TY - JOUR. T1 - Libman-Sacks Endocarditis in a Patient with Antiphospholipid Syndrome. AU - Kotkar, Kunal D.. AU - Said, Sameh M.. N1 - Publisher Copyright: © 2016 The Society of Thoracic Surgeons. Copyright: Copyright 2017 Elsevier B.V., All rights reserved.. PY - 2016/7/1. Y1 - 2016/7/1. N2 - Antiphospholipid syndrome is a systemic autoimmune syndrome with cardiac manifestations such as nonbacterial thrombotic endocarditis, also known as Libman-Sacks endocarditis. A 61-year-old female with history of antiphospholipid syndrome presented in acute pulmonary edema. Echocardiography demonstrated mobile vegetations on the free margins of both the anterior and the posterior mitral valve leaflets. Blood cultures and fungal serologies were negative. During mitral valve replacement both the anterior and posterior mitral leaflets were covered with multiple small vegetations with features of nonbacterial thrombotic endocarditis. Though mostly asymptomatic, Libman-Sacks endocarditis may be an indication ...
Nonbacterial thrombotic endocarditis (NBTE) is most commonly found on previously undamaged valves.[2] As opposed to infective endocarditis, the vegetations in NBTE are small, sterile, and tend to aggregate along the edges of the valve or the cusps.[2] Also unlike infective endocarditis, NBTE does not cause an inflammation response from the body.[2] NBTE usually occurs during a hypercoagulable state such as system-wide bacterial infection, or pregnancy, though it is also sometimes seen in patients with venous catheters.[2] NBTE may also occur in patients with cancers, particularly mucinous adenocarcinoma[2] where Trousseau syndrome can be encountered. Typically NBTE does not cause many problems on its own, but parts of the vegetations may break off and embolize to the heart or brain, or they may serve as a focus where bacteria can lodge, thus causing infective endocarditis.[2]. Another form of sterile endocarditis is termed Libman-Sacks endocarditis; this form occurs more often in patients with ...
Infective endocarditis (IE) at the right side represents the 5-10% of IE cases. It is more frequent in people with intravenous drug addiction (IVDA); however, there is another population susceptible to this infection; hemodialytic patients, intracardiac devices, and congenital heart diseases are included inside this group. Right-sided infective endocarditis (RSIE) has lower mortality than the left-sided infective endocarditis (LSIE). Common symptoms secondary to right-sided endocarditis are the respiratory symptoms characterized by a cough, hemoptysis, persistent fever, dyspnea, and chest pain. Echocardiography and blood cultures are the first tools to perform the diagnosis. The tricuspid valve is the main anatomical structure affected. Medical treatment with antibiotic therapy resolves the infection majority of the time; the surgical treatment is indicated in some cases, such as right-heart failure due to severe tricuspid valve regurgitation; inability to eliminate bacteremia or organism; resistance to
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The vegetations are small and formed from strands of fibrin, neutrophils, lymphocytes, and histiocytes. The mitral valve is typically affected, and the vegetations occur on the ventricular and atrial surface of the valve. Libman-Sacks lesions rarely produce significant valve dysfunction and the lesions only rarely embolize.[4] However, there is data to suggest an association between Libman-Sacks endocarditis and a higher risk for embolic cerebrovascular disease in people with systemic lupus erythematosus (SLE).[5] ...
OBON AZUARA, B.; ZALBA ETAYO, B.; GUTIERREZ CIA, I. y VILLANUEVA ANADON, B.. Aorto pulmonary fistula: left-sided infective endocarditis in HIV and intravenous drugs abuser patient: Review of literature. An. Med. Interna (Madrid) [online]. 2007, vol.24, n.11, pp.547-550. ISSN 0212-7199.. Infective endocarditis (IE) is the most severe complication in intravenous drug abusers (IVDAs). HIV infection increases the risk of IE in IVDAs too. IE in both population are special tendency to infect the rigth-sided heart, but unusual infective aortic valve. We report a case of HIV and IVDA patient admitted in hospital due to fever syndrome, with X-ray test normal and the first blood cultures negatives. CD4 count cell 90 mm3. It was impossible doing a transesophageal echocardiography (TEE) and transtoracic echocardiogramma (TTE) only showed a moderate aortic insufficiency with conserved systolic function. Despite using antibiotics, antifungals and highly active antirretroviral therapy, he developed ARDS, and ...
