nature of vegetations is capital in choosing how to remove the pacemakers. Percutaneous ablation by simply pulling or by catheterization currently gives the best results, but it may be necessary to resort to surgery involving right atriotomy if emboligenic vegetations are present. By combining antibiotic treatment and ablation of the intracavitary material, a cure is obtained in 92% of cases. These figures should be compared with the lack of success of using antibiotic treatment alone which results in a high level of mortality (84%).

Adult↗
PubMed1998

[Communication between the left ventricle and the right atrium in infectious endocarditis. Diagnosis using Doppler-echocardiography].

The diagnosis of a communication between the left ventricle and right atrium was made by transthoracic and transoesophageal echocardiography in a 67 year old man with a recurrence of a methicillin-resistant staphylococcus aureus infectious endocarditis complicating aortic valve replacement with a bioprosthesis seven weeks previously. This diagnosis was confirmed at surgery; the left ventricular-right atrial communication was closed by suturing its edges and a new aortic valve prosthesis was implanted. Unfortunately, the patient died 4 months later of myocardial dysfunction although the infectious endocarditis seemed to have been sterilised by antibiotic therapy. Doppler echocardiography, especially using the transoesophageal approach is the best diagnostic method for rare complications of infectious endocarditis, usually of the aortic valve, the prognosis of which is improved by early surgery and appropriate antibiotic therapy for the causal organisms.

Aged↗
PubMedDate not supplied

[Neurological complications in infectious endocarditis].

Despite considerable progress in both diagnostic studies and therapeutic management serious complications of infectious endocarditis have become rather more common. Next to intracardiac complications arterial embolization to the central nervous system is the second most common life-threatening event, which might lead to infarction, hemorrhage, mycotic aneurysm and/or metastatic infection with a wide spectrum of neurological symptoms and an overall very poor prognosis. The most effective prevention of neurological complications is the early diagnosis of infectious endocarditis with isolation of the infecting agent and adequate antimicrobial chemotherapy in combination with well-timed cardiosurgical measures. Computed tomography and cerebral angiography is mandatory in any patient with neurological symptoms to check the need for a neurosurgical intervention as well as in patients assigned for anticoagulation for cardiac reasons.

Adolescent↗
PubMed2005

[Non infectious endocarditis: retrospective study (6 cases)].

PURPOSE: If there is cardiac valve vegetation and the blood cultures are negatives we need to look for slow growing bacteria, fungi, Legionella pneumophilia, Bartonella henselae and quintana, Brucella melitensis and abortus, Coxiella burneti, Chlamydiae pneumoniae by serologic tests. The diagnosis of non- infectious endocarditis could be considered only if these results were negative. The main purpose of this study was to describe the clinical and echocardiographic signs of non-infectious endocarditis cases observed in two different wards. METHODS: This study was done retrospectively during a five-year period in a cardiology and an internal medicine wards. The selection criteria are: the proof of at least one cardiac valve vegetation, observed on echocardiography, negative blood cultures and negative serologic tests as described above. RESULTS: Six non-bacterial endocarditis were described. Four Libman-Sacks endocarditis, two associated with a primary antiphospholipid syndrome revealed by an acute ischemia of leg for one patient and by an eclampsia for another and the other two associated with a systemic lupus erythematous revealed by fever for one patient and by neurologic symptoms for the other. One fibroblastic endocarditis associated to an essential hypereosinophilia and one marastic endocarditis associated to a metastatic mucin-producing cancer. CONCLUSIONS: For these six cases, a complete physical examination, a CBC for hypereosinophylia, a dosage of antiphospholipid antibodies and a thoraco-abdominal CT-scan allowed the etiologic diagnosis of non infectious endocarditis. Libman Sacks endocarditis associated with an antiphospholipid syndrome is the main etiology for which a long-term anticoagulation treatment was not followed.

Adolescent↗
PubMed2001

[Pitfalls in the diagnosis of infectious endocarditis].

A group of 63 patients with infectious endocarditis (IE) (1991-1998) was subjected to a detailed retrospective analysis. The authors investigated the age of the patients, site of IE, type of infectious agent, incidence of coinciding diseases or interventions in the close premorbid period of IE, size of vegetation, incidence of embilizations, heart failure, indications for vital early cardiosurgery, number of deaths. From the clinical analysis it may be concluded: 1. There is a new group of patients with IE, who before development of the disease have no manifest cardiac disease who however frequently suffer from another coinciding disease; 2. There is a significant increase of dextrolateral IE (frequently "pacemaker" IE); 3. The ratio of staphylococcal strains in the etiopathogenesis of IE is rising; 4. The mean age of the affected patients is rising (as well as the age scatter); 5. IE is unfortunately frequently diagnosed only after embolization of the vegetation (mostly cerebrovascular attacks) in obscure febrile conditions.

Adult↗
PubMed1992

[Problems posed by the association of streptococcus D infectious endocarditis and colorectal tumor].

