Diagnosis and management of bacterial endocarditis in 2003

Murtagh, Blaithnead; Frazier, O. H.; Letsou, George V.

doi:10.1097/00001573-200303000-00006

Cited by 18 publications

(6 citation statements)

References 12 publications

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“…Although 20 to 30% of patients with infective endocarditis have no predisposing risk factors [1,2], this case involved rare clinical and anatomical abnormalities occurring simultaneously: ASA with PFO and right-sided infective endocarditis. The prevalence in the general population of ASA is 2-4%, and when associated with a PFO, it is up to 70% [3].…”

Section: Discussionmentioning

confidence: 89%

Dual-sided Infective Endocarditis due to Atrial Septal Aneurysm With Patent Foramen Ovale

Kondō¹,

Machizuka²,

Hirata³

et al. 2005

J Echocardiogr

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Right-sided infective endocarditis is generally known to occur in drug abusers and in patients with long indwelling venous catheters. Paradoxical cerebral embolization is a rare condition causing cerebrovascular accident. This patient had neither apparent drug history nor predisposing factors to infective endocarditis and systemic thromboembolism. It was a very rare case that was complicated not only by both-sided infective endocarditis but also by paradoxical embolism through a patent foramen ovale (PFO). CaseA 36-year-old female was admitted to our hospital for evaluation of 5 days of high fever of unknown origin and abrupt abnormal behavioral change associated with mental disturbance. Her vital signs were as follows: body temperature, 39.7 ; blood pressure, 120/80 mmHg; pulse, 140 bpm. On physical examination, the patient was drowsy and disoriented. Cardiac auscultation revealed a grade II pan-systolic murmur at the right sternal border. There were no prominent peripheral signs or neurological deficits. The chest Xray showed mild cardiomegaly and pulmonary artery dilation but she had no symptoms of heart failure. An abdominal CT showed a right iliopsoas abscess; a head CT showed a hematoma at the right frontal lobe, and edema of the brain stem and right occipital lobe. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) disclosed a huge vegetation of the tricuspid valve and an atrial septal aneurysm (ASA) with PFO that had a right to left shunt confirmed by intravenous bubble injection (Figure 1, 2). The mitral and aortic valve was not affected, and during color Doppler examination, no abnormal flow was detected. Additionally, methicillinsensitive Staphylococcus aureus was detected by blood culture. We diagnosed right-sided infective endocarditis complicated by systemic septic embolization and started large doses of two kinds of antibiotic therapy, as well as immediate management of mild right heart

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Section: Discussionmentioning

confidence: 89%

Dual-sided Infective Endocarditis due to Atrial Septal Aneurysm With Patent Foramen Ovale

Kondō¹,

Machizuka²,

Hirata³

et al. 2005

J Echocardiogr

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“…The resulting thrombus then is susceptible to seeding during normal transient episodes of bacteremia. 2 Many microorganisms, including bacteria and fungi, can infect the endocardial tissue. The most common pathogenic organism isolated in infective endocarditis is Staphylococcus aureus.…”

Section: Resident Discussionmentioning

confidence: 99%

“…3 Although most patients who develop endocarditis have a history of either underlying cardiac valvular disease or IVDU, as many as 30% of patients have no known underlying risk factors. 2 The modified Duke's Criteria currently are used to diagnose endocarditis ( Table 1). 4 This is divided into major and minor criteria.…”

Section: Resident Discussionmentioning

confidence: 99%

Clinicopathological Conference: Case Report—A Case of Anorexia and Weak Arm

Wiler

Bailey

2007

Academic Emergency Medicine

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The authors present the case of a 49-year-old female who presented to the emergency department with a chief complaint of ''not eating well.'' She was found to have a heart murmur, a focal neurological deficit, and large mitral valve vegetation. The patient was later diagnosed with acute Pseudomonal endocarditis with septic emboli to the brain, liver, spleen, and kidneys. A discussion of the patient presentation, diagnostic evaluation, and outcome are reviewed.

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“…Surgical therapy is recommended for patients with infective endocarditis who have congestive heart failure, perivalvular invasive disease, uncontrolled infection despite maximal antimicrobial therapy, or episodes of embolization with residual large vegetation (9,15,16). The highest incidence of embolic complication is observed in infective endocarditis due to hemolytic streptococcus C species as well as Staphyrococcus aureus, resulting in a high mortality rate (17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Infective Endocarditis and Acute Purulent Pericarditis in a Patient with Hyperglycemia

et al. 2005

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A diabetic patient was admitted to our hospital for infective endocarditis with acute purulent pericarditis and diabetic ketoacidosis. Echocardiography revealed attachment of vegetation to the chordae tendineae in the left ventricle and pericaridial effusion. The vegetation was enlarged and pendulated for a few days despite maximal antimicrobial therapy. Surgical resection was desirable to decrease the risk of embolic complications and cardiovascular collapse. We could not open the heart because of accumulation of purulent pericardial fluid, and right renal infarction was complicated. We believe that the immunocompromised and hypercoagulable state due to diabetes caused these conditions. (Internal Medicine 44: 666-670, 2005)

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Diagnosis and management of bacterial endocarditis in 2003

Cited by 18 publications

References 12 publications

Dual-sided Infective Endocarditis due to Atrial Septal Aneurysm With Patent Foramen Ovale

Dual-sided Infective Endocarditis due to Atrial Septal Aneurysm With Patent Foramen Ovale

Clinicopathological Conference: Case Report—A Case of Anorexia and Weak Arm

Infective Endocarditis and Acute Purulent Pericarditis in a Patient with Hyperglycemia

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