1/23. diagnosis of cardiobacterium hominis endocarditis by broad-range PCR from arterio-embolic tissue.A case of culture-negative endocarditis is reported, in which the diagnosis of cardiobacterium hominis endocarditis was made from arterio-embolic tissue removed by percutaneous transluminal embolectomy by broadrange polymerase chain reaction amplification of the 16 rRNA gene, followed by single-strand sequencing.The use of this technique to identify etiologic agents from arterio-embolic material has not been reported so far. A serologic assay employing complement fixation against a crude antigen of cardiobacterium hominis confirmed the diagnosis of endocarditis caused by this unusual fastidious etiologic agent.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/23. glomerulonephritis due to staphylococcus aureus antigen.staphylococcus aureus antigen was identified within the glomeruli of a patient with acute bacterial endocarditis and diffuse glomerulonephritis. Routine immunofluorescence had revealed only granular deposits of complement (C3). C3 activator and C4 were not present. Direct immunofluorescence studies with a specific anti-staphylococcus aureus conjugate were positive. Electron microscopy showed subepithelial and intramembranous electron-dense deposits. Eluates of the kidney did not contain anti-S. aureus antibody. The absence of immunoglobin suggests that the toxic action of S. aureus antigens may activate complement and cause glomerular injury and that immune complexes are not essential for the production of glomerulonephritis in this entity.- - - - - - - - - - ranking = 6keywords = antigen (Clic here for more details about this article) |
3/23. q fever endocarditis: diagnostic approaches and monitoring of therapeutic effects.The scope of current diagnostic methods for q fever endocarditis includes serology, direct demonstration of coxiella burnetii in the resected heart valve tissue, and animal inoculation studies. Illustrated by a clinical case report, the different methods are presented and discussed. serology represents the primary method, using the techniques of complement fixation, indirect immunofluorescence, and enzyme-linked immunosorbent assay (ELISA). The latter two techniques allow the detection of immunoglobulins G, M, and A to the phase I and II antigens of C. burnetii. After cardiac surgery, we visualized C. burnetii on smears and specifically stained it on histologic sections of the resected heart valve by light and electron microscopic immunohistochemistry. In addition, seroconversion in animals after inoculation with valve specimens confirmed the presence of C. burnetii in the heart valve. The antibody titers determined by ELISA correlated well with the patient's clinical course during the treatment period. Therefore it is suggested that its usefulness for monitoring the efficacy of antimicrobial agents in patients with q fever endocarditis should be further evaluated.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/23. Normalization of cancer antigen 125 after mitral valve replacement in a patient with congestive heart failure due to mitral valve endocarditis.A 63-year-old woman with a history of uterine cancer was admitted to our hospital with dyspnea and stroke. echocardiography showed a huge vegetation attached to the posterior mitral leaflet with severe mitral regurgitation. blood culture identified streptococcus galactiae. The serum level of cancer antigen 125 (CA125) was elevated at 199.4 U/ml. Resection of infected tissue including mobile vegetation and replacement of mitral valve were performed. The postoperative course was uneventful and the patient was discharged after 4 weeks of antibiotic therapy. The values of CA125 returned to normal (less than 15 U/ml) on the 90th postoperative day. These findings have suggested that a high serum value of CA125 is a possible indicator of infection-related congestive heart failure.- - - - - - - - - - ranking = 5keywords = antigen (Clic here for more details about this article) |
5/23. Chronic q fever in the united states.Infections due to coxiella burnetii, the causative agent of q fever, are uncommon in the united states. Cases of chronic q fever are extremely rare and most often manifest as culture-negative endocarditis in patients with underlying valvular heart disease. We describe a 31-year-old farmer from west virginia with a history of congenital heart disease and recurrent fevers for 14 months who was diagnosed with q fever endocarditis based on an extremely high antibody titer against coxiella burnetii phase I antigen. Despite treatment with doxycycline, he continued to have markedly elevated coxiella burnetii phase I antibody titers for 10 years after the initial diagnosis. To our knowledge, this case represents the longest follow-up period for a patient with chronic q fever in the united states. We review all cases of chronic q fever reported in the united states and discuss important issues pertaining to epidemiology, diagnosis, and management of this disease.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
6/23. Urosepticemia and fatal endocarditis caused by aerococcus-like organisms.Two cases of invasive infections with aerococcus-like organisms (ALO) are presented: an 81-year-old man with fatal endocarditis and a 63-year-old man with urosepticemia. No antigenic relationship was found between ALO and aerococcus viridans (NCTC 8251) in crossed immunoelectrophoretic assay.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/23. T lymphocyte disorder after capnocytophaga ochracea endocarditis.capnocytophaga species are gram-negative rods which may cause disease in both non-immunocompromised and immunocompromised hosts. We describe a case of endocarditis due to capnocytophaga ochracea in a non-immunocompromised patient with a decrease of blood CD4/CD8 ratio and lymphocyte proliferative response to ConA during infection. in vitro experiments showed that C. ochracea decreased lymphocyte proliferation to mitogens (ConA, PHA), cell surface CD4 antigen and IL2 receptor expression on peripheral blood mononuclear cells (PBMC) from normal volunteers.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/23. Acute heart failure due to q fever endocarditis.We report a case of q fever endocarditis in a patient who presented with a slight pyrexia and acute cardiac failure due to aortic incompetence. The diagnosis was made by detecting high titres of serum IgG and IgA antibody against coxiella burnetii phase I antigens and confirmed by demonstrating C. burnetii on the excised aortic valve using immunofluorescence and electron microscopy. aortic valve replacement was followed by initially successful antibiotic treatment for 15 months. Reappearance of IgA anti-phase I antibodies 5 months later suggested continued presence of bacteria, although the patient's condition remained satisfactory. In endemic areas, such as rural southern france, q fever endocarditis should be considered when there is evidence of acute heart valve damage but are few other features of infection.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
9/23. Glomerular nephropathy associated with chronic q fever.Of three patients with coxiella burnetii endocarditis, two developed focal segmental proliferative glomerulonephritis (GN), and the third developed diffuse intracapillary proliferative glomerulonephritis. In one case, a good therapeutic response was followed by partial remission of the renal alterations, but 10 months later there were clinical and histological signs of active glomerular nephropathy, suggesting that the antigenic stimulus persisted. In another case, poor evolution of the infection was accompanied by clinically and histologically aggressive glomerular nephropathy, and advanced renal failure. The third patient, who had diffuse proliferative glomerulonephritis, underwent renal biopsy earlier than the other two cases, and the behavior of the nephropathy has not been aggressive to date. Immunohistopathologic study revealed a diffuse granular deposit of IgM and C3 in all three cases; the first two also presented a discrete linear IgG deposit in the capillary loops. Attempts to identify C burnetii antigen at the glomerular level by immunohistologic techniques failed in two patients. The literature on the association of chronic q fever with glomerulonephritis is briefly reviewed.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
10/23. q fever endocarditis: relapse five years after successful valve replacement for a first unrecognized episode.A 59-yr-old man presented with mitral endocarditis and negative blood cultures. antibodies to phase 2 and phase 1 antigens of Coxiella burneti were detected and a diagnosis of q fever endocarditis was made. Five years earlier, this patient had been successfully treated by aortic valve replacement for a first episode of endocarditis with negative blood cultures. Giemsa and Machiavello stains of the native aortic valve were made retrospectively and showed coccobacilli highly suggestive of Coxiella organisms. It is concluded that the first episode was q fever endocarditis and that the failure to recognize this aetiology at that time, and the absence of adequate medical therapy, is the cause of the present episode.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
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