ABSTRACT
This study was designed to analyze results of daptomycin therapy in 7 patients with enterococcal infectious endocarditis caused by Enterococcus faecium in two of them. Mean duration of therapy was 36.7 days. 70% of the strains proved resistant to gentamycin, 40% showed resistance to penicillin antibiotics, and 14.3% to vancomycin. Three patients suffered prosthetic valve endocarditis, six had elevated presepsin level (up to 768.8 pg/ml). 28,6% of the patients underwent valve prosthetic surgery. Hospital lethality was 14,3%. The effectiveness of ampicillin plus ceftriaxone treatment of gentanycin-resistant enterococci is discussed. Recommendation for the antibacterial treatment of enterococcal infectious endocarditis (ESC 2015) are provided.
Subject(s)
Daptomycin/administration & dosage , Endocarditis, Bacterial , Enterococcus faecium , Gram-Positive Bacterial Infections , Anti-Bacterial Agents/administration & dosage , Echocardiography/methods , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/microbiology , Endocarditis, Bacterial/mortality , Endocarditis, Bacterial/therapy , Enterococcus faecium/drug effects , Enterococcus faecium/isolation & purification , Female , Gram-Positive Bacterial Infections/diagnosis , Gram-Positive Bacterial Infections/microbiology , Gram-Positive Bacterial Infections/mortality , Gram-Positive Bacterial Infections/therapy , Heart Valve Prosthesis/microbiology , Heart Valves/microbiology , Humans , Male , Middle Aged , Russia/epidemiology , Survival Analysis , Treatment OutcomeSubject(s)
Alcoholism/diagnosis , Internal Medicine , Adult , Aged , Diagnosis, Differential , Diagnostic Tests, Routine , Female , Humans , Male , Middle AgedSubject(s)
Cardiomyopathy, Alcoholic/immunology , Adult , B-Lymphocytes/immunology , Humans , Leukocyte Count , Male , Middle Aged , T-Lymphocytes/immunologySubject(s)
Endocarditis, Bacterial/etiology , Liver Cirrhosis, Alcoholic/complications , Meningitis/etiology , Pneumonia/etiology , Acute Disease , Endocarditis, Bacterial/pathology , Humans , Liver Cirrhosis, Alcoholic/pathology , Male , Meningitis/pathology , Middle Aged , Pneumonia/pathology , Rheumatic Heart Disease/etiology , Rheumatic Heart Disease/pathologyABSTRACT
A study was made of opportunities for the use of some signs of alcoholic intoxication in the verification of alcoholic etiology of heart lesion. Clinical signs like hyperemia of the face with telangiectasia, venous plethora of the eyeballs, tremor of the lips, tongue, limbs, Dupuytren's contracture, enlarged liver size combined with a positive macrocytosis test and, to a lesser degree, with a higher activity of gamma-glutamyl transpeptidase, and the detection of fatty hepatosis in liver puncture biopsy were shown to suggest alcoholic intoxication, and excluding other cases of heart lesion they can be of great help in the verification of diagnosis of alcoholic heart lesion.