This 6-year, fully integrated, controlled, cross-sectional, longitudinal study revealed 5 major findings: 1) patients with NPSLE as compared with SLE had more Libman-Sacks vegetations, cerebromicroemboli, neurocognitive dysfunction, and focal brain lesions; 2) patients with vegetations had 3.0 times more cerebromicroemboli per hour, lower cerebral perfusion, more stroke/TIA and overall NPSLE events, greater neurocognitive dysfunction, and greater brain injury; 3) valve vegetations were strong independent risk factors for stroke/TIA and NPSLE, neurocognitive dysfunction, brain lesions, and all 3 outcomes combined; 4) vegetations, cerebromicroembolism, NPSLE, neurocognitive dysfunction, and brain perfusion and lesion load improved with anti-inflammatory and/or antithrombotic therapy; and 5) patients with vegetations had poor outcomes, with reduced event-free time to stroke/TIA, cognitive disability, or death. These findings support that Libman-Sacks vegetations may generate platelet or fibrin ...
SUMMARY. To form a comprehensive picture of endocarditis in narcotic addicts, twenty-nine hospitalized and seven nonhospitalized cases were identified and studied. Sole tricuspid valve involvement was found in only 9%; a bilateral endocarditis involving the tricuspid valve was noted in another 9%. The most commonly affected valves were, in order of frequency, the aortic and the mitral.. Staphylococci were isolated in 48% of the hospitalized patients; streptococci were found in 14%; and candida were found in three patients. Gram-negative or no organizisms were isolated in the remaining patients.. A history of underlying heart disease was less frequent in the addicts than in age-matched controls.. Major embolic episodes were common in these patients, particularly in those with aortic involvement; seven patients died suddenly out of the hospital with cerebral or myocardial emboli.. Although there does appear to be an increased frequency of tricuspid and candida endocarditis in the addicts as ...
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Where there has been sufficient epidemiological information provided, a comparison of clinical characteristics and outcome of these cases of CA-MRSA IE (Table 3) has been made with collated cases of native valve MSSA IE and native valve MRSA IE, taken from the merged database of the International Collaboration on Endocarditis (ICE), as previously published.18 This comparison shows a close correlation of CA-MRSA IE to MSSA IE, particularly in terms of age, acquisition in the community, vegetation location and embolic complications. Mortality associated with CA-MRSA IE has been shown, to date from the limited numbers of cases reported, to be markedly lower at 13%, in comparison with either HA-MRSA IE or MSSA IE, which is 37.2% and 23.2%, respectively (Table 3), whereas associated mortality due to Propionibacterium and Candida endocarditis has been 13.3% and 37%, respectively, as reported previously by ICE.19,20 Although CA-MRSA IE resembles MSSA IE more closely than MRSA IE, the antibiotic ...
Endocarditis is condition affecting the heart lining, heart valves, or blood vessels. Endocarditis can be caused by bacterial or fungal infection (infective endocarditis) or by blood clots that form on the heart valves or lining (non-infective endocarditis or non-bacterial thrombotic endocarditis (NBTE)). In cases of infective endocarditis, the infected area becomes inflamed and immune cells can be seen in the affected area. In cases of non-infective endocarditis, there is no inflammation of the heart lining or valves. The young and the old are at increased risk of experiencing endocarditis. Those with cancer, diabetes, HIV/AIDS, or a weakened immune system are also at an increased risk. Those with certain blood clotting conditions are at increased risk for NBTE. Symptoms of infective endocarditis can include fever, chills, fatigue, and achiness. Symptoms of both infective and non-infective endocarditis can include coughing, shortness of breath, weight loss, muscle and joint pain, a heart ...
Objective: Surgical treatment of active infective endocarditis (IE) requires not only homodynamic repair, but also, special emphasis on the eradiation of the infection to prevent recurrence. This study was undertaken to examine the outcome of surgery for active infective endocarditis in a cohort of patients. Patients and Methods: One hundred and sixty-four consecutive patients underwent valve surgery for active IE in Madani heart centre (Tabriz, Iran) from 1996 to 2006. The patients with diagnosis of IE (according to Duke Criteria) were eligible for the study. Results: The mean age of patients was 36.3 ± 16 years, with 34.6±17.5 yrs for native valve endocarditis and 38.6±15.2 yrs for prosthetic valve endocarditis (p= 0.169). Ninety-one (55.5%) of patients were males. The infected valve was native in 112 (68.3%) of patients and prosthetic in 52 (31.7%). There was no predisposing heart disease in 61 (37%) of patients. The aortic valve was infected in 78(47.6%), the mitral valve in 69 (42.1%),
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PURPOSE: Early detection of infectious endocarditis is challenging. For diagnosing infectious endocarditis, the revised Duke criteria are the gold standard. Evidence of endocardial involvement on echocardiography is a major criterion, but sensitivity and specificity of echocardiography are not optimal. Here we investigated the utility of (18)F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) to diagnose infectious endocarditis in patients with gram-positive bacteraemia. METHODS: Seventy-two patients with gram-positive bacteraemia were prospectively included. Patients with a positive blood culture growing Staphylococcus aureus, Streptococcus species or Enterococcus species were eligible when a risk factor for developing metastatic infectious foci was present. Infectious endocarditis was defined according to the revised Duke criteria. All patients underwent (18)F-FDG PET/CT and echocardiography. (18)F-FDG uptake in or around the heart valves was evaluated ...
