The accelerated streptokinase regimen was well tolerated and resulted in a significantly higher coronary reperfusion rate and significantly lower mortality compared with the traditional regimen. The 0.75 streptokinase + enoxaparin combination was at least as efficacious as the 0.75 streptokinase + UFH combination and is preferred because of its ease of administration and predictable anticoagulant effect.
Infective endocarditis is a diagnostic challenge with a variety of clinical forms, acute or subacute onset and severe complications by septic embolism or manifestations of immune response with production of antigenantibody complexes. We present a 63-year-old adult case, diagnosed with chronic renal failure, a month before admission to „Dr. Victor Babeş“ Clinical Hospital of Infectious and Tropical Diseases and transferred with suspicion of bacterial endocarditis on native valve. Diagnosis is confirmed by presence of two major Duke criteria: echocardiographic demonstrated valvular involvement, and identification of the pathogen agent – Streptococcus mutans in blood cultures. After completing four weeks of antibiotic treatment, surgical intervention was required. Surgery has been performed, and prosthetic valve in mitral position was used. The patient returns to the clinic for antibiotic treatment (consolidation) for two weeks. After the patient has been discharged, he neglected cardiology treatment administration, leading to a hemorrhagic stroke and irreversible cardiopulmonary arrest. The specific feature of the case lies in the fact that kidney damage was the main onset event of subacute bacterial endocarditis.
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