The problems arising from the discovery of a colorectal tumor during an infectious endocarditis caused by Streptococci D have rarely been mentioned in the surgical literature. The frequency of association of an asymptomatic colorectal tumor and of a Streptococcus bovi endocarditis is now undisputed. This notion implies the systematic search for an intestinal lesion (adenoma or carcinoma) in case of endocarditis or septicemia without involvement of the valves, caused by a streptococcus of group D. The authors report about 3 cases of enterococcal (1 case) and S. bovis (2 cases) infectious endocarditis revealing a colic adenocarcinoma (2 cases) and a villous adenoma (1 case), all being perfectly latent. The specific therapeutic problems arising from this association are outlined, including the antibiotic therapy, the role of the anticoagulant treatment and the priority given to valve surgery in case of hemodynamic instability.

Adenocarcinoma↗
PubMed1976

A consideration of the differences between a Janeway's lesion and an Osler's node in infectious endocarditis.

Janeway's lesions and Osler's nodes are regarded as excellent clues to the diagnosis of infectious endocarditis; however, very few physicians have actually witnessed these findings, and there is some confusion in distingushing between the two. This article concerns a patient with infectious endocarditis due to Diplococcus pneumoniae, who had tender vesicular lesions thought to be Osler's nodes and a nontender erythematous nodule on the foot compatible with a Janeway's lesion. The original comments by William Osler and Edward Janeway are presented, and the literature following their descriptions is reviewed. It is concluded that the only essential diagnostic difference between the two is the tenderness that is associated with an Osler's node but not with a Janeway's lesion.

Adolescent↗
PubMed2002

[Urgent problems of medical aid in infectious endocarditis].

The authors analyze the incidence of infectious endocarditis (IE), the influence of diagnostic time on the lethality, the significance of surgical treatment. The main ways of further improvement of IE patient therapy are defined. They include the training of medical staff, centralization of the patients in the military medical institutions of the center by transfer from the districts after making the diagnosis in order to conduct the adequate medicamentous and appropriate surgical treatment.

Anti-Bacterial Agents↗
PubMed2003

[Management of patients with infectious endocarditis].

The paper presents clinical manifestations of infectious endocarditis (IE), its new clinical classification, diagnostic criteria, potentialities and limitations of echocardiography. General principles of management of patients with IE are considered. The management algorithm is given, which involves the initial assessment of these patients, empirical therapy, etiotropic chemotherapy (CT) regimens in streptococcal, staphylococcal, gram-negative, fungal endocarditis, and IE of unknown etiology. Possible complications due to IE (refractory heart failure, infection dissemination, thrombohemorrhagic syndrome, immune diseases, persistent fever) are described, which need supplementary treatment, particularly schemes for correction of hemostatic and immune disorders. Clinical and microbiological criteria are proposed for evaluating the efficiency of treatment for IE. The conditions showing a higher risk for the types of IE that require antibiotic prophylaxis and the criteria for choosing its regimen are given. New trends in the treatment of IE, such as shorter courses of antibacterial CT, stepwise antibacterial therapy (ABT), and parenteral ABT at home, are outlined.

Algorithms↗
PubMedDate not supplied

[Infectious endocarditis in drug addicts].

Clinicomorphological features of infectious endocarditis (IE) were studied on autopsy material from chronic drug addicts. Of special interest were morphological changes in the lymphoid organs. The experience of the author and literature data suggest that IE in drug addicts is a manifestation of secondary immunodeficiency syndrome on the background of chronic narcotic intoxication.

Adolescent↗
PubMed1983

Clinical implications of large vegetations in infectious endocarditis.

Thirty-four patients with clinical infectious endocarditis were examined by M-mode and two-dimensional (2D) echocardiography. Vegetations were identified in 16 patients (47%) by M-mode and in 27 patients (87%) by 2D echocardiography. Vegetations identified by 2D echocardiography were categorized as small (less than 5 mm), medium (5 to 9 mm), or large (greater than or equal to 10 mm). Large vegetations were caused by a variety of organisms, had a higher incidence of surgery (44% v 0%), and had no increased incidence of stroke or death. The larger the vegetation, the more detectable it was by M-mode. Aortic valve vegetations were associated with a higher incidence of congestive heart failure (CHF) (67% v 14%) and stroke (44% v 9%). Four patients with large aortic valve vegetations had the highest complication rate; CHF developed in all four, two had valve replacement, one had a stroke, and two died.

Cerebrovascular Disorders↗
PubMed1996

[The diagnostic difficulties in a current course of infectious endocarditis].

The paper reports 152 cases of infectious endocarditis observed in two Moscow hospitals. Accurate diagnosis of the disease is complicated by frequent nosocomial endocarditis, endocarditis occurrence in aged patients the diagnosis in whom requires differentiation with tumors, lymphogranulomatosis, blood diseases, etc. To make the diagnosis easier, transesophageal echocardiography and comparison of clinical and echo-CG findings were practiced.

Adult↗