To know more, request sample pages @Endocarditis Market Landscape. DelveInsights Endocarditis Market Insight, Epidemiology, and Market Forecast-2030″ report delivers an in-depth understanding of the Endocarditis, historical and forecasted epidemiology as well as the Endocarditis market trends in the United States, EU5 (Germany, Spain, Italy, France, and United Kingdom) and Japan.. The Endocarditis market report provides current treatment practices, emerging drugs, Endocarditis market share of the individual therapies, current and forecasted Endocarditis market Size from 2017 to 2030 segmented by seven major markets. The Report also covers current Endocarditis treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate best of the opportunities and assesses the underlying potential of the market.. Endocarditis Market Outlook. According to DelveInsight, Endocarditis market in 7MM is expected to change in the study period 2017-2030.. The Endocarditis market ...
To know more, request sample pages @Endocarditis Market Landscape. DelveInsights Endocarditis Market Insight, Epidemiology, and Market Forecast-2030″ report delivers an in-depth understanding of the Endocarditis, historical and forecasted epidemiology as well as the Endocarditis market trends in the United States, EU5 (Germany, Spain, Italy, France, and United Kingdom) and Japan.. The Endocarditis market report provides current treatment practices, emerging drugs, Endocarditis market share of the individual therapies, current and forecasted Endocarditis market Size from 2017 to 2030 segmented by seven major markets. The Report also covers current Endocarditis treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate best of the opportunities and assesses the underlying potential of the market.. Endocarditis Market Outlook. According to DelveInsight, Endocarditis market in 7MM is expected to change in the study period 2017-2030.. The Endocarditis market ...
To know more, request sample pages @Endocarditis Market Landscape. DelveInsights Endocarditis Market Insight, Epidemiology, and Market Forecast-2030″ report delivers an in-depth understanding of the Endocarditis, historical and forecasted epidemiology as well as the Endocarditis market trends in the United States, EU5 (Germany, Spain, Italy, France, and United Kingdom) and Japan.. The Endocarditis market report provides current treatment practices, emerging drugs, Endocarditis market share of the individual therapies, current and forecasted Endocarditis market Size from 2017 to 2030 segmented by seven major markets. The Report also covers current Endocarditis treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate best of the opportunities and assesses the underlying potential of the market.. Endocarditis Market Outlook. According to DelveInsight, Endocarditis market in 7MM is expected to change in the study period 2017-2030.. The Endocarditis market ...
To know more, request sample pages @Endocarditis Market Landscape. DelveInsights Endocarditis Market Insight, Epidemiology, and Market Forecast-2030″ report delivers an in-depth understanding of the Endocarditis, historical and forecasted epidemiology as well as the Endocarditis market trends in the United States, EU5 (Germany, Spain, Italy, France, and United Kingdom) and Japan.. The Endocarditis market report provides current treatment practices, emerging drugs, Endocarditis market share of the individual therapies, current and forecasted Endocarditis market Size from 2017 to 2030 segmented by seven major markets. The Report also covers current Endocarditis treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate best of the opportunities and assesses the underlying potential of the market.. Endocarditis Market Outlook. According to DelveInsight, Endocarditis market in 7MM is expected to change in the study period 2017-2030.. The Endocarditis market ...
To know more, request sample pages @Endocarditis Market Landscape. DelveInsights Endocarditis Market Insight, Epidemiology, and Market Forecast-2030″ report delivers an in-depth understanding of the Endocarditis, historical and forecasted epidemiology as well as the Endocarditis market trends in the United States, EU5 (Germany, Spain, Italy, France, and United Kingdom) and Japan.. The Endocarditis market report provides current treatment practices, emerging drugs, Endocarditis market share of the individual therapies, current and forecasted Endocarditis market Size from 2017 to 2030 segmented by seven major markets. The Report also covers current Endocarditis treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate best of the opportunities and assesses the underlying potential of the market.. Endocarditis Market Outlook. According to DelveInsight, Endocarditis market in 7MM is expected to change in the study period 2017-2030.. The Endocarditis market ...
