RESUMO
Fourteen years after shunt implantation, a 26-year-old patient with myelomeningocele, concomitant hydrocephalus and a ventriculoatrial cerebrospinal fluid (CSF) shunt presented with brief but recurrent episodes of fever predominantly when taking showers or during physical exertion. After 4â years of inconclusive multidisciplinary investigations, the patient progressed into end-stage renal disease before an echocardiogram revealed a vegetative plaque on the tendinous chords of the tricuspid valve. CSF cultures were grown from the shunt valve, confirming bacterial growth of Propionibacterium acnes suspected of causing subacute bacterial endocarditis and subsequent shunt nephritis. The patient was successfully treated with antibiotics combined with ventriculoatrial shunt removal and endoscopic third ventriculocisternostomy (VCS). This case illustrates the nowadays rare, but potentially severe complication of subacute bacterial endocarditis and shunt nephritis. It also exemplifies the VCS as an alternative to implanting foreign shunt systems for CSF diversion.
Assuntos
Derivações do Líquido Cefalorraquidiano/efeitos adversos , Endocardite Bacteriana Subaguda/etiologia , Glomerulonefrite/etiologia , Infecções por Bactérias Gram-Positivas/etiologia , Falência Renal Crônica/etiologia , Propionibacterium acnes , Adulto , Feminino , Átrios do Coração , Humanos , Hidrocefalia/complicações , Hidrocefalia/cirurgia , Meningomielocele/complicações , Meningomielocele/cirurgiaAssuntos
Endocardite Bacteriana Subaguda/diagnóstico , Dermatoses da Mão/diagnóstico , Infecções Estreptocócicas/diagnóstico , Extração Dentária/efeitos adversos , Estreptococos Viridans , Endocardite Bacteriana Subaguda/etiologia , Dermatoses da Mão/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Estreptocócicas/etiologiaRESUMO
S. bovis is known for causing bacteremia and endocarditis as well as accompanying malignant diseases of the gastrointestinal tract. Hence, identification of this species and recognition of the clinical characteristics of infections caused are essential for both therapy and prognosis. S. bovis isolated from haemoculture requires an immediate search for gastrointestinal tract lesions.
Assuntos
Adenocarcinoma/diagnóstico , Bacteriemia/microbiologia , Neoplasias do Colo/diagnóstico , Endocardite Bacteriana Subaguda/microbiologia , Infecções Oportunistas/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus bovis/isolamento & purificação , Adenocarcinoma/complicações , Adenocarcinoma/microbiologia , Bacteriemia/etiologia , Neoplasias do Colo/complicações , Neoplasias do Colo/microbiologia , Endocardite Bacteriana Subaguda/etiologia , Febre de Causa Desconhecida/etiologia , Trato Gastrointestinal/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/microbiologia , Infecções Oportunistas/etiologia , Infecções Estreptocócicas/etiologiaAssuntos
Endocardite Bacteriana Subaguda/diagnóstico , Antibacterianos/uso terapêutico , Bactérias/isolamento & purificação , Ecocardiografia , Endocardite Bacteriana Subaguda/complicações , Endocardite Bacteriana Subaguda/diagnóstico por imagem , Endocardite Bacteriana Subaguda/tratamento farmacológico , Endocardite Bacteriana Subaguda/etiologia , Endocardite Bacteriana Subaguda/microbiologia , Endocardite Bacteriana Subaguda/prevenção & controle , Endocardite Bacteriana Subaguda/cirurgia , Fadiga/etiologia , Febre/etiologia , Implante de Prótese de Valva Cardíaca , Humanos , Fatores de Risco , Staphylococcus aureus/isolamento & purificação , StreptococcusRESUMO
No disponible
Assuntos
Masculino , Pessoa de Meia-Idade , Humanos , Endocardite Bacteriana Subaguda/cirurgia , Circulação Extracorpórea/métodos , Endocardite Bacteriana Subaguda/etiologia , Marca-Passo Artificial/efeitos adversosRESUMO
Q-fever is antropozoonosis caused by Coxiella burnetii. The microorganism usually transmitted to humans through the inhalation of infected dust from sub clinical infected mammals. The most common reservoirs for Coxiella burnetii are large numbers domestic and wild animals. The illness can occur by farmers or slaughterhouses, or veterinarian and laboratories workers. In this report we presented case of endocarditic caused by Coxiella burnetii. The patient is driver 43 years old, who lived in the countryside Nahorevo. He hospitalized in May, 2002. He had symptoms of hepatitis, with elevation of transaminases in sera. Endocarditic was diagnosed by echosonografy. The patient is controlled by infectologist, cardiologist by cardio-surgeon, but since disease is in progress and operation treatment will be probably necessary.
