Focal neurologic deficits in infective endocarditis and other septic diseases

Bitsch, Andreas; Nau, R.; Hilgers, Reinhard; Verheggen, Raphaela; Werner, Gerald S.; Prange, Hilmar

doi:10.1111/j.1600-0404.1996.tb07066.x

Cited by 29 publications

(11 citation statements)

References 19 publications

(27 reference statements)

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“…Autopsy data have indicated that embolic meningoencephalitis is the fundamental neuropathological change in IE [26] and a continuum between vascular and infectious cerebral complications in endocarditis has been suggested [27,28] Staphylococcus aureus aetiology was a major risk factor for CVC in our study as has been shown previously [22]. Vegetation length was associated with a higher frequency of cerebral complications, but since most CVC were established before the first echocardiographic examination was performed, the implications of this finding to reduce the number of CVC in IE patients are limited.…”

Section: Discussionmentioning

confidence: 99%

Warfarin therapy and incidence of cerebrovascular complications in left-sided native valve endocarditis

Snygg‐Martin

Rasmussen

Hassager

et al. 2010

Eur J Clin Microbiol Infect Dis

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Anticoagulant therapy has been anticipated to increase risk of cerebrovascular complications (CVC) in native valve endocarditis (NVE). This study investigates the relationship between ongoing oral anticoagulant therapy and incidence of symptomatic CVC in left-sided NVE. In a prospective cohort study CVC incidence was compared between NVE patients with and without ongoing warfarin. Among 587 NVE episodes, 48 (8%) occurred in patients on warfarin. A symptomatic CVC was seen in 144 (25%) patients with only 3 on warfarin.CVC were significantly less frequent in patients on warfarin (6% vs. 26 %, OR 0.20, p=0.006).No increase in haemorrhagic lesions was detected in patients on warfarin. Staphylococcus aureus aetiology

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Section: Discussionmentioning

confidence: 99%

Warfarin therapy and incidence of cerebrovascular complications in left-sided native valve endocarditis

Snygg‐Martin

Rasmussen

Hassager

et al. 2010

Eur J Clin Microbiol Infect Dis

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“…Especially in the case of IE due to S. aureus, mortality is higher in prosthetic valve IE than in native valve IE. Effects of anticoagulant therapy can be deleterious [7,8]. In accordance with current guidelines for the treatment of brain abscess linezolid was chosen instead of the glycopeptides vancomycin or teicoplanin because the oxazolidinone linezolid has a much higher penetration into the cerebrospinal fluid and was shown to effectively cure staphylococcal CNS infections in several reports [9,10].…”

Section: Discussionmentioning

confidence: 99%

Septic embolic encephalitis after Staphylococcus aureus endocarditis of a prosthetic valve in a 57-year-old woman: a case report

Tönges

Pilgram‐Pastor

Puls

et al. 2009

Cases J

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For prosthetic heart valves the risk of infection is much higher than for native heart valves. During the course of infective endocarditis 20-40% of all patients suffer from cerebrovascular complications such as ischaemic stroke or intracerebral haemorrhage. We present the case of a 57-year-old woman who had undergone surgery to mechanically replace an aortic heart valve 11 months ago and suffered from repeated ischaemic strokes with secondary haemorrhage. The initial antibiotic regimen was ineffective in treating the later diagnosed Staphylococcus aureus infection of the prosthetic valve. Escalation of the antibiotic treatment was not able to halt the clinical course that finally led to the patient’s death. The case report emphasizes the importance of early identification of the aetiology of infection in patients with mechanical heart valve replacement. Without rapid and adequate treatment there is a considerable risk for the development of severe neurological sequelae and cardiac failure that can ultimately result in a fatal course of this clinical picture.

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“…CNS infections due to Klebsiella species such as septic embolic focal meningoencephalitis are a very rare condition, in particular in Western countries [1].…”

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confidence: 99%