To know more, request sample pages @Endocarditis Market Landscape. DelveInsights Endocarditis Market Insight, Epidemiology, and Market Forecast-2030″ report delivers an in-depth understanding of the Endocarditis, historical and forecasted epidemiology as well as the Endocarditis market trends in the United States, EU5 (Germany, Spain, Italy, France, and United Kingdom) and Japan.. The Endocarditis market report provides current treatment practices, emerging drugs, Endocarditis market share of the individual therapies, current and forecasted Endocarditis market Size from 2017 to 2030 segmented by seven major markets. The Report also covers current Endocarditis treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate best of the opportunities and assesses the underlying potential of the market.. Endocarditis Market Outlook. According to DelveInsight, Endocarditis market in 7MM is expected to change in the study period 2017-2030.. The Endocarditis market ...
To know more, request sample pages @Endocarditis Market Landscape. DelveInsights Endocarditis Market Insight, Epidemiology, and Market Forecast-2030″ report delivers an in-depth understanding of the Endocarditis, historical and forecasted epidemiology as well as the Endocarditis market trends in the United States, EU5 (Germany, Spain, Italy, France, and United Kingdom) and Japan.. The Endocarditis market report provides current treatment practices, emerging drugs, Endocarditis market share of the individual therapies, current and forecasted Endocarditis market Size from 2017 to 2030 segmented by seven major markets. The Report also covers current Endocarditis treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate best of the opportunities and assesses the underlying potential of the market.. Endocarditis Market Outlook. According to DelveInsight, Endocarditis market in 7MM is expected to change in the study period 2017-2030.. The Endocarditis market ...
To know more, request sample pages @Endocarditis Market Landscape. DelveInsights Endocarditis Market Insight, Epidemiology, and Market Forecast-2030″ report delivers an in-depth understanding of the Endocarditis, historical and forecasted epidemiology as well as the Endocarditis market trends in the United States, EU5 (Germany, Spain, Italy, France, and United Kingdom) and Japan.. The Endocarditis market report provides current treatment practices, emerging drugs, Endocarditis market share of the individual therapies, current and forecasted Endocarditis market Size from 2017 to 2030 segmented by seven major markets. The Report also covers current Endocarditis treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate best of the opportunities and assesses the underlying potential of the market.. Endocarditis Market Outlook. According to DelveInsight, Endocarditis market in 7MM is expected to change in the study period 2017-2030.. The Endocarditis market ...
To know more, request sample pages @Endocarditis Market Landscape. DelveInsights Endocarditis Market Insight, Epidemiology, and Market Forecast-2030″ report delivers an in-depth understanding of the Endocarditis, historical and forecasted epidemiology as well as the Endocarditis market trends in the United States, EU5 (Germany, Spain, Italy, France, and United Kingdom) and Japan.. The Endocarditis market report provides current treatment practices, emerging drugs, Endocarditis market share of the individual therapies, current and forecasted Endocarditis market Size from 2017 to 2030 segmented by seven major markets. The Report also covers current Endocarditis treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate best of the opportunities and assesses the underlying potential of the market.. Endocarditis Market Outlook. According to DelveInsight, Endocarditis market in 7MM is expected to change in the study period 2017-2030.. The Endocarditis market ...
To know more, request sample pages @Endocarditis Market Landscape. DelveInsights Endocarditis Market Insight, Epidemiology, and Market Forecast-2030″ report delivers an in-depth understanding of the Endocarditis, historical and forecasted epidemiology as well as the Endocarditis market trends in the United States, EU5 (Germany, Spain, Italy, France, and United Kingdom) and Japan.. The Endocarditis market report provides current treatment practices, emerging drugs, Endocarditis market share of the individual therapies, current and forecasted Endocarditis market Size from 2017 to 2030 segmented by seven major markets. The Report also covers current Endocarditis treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate best of the opportunities and assesses the underlying potential of the market.. Endocarditis Market Outlook. According to DelveInsight, Endocarditis market in 7MM is expected to change in the study period 2017-2030.. The Endocarditis market ...
Mitral annular calcification is a common finding in elderly patients; it is considered a benign cardiac abnormality but it can be a predisposing factor for infective endocarditis. Although described in numerous necropsy studies, endocarditis on mitral annular calcification has rarely been reported during life, and the frequency of sepsis can be underestimated because of difficult diagnosis. We present a case of infective endocarditis on mitral annulus calcification in a patient with acute coronary syndrome, diagnosed with transthoracic echocardiography. Transthoracic echocardiography may contribute to a correct diagnosis, showing typical findings of infective endocarditis on mitral annular calcification in order to administrate an adequate antibiotic prophylaxis in patients undergoing endoscopic or invasive procedures.
