Testicular swelling with pneumonia and septicaemia: a rare presentation of right-sided endocarditis

Muthukumaran, Chinnasamy Sivaprakasam; Govindaraj, Poonamallee; Vettukattil, Joseph J.

doi:10.1017/s1047951105001459

Cited by 4 publications

(3 citation statements)

References 3 publications

(4 reference statements)

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“…The clinical presentation of RSE often involves fever accompanied by respiratory signs and symptoms secondary to septic emboli to the lungs 3,4,17. Due to this unique clinical presentation the diagnosis of RSE is often delayed 18.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Clinical Characteristics and Prognosis in Patients with Right- and Left-sided Infective Endocarditis

Stavi¹,

Brandstaetter²,

Sagy³

et al. 2019

Rambam Maimonides Med J

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Objective: Right-sided endocarditis (RSE) accounts for 5%-10% of all cases of infective endocarditis (IE) and frequently has different etiological, pathogenetic, and clinical presentations compared with left-sided endocarditis (LSE). The aims of this study were to evaluate the epidemiologic and clinical characteristics and prognosis of RSE patients and to compare them with those of LSE patients. This study's importance relates to the local understanding of RSE and LSE, since Israeli demographics are different compared to the Unites States and Europe with regard to intravenous drug abuse and rheumatic valvular disease prevalence. Material and Methods:A retrospective cohort study of 215 patients with infective endocarditis was performed. The primary outcome was in-hospital mortality. The secondary outcomes were duration of hospitalization, recurrent hospitalization, recurrent infective endocarditis, and one-year mortality. Results:Of the 215 patients in the study, 176 had LSE and 39 had RSE. The RSE patients were younger than the LSE patients (48.1±18.9 years versus 61.8±17.0 years, P<0.001). The most common pathogen in both groups was Staphylococcus aureus, which occurred more in the RSE group (51%) versus the LSE group (19%). In-hospital mortality was lower among patients with RSE (2.6% versus 17%, P<0.037). Comparison of Right-and Left-sided Endocarditis

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Section: Introductionmentioning

confidence: 99%

Comparison of Clinical Characteristics and Prognosis in Patients with Right- and Left-sided Infective Endocarditis

Stavi¹,

Brandstaetter²,

Sagy³

et al. 2019

Rambam Maimonides Med J

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“…However, the authors believe that at least a brief overview of this under-recognized topic is warranted. In terms of testicular involvement, symptomatic presentation, including swelling, has been reported in conjunction with right-sided endocarditis [107]. It is thought that the this unusual clinical picture may result from SE [52,107].…”

Section: Reproductive Organsmentioning

confidence: 99%

“…In terms of testicular involvement, symptomatic presentation, including swelling, has been reported in conjunction with right-sided endocarditis [107]. It is thought that the this unusual clinical picture may result from SE [52,107]. In another case, pneumococcal pulmonary valve endocarditis has been circumstantially linked to epididymo-orchitis and a scrotal abscess [108], although the directionality of causation may be difficult to prove except for the fact that Streptococcus pneumoniae isolated from the epididymo-orchitis is seldom a primary cause of scrotal infection.…”

Section: Reproductive Organsmentioning

confidence: 99%

Septic Embolism in Endocarditis: Anatomic and Pathophysiologic Considerations

Yellapu¹,

Ackerman²,

Longo³

et al. 2018

Advanced Concepts in Endocarditis

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Septic embolism is a relatively common and potentially severe complication of infective endocarditis (IE). Septic emboli (SE), most often described as consisting of a combination of thrombus and infectious material-either bacterial or fungal-can be caused by hematogenous spread from virtually any anatomic site; however, it most commonly originates from cardiac valves. During the past two decades there has been a confluence of various risk factors that, both alone and in combination, led to greater incidence of both IE and SE, including increasing population age, greater use of prosthetic valves, implantation of various intracardiac devices, escalating intravenous drug use, and the high incidence of healthcare associated infections with antibiotic resistant microorganisms. From a clinical standpoint, SE can present at any time during the course of IE and may even be the initial presenting sign. SE may affect virtually any location in the human body, but some organs (e.g., liver, spleen, brain) and anatomic regions (e.g., lower extremity) tend to be more frequently involved. The most important aspect of management involves prompt recognition and proactive therapeutic approach. Given the broad spectrum of clinical presentations, symptoms and complications, SE can be challenging to diagnose and treat. Following the identification of SE, appropriate antibiotic coverage should be immediately instituted followed by supportive and/or interventional management, depending on the severity of presentation and the associated complications. In this chapter we explore the pathophysiology, anatomic origins, diagnostic tools, therapeutic measures, and new developments in SE, focusing predominantly on bacterial infections of cardiac origin.

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