1/28. staphylococcus lugdunensis endocarditis.A case of staphylococcus lugdunensis endocarditis is presented with low back pain suggesting a secondary bone focus of infection. An umbilical skin lesion may have been an additional embolic phenomenon. The case highlights the aggressive nature of S lugdenensis endocarditis compared with other coagulase negative staphylococci and its association with native heart valves. In addition the importance of full identification of coagulase negative staphylococci isolated from patient samples in a case of suspected S lugdenensis infection is emphasised. Antibiotic treatment may be insufficient alone in the treatment of S lugdenensis endocarditis and early recourse to surgical intervention and valve replacement should therefore be considered.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/28. Acquired left ventricular-right atrial communication: Gerbode-type defect.Left ventricular-right atrial (LV-RA) communications are rare intracardiac defects, often congenital in nature and clinically apparent during childhood. Acquired LV-RA shunts are encountered occasionally in the adult population as a result of a defect in the upper portion of the membranous ventricular septum. We describe the clinical and echocardiographic features of an elderly patient with an acquired LV-RA communication in the setting of an aortic composite valve graft and endocarditis. We also review the anatomical features and hemodynamic consequences of such defects.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/28. The "surreptitious Staphylococcus": staphylococcus lugdunensis endocarditis in a child.A child with congenital heart disease developed infective endocarditis caused by staphylococcus lugdunensis. Despite an apparent excellent response to initial antibiotic treatment in clinical, inflammatory and echocardiographic indices, the patient's valve damage progressed silently and surgical intervention was required. This case highlights the potential for misidentification of S. lugdunensis, its usual susceptibility to penicillin and in particular the aggressive nature of endocarditis caused by this coagulase-negative staphylococcus. The epidemiology and treatment of endocarditis caused by this organism are reviewed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/28. Recurrent acute rheumatic fever: a forgotten diagnosis?The incidence of acute rheumatic fever has seen a dramatic decline over the last 15 to 20 years in most developed countries and treatment of this disease has changed little since. The ease of travel and immigration and the cosmopolitan nature of many cities mean that occasionally the disease will come to the attention of clinicians not familiar with its presentation, resulting in delayed diagnosis and treatment. We present a case of recurrent acute rheumatic fever in a patient who was initially thought to be suffering from acute bacterial endocarditis on her previously diseased rheumatic aortic valve. This culminated in her undergoing urgent aortic valve replacement during a phase of the illness that should have been treated with high dose anti-inflammatory medication. Therefore, clinicians should be aware of this condition and include it in their differential diagnosis of the febrile patient with a previous history of rheumatic fever. We briefly discuss the diagnostic dilemma of patients suffering from this condition and in differentiating it from acute endocarditis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/28. Three cases of destructive native valve endocarditis caused by staphylococcus lugdunensis.Described here are three cases of acute native valve endocarditis due to the coagulase-negative pathogen staphylococcus lugdunensis with serious complications. Two of the three patients died despite optimal antibiotic therapy and cardiovascular surgery. These cases demonstrate the aggressive nature of S. lugdunensis and emphasize the importance of identifying coagulase-negative staphylococci to the species level and not considering the isolation of S. lugdunensis from normally sterile body fluids as contamination. On the contrary, when this organism is found in patients with endocarditis, early surgery should be considered. The possibility that this organism could be misidentified as S. aureus because of "autocoagulation" and that commercial identification systems may misidentify it as S. haemolyticus, S. hominis or S. warneri should also be remembered.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/28. q fever endocarditis masquerading as Mixed cryoglobulinemia type II. A case report and review of the literature.BACKGROUND: The clinical manifestations of q fever endocarditis are protean in nature. Mixed cryoglobulinemia type II is rarely a facet of the presenting clinical manifestations of q fever endocarditis. CASE PRESENTATION: We report a case of a 65-year-old pensioner with such an association and review the literature. As transesophageal echocardiograms are usually normal and blood cultures are usually negative in q fever endocarditis, many of the manifestations (fever, rash, glomerulonephritis/evidence of renal disease, low serum C4 complement component, presence of mixed type II cryoglobulin, constitutional symptoms as arthralgias and fatigue) can be attributed to Mixed cryoglobulinemia type II per se. The use of Classic Duke endocarditis Service criteria does not always suffice for the diagnosis of q fever. CONCLUSION: The application of the modified criteria proposed by Fournier et al for the improvement of the diagnosis of q fever endocarditis will help to reach the diagnosis earlier and thus reduce the high mortality of the disease. We would like to stress the importance of ruling out the diagnosis of q fever endocarditis in cases of mixed type II cryoglobulinemia.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/28. q fever endocarditis: a case report and review of the literature.The case of a 31-year-old man from alberta diagnosed with q fever endocarditis is presented. To the authors' knowledge, this is the first case of q fever endocarditis diagnosed in the province of alberta. The patient had undergone open valvulotomy for congenital aortic stenosis as an infant. He presented with congestive heart failure secondary to severe aortic regurgitation and underwent mechanical aortic valve replacement. Early failure of the mechanical prosthesis and numerous laboratory abnormalities prompted an investigation for endocarditis, which was initially negative. Markedly positive serology eventually established the diagnosis of chronic q fever. The patient subsequently underwent a second aortic valve replacement following initiation of appropriate antimicrobials directed against coxiella burnetii. The present report reviews the clinical presentation and diagnosis of q fever endocarditis. It highlights the insidious and nonspecific nature of the presenting symptoms, and emphasizes the use of serology for diagnosis. Increased awareness and earlier diagnosis can significantly decrease the morbidity and mortality associated with this disease.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/28. abiotrophia defectiva: a rare cause of infective endocarditis.A case of abiotrophia defectiva-caused infective endocarditis is described. The patient was successfully treated with penicillin combined with gentamicin. Due to the fastidious nature of the agent, there is a need for special media for isolation and moreover, there is a need for a future development of susceptibility assays applicable to the organism.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/28. Septicemia and endocarditis caused by group G streptococci in a Norwegian hospital.The clinical and bacteriological features of septicemia caused by group G streptococci were analyzed in nine patients seen during a period of 28 months. Four of these patients had acute endocarditis with a high rate of serious neurological complications. The clinical response to antibiotic treatment was slow in the endocarditis patients despite sensitivity of the organism in vitro. Group G streptococcal septicemia can be a very serious condition associated with endocarditis of a destructive nature. Comparison with previous reports suggests that group G streptococcal infections are of increasing importance. The virulence of group G streptococci may be changing, resulting in more serious infections and complications. This series stresses the importance of prompt recognition of this infection and the need for aggressive management of these patients.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/28. Demonstration of the ascending aorta in infective endocarditis by intravenous digital subtraction angiography.Four patients with infective endocarditis were examined by digital subtraction angiography immediately before operation. In three a root abscess was suspected and the remaining patient was believed to have a false aneurysm at an infected aortic cannulation site. In all the cases digital subtraction angiography showed the structure in several projections and confirmed the presence of a cavity. Subsequent operation confirmed the site and nature of the lesions.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
| | Next -> |