Infectious endocarditis results from bacterial or fungal infection of the endocardial surface of the heart and is associated with significant morbidity and mortality. Risk factors include the presence of a prosthetic heart valve, structural or congenital heart disease, intravenous drug use, and a recent history of invasive procedures. Endocarditis should be suspected in patients with unexplained fevers, night sweats, or signs of systemic illness. Diagnosis is made using the Duke criteria, which include clinical, laboratory, and echocardiographic findings. Antibiotic treatment of infectious endocarditis depends on whether the involved valve is native or prosthetic, as well as the causative microorganism and its antibiotic susceptibilities. Common blood culture isolates include Staphylococcus aureus, viridans Streptococcus, enterococci, and coagulase-negative staphylococci. Valvular structural and functional integrity may be adversely affected in infectious endocarditis, and surgical consultation is
A 2-year-old boy was admitted for a 16-day history of intermittent fever (up to 40.5°C) with no other symptom. He had been followed since birth for a large midmuscular ventricular septal defect with a left-to-right shunt and signs of congestive heart failure. At 2 months of age, the patient had a pulmonary artery banding, and at 16 months of age he underwent hybrid periventricular closure of a muscular ventricular septal defect by Amplatzer occluder and removal of the pulmonary band.. A 12-mm Amplatzer muscular ventricular septal defect (VSD) occluder was implanted through a direct puncture of the right ventricular free wall. Postoperative echocardiography initially showed a 7-mm residual muscular VSD at the inferior border of the device with a moderate left-to-right shunt that progressively decreased to a 3- to 4-mm residual VSD over the next few months. During postoperative follow-up, the patients condition improved with decreasing heart failure signs. Treatment with diuretics and ...
Libman-Sacks endocarditis (LSE), characterized by verrucous vegetations formation, is a typical cardiac manifestation of autoimmune diseases such as systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). It primarily leads to lesions of cardiac valves and mostly involved valves are mitral and aortic, but isolated tricuspid valve involvement is exceptional. Here we reported a 20-years-old female with past SLE history suffered from acute right heart failure caused by multiple tricuspid vegetations and valve regurgitation. The patient recovered following tricuspid valve replacement with a bioprosthesis. Transesophageal echocardiography(TEE), especially real time 3-dimensional (RT3D) TEE provide a better imaging modality for assessing cardiac valvular involvement of LSE. For patients with active SLE/APS course, uncontrolled systemic inflammation may made it difficult for surgical exposure and suture. The durability of bioprosthesis for this patient and the prosthesis selection for tricuspid
Rhonda Rollinson underwent a safe, legal abortion by Dr. Jay I. Levin at Malcom Poliss Philadelphia Womens Center September 3, 1992. The abortion attempt was unsuccessful. Rhonda was then sent home, with instructions to return on September 12 to try again. Rhonda experienced such severe pain, dizziness, fever, and discharge that on September 10 she sought emergency care at a hospital. She was suffering severe non-cardiogenic pulmonary edema consistent with adult respiratory distress syndrome. Doctors did a laparoscopy, dilation and evacuation, abdominal hysterectomy, and splenectomy, to no avail. Rhonda died on September 14. The autopsy revealed a perforation from her vagina into the uterine cavity, sepsis, disseminated intravascular coagulopathy (a clotting disorder), non-bacterial thrombotic endocarditis, pulmonary infarctions, and dysplastic kidney. The suit filed by Rhondas survivors also charged the facility and Polis with hiring Levin despite his lack of competence, failure to ...
To explore the trends in epidemiology and the risk factors related to the prognosis of infective endocarditis in a tertiary hospital over the past ten years. A retrospective cohort study was performed. A total of 407 consecutive patients who were admitted with infective endocarditis were included. The clinical characteristics and the risk factors related to the prognosis of infective endocarditis during this period were analyzed. A total of 407 patients with infective endocarditis were included, the average age was 48 ± 16 years old with an increasing trend and in-hospital mortality rate was 10.6% and one-year mortality rate was 11.3%. Among patients with underlying heart disease, congenital heart disease was the most common (25.8%), followed by rheumatic heart disease (17.0%) which showed a decreased trend during this period (P | 0.001). There were 222(54.5%) patients with positive blood cultures results and Streptococci (24.6%) was the main pathogens with an increasing trend. There were 403 patients
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MARTINEZ ODRIOZOLA, P. et al. Enterococcal infective endocarditis: description of 12 cases. An. Med. Interna (Madrid) [online]. 2007, vol.24, n.11, pp.539-542. ISSN 0212-7199.. We have performed a retrospective study of patients diagnosed with infective endocarditis due to Enterococcus in our hospital for a period of 12 years (1994-2005). We review clinical and microbiological aspects, therapy, and outcome. We found 12 cases that were 6 % of total endocarditis, and 7% of enterococcal bacteremia. Eight cases were male, and 4 were female, aged between 37 and 94 years. The causative organism of endocarditis was E. faecalis in 10 patients and E. faecium in 2. Two E. faecalis were resistant to aminoglycosides. Aortic valve was the most frequently affected with 9 cases, followed by mitral valve (2 cases), and tricuspid valve (1 case). In 10 cases endocarditis affected a native valve, and only in 2 cases a prosthetic valve. Only 5 patients had underlying valve disease. The most frequently used ...
