1/66. Haemophilus aphrophilus endocarditis after tongue piercing.Piercing invades subcutaneous areas and has a high potential for infectious complications. The number of case reports of endocarditis associated with piercing is increasing. We studied a 25-year-old man with a pierced tongue, who arrived at Memorial health University Medical Center with fever, chills, rigors, and shortness of breath of 6 days' duration and had an aortic valvuloplasty for correction of congenital aortic stenosis.- - - - - - - - - - ranking = 1keywords = endocarditis (Clic here for more details about this article) |
2/66. Haemophilus segnis polymicrobial and monomicrobial bacteraemia identified by 16S ribosomal rna gene sequencing.This paper reports a case of Haemophilus segnis polymicrobial bacteraemia and a case of H. segnis monomicrobial bacteraemia identified by 16S ribosomal rna gene sequencing. In the first case, a gram-negative aerobic coccobacillus was isolated with streptococcus intermedius and S. sanguis from the blood culture of a 32-year-old intravenous drug addict with left thoracic empyema. In the second case, a gram-negative aerobic coccobacillus was isolated from the blood culture of an 82-year-old woman with clostridium difficile colitis and septicaemic shock. Both gram-negative coccobacilli grew on chocolate agar as colonies of 1 mm in diameter after incubation for 24 h at 37 degress C in air with CO2 5%, but only to pinpoint sizes on blood agar under the same incubation conditions. Both strains were factor v-dependent, but not factor x-dependent. For the first isolate, the Vitek system (NHI) showed that it was 56% likely to be actinobacillus actinomycetemcomitans and 40% neisseria subflava; whereas the API system (NH) showed that it was 58% likely to be H. aphrophilus/paraphrophilus and 42% H. parainfluenzae. For the second isolate, the Vitek system (NHI) showed that it was 95% likely to be H. influenzae VIII; whereas the API system (NH) showed that it was 58% likely to be H. aphrophilus/paraphrophilus and 42% H. parainfluenzae. 16S rRNA gene sequencing showed that there were four base differences between isolate 1 and H. segnis and two base differences between isolate 2 and H. segnis, indicating that both isolates most closely resembled a strain of H. segnis. Only two cases of H. segnis bacteraemia were found in the English scientific literature, one in a case of infective endocarditis and the other in a case of pancreatic abscess. Including the present two cases, the overall mortality of H. segnis bacteraemia was 50%.- - - - - - - - - - ranking = 0.2keywords = endocarditis (Clic here for more details about this article) |
3/66. HACEK endocarditis in infants and children: two cases and a literature review.We report 2 cases of haemophilus parainfluenzae endocarditis and review 34 cases of HACEK endocarditis from the literature. HACEK organisms are the most common cause of Gram-negative endocarditis in children. They have a propensity to form friable vegetations (especially H. parainfluenzae) that break off and cause symptomatic emboli. HACEK endocarditis (from a review of the 36 published cases) may involve previously normal hearts (33%), may be complicated by embolization (31%) and may require vegetectomy or other surgery (31%). mortality with HACEK endocarditis was 14%. HACEK organisms may be resistant to penicillins but are susceptible to third generation cephalosporins.- - - - - - - - - - ranking = 1.8keywords = endocarditis (Clic here for more details about this article) |
4/66. Haemophilus segnis: a rare cause of endocarditis.This report presents a case of endocarditis due to Haemophilus segnis, which represents a speciation difficulty for the routine laboratory. In this study, a molecular approach provided speciation, which was confirmed phenotypically by a reference laboratory. The use of molecular genotypic analysis is an additional strategy in the investigation of endocarditis. It has applications not only in isolate identification but also in primary detection of infection, particularly in patients whose blood is culture negative by conventional methodologies.- - - - - - - - - - ranking = 1.2keywords = endocarditis (Clic here for more details about this article) |
5/66. Hemophilus influenza infection of an implantable insulin-pump pocket.OBJECTIVE--To increase awareness of adverse events associated with the use of implantable insulin pumps. research design AND methods--A descriptive case report of a pump implant infection. RESULTS--This is a case report of one implanted insulin pump-pocket infection among a series of 15 patients. After exposure to a child with a respiratory infection on PID 30, V.L.C. (the patient) developed a fulminant pump-pocket infection. H. influenza was recovered from it. Despite aggressive antibiotic therapy, the infection could not be controlled. insulin delivery ceased, and the pump was explanted. The pump-pocket infection rapidly resolved with pump removal, permitting later reimplantation. CONCLUSIONS--We have adopted the american heart association indications and antimicrobial prophylaxis regimens recommended for prevention of endocarditis in patients with prosthetic values for patients with implanted insulin pumps.- - - - - - - - - - ranking = 0.2keywords = endocarditis (Clic here for more details about this article) |
