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At least 109 records · Page 6Linked to original sources
PubMed1978

Vancomycin therapy of bacterial endocarditis.

Fifteen patients with bacterial endocarditis were treated with vancomycin between 1967 and 1976. The indications for vancomycin therapy were penicillin-cephalosporin allergy in six patients, antibiotic resistant bacteria in six, initial therapy in one and culture-negative endocarditis in two. The causative microorganisms were Staph. epidermidis (four patients), Staph. aureus (two patients), diphtheroids (four patients), viridans streptococci (two patients) and enterococci (one patient). Minimum inhibitory concentrations of vancomycin for these organisms ranged from 0.8 to 3.1 micrograms/ml. The patients received vancomycin for two to 10 weeks (mean five weeks). Cure was achieved in 13 patients, including six with prosthetic valve endocarditis (PVE). Two patients had a relapse of PVE and cultures of blood or heart valve were positive within two months of vancomycin therapy. Vancomycin serum levels did not exceed 50 micrograms/ml, and no serious drug toxicity was encountered in any patient. Three patients had minimal audiogram changes beyond the social hearing range. One patient had mild phlebitis and a rash, and one patient had a transient leukopenia. Vancomycin is an effective nontoxic antibiotic in patients with endocarditis when penicillin or cephalosporin therapy is not appropriate.

Adult↗
PubMed1975

[Complete atrioventricular block in bacterial endocarditis].

A case of bacterial endocarditis complicated by complete auriculoventricular block is reported. The pathological findings and data from previously reported cases point to the fact that this complication is generally indication of very extensive cardiac and valvular damage. Surgery, although dangerous, should be attempted in the circumstances.

Aged↗
PubMed1991

[The overdiagnosis of bacterial endocarditis].

The diagnosis of bacterial endocarditis (BE) is analyzed in 255 patients. After examination, the diagnosis of BE was verified but in 92 patients (36.1%). Of these, BE was overdiagnosed in 163 patients (63.9%). The main causes of the overdiagnosis were body temperature rise in 134 patients (52.6%), heart murmur in 163 patients (63.9%), and positive hemoculture in 57 patients (22.3%). Three cases of BE overdiagnosis are provided. Exaggeration of the specificity of body temperature rise in patients with heart murmur often leads to BE overdiagnosis. Mitral valve prolapse is one of the predisposing BE factors. At the same time it is a cause of overdiagnosis of BE in patients with fever, BE overdiagnosis often results in unbased long-term antibacterial therapy, while other causes of the symptoms are not considered. Ineffectiveness of antibacterial treatment (no clinical improvement, continuous or recurrent fever) points to the necessity of further diagnostic search.

Adolescent↗
PubMed1993

Adolescent knowledge of bacterial endocarditis prophylaxis.

OBJECTIVE: To determine if adolescents with congenital heart disease have adequate knowledge of bacterial endocarditis prophylaxis. DESIGN: Forty-eight adolescents attending a congenital heart disease summer camp were asked to complete an eight-question survey to assess their knowledge of heart disease, endocarditis, and endocarditis prophylaxis. RESULTS: Forty-five of 48 (94%) completed the questionnaire. Thirty-one (69%) knew the name of their heart disease. Two correctly defined endocarditis. None knew measures which could prevent endocarditis. Although 36 (80%) knew they needed to take "a medicine" prior to dental procedures, only 18 (40%) knew that an antibiotic was needed. There were significant gender differences for knowledge of antibiotics and for knowledge of current medications. However, patient gender and regular use of cardiac medications did not correlate significantly with knowledge of endocarditis or bacterial endocarditis prophylaxis. CONCLUSION: Whereas most adolescents know the names of their heart lesions and current medications, knowledge of endocarditis and bacterial endocarditis prevention and prophylaxis is inadequate.

Adolescent↗
PubMed1987

Surgical techniques for treatment of bacterial endocarditis of the mitral valve.

Bacterial endocarditis of the mitral valve appears to be much less common than bacterial endocarditis of the aortic valve. One of the main etiologic factors is the presence of degenerative lesions of the mitral apparatus, ballooning or mitral floppy valve. The surgical anatomy of the lesions is described: vegetations, perforations, rupture of chordae tendinae, abscess of the mitral ring observed in the isolated mitral endocarditis, mitral-aortic dislocation, abscesses and aneurysms of the mitral-aortic fibrosa and jet lesions on the anterior mitral leaflet. In the isolated primitive mitral infective lesions, all the technical skills are directed toward the prevention of the perivalvular leakage of the prostheses. Special procedures are described for the management of the abscesses of the mitral ring. In patients with mitral-aortic lesions, the main problem is treatment of the dislocation of the annuli or aneurysms of the mitral-aortic fibrosa. Despite technical advances, the surgical prognosis of the mitral endocarditis remains severe. In a personal series, the authors recorded a mortality of 12% in isolated mitral cases and 42% in the combined mitral-aortic patients. Early surgical treatment remains the most significant factor in decreasing the fatality of such lesions.

Aortic Valve↗
PubMed1975

Bacterial endocarditis in children under 2 years of age.

The risk of bacterial endocarditis in infants with bacterial sepsis was assessed by review of clinical and autopsy records (1930 to 1972). There were 12 cases of bacterial endocarditis among 847 patients (1.4%) dying with bacterial sepis; a single survivor was noted during the entire period. Of the 12 autopsy patients, six had underlying congenital heart disease (CHD). Among 61 patients with bacterial sepsis associated with CHD, six acquired bacterial endocarditis (10%), whereas in 786 infants with sepsis but without underlying heart disease, only six developed bacterial endocarditis (0.8%) (P less than .01). There is a high mortality in infants with bacterial endocarditis, and an increased risk of it in infants with sepsis and CHD.

Age Factors↗