TY - JOUR. T1 - Echocardiographic assessment of patients with infectious endocarditis. T2 - Prediction of risk for complications. AU - Sanfilippo, Anthony J.. AU - Picard, Michael H.. AU - Newell, John B.. AU - Rosas, Emma. AU - Davidoff, Ravin. AU - Thomas, James D.. AU - Weyman, Arthur E.. PY - 1991/11/1. Y1 - 1991/11/1. N2 - To enhance the echocardiographic identification of high risk lesions in patients with infectious endocarditis, the medical records and two-dimensional echocardiograms of 204 patients with this condition were analyzed. The occurrence of specific clinical complications was recorded and vegetations were assessed with respect to predetermined morphologic characteristics. The overall complication rates were roughly equivalent for patients with mitral (53%), aortic (62%), tricuspid (77%) and prosthetic valve (61%) vegetations, as well as for those with nonspecific valvular changes but no discrete vegetations (57%), although the distribution of specific complications varied ...
To the editor: Animal valves are used with varying success as transplants in man; their degradation or infection is relatively uncommon. An unusual fungal endocarditis on a transplanted porcine valve prompts this report.. A 56-year-old white housewife underwent replacement of her calcified mitral valve on 12 May 1970, by a porcine aortic valve (1), and did well thereafter. When readmitted on 17 September 1971, she had had fever up to 38.8 °C for 4 weeks, with chills, shortness of breath, and cough. Outpatient treatment with penicillin had brought no relief.. Examination showed a moribund woman with a temperature of 37.7 ...
Learning Objectives:1. Review the most common causative microbes in infective endocarditis2. Outline the role of surgical intervention in infective endocarditis 3. Discuss the implication of heart failure in infective endocarditis
We present a case of leaking mycotic aneurysm of abdominal aorta complicated by infective endocarditis in a young boy of 14 years age. This boy with history of rheumatic heart disease with vegetations on mitral valve and severe mitral regurgitation landed up in complications of infective endocarditis like femoral artery thrombo embolism followed by an abdominal aortic aneurysm with contained rupture. This case was successfully managed addressing two problems i.e. valve and aneurysm repair in single sitting.
The clinical, serological and electron microscopic findings in a 47 year old woman with bioprosthetic valve coxiella endocarditis occurring 15 years after streptococcal endocarditis are described. The patient underwent valvular surgery a total of four times to control symptoms and remains well on medical therapy more than two years after her last operation.. ...
Background Infective endocarditis often is complicated by embolic events after hospital admission. Identifying patients at higher risk may improve the disease outcome. This study was aimed at identifying predictors of embolic risk among the clinical and laboratory data obtained on hospital admission in patients diagnosed as having definite infective endocarditis according to the Duke criteria. Methods Ninety-four patients were enrolled in a prospective study. The results of hematologic, echocardiographic, and microbiological investigations were analyzed, using statistical methods as appropriate. Multivariate analysis was applied to variables significantly associated with embolism in univariate analysis. Results Forty-six percent of patients had a major embolic complication after admission. No association was found between embolism and sex, site of infection, or microorganism involved. Patients with embolism were significantly younger, had larger vegetation, and showed a significantly higher ...
OVERVIEW: What every practitioner needs to know about native valve endocarditis Are you sure your patient has native valve endocarditis? Native valve endocarditis (NV-IE) is one of the most important life-threatening infectious diseases, and its timely diagnosis, antibiotic treatment, and management of complications is critical to optimal outcomes. Typical symptoms are variable and depend on the…. ...
During the period 1970-1993, 116 patients (63 men, 53 women) with native aortic valvular infective endocarditis were treated surgically. The mean age was 37 years. The main causative organisms were streptococci and staphylococci. Indication for surgery was cardiac failure (70 cases), uncontrolled sepsis (30), peripheral emboli (11) and overwhelming destruction of the aortic valve (five). Hospital and late mortality rates were 8% and 11% respectively. Patients who died in hospital and those who presented a paravalvular leakage had a ring abscess associated with aortic wall destruction. Among 34 patients screened for cerebral septic emboli the condition was confirmed in 15, of whom six were symptom-free. Thus, it is believed that in the presence of root abscess, surgery should be undertaken promptly, regardless of the cardiac status. It is confirmed that cerebral septic emboli should be systematically screened for in the presence of any infective endocarditis. ...