6/66. Pacemaker lead infection secondary to haemophilus parainfluenzae.Cardiac device infections are a rare complication of pacing and defibrillator therapy. The number of implanted devices will likely continue to rise with increasing implantation of the cardioverter defibrillator and cardiac resynchronization devices. This report describes a case of an uncommon pathogen for device-associated endocarditis.- - - - - - - - - - ranking = 0.2keywords = endocarditis (Clic here for more details about this article) |
7/66. haemophilus parainfluenzae mitral prosthetic valve endocarditis in an intravenous drug abuser.Haemophilus species are an infrequent cause of subacute bacterial endocarditis. Of the Haemophilus species causing endocarditis, H. aphrophilus and H. parainfluenzae are more frequent causes of subacute bacterial endocarditis than H. influenzae. H. parainfluenzae requires growth factor v (nicotinamide adenine dinucleotide) and grows very slowly on routine culture media. H. parainfluenzae is a rare cause of "culture negative" endocarditis because it is a slow-growing organism. We present a case of a 42-year-old intravenous drug abuser with H. parainfluenzae mitral prosthetic valve endocarditis. To the best of our knowledge, this is the first case of mitral prosthetic valve endocarditis caused by H. parainfluenzae in an intravenous drug abuser.- - - - - - - - - - ranking = 2keywords = endocarditis (Clic here for more details about this article) |
8/66. Operative intervention in active endocarditis in children: report of a series of cases and review.We describe in detail 14 children (age, less than or equal to 19 years) who underwent operative intervention during active infection of the heart and/or great vessels. The series included five children less than 6 years old, who constitute 10% of all such cases reported in this age group to date. We also review the 132 published reports in which children underwent operative intervention during active endocarditis. We found the following: (1) The survival rate for all cases was 77%. (2) Persistent infection, embolic phenomena, and increasing congestive heart failure were the most frequent indications for operative intervention. (3) Survival rates were independent of the duration of preoperative antibiotic treatment. (4) Survival rates were independent of positive results of cultures of blood or tissue obtained at operation. (5) The perioperative mortality in our series was 14%. (6) Only 67% of patients had conditions thought to predispose to endocarditis. (7) Except for removal of catheter-associated cardiac masses from neonates, operative intervention in active endocarditis was uncommon among children less than 4 years old. (8) staphylococcus aureus and viridans streptococci were the etiologic agents in the majority of cases of endocarditis requiring operation during active infection in children.- - - - - - - - - - ranking = 1.6keywords = endocarditis (Clic here for more details about this article) |
9/66. Treatment of Haemophilus aphrophilus endocarditis with ciprofloxacin.A patient with Haemophilus aphrophilus endocarditis was successfully treated with ciprofloxacin. The response to treatment with cefotaxime and netilmicin for 12 days was poor but was satisfactory to a 6 weeks' course of ciprofloxacin.- - - - - - - - - - ranking = 1keywords = endocarditis (Clic here for more details about this article) |
10/66. Human immunodeficiency virus and infected aneurysm of the abdominal aorta: report of three cases.Three patients who were seropositive for human immunodeficiency virus underwent surgery for infected aneurysm of the abdominal aorta. fever and abdominal pain were the principal presenting clinical features. None of the patients had any opportunistic infections or endocarditis. In two cases, a ruptured aneurysm was demonstrated radiographically. In the remaining case, sonograms were diagnostic. The organisms responsible were salmonella, Hemophilus influenzae, and mycobacterium tuberculosis. In two cases, the infectious origin was evidenced by bacteriologic examination of the aortic wall, which revealed the presence of salmonella enteritidis and Koch's bacillus. Although Hemophilus influenzae was not found in the aortic wall of the remaining case, the infectious origin of the aneurysm was established because preoperative blood cultures were positive for this pathogen, and pathohistologic examination of the specimen showed destruction associated with leukocyte infiltration of the aneurysmal wall. An in situ prosthetic graft replacement protected by omentum was performed in all three cases. Antibiotic therapy was continued for several weeks. All patients are well with follow-up ranging from 10 to 21 months. Infectious aneurysm associated with human immunodeficiency virus seropositivity results in bacterial infestation of an atheromatous aorta. Infected phenomena are promoted by cellular immunodeficiency. Surgery was justified in these cases because of the immediate threat of rupture.- - - - - - - - - - ranking = 0.2keywords = endocarditis (Clic here for more details about this article) |
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