Cases reported "Endocarditis, Bacterial"

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11/21. Imaging infection with 18F-FDG-labeled leukocyte PET/CT: initial experience in 21 patients.

    The aim of this study was to assess the feasibility and the potential role of PET/CT with (18)F-FDG-labeled autologous leukocytes in the diagnosis and localization of infectious lesions. methods: Twenty-one consecutive patients with suspected or documented infection were prospectively evaluated with whole-body PET/CT 3 h after injection of autologous (18)F-FDG-labeled leukocytes. Two experienced nuclear medicine physicians who were unaware of the clinical end-diagnosis reviewed all PET/CT studies. A visual score (0-3)-according to uptake intensity-was used to assess studies. The results of PET/CT with (18)F-FDG-labeled white blood cell ((18)F-FDG-WBC) assessment were compared with histologic or biologic diagnosis in 15 patients and with clinical end-diagnosis after complete clinical work-up in 6 patients. RESULTS: Nine patients had fever of unknown etiology, 6 patients had documented infection but with unknown extension of the infectious disease, 4 patients had a documented infection with unfavorable evolution, and 2 patients had a documented infection with known extension. The best trade-off between sensitivity and specificity was obtained when a visual score of >or=2 was chosen to identify increased tracer uptake as infection. With this threshold, sensitivity, specificity, and accuracy were each 86% on a patient-per-patient basis and 91%, 85%, and 90% on a lesion-per-lesion basis. In this small group of patients, the absence of areas with increased WBC uptake on WBC PET/CT had a 100% negative predictive value. CONCLUSION: Hybrid (18)F-FDG-WBC PET/CT was found to have a high sensitivity and specificity for the diagnosis of infection. It located infectious lesions with a high precision. In this small series, absence of areas with increased uptake virtually ruled out the presence of infection. (18)F-FDG-WBC PET/CT for infection detection deserves further investigation in a larger prospective series.
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keywords = infectious disease
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12/21. The first pediatric case of staphylococcus aureus with heterogenous resistant to vancomycin endocarditis in thailand.

    staphylococcus aureus with reduced susceptibility to vancomycin has been reports worldwide. Here we report the first pediatric case of heterogeneous vancomycin intermediate resistance Staphylacoccus aureus (hVISA) causing endocarditis in thailand. A 4 months old girl with truncus arteriosus type IV and ventricular septal defect developed methicillin-resistant S. aureus (MRSA) bacteremia and endocarditis after total repair operation. The patient did not respond to combination antimicrobial treatment including vancomycin. The strain was susceptible to trimethoprim-sulfamethoxazole and vancomycin by conventional antimicrobial susceptibily test. The vancomycin minimal inhibitory concentration by E-test was 2 microg/ml. The strain was judged to be possible heteroresistant when screening was done by one-point population analysis. The subsequent population analysis and testing for the emergence of mutants with reduced susceptible to vancomycin confirmed that this strain was hVISA. Despite the treatment with vancomycin, amikacin, rifampicin and cotrimoxazole, the patient died. hVISA should be suspected in MRSA infections that were refractory to vancomycin therapy could be due to. The emergence hVISA underscored the importance of the prudent use of antibiotics, the laboratory capacity to identify MRSA and hVISA and proper communication with treating clinicians, and the meticulous infection-control measures to prevent transmission.
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ranking = 0.016951988824146
keywords = transmission
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13/21. A case of guillain-barre syndrome following staphylococcus aureus endocarditis.

    guillain-barre syndrome (GBS) is the most important cause of acute neuromuscular paralysis in western countries and it is preceded in almost all cases by an infectious disease such as campylobacter jejuni or cytomegalovirus. However, GBS associated with previous bacterial endocarditis is very rare. We report the case of a 74-year-old man with GBS following staphylococcus aureus endocarditis affecting aortic valve. Although the absolute incidence of GBS is low, the present case stresses the need to consider GBS in patients developing neurological symptoms following any infectious illness, such as endocarditis, and highlights the challenging problem of rehabilitation and surgical management in these patients.
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keywords = infectious disease
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14/21. Cytoplasmic antineutrophil cytoplasmic antibody positive pauci-immune glomerulonephritis associated with infectious endocarditis.