Endocarditis is an inflammation of the endocardium, the membrane lining the chambers of the heart and covering the cusps of the heart valves. Infective endocarditis refers to infection of the heart valves by microorganisms. Endocarditis is often referred to as either acute or subacute depending on the clinical presentation. Acute bacterial endocarditis is a fulminating infection associated with high fevers, systemic toxicity, and death within a few days to weeks if untreated. ...
PVE represents a diagnostic challenge. The present study tested the use of 18F-FDG PET/CT for diagnosing PVE. We demonstrated that this imaging technique has good diagnostic value, especially when abnormal FDG uptake around the prosthetic valve was added as a major criterion to the modified Duke classification established within a few days after admission. The inclusion of this new criterion significantly increased the sensitivity of the modified Duke classification and allowed for an earlier diagnosis, especially when echocardiography was normal or doubtful.. The early diagnosis of endocarditis is of crucial importance because a delay in antibiotic therapy and cardiac surgery has negative effects on clinical outcomes (3,25). However, diagnosis of this condition is often difficult, especially in the presence of foreign materials such as pacemaker/defibrillator leads and prosthetic valves. In such a situation, echocardiography shows a decreased sensitivity and specificity (2,26). Therefore, ...
TY - JOUR. T1 - Microbial biofilm correlates with an increased antibiotic tolerance and poor therapeutic outcome in infective endocarditis. AU - Di Domenico, Enea Gino. AU - Rimoldi, Sara Giordana. AU - Cavallo, Ilaria. AU - DAgosto, Giovanna. AU - Trento, Elisabetta. AU - Cagnoni, Giovanni. AU - Palazzin, Alessandro. AU - Pagani, Cristina. AU - Romeri, Francesca. AU - De Vecchi, Elena. AU - Schiavini, Monica. AU - Secchi, Daniela. AU - Antona, Carlo. AU - Rizzardini, Giuliano. AU - Dichirico, Rita Barbara. AU - Toma, Luigi. AU - Kovacs, Daniela. AU - Cardinali, Giorgia. AU - Gallo, Maria Teresa. AU - Gismondo, Maria Rita. AU - Ensoli, Fabrizio. PY - 2019/10/21. Y1 - 2019/10/21. N2 - Background: Infective endocarditis (IE) is associated with high rates of mortality. Prolonged treatments with high-dose intravenous antibiotics often fail to eradicate the infection, frequently leading to high-risk surgical intervention. By providing a mechanism of antibiotic tolerance, which escapes conventional ...
Evidence-based recommendations on antimicrobial prophylaxis (antibiotics) against infective endocarditis (IE) in adults and children having interventional
In their Seminar (Feb 27, p 882), Thomas Cahill and Bernard Prendergast1 point out that the prevalence of health-care-acquired infective endocarditis has increased in the past decades, accounting for more than 25% of cases at present. However, the epidemiological concept of health-care-acquired does not highlight at-risk populations. In particular, the authors briefly mention but regrettably omit haemodialysis as a risk factor for infective endocarditis.. ...
The treatment of infective endocarditis (IE) is still a challenge. Despite the availability of transoesophageal echocardiography which enables earlier diagnosis, and the use of appropriate antibiotics, the death rate remains high (20%). The reasons are that the population continues to become older with more comorbidities and more aggressive microorganisms like Staphylococcus aureus and Enterococcus faecalis are more frequently responsible for IE. These microorganisms induce more tissue destruction in a short time, leading to severe heart valve dysfunction early in the course of the disease. This evolution necessitates valve surgery, according to the 2006 ACC/AHA1 and 2009 ESC guidelines.2 However, the issue is the timing of surgery. Every delay in surgery compromises the final result. However, there may … ...
Active infective endocarditis is a life-threatening condition that commonly affects the heart valves and requires urgent medical care. Appropriate …
Backgrounds: Infective endocarditis (IE) is associated with a high incidence of embolic events (EE), but surgical indications to prevent embolism remain controversial. We tried to compare clinical outcomes of early surgery to conventional management.. Methods: From 1998 to 2006, we prospectively enrolled a total of 136 consecutive patients (89 men, age; 49±17 years) with definite IE based on Duke criteria, and excluded patients with urgent indications of surgery based on current guidelines. The exclusion criteria were defined as patients with severe heart failure, aortic abscess, periannular complications, prosthetic valve IE, right-sided vegetations, small vegetations with diameter less than 5mm, or embolic stroke. The end point was defined as the composite of in-hospital death and clinical embolism confirmed by imaging studies.. Results: Early surgery was performed on 67 patients (OP group) within 7 days of the diagnosis, and medical management was chosen on 69 patients (MED group). There ...
1) Endocarditis is a serious infection of one of the four heart valves. Endocarditis is caused by a growth of bacteria on one of the heart valves, leading to an infected mass called a vegetation. The infection may be introduced during brief periods of having bacteria in the bloodstream, such as after dental work, colonoscopy, and other similar procedures. (2) The heart is constituted of three types of tissues, which are from out- to inside the heart: the pericardium, the myocardium and the endocardium. The endocardium is therefore the tissue situated on the internal face of the heart, directly in the contact with blood. An endocarditis corresponds to an inflammation (or irritation) of the endocardium or a microbial infection of the endothelial surface of the heart. The most harmed area of the endocardium during an endocarditis is as a rule the one of the cardiac valves, especially if they were injured initially. These valves are to the number of 4: 2 on the right side of the heart and 2 on the ...
Endocarditis can also involve the heart muscle, valves or lining of the heart. Most people who develop endocarditis have had a heart valve abnormality. Risk factors for developing endocarditis can be various and include injection drug use, placement of permanent access roads in the veins, after valve surgery, recent dental surgery, and weakened valves. Bacterial infection is the most common source of endocarditis. It can also be caused by fungi, although in some cases no cause can be identified ...
© 2019 The Society of Thoracic Surgeons This report describes the case of an 80-year-old man with culture-negative prosthetic valve endocarditis who ultimately was given a diagnosis of Legionella pneumophila endocarditis.
This Duke criteria calculator evaluates symptoms for infectious endocarditis and allows the clinician to put a quick diagnosis based on patient data.
Infective endocarditis (IE), or bacterial endocarditis, is an infection caused by bacteria that enter the bloodstream and settle in the heart lining, a heart valve or a blood vessel. IE is uncommon, but people with some heart conditions have a greater risk of developing it.
Infective endocarditis (IE), or bacterial endocarditis, is an infection caused by bacteria that enter the bloodstream and settle in the heart lining, a heart valve or a blood vessel. IE is uncommon, but people with some heart conditions have a greater risk of developing it.
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AIMS: The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) European Endocarditis (EURO-ENDO) registry aims to study the care and outcomes of patients diagnosed with infective endocarditis (IE) and compare findings with recommendations from the 2015 ESC Clinical Practice Guidelines for the management of IE and data from the 2001 Euro Heart Survey. METHODS AND RESULTS: Patients (n = 3116) aged over 18 years with a diagnosis of IE based on the ESC 2015 IE diagnostic criteria were prospectively identified between 1 January 2016 and 31 March 2018. Individual patient data were collected across 156 centres and 40 countries. The primary endpoint is all-cause mortality in hospital and at 1 year. Secondary endpoints are 1-year morbidity (all-cause hospitalization, any cardiac surgery, and IE relapse), the clinical, epidemiological, microbiological, and therapeutic characteristics of patients, the number and timing of non-invasive imaging techniques, and adherence to recommendations
Clinical trial for Bacterial Endocarditis | Endocarditis , Oral Switch During Treatment of Left-sided Endocarditis Due to Multi-susceptible Staphylococcus
Conclusions. Infective Endocarditis arose mainly in bicuspid aortic valve and bioprosthesis valve followed by floppy mitral valve. An important relationship exists between systemic co-morbid factors and underlying cardiac conditions at high risk for poor prognosis for Infective Endocarditis. We didnt find association between dental care and occurrence of Infective Endocarditis due to microorganisms of the oral cavity. Nevertheless patients with endo-periodontal diseases are prone to development of endocarditis. Maintenance of optimal oral health and hygiene may reduce the incidence of bacteremia from daily activities (brushing teeth and chewing). Thus people at risk of developing Infective Endocarditis should have an high standard of oral health including endodontic and periodontal therapy. ...
Endocarditis develops solely from the onset of a bacterial or fungal infection in the bloodstream. As the infection is carried through the blood to all outlets of the body, it eventually deposits in the valves of the heart, causing inflammation and decreased heart function. Although the reasoning is unclear, it is known that both the aortic and mitral valves are the most commonly affected by endocarditis, with the tricuspid valve rarely being touched. While endocarditis may be the first condition to be diagnosed as a result of infection, it is typically just the first place that infection is noticed. Because the valves of the heart pump blood throughout the entire body, the infection is carried and can develop in other locations, ultimately affecting the function of other bodily organs. ...
Viral endocarditis symptoms, causes, diagnosis, and treatment information for Viral endocarditis (Endocarditis) with alternative diagnoses, full-text book chapters, misdiagnosis, research treatments, prevention, and prognosis.