ABSTRACT
Se presenta el caso clínico de un paciente de 53 años que tras una intervención neuroquirúrgica (laminectomía) presentó cuadro séptico. Se identificó la presencia de S. lugdunensis en la herida operatoria. El ecocardiograma transesofágico demostró rotura valvular mitral, vegetaciones e insuficiencia mitral masiva. El paciente se recuperó satisfactoriamente tras reemplazo valvular por prótesis mecánica.
A 53 year old man developed sepsis following laminectomy for spinal disease. S lugdunensis was identified from the surgical wound. Trans esophageal echocardiography demonstrated mitral valve rupture, vegetations and severe mitral regurgitation. The patient successfully recovered following mitral valve replacement with a mechanical prosthesis.
Subject(s)
Humans , Male , Middle Aged , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/therapy , Staphylococcal Infections/diagnosis , Staphylococcal Infections/therapy , Anti-Bacterial Agents/therapeutic use , Cross Infection , Heart Valve Prosthesis Implantation/methods , Staphylococcus lugdunensis/isolation & purification , Mitral Valve/surgery , Mitral Valve/microbiologyABSTRACT
Patients diagnosed with multiple myeloma are more susceptible to infections which are the major causes of morbidity and mortality associated to this disease. The main infectious agents involved are Gram-positive bacteria. However, after chemotherapy an increase in the incidence of Gram-negative strains is observed. These bacteria are also responsible for most cases of urinary tract infections. Here is reported a rare case in a 73-year-old man with multiple myeloma who developed endocarditis due to pseudomonas.
Pacientes diagnosticados com mieloma múltiplo são mais suscetíveis a infecções, que é a principal causa de morbidade e mortalidade associadas a essa doença. Os principais agentes infecciosos envolvidos são as bactérias Gram-positivas, mas, após a quimioterapia, pode haver aumento na incidência de Gram-negativos, que são responsáveis, na maioria dos casos, por infecções do trato urinário. Assim, descrevese um raro caso de um paciente de 73 anos de idade, com mieloma múltiplo diagnosticado com endocardite por pseudomonas.
Subject(s)
Aged , Humans , Male , Endocarditis, Bacterial/microbiology , Mitral Valve/microbiology , Multiple Myeloma/complications , Pseudomonas Infections/complications , Magnetic Resonance SpectroscopySubject(s)
Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Fluconazole/therapeutic use , Humans , Immunologic Deficiency Syndromes/complications , Immunologic Deficiency Syndromes/immunology , Infant , Mitral Valve/microbiology , Female , Mitral Valve/pathology , Mitral Valve/diagnostic imaging , Mitral Valve Insufficiency/microbiology , Mitral Valve Insufficiency/therapy , Mitral Valve Insufficiency/diagnostic imaging , Mucormycosis/drug therapy , Mucormycosis/immunology , Mucormycosis/diagnostic imaging , T-Lymphocytes/immunology , T-Lymphocytes/pathologyABSTRACT
The Salmonella species is an extremely rare cause of infective endocarditis. This case report is for Salmonella spp. group B proven by positive multiple blood cultures, and positive intraoperative culture from the vegetation of the mitral valve prosthesis
Subject(s)
Humans , Female , Endocarditis/microbiology , Salmonella , Mitral Valve/microbiology , Heart Valve Prosthesis/microbiology , Echocardiography, TransesophagealABSTRACT
Background: Surgery for active endocarditis is indicated in cases of congestive heart failure (CHF), persistent sepsis, systemic embolization and paravalvular involvement. Aim: To assess and report the long term results of surgery in adult patients. Patients and methods: Retrospective review of clinical records and operative procedures of 32 patients aged 43± 13 years (28 women) subjected to reparative surgery for complications of endocarditis between 1993 to 2005. Results: In 25 percent of cases, endocarditis presented as a prolonged sepsis syndrome and in 31 percent as a CHF or both. The causative bacteria was Gram (+) in 53 percent and blood cultures were negative in 47 percent. Preoperative echocardiography showed vegetations in 56 percent of cases. An annular abscess, aortic valve rupture and bicuspid valve, was observed in 13 percent of patients. Post operative mortality was due to persistent sepsis and multiorganic dysfunction in 16 percent. Mean long term follow up was 43.8±47.2 months. Actuarial survival was 78 percent at 146 months. Conclusion: Surgical management of active endocarditis provides a good symptomatic recovery, with an excellent long term actuarial survival.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Aortic Valve/surgery , Endocarditis, Bacterial/surgery , Heart Valve Diseases/surgery , Heart Valve Prosthesis/adverse effects , Mitral Valve/surgery , Prosthesis-Related Infections/surgery , Aortic Valve/microbiology , Chile/epidemiology , Endocarditis, Bacterial/microbiology , Endocarditis, Bacterial/mortality , Follow-Up Studies , Heart Valve Prosthesis/microbiology , Mitral Valve/microbiology , Prosthesis-Related Infections/mortality , Reoperation , Retrospective Studies , Sepsis/mortality , Sepsis/surgery , Treatment OutcomeSubject(s)
Humans , Male , Aspergillus flavus , Mitral Valve/microbiology , Heart Valve Prosthesis/microbiologySubject(s)
Adult , Humans , Male , Bioprosthesis/microbiology , Endocarditis, Bacterial , Heart Valve Prosthesis/microbiology , Mitral Valve/microbiology , Echocardiography, Three-Dimensional , Echocardiography, Transesophageal , Endocarditis, Bacterial/complications , Endocarditis, Bacterial/surgery , Mitral Valve/surgery , Mitral Valve , Prosthesis Failure , ReoperationABSTRACT
Streptococcus pneumoniae es el principal agente de infección bacteriana invasora en niños; sin embargo, es extremadamente infrecuente como causa de endocarditis. Esta entidad clínica se manifiesta generalmente como una enfermedad aguda y grave con alta mortalidad, que requiere tratamiento médico-quirúrgico precoz, afectando con mayor frecuencia la válvula mitral. Presentamos el caso de una niña de 6 años 4 meses, de extrema ruralidad, que presentó endocarditis infecciosa (EI) de válvula mitral asociada a meningitis, aislándose en hemocultivos S. pneumoniae resistente a penicilina y se discute las estrategias terapéuticas...