Assuntos
Endocardite Bacteriana Subaguda/etiologia , Febre Q/complicações , Endocardite Bacteriana Subaguda/diagnóstico , Endocardite Bacteriana Subaguda/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Febre Q/terapiaRESUMO
INTRODUCTION: Infections by Bartonella spp. include a wide spectrum of emerging and re-emerging infectious diseases, such as culture-negative endocarditis. METHODS: Description of 3 cases of endocarditis due to Bartonella spp. and review of those previously reported in Spain. RESULTS: Including these 3 new cases of endocarditis due to Bartonella spp., a total of 6 cases have been reported in Spain. The median age of the patients was 51.6 years and 83.3% were men. There was history of contact with cats in 66.7%, and 50% were alcoholic. Only one patient had prior valvular disease. There were no clinical manifestations typical to any of the Bartonella species. The aortic valve was the one most commonly affected. In all cases, B. henselae was the agent implicated. The diagnosis was made by serology in 5 cases (83.3%). The outcome was favorable in all patients, although 4 of them (66.7%) required valve replacement. CONCLUSION: Endocarditis due to Bartonella spp. is present in Spain and is likely to be underestimated. We should suspect this pathogen in patients with negative blood cultures and a history of chronic alcoholism, homeless patients, and those who have had contact with cats or who have been bitten by fleas or lice, as well as patients with endocarditis and positive serology against Chlamydia spp.
Assuntos
Infecções por Bartonella/complicações , Bartonella henselae/isolamento & purificação , Endocardite Bacteriana/microbiologia , Infecções por Actinobacillus/complicações , Adulto , Idoso , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Alcoolismo/complicações , Animais , Antibacterianos/uso terapêutico , Anticorpos Antibacterianos/sangue , Valva Aórtica/microbiologia , Infecções por Bartonella/sangue , Infecções por Bartonella/diagnóstico , Infecções por Bartonella/tratamento farmacológico , Infecções por Bartonella/epidemiologia , Infecções por Bartonella/cirurgia , Bartonella henselae/imunologia , Sangue/microbiologia , Cardiomiopatia Hipertrófica/complicações , Doença da Arranhadura de Gato/sangue , Doença da Arranhadura de Gato/complicações , Doença da Arranhadura de Gato/diagnóstico , Doença da Arranhadura de Gato/tratamento farmacológico , Doença da Arranhadura de Gato/cirurgia , Gatos , Ceftriaxona/uso terapêutico , Chlamydia/imunologia , Ciprofloxacina/uso terapêutico , Terapia Combinada , Suscetibilidade a Doenças , Doxiciclina/uso terapêutico , Endocardite Bacteriana/sangue , Endocardite Bacteriana/tratamento farmacológico , Endocardite Bacteriana/epidemiologia , Endocardite Bacteriana/etiologia , Endocardite Bacteriana/cirurgia , Endocardite Bacteriana Subaguda/etiologia , Endocardite Bacteriana Subaguda/microbiologia , Reações Falso-Negativas , Feminino , Gentamicinas/uso terapêutico , Implante de Prótese de Valva Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologia , Vancomicina/uso terapêuticoRESUMO
Sydenham's chorea (SC), a major manifestation of acute rheumatic fever (RF), is characterized by chorea and other motor and non-motor features. Among the latter are behavioral symptoms, including obsessive-compulsive disorder. Although SC is typically a self-limited condition, up to 50% of patients may evolve with persistent chorea. There is evidence that Gustav Mahler had a movement disorder, but its nature remains undetermined. There are witnesses describing him as having facial dyskinesia and a gait disorder consistent with chorea. His conducting performance was notorious for obsessive attention to details of the staging and musical production. Mahler was diagnosed with a valvulopathy in 1907 and died of subacute bacterial endocarditis in 1911. It is possible that the composer suffered from RF in childhood with carditis and SC, which may left him with valvulopathy, obsessive-compulsive disorder, and persistent chorea.
Assuntos
Coreia/história , Música/história , Coreia/etiologia , Coreia/fisiopatologia , Discinesia Induzida por Medicamentos/etiologia , Endocardite Bacteriana Subaguda/etiologia , Endocardite Bacteriana Subaguda/fisiopatologia , Alemanha , Doenças das Valvas Cardíacas/microbiologia , Doenças das Valvas Cardíacas/fisiopatologia , História do Século XIX , História do Século XX , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/etiologia , Febre Reumática/complicaçõesRESUMO
Congenital cardiac disease is recognized as a major predisposing substrate for infective endocarditis. We present three cases of unanticipated intraoperative discovery of vegetations in patients with congenital cardiac malformations without preoperative clinical, laboratory or echocardiographic evidence of infective endocarditis, and their successful treatment. The relevant literature is reviewed, with emphasis of the need to maintain a high index of suspicion for the presence of endocarditis during repair of congenital cardiac lesions.
Assuntos
Endocardite Bacteriana Subaguda/etiologia , Aneurisma Cardíaco/complicações , Comunicação Interventricular/complicações , Tetralogia de Fallot/complicações , Adulto , Anti-Infecciosos/uso terapêutico , Pré-Escolar , Quimioterapia Combinada , Endocardite Bacteriana Subaguda/tratamento farmacológico , Endocardite Bacteriana Subaguda/microbiologia , Feminino , Humanos , MasculinoAssuntos
Embolia/etiologia , Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana Subaguda/diagnóstico , Febre de Causa Desconhecida/etiologia , Sopros Cardíacos , Vasculite/etiologia , Adulto , Insuficiência da Valva Aórtica/diagnóstico , Insuficiência da Valva Aórtica/etiologia , Insuficiência da Valva Aórtica/terapia , Implante de Prótese Vascular , Terapia Combinada , Endocardite/diagnóstico , Endocardite/etiologia , Endocardite/terapia , Endocardite