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Bacterial Endocarditis (bacterial + endocarditis)

Distribution by Scientific Domains

Medical Sciences	100%

Distribution within Medical Sciences

Cardiovascular Disease	20%
Dermatology	13%

Selected Abstracts

Unusual Pulmonary Venous Flow Profile in a Patient with Mitral Valve Perforation Secondary to Bacterial Endocarditis

ECHOCARDIOGRAPHY, Issue 2 2006
Shalini Modi M.D.
Pulmonary venous flow patterns have been well described in the literature to assess severity of mitral regurgitation (MR) and the degree of diastolic dysfunction. We report a case of posterior mitral leaflet perforation due to bacterial endocarditis causing an alteration of pulmonary venous flow, not previously described in the literature. This pulmonary venous flow pattern is unique in that it reflects dynamic changes in left atrial pressure in the background of severe MR. [source]

Bacterial endocarditis in a child with haemophilia B: risks of central venous catheters

HAEMOPHILIA, Issue 5 2001
D. K. Hothi
The use of central venous catheters may be complicated by thrombosis and infection. We report a case of a needle-phobic 5-year-old boy with factor IX deficiency, in whom a portacath was inserted owing to poor compliance with prophylactic treatment. Within a week, he developed a Staphylococcus aureus line infection that was treated with a 2-week course of intravenous antibiotics. One month later he presented with nonspecific symptoms and blood cultures again grew S. aureus. An echocardiogram revealed a large vegetation adherent to the tricuspid valve, confirming the diagnosis of bacterial endocarditis. His clinical course was further complicated by the development of pulmonary emboli. Medical treatment with intravenous antibiotics led to a successful resolution of the endocarditis and pulmonary emboli with a favourable long-term outcome. [source]

Antibiotic Prophylaxis Guideline Awareness and Antibiotic Prophylaxis Use Among New York State Dermatologic Surgeons

DERMATOLOGIC SURGERY, Issue 9 2002
Noah Scheinfeld JD
background. Use of antibiotic prophylaxis in dermatologic surgery patients remains controversial and several sets of guidelines exist. objective. We investigated dermatologic surgeon's awareness of the American Heart Association (AHA) 1997 antibiotic prophylaxis guidelines, their use of prophylactic antibiotics, and their practices as compared with the Haas and Grekin's 1995 antibiotic prophylaxis guidelines. methods. We mailed postage-paid questionnaires regarding AHA guideline awareness and antibiotic prophylaxis use to the 235 New York State members of the American Society for Dermatologic Surgery (ASDS). We received 87 replies. results. Most participants recognize AHA guidelines and claim to follow them. We reiterate previous studies' findings. Most dermatologic surgeons use antibiotics appropriately. However, antibiotics are occasionally overused or dosed outside the guidelines. Many participants prescribe antibiotics based on a patient's other physicians' recommendations. Notably, erythromycin is sometimes used, an antibiotic the AHA no longer recommends. conclusion. Dermatologic surgeons commonly use antibiotic prophylaxis to prevent bacterial endocarditis. Based on previous studies, though, the risk of endocarditis following cutaneous surgery is low and thus the use of antibiotic prophylaxis is controversial. Although this practice is appropriate for high-risk patients when skin is contaminated, it is not recommended for noneroded, noninfected skin. We report that dermatologists may be aware of the guidelines, but only seem to partially follow them. Further studies are still needed to establish optimal guidelines. [source]

Unusual Pulmonary Venous Flow Profile in a Patient with Mitral Valve Perforation Secondary to Bacterial Endocarditis

Vegetative bacterial endocarditis associated with septic tenosynovitis of the digital sheath in a Thoroughbred racehorse

EQUINE VETERINARY EDUCATION, Issue 3 2000
P. H. L. Ramzan
[source]

Activated complement is more extensively present in diseased aortic valves than naturally occurring complement inhibitors: a sign of ongoing inflammation

EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 1 2010
M. Ter Weeme
Eur J Clin Invest 2010; 40 (1): 4,10 Abstract Background, Recent studies indicate a role for complement in the pathogenesis of aortic valve disease. However, the role of naturally occurring anti-complement mediators in this context is unknown. In this study, we have analysed this in three different pathological conditions of the aortic valve: degeneration, atherosclerosis and bacterial endocarditis. Materials and methods, Human aortic valves were obtained at autopsy (n = 30): 5 control valves, 10 aortic valves with atherosclerotic changes, 10 aortic valves with degenerative changes and 5 degenerative changed aortic valves with bacterial infection. These valves were analysed immunohistochemically for the presence of activated complement (C3d and C5b9) and the complement inhibitors C1-inh and clusterin. Areas of positivity were then quantified. Results, C3d, C5b9 and the complement inhibitors C1-inh and clusterin depositions were mainly found in the endothelium and extracellular matrix in aortic valves. All these mediators were already present in control valves, but the area of positivity increased significantly in response to the different diseases, with the highest increase in response to bacterial endocarditis. Interestingly, in all three aortic diseases, the depositions of complement were significantly more widespread than that of their inhibitors. Conclusions, Our study indicates that anti-complement mediators (C1-inh and clusterin) are deposited in diseased aortic valves together with activated complement, indicating an existing counter response against complement locally in the valve. However, deposition of activated complement is significantly more widespread than that of its inhibitors, which could explain ongoing inflammation in those diseased aortic valves. [source]

Dysregulation of monocyte oxidative burst in streptococcal endocarditis

EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 10 2001
E. Presterl
Background Streptococcal subacute endocarditis is characterized by low-grade systemic inflammation. Although structural cardiac defects are pivotal, phagocytic cells, i.e. monocytes and neutrophils, are involved in the induction and the course of bacterial endocarditis. Decreased production of reactive oxygen metabolites was described in long-lasting infections. We hypothesized that the oxidative burst of phagocytes induced by the infecting organism is defective in patients with streptococcal endocarditis. Patients and methods The monocytes and neutrophils of 11 patients with streptococcal native valve endocarditis were challenged with the respective pathogens and two control streptococcal strains, and the oxidative burst was determined by fluorescence-activated cell sorter analysis. These experiments were done before any antibiotic therapy was administered, and repeated at least 12 months after recovery. Eight volunteers served as healthy controls. Results The monocyte response to the respective pathogens was decreased in the patient groups compared to the response to the control streptococci. After cure the monocyte response to the pathogens was not different to the response to the control strains. The monocyte response of the healthy volunteers did not show any differences between the patients' pathogens and the control strains. The neutrophil oxidative burst to the pathogens was similar to that to the control streptococci in both patient and the volunteer group. Conclusion The decreased response of patient monocytes to the pathogens may contribute to the low-grade inflammatory response and to the course of streptococcal endocarditis. [source]

Bacterial endocarditis in a child with haemophilia B: risks of central venous catheters

The salvage of aneurysmal fistulae utilizing a modified buttonhole cannulation technique and multiple cannulators

HEMODIALYSIS INTERNATIONAL, Issue 2 2006
Rosa M. MARTICORENA
Abstract We describe the St Michael's Hospital (SMH) modified buttonhole (BH) cannulation technique as a method that offers a solution for fistulae with aneurysmal dilatation due to repetitive cannulation in a restricted area. This is a prospective cohort study of 14 chronic hemodialysis (HD) patients with problematic fistulae (marked aneurysmal formation and thinning of the overlying skin, bleeding during treatment, and prolonged hemostasis post-HD) because of repetitive, localized cannulation. Each patient was followed for 12 months. The protocol was as follows: creation of tunnel tracks by 1 to 3 experienced cannulators per patient, using sharp needles. After the tunnel tracks were established and cannulation was easily achieved with dull needles, additional cannulators were incorporated with the guidance of a mentor. Bleeding from cannulation sites during dialysis ceased within 2 weeks and skin damage resolved within 6 months in all patients. Hemostasis time postdialysis decreased from 24 to 15 min. Cannulation pain scores decreased significantly. Access flows and dynamic venous pressure measurements remained unchanged. No interventions were required to maintain access patency. In 2 cases, the aneurysms became much less evident. Complications included one episode of septic arthritis and one contact dermatitis. A third patient developed acute bacterial endocarditis 9 months following completion of her follow-up. The SMH modified BH cannulation technique can salvage problematic fistulae, prevent further damage, and induce healing of the skin in the areas of repetitive cannulation. This technique can be successfully achieved by multiple cannulators in a busy full-care HD unit. [source]

Management of Anomalous Left Circumflex Artery Encircling the Aortic Annulus in a Patient Undergoing Multivalvular Surgery

JOURNAL OF CARDIAC SURGERY, Issue 6 2009
Javier G. Castillo M.D.
In patients undergoing aortic valve replacement, this finding becomes crucial because the left circumflex is at risk of injury during the procedure. The scenario is even more complex in patients undergoing multi-valve surgery. We report the diagnosis and successful operative strategy in a patient with anomalous left circumflex arising from the proximal right sinus of Valsalva undergoing double aortic and tricuspid valve surgery for active bacterial endocarditis. [source]

