Cases reported "Endocarditis, Bacterial"

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1/24. Allograft aortic root replacement for aortic valve endocarditis with aortopulmonary fistula.

    Acute infective endocarditis affecting the aortic root and valve associated with development of a fistulous communication between the aorta and pulmonary artery was presented in a young Turkish girl. Emergency surgery was required. Operation consisted initially of closure of the defect on the main pulmonary artery with a pericardial patch. This was followed by allograft aortic root replacement.
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2/24. Psychiatric issues in the management of patients with hiv infection.

    Approximately 1 million persons are now infected with human immunodeficiency virus (hiv) in the united states. Evidence exists that psychiatric disorders are common in patients with hiv and that these patients may not receive optimal care because their psychiatric disorders are a barrier to medical care, communication with clinicians, and adherence to medical recommendations. We describe herein a complex case seen at The Johns Hopkins Hospital with several psychiatric conditions that are common in our hiv clinic population. We describe the collaborative treatment of the patient by a multidisciplinary team including both medical and mental health practitioners. We briefly describe a coherent diagnostic and treatment approach to patients in hiv clinics and the supporting rationale from the literature. We discuss the need for comprehensive evaluation, a multidisciplinary treatment team, and therapeutic optimism.
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3/24. 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.
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4/24. erysipelothrix endocarditis.

    This communication describes the second reported Australian case of erysipelothrix endocarditis; after treatment with penicillin, the patient survived. It also gives up-to-date summary and brief discussion of the literature.
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5/24. Mycotic aneurysm: an uncommon cause for intra-cranial hemorrhage.

    Intra-cranial mycotic aneurysms due to an infective process elsewhere in the body constitute an uncommon cause of intra-cranial hemorrhage. The condition carries a grave prognosis. Mycotic aneurysms secondary to infective endocarditis (IE) rarely occur in children. This communication describes a seven-year-old girl who presented with fever and neurological abnormalities. She was diagnosed to have a mycotic aneurysm secondary to IE. Digital subtraction angiography (DSA) confirmed the diagnosis, delineated anatomical details and later detected the complete resolution of the aneurysm following conservative management with intravenous antimicrobial agents.
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6/24. Gerbode's defect resulting from infective endocarditis.

    We present a report of a Gerbode's defect (left ventricular-right atrial communication) resulting from bacterial endocarditis in a 63-year-old man. Also presented is a brief overview of the literature and a possible preoperative echocardiographic diagnostic criterion relating to this unusual condition.
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7/24. Aortic root abscess complicated by fistulization and intracerebral hemorrhagic infarction.

    We report an unusual case of a 12-year-old male with aortic root abscess complicated by fistulization and intracerebral hemorrhagic infarction. Transesophageal echocardiography provided exact information about the location and dimension. color-flow mapping demonstrated fistulous communication between the abscess and both the aorta and the left ventricle, causing severe diastolic regurgitation through the paravalvular leak. Pulmonary autograft aortic root replacement was performed with good result.
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8/24. Transoesophageal echocardiographic diagnosis of aortico-left atrial fistula in aortic valve endocarditis.

    Intra-cardiac fistulas are rarely seen and they are estimated to account for <1% of all cases of infective endocarditis. Fistulization of paravalvular abscesses has been found in 6% to 9% of cases. This is a report of an unusual communication between the abscess region in the aortic root and the left atrium. A 44-year-old patient diagnosed with infective endocarditis had continuous fevers despite antibiotic therapy. Transoesophageal echocardiography revealed multiple vegetations on aortic valve, fistulization of an aortic root abscess to the left atrium and mitral regurgitation and moderate aortic regurgitation. At surgery, multiple vegetations on the aortic valve and a large abscess cavity establishing direct communication between aortic root and the left atrial cavity through a fistulous tract were discovered. This experience demonstrates the improved sensitivity and specificity of transoesophageal echocardiography in defining periannular extension of infective endocarditis.
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9/24. Fatal ascending aorta-to-right ventricle fistula formation after staphylococcus aureus endocarditis of bicuspid aortic valve.

    We present a case of a 46-year-old man with advanced acquired immunodeficiency syndrome and congenitally bicuspid aortic valve endocarditis caused by methicillin- and gentamicin-resistant staphylococcus aureus. endocarditis led to root abscess formation, a complete heart block, and fistulous tract formation between the ascending aorta and the right ventricle. Although perivalvular abscess is not an unusual complication of native valve endocarditis, a fatal fistulous communication between the ascending aorta and the right ventricle is exceedingly rare.
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10/24. Mycotic aneurysms of aortic root and aorta-to-left atrial fistula complicating bicuspid aortic valve endocarditis.

    Unlike root abscess, fistula formation is quite uncommon in aortic valve endocarditis. In this report, we describe a patient with subacute bicuspid aortic valve endocarditis complicated by aortic insufficiency, mycotic aneurysms of the aortic root and fistulous communication between the aorta and the left atrium and his recovery upon surgical treatment.
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