1/430. 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 = heart (Clic here for more details about this article) |
2/430. 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 = 0.8keywords = heart (Clic here for more details about this article) |
3/430. 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 = 0.2keywords = heart (Clic here for more details about this article) |
4/430. Echocardiographic features of an unusual case of aortic valve endocarditis.In a patient with aortic valve endocarditis a myocardial abscess, complete heart block and acute aortic regurgitation developed. echocardiography gave evidence of large aortic valve vegetations, and at operation vegetations were found to have destroyed the right coronary cusp and part of the noncoronary cusp. Following surgery the patient recovered. echocardiography may prove to be a useful noninvasive technique to aid in the timing of surgical therapy in patients with valvular vegetations.- - - - - - - - - - ranking = 0.2keywords = heart (Clic here for more details about this article) |
5/430. Severe prosthetic valve-related endocarditis following dental scaling: a case report.There is a well-known correlation between surgical dental procedures and the risk of bacterial endocarditis in patients with prosthetic cardiac valves. A 43-year-old patient with prosthetic aortic and mitral valves, which already have been removed twice because of endocarditis, suffered from a prosthetic valve-related endocarditis following dental scaling, which was performed without any antibiotic prophylaxis. Invasive medical procedures in patients with prosthetic heart valves may lead to endocarditis. antibiotic prophylaxis is recommended even for dental procedures considered to be "harmless," such as dental scaling.- - - - - - - - - - ranking = 0.2keywords = heart (Clic here for more details about this article) |
6/430. Post-parturition infectious endocarditis in a patient with a normal mitral valve.A 29-year-old woman with no history of heart disease was admitted for the treatment of congestive heart failure. Six months earlier, she had given birth, then 20 days later developed a fever and cardiac failure ensued. An echocardiogram demonstrated severe mitral valve regurgitation. Her blood cultures were positive, and we made a diagnosis of mitral valve regurgitation due to infectious endocarditis. Despite treatment for congestive heart failure and antibiotic therapy, resulting in negative blood cultures, her congestive heart failure did not improve, and vegetation on the mitral valve was observed by echocardiography. We successfully removed the infected tissue with mitral valve plasty.- - - - - - - - - - ranking = 0.8keywords = heart (Clic here for more details about this article) |
7/430. aortic valve replacement after retrosternal gastric tube reconstruction for esophageal cancer.A 59-year-old man with a history of the thoraco-abdominal esophagus resection with retrosternal gastric tube reconstruction for esophageal cancer complicated by anastomosis leakage and purulent pericarditis was admitted for aortic regurgitation due to infective endocarditis. Floppy vegetation and worsening cardiac failure indicated aortic valve replacement. In a median sternotomy approach, the thickest adhesion between the cervical esophagus and posterior surface of the manubrium sternae was freed using an ultrasonic osteotome. Severe adhesions in the pericardium due to purulent pericarditis were found. Median sternotomy enabled minimal exposure of the aortic root, upper right atrium, and right superior pulmonary vein for instituting extracorporeal circulation and replacing the aortic valve. The patient's postoperative course was uneventful. For cardiac surgery in patients with a retrosternal gastric tube, left anterior or right thoracotomy may be considered to avoid gastric tube injury. Median sternotomy, however, is an alternative enabling safe heart exposure, and the ultrasonic osteotome was very useful in incising the sternum without injuring the cervical esophagus, which had no serosa.- - - - - - - - - - ranking = 0.2keywords = heart (Clic here for more details about this article) |
8/430. Whipple endocarditis without overt gastrointestinal disease: report of four cases.BACKGROUND: Cardiac manifestations of whipple disease are rarely diagnosed before death. OBJECTIVE: To describe four patients with endocarditis caused by tropheryma whippelii who did not have overt gastrointestinal disease. DESIGN: Case series. SETTING: Five hospitals in eastern switzerland. patients: Three men and one woman undergoing replacement of insufficient heart valves. MEASUREMENTS: Histologic characteristics of heart valves and intestinal biopsy; broad-range and specific polymerase chain reaction for T. whippelii. RESULTS: tropheryma whippelii was found in the heart valves (three aortic valves and one mitral valve) of four patients with culture-negative endocarditis necessitating valve replacement. All patients had arthralgia for different lengths of time. Only one patient had mild gastrointestinal symptoms. Histologic characteristics of intestinal mucosa were normal in all patients, and polymerase chain reaction on intestinal biopsy was positive for T. whippelii in only one patient, who did not have diarrhea. In all patients, arthralgia resolved promptly after institution of antibiotic therapy. Disease did not recur in any patient after prolonged antibiotic therapy with cotrimoxazole. CONCLUSION: In patients with culture-negative endocarditis, the absence of clinical, microscopic, or microbiological evidence of gastrointestinal disease did not rule out T. whippelii.- - - - - - - - - - ranking = 0.6keywords = heart (Clic here for more details about this article) |
9/430. endocarditis caused by group A beta-hemolytic streptococcus in an infant: case report and review.Acute bacterial endocarditis in the absence of underlying heart disease is rare. We report the occurrence of endocarditis caused by group A beta-hemolytic streptococcus (GABHS), following varicella, in a 5-month-old child without heart disease. In addition to this child, seven other children with endocarditis caused by GABHS have been reported since 1966, six of whom did not have preexisting heart disease. In one of these children, GABHS endocarditis was preceded by varicella. These cases indicate that GABHS is capable of causing endocarditis in the absence of heart disease, and they provide further evidence that varicella is an important risk factor for invasive GABHS infections.- - - - - - - - - - ranking = 0.8keywords = heart (Clic here for more details about this article) |
10/430. Staphylococcus capitis endocarditis: two cases and review of the literature.coagulase negative staphylococci are the principal cause of prosthetic valve endocarditis but are a rare cause of native valve infections. However, the incidence of native valve endocarditis is increasing. Staphylococcus capitis is a coagulase negative staphylococcus with the capacity to cause endocarditis on native heart valves. Two cases of native valve endocarditis caused by S capitis are presented; both in patients with aortic valve disease. The patients were cured with prolonged intravenous vancomycin and rifampicin and did not need surgery during the acute phase of the illness. Five of the six previously described cases of endocarditis caused by this organism occurred on native valves and responded to medical treatment alone.- - - - - - - - - - ranking = 0.2keywords = heart (Clic here for more details about this article) |
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