Infektiöse Endokarditis

Knebel, Fabian; Frumkin, David; Flachskampf, Frank A.

doi:10.1055/a-1028-3806

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…Infective endocarditis (IE) is still a life-threatening disease with a high morbidity and mortality. To date, in Germany the incidence of an acute IE is about 11.6/100.000 residents with an intrahospital mortality of 17% [1,2]. Therefore, the early diagnosis of an IE with beginning of an appropriate anti-infective therapy is crucial.…”

Section: Introductionmentioning

confidence: 99%

Case Report of Abiotrophia Defectiva Endocarditis: Treatment of Severe Mitral Regurgitation and Anemia in a Jehovah’s Witness Patient

2024

Ann Case Report

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Background:We report a case of a 50-year-old Jehova´s Witness male with Abiotrophia defectiva endocarditis on the mitral valve (MV) with severe mitral regurgitation (MR), multiple septic emboli and accompanying anemia. Due to his religious beliefs, he strictly refused blood transfusion. The aim of this case is to show that with an individual preoperative management a surgical valve replacement without blood transfusion is feasible.Case Summary: Our patient presented with a 6-month history of B-symptoms, abdominal pain and shortness of breath. In clinical examination cardiac murmur was found, ultrasound showed splenomegaly with suspicion of segmental splenic infarct which was confirmed by magnetic resonance imaging (MRI). A severe MR with multiple vegetation's was found by transthoracic echocardiogram (TTE) and trans-oesophageal echocardiogram (TEE). Multiple blood culture samples detected the streptococcus Abiotrophia defectiva. First, a calculated antibiotic treatment was initiated and as the patient refused blood transfusion, an additional iron treatment as well as recombinant human erythropoietin substitution were performed to address the anemia. Finally, the patient underwent open cardiac surgery with biological valve replacement using autologous transfusion. Following surgery, he showed regular function of the MV-prothesis by TTE up to 24 months postoperative.Discussion: Infective endocarditis (IE) is mostly caused by common pathogens like staphylococcus aureus, streptococcus viridans and enterococcus faecalis. Nevertheless, multiple rare pathogens are described to provoke IE. In our case the streptococcus Abiotrophia defectiva, belonging to the natural environment of the oral cavity, the gastrointestinal and urogenital tract, was found. Due to its slow growing rate, its identification is challenging. As our patient refused blood transfusion and early surgical valve replacement, but showed hemodynamic stability we could develop this individual therapeutic management with intravenous antibiotics as well as iron and erythropoietin substitution to achieve operability.

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Section: Introductionmentioning

confidence: 99%

Case Report of Abiotrophia Defectiva Endocarditis: Treatment of Severe Mitral Regurgitation and Anemia in a Jehovah’s Witness Patient

2024

Ann Case Report

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“…Infective endocarditis (IE) is a serious diagnosis that occurs around 30 new cases per million worldwide, it is a challenging condition that requires the most attention for early diagnosis and proper treatment [1][2][3]. IE can occur following valvular problems and other heart surgeries and devices and leads to fatal cardiac and non-cardiac manifestations.…”

Section: Introductionmentioning

confidence: 99%

Recurrent culture-negative endocarditis and osteomyelitis caused by Q fever in Iran, a case report

Moradi

Kanafgorabi

Larti

et al. 2022

Preprint

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Background: Endocarditis is an infection of the endocardial layer of the heart known as fatal infection. Gold standard diagnosis of infectious endocarditis is blood culture, which in some cases can be negative. In blood culture-negative endocarditis, the early diagnosis, and treatment are much harder, which can increase morbidities and also mortality. Case presentation: In this case report we are presenting a patient with intermittent fever for three months with a history of aortic and pulmonary valve replacement and also recurrent blood culture-negative endocarditis. According to the pandemic situation, we checked the Covid-19 PCR and also performed a chest computed tomography (CT) -scan, which both were negative and did not represent any pathologic conditions. Other examinations such as transesophageal echocardiography (TEE) and blood cultures were all normal and the only abnormal finding we had was a positron emission tomography (PET) - CT scan with endocarditis and sternum osteomyelitis evidence. Conclusion: After several evaluations based on endemic epidemiology, the Real-time PCR and IFA (IgG phase I; 1:16384, IgG phase II; 1:16384) were positive for Q fever and the patient responded to the proper doxycycline and hydroxychloroquine treatment.

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“…This uncommon infection usually affects the native or prosthetic heart valve, endocardial surface, and indwelling cardiac devices [3]. Although the one-year mortality rate of IE has not altered for decades [4], the associated morbidity (15/1000000 in the USA) and mortality (10%-30% worldwide) remain high [5], and considerably worse than several cancer outcomes.…”

Section: Introductionmentioning

confidence: 99%

Association Between Elevated Cardiac Troponin Level and Clinical Outcomes in Patients with Infective Endocarditis: A Meta-Analysis

Chai

et al. 2021

Preprint

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Background: Infective endocarditis is a serious infection associated with high mortality. Timely intervention is paramount to achieve a favorable prognosis in patients with Infective endocarditis. At present, the correlation between cardiac troponin level and Infective endocarditis prognosis is not well established.Methods: Pubmed, Embase, and Cochrane databases were systematically searched for studies examining the relationship between elevated serum cardiac troponin concentration and prognosis in patients with IE. Literature screening, data extraction and quality appraisal were undertaken by two independent reviewers.Results: A total of 7 relevant studies were included in this study. Patients with elevated troponin were significantly associated with higher incidences of in-hospital mortality [OR=5.87, 95% CI (3.37,10.21)], one-year mortality [OR=3.28, 95% CI (1.01,10.62)], surgery or valve replacement [OR=2.18, 95% CI (1.36,3.51)], symptoms of central nervous system (CNS) [OR=3.28, 95% CI (1.01,10.62)], and cardiac abscesses [OR=3.28, 95% CI (1.01,10.62)]. There was no significant correlation between elevated troponin and incidence of renal failure, embolization, or cerebrovascular events in patients with Infective endocarditis.Conclusion: Elevated cardiac troponin in patients with Infective endocarditis is associated with higher risks of several adverse clinical outcomes. Therefore, these patients would warrant a more aggressive approach and early intervention in clinical management to improve prognosis.

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Infektiöse Endokarditis

Cited by 3 publications

References 10 publications

Case Report of Abiotrophia Defectiva Endocarditis: Treatment of Severe Mitral Regurgitation and Anemia in a Jehovah’s Witness Patient

Case Report of Abiotrophia Defectiva Endocarditis: Treatment of Severe Mitral Regurgitation and Anemia in a Jehovah’s Witness Patient

Recurrent culture-negative endocarditis and osteomyelitis caused by Q fever in Iran, a case report

Association Between Elevated Cardiac Troponin Level and Clinical Outcomes in Patients with Infective Endocarditis: A Meta-Analysis

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