1/553. Group G streptococcal endocarditis.The group G streptococcus may be a more common human pathogen than previously recognized. A case of group G streptococcal endocarditis is reported and the 11 cases reported previously are reviewed. Group G endocarditis may have significant clinical and prognostic differences from endocarditis caused by the more commonly identified viridans or group D streptococci. Routine serologic grouping of beta-hemolytic streptococcal isolates from serious infections is warranted.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/553. aortitis with multiple aneurysms mimicking infective endocarditis.aortitis usually produces aortic insufficiency by aortic root dilation. In rare cases the inflammation may involve the aortic valve cusps, causing valvular insufficiency. A patient in whom aortitis produced valvular masses, with aortic and peripheral arterial aneurysms, embolic episodes and aortic insufficiency is described. Valve replacement for suspected infective endocarditis was complicated by homograft dehiscence and multiple false aneurysms. Although immunosuppression was successful in decreasing the patient's vasculitis, he became infected and died of complications of aspergillus infection.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
3/553. mitral valve homograft for mitral valve replacement in acute bacterial endocarditis.Homograft use for aortic valve replacement (AVR) in aortic valve acute bacterial endocarditis (ABE) has gained in popularity, due mainly to the relative resistance of homografts to infection. Recent success with mitral valve homograft use led us to apply homograft mitral valve replacement (MVR) in a patient with severe ABE that was not amenable to valve repair. Following surgery, the patient improved rapidly with normalization of infection parameters and chest radiography, and was discharged home on postoperative day 11. Follow up echocardiography showed good function of the homograft mitral valve with no regurgitation. After four months, the patient had normal valve function, with no evidence of infection. In conclusion, MVR with a mitral valve homograft in the setting of ABE was satisfactory, though patient follow up was relatively short (four months).- - - - - - - - - - ranking = 3keywords = infection (Clic here for more details about this article) |
4/553. bacillus popilliae endocarditis with prolonged complete heart block.bacillus popilliae, a fastidious, aerobic, gram-positive, spore-forming bacillus, has never been reported as a pathogen in human infectious diseases. We report the first case of a human infected by the pathogen B. popilliae, which presented as endocarditis involving the bicuspid aortic valve and complicated with prolonged (> 30 days; to our knowledge, the longest in the literature) complete heart block. Although surgery may be warranted by previous reports, the patient was successfully managed by medical treatment instead, because of the absence of evidence from various approaches that support the existence of perivalvular extension of infection.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
5/553. Infectious disease emergencies in primary care.Infectious disease emergencies can be described as infectious processes that, if not recognized and treated immediately, can lead to significant morbidity or mortality. These emergencies can present as common or benign infections, fooling the primary care provider into using more conservative treatment strategies than are required. This review discusses the pathophysiology, history and physical findings, diagnostic criteria, and treatment strategies for the following infectious disease emergencies: acute bacterial meningitis, ehrlichiosis, rocky mountain spotted fever, meningococcemia, necrotizing soft tissue infections, toxic shock syndrome, food-borne illnesses, and infective endocarditis. Because most of the discussed infectious disease emergencies require hospital care, the primary care clinician must be able to judge when a referral to a specialist or a higher-level care facility is indicated.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
6/553. culture-positive bartonella quintana endocarditis.A 50-year-old alcoholic man with a 1-year history of pyrexia of unknown origin was admitted with symptoms of endocarditis. Large vegetations on his mitral and aortic valve were found on echocardiography. Using the Bactec 9240 system. bartonella quintana could be grown from two culture sets of blood collected before the start of antimicrobial therapy. This is the first case report of culture-proven bartonella infection in the UK. and is noteworthy because bartonella quintana was detected in conventional blood culture systems after prolonged incubation.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
7/553. Pacemaker lead infection: report of three cases and review of the literature.Pacemaker lead infection is a rare condition, most often occurring when intervention is needed after pacemaker implantation. diagnosis is by blood cultures and confirmation by transoesophageal echocardiography; transthoracic echocardiography is often inadequate. A literature review indicated the microorganism most responsible for late lead infection is staphylococcus epidermidis (which can grow on plastic material). A retrospective analysis of patient files from the authors' institution (1993-97) yielded three patients with proven pacemaker lead endocarditis. The diagnosis of pacemaker endocarditis was by transoesophageal echocardiography. The endocarditis appeared after a long period and in two of the three patients there was S epidermidis infection. thoracotomy with removal of the infected system was performed because of the large dimensions of the vegetations. A new pacemaker was implanted: in one patient with endocardial leads, in the other two with epicardial leads. All three patients recovered well and follow up was uneventful for at least one year.- - - - - - - - - - ranking = 7keywords = infection (Clic here for more details about this article) |
8/553. Recurrent endocarditis in silver-coated heart valve prosthesis.BACKGROUND AND AIM OF THE STUDY: In order to prevent prosthetic valve endocarditis (PVE), the implantation of a new silver-coated sewing ring has been introduced to provide peri- and postoperative protection against microbial infection. methods: A 56-year-old woman with aortic stenosis had elective replacement with a St. Jude Medical mechanical valve fitted with a silver-coated sewing ring (Silzone). The patient developed early PVE, which necessitated reoperation after one month. Despite a second Silzone prosthesis being implanted, the endocarditis recurred. During a third operation an aortic homograft was implanted, and after six months a fourth operation was performed for a pseudoaneurysm at the base of the homograft, in proximity to the anterior mitral valve leaflet. RESULTS: The diagnosis of PVE was confirmed by the presence of continuous fever, transesophageal echocardiography and growth of penicillin-resistant staphylococcus epidermidis from the valve prosthesis. CONCLUSION: The implantation of all prosthetic valves is encumbered with a risk of endocarditis. Although silver has bacteriostatic actions, the advantages of silver-coated prostheses in the treatment of this condition have yet to be assessed in clinical trials.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
9/553. Destructive aortic valve endocarditis from brucella abortus: survival with emergency aortic valve replacement.brucella abortus infection of the aortic valve caused acute aortic regurgitation leading to severe left ventricular failure in a 62-year-old man. He made an excellent recovery after emergency aortic valve replacement. This is the third reported case of successful heart valve replacement for Brucella endocarditis and the second such case involving the aortic valve.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
10/553. Simultaneous surgery for infective endocarditis and endophthalmitis.A 54-year-old woman was diagnosed as having septicemia secondary to infective endocarditis with aortic regurgitation which was complicated by endophthalmitis. Her septicemia was controlled by intravenous antibiotic therapy. Then the localized eye infection and the aortic regurgitation with a massive vegetation were surgically treated simultaneously. She had no relapse of infection after intensive postoperative antibiotic therapy.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
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