    Renal deterioration often occurs in cases of infectious endocarditis (IE), but, IE- associated nephritis with rapidly progressive glomerulonephritis (RPGN) is rare. patients with severe infection (e.g., IE) sometimes show positivity for cytoplasmic antineutrophil cytoplasmic antibodies (C-ANCA). Therefore, diagnosis and treatment are very difficult in cases of RPGN with IE and positivity for C-ANCA. Such cases are rare, only 12 have been reported in the English literature. Herein, we describe the case of a 50-year-old man who presented with RPGN with IE and tested positively for C-ANCA. He was referred to our hospital because of leg edema, purpura and renal dysfunction. Laboratory tests revealed serum creatinine elevation and positivity for C-ANCA and proteinase 3-specific (PR3)-ANCA. RPGN and acute renal failure were diagnosed. Hemodialysis and steroid therapy were started. streptococcus oralis was isolated by blood culture. Transthoracic echocardiography revealed grade III mitral valve insufficiency with two vegetations. Therefore, IE was diagnosed. The steroid therapy was stopped, and antibiotic therapy was begun. Because there was no improvement, surgical therapy was performed. The operation was successful, but the patient died of brain hemorrhage. Our experience in this case indicates C/PR3-ANCA positive RPGN must be ruled out in patients with infectious disease, particularly IE, together with renal symptoms, and renal biopsy should be performed.
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keywords = infectious disease
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15/21. Henoch-Schonlein purpura complicating staphylococcal endocarditis in a heroin addict.

    A 21-year-old heroin addict with right-sided staphylococcal endocarditis developed skin purpura, abdominal pain, bloody diarrhea, proteinuria and microscopic hematuria. skin biopsy showed leukocytoclastic vasculitis with IgA deposits in dermal vessels and renal biopsy disclosed proliferative glomerulonephritis with granular mesangial IgA and fibrinogen deposition. These features are typical of Henoch-Schonlein purpura. Symptoms abated spontaneously. Since the syndrome appeared during cloxacillin therapy, both this drug or the infectious disease itself could have triggered the immune response. Henoch-Schonlein purpura is a distinct clinical entity that can complicate the course of staphylococcal endocarditis.
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keywords = infectious disease
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16/21. A scanning and transmission electron microscopic study of an infected endocardial pacemaker lead.

    We studied the pacemaker lead that had been removed from a patient who suffered three sequential episodes of staphylococcus aureus bacteremia. This organism was recovered from the surface of the lead. Scanning electron microscopy showed differential colonization of the pacemaker lead. The metal tip, the inner surface and the internal wires were covered with a heavy biofilm of bacteria. The outer silastic surface had no biofilm adherent to it; instead, well-spaced bacterial cells were seen. These observations illustrate why infection of implantable devices persists despite intensive antibiotic chemotherapy.
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ranking = 0.067807955296584
keywords = transmission
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17/21. endocarditis from human-to-human transmission of staphylococcus aureus.

    endocarditis due to Staphlyococcus aureus developed in two drug abusers who used the same paraphernalia for parenteral injections. The phage type of the organism isolated from the blood and nasal secretions of the first patient was identical to that of the organism isolated from the blood of the second patient. The epidemiologic and microbiologic data from our cases indicate human-to-human transmission of the responsible agent.
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ranking = 0.08475994412073
keywords = transmission
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18/21. In vivo endogenous spore formation by coxiella burnetii in q fever endocarditis.

    AIMS--To determine whether coxiella burnetii, the aetiological agent of q fever, undergoes endogenous spore-like formation, the crucial stage of the developmental cycle, in the infected cardiac valves of patients with chronic q fever endocarditis. methods--Surgically removed valves from three cases of q fever endocarditis were processed for electron microscopy. Sections were stained with potassium permanganate and uranyl acetate before being extensively examined by transmission electron microscopy. RESULTS--In all three cases endogenous spore-like formation was seen in the infected cardiac valves. CONCLUSIONS--As the factors that govern sporogenesis in C burnetii are still largely unknown, it is uncertain how important are the implications of the discovery of endogenous spore-like formation in q fever endocarditis. However, this finding may add new dimensions to current thinking about the treatment of chronic q fever.
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ranking = 0.016951988824146
keywords = transmission
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19/21. Molecular analysis provides evidence for human to human transmission of staphylococcus aureus endocarditis in non-drug abusers.

    Two cases of invasive staphylococcus aureus are reported in which human to human transmission resulted in primary bacteremia and endocarditis. The identity of the organism was confirmed by phage typing, antibiograms, coagulase gene polymorphisms and ribotyping. This is the first documented case of such transmission not involving an intravenous drug abuser.
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ranking = 0.10171193294488
keywords = transmission
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20/21. Infective endocarditis following human-to-human enterococcal transmission: a complication of intravenous narcotic abuse.

    Two heroin addicts, husband and wife, who shared injection paraphernalia extensively, developed enterococcal endocarditis within six weeks of one another. The etiologic organisms were of the same subspecies and had identical antibiotic susceptibilities and biochemical profiles. The clinical, epidemiologic, and bacteriologic data strongly suggest human-to-human transmission of the pathogen.
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ranking = 0.08475994412073
keywords = transmission
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