Subject(s)
Humans , Female , Child , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/microbiology , Endocarditis, Bacterial/drug therapy , Pneumococcal Infections/complications , Streptococcus pneumoniae/isolation & purification , Mitral Valve/microbiology , Anti-Bacterial Agents/therapeutic use , Clinical Evolution , Endocarditis, Bacterial/surgery , Penicillin Resistance , Treatment Outcome , Mitral Valve/surgeryABSTRACT
A endocardite infecciosa (EI) acometendo próteses valvares é uma complicaçäo freqüente, sendo tratada geralmente com cirurgia, devido ao seu difícil controle clínico e má resposta à antibioticoterapia. Este relato descreve o caso de uma paciente com EI, acometendo simultaneamente as biopróteses aórtica (Ao) e mitral (Mi) após vinte e quatro meses de cirurgia de implantes valvares, submetida a tratamento cirúrgico conservador, e com resultado favorável. Discutem-se as vantagens deste procedimento em situaçöes específicas
Subject(s)
Humans , Female , Adult , Endocarditis, Bacterial/surgery , Heart Valve Prosthesis Implantation/adverse effects , Mitral Valve/surgery , Aortic Valve/surgery , Endocarditis, Bacterial/etiology , Mitral Valve , Mitral Valve/microbiology , Aortic Valve/microbiology , Aortic ValveSubject(s)
Adult , Anti-Bacterial Agents , Diagnosis, Differential , Drug Therapy, Combination/therapeutic use , Echocardiography , Endocarditis, Bacterial/complications , Heart Failure/etiology , Heart Valve Diseases/complications , Heart Valve Prosthesis Implantation , Humans , Male , Mitral Valve/microbiology , Prognosis , Streptococcal Infections/complications , Streptococcus/isolation & purificationSubject(s)
Humans , Female , Adult , Endocarditis, Bacterial/etiology , Micrococcaceae/pathogenicity , Mitral Valve/microbiology , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/drug therapy , Gentamicins/therapeutic use , Micrococcaceae/drug effects , Micrococcaceae/isolation & purification , Penicillins/therapeutic use , Rifampin/therapeutic use , Vancomycin/therapeutic useABSTRACT
Este estudio analizó las características de cuarenta episodios de endocarditis infecciosa en 38 pacientes con drogadicción intravenosa como factor predisponente. Tenían una edad promedio de 28,9 años; 90 por ciento eran de sexo masculino, con compromiso de válvula sana en 82,5 por ciento de los casos; 20 por ciento de los pacientes habían tenido un episodio o más de endocarditis previa; 77,5 por ciento tuvieron afectación derecha; el agente causal más frecuente fue el Staphylococcus aureus, con 70 por ciento de hemocultivos positivos y 90 por ciento de incidencia de HIV. Las complicaciones más frecuentes fueron la insuficiencia cardíaca y el tromboembolismo de pulmón.La mortalidad hospitalaria fue más elevada que la descripta habitualmente en esta población
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Endocarditis, Bacterial/complications , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/mortality , Endocarditis, Bacterial/therapy , Aortic Valve/microbiology , Mitral Valve/microbiology , Tricuspid Valve/microbiology , HIV , Hospital Mortality , Heart Failure , Pulmonary Embolism , Staphylococcal Infections , Substance-Related DisordersABSTRACT
A 17-year-old man presented with acute febrile illness with jaundice, embolic skin lesion, heart murmur, renal insufficiency and abnormal CSF. Pasteurella multocida was isolated from blood cultures. In spite of adequate antibiotic treatment for endocarditis of the mitral valve, he developed a fatal ruptured cerebral mycotic aneurysm. Post mortem examination revealed an atrial septal defect, vegetation at the anterior mitral leaflet, intraventricular, subarachnoid and intracerebral hemorrhage.
Subject(s)
Adolescent , Aneurysm, Infected , Endocarditis, Bacterial/microbiology , Heart Septal Defects, Atrial , Heart Valve Diseases/microbiology , Humans , Male , Mitral Valve/microbiology , Pasteurella InfectionsABSTRACT
We report a 64 year old lady in whom infective endocarditis of the mitral valve occurred with no previous underlying heart disease. Streptococcus sanguis I was isolated on blood culture and 2-D echo cardiography showed a vegetation on the anterior mitral leaflet. The viridans group of streptococci are classically associated with subacute endocarditis occurring on structurally abnormal valves, but involvement of a normal valve by these organisms is rare.