Did Gustav Mahler have Sydenham's chorea?,

MOVEMENT DISORDERS, Issue 3 2006
Francisco Cardoso MD
Abstract Sydenham's chorea (SC), a major manifestation of acute rheumatic fever (RF), is characterized by chorea and other motor and nonmotor features. Among the latter are behavioral symptoms, including obsessive,compulsive disorder. Although SC is typically a self-limited condition, up to 50% of patients may evolve with persistent chorea. There is evidence that Gustav Mahler had a movement disorder, but its nature remains undetermined. There are witnesses describing him as having facial dyskinesia and a gait disorder consistent with chorea. His conducting performance was notorious for obsessive attention to details of the staging and musical production. Mahler was diagnosed with a valvulopathy in 1907 and died of subacute bacterial endocarditis in 1911. It is possible that the composer suffered from RF in childhood with carditis and SC, which may left him with valvulopathy, obsessive,compulsive disorder, and persistent chorea. © 2006 Movement Disorder Society [source]

Very severe thrombocytopenia and fragmentation hemolysis mimicking thrombotic thrombocytopenic purpura associated with a giant intracardiac vegetation infected with Staphylococcus epidermidis: Role of monocyte procoagulant activity induced by bacterial supernatant

AMERICAN JOURNAL OF HEMATOLOGY, Issue 8 2007
Kathleen Selleng
Abstract The pathogenesis of very severe thrombocytopenia in bacterial endocarditis is uncertain. We report a 50-year-old male with platelet counts < 10 × 109/l and fragmentation hemolysis complicating Staphyloccoccus epidermidis pacemaker endocarditis with a giant vegetation. Antibiotics, corticosteroids, high-dose intravenous gammaglobulin, and plasmapheresis (for initially-suspected thrombotic thrombocytopenic purpura) failed to produce significant platelet count increase. However, therapeutic-dose heparin anticoagulation was associated with a platelet count increase from <10 to ,40 × 109/l, with parallel reduction in thrombin-antithrombin complexes (from 8.9 to 3.5 ,g/l), facilitating surgical intervention. The thrombocytopenia promptly resolved following surgical removal of the vegetation. Culture supernatant from S. epidermidis isolated from the patient's blood induced monocytes to express procoagulant activity (assessed by factor Xa generation) equivalent to lipopolysaccharide (1 ,g/ml), with half-maximal activation seen with culture supernatant diluted to 1:12,800. These data are consistent with previous animal models of endocarditis demonstrating staphylococci-induced procoagulant changes in monocytes. This case demonstrates that heparin anticoagulation can be therapeutic in infective endocarditis-associated severe thrombocytopenia in a non-bleeding patient, and that such therapy may ameliorate the platelet count enough to permit surgical intervention. Am. J. Hematol 2007. © 2006 Wiley-Liss, Inc. [source]

Drug-induced linear IgA bullous disease following antibiotics

AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 3 2001
Todd P Wiadrowski
SUMMARY A 69-year-old woman presented with pneumonia and subacute bacterial endocarditis. Nine days after intravenous vancomycin and ciprofloxacin were commenced, the patient developed a bullous mucocutaneous eruption. Clinical presentation and histopathology were consistent with drug-induced linear IgA bullous disease (LABD). The patient's lesions resolved with cessation of antibiotics. A review of the features of drug-induced LABD and the drugs that have been implicated are presented. [source]

Complete heart block associated with lupus in a dog

AUSTRALIAN VETERINARY JOURNAL, Issue 7 2003
R MALIK
A 5-year-old Poodle-cross was initially presented for exercise intolerance and difficulty in chewing and yawning. Some months later it acutely developed lethargy referable to complete heart block. Further investigations before and after permanent pacemaker implantation demonstrated Coombs-positive immune-mediated haemolytic anaemia, presumptive masticatory myositis and hypoadrenocorticism, suggesting the possibility of multisystem auto-immune disease. A diagnosis of systemic lupus erythematosus (SLE) was made based on these findings and a positive anti-nuclear antibody titre. It was thought that immune-mediated destruction of cardiac conduction tissues was responsible for the development of atrioventricular conduction block. Glucocorticoid deficiency was corrected using cortisone replacement therapy. SLE was controlled successfully for 10 months using azathio-prine monotherapy until signs, subsequently shown to be due to subacute bacterial endocarditis, resulted in the death of the patient. Lupus should be considered as a potential underlying aetiology in dogs that develop heart block. [source]

Tricuspid valvectomy: Long-term survival and surgical options

CLINICAL CARDIOLOGY, Issue 2 2006
Robert D. Chait M.D.
Abstract This paper reports an 18-year survivor of tricuspid valvectomy that was performed for bacterial endocarditis. The various surgical treatment options are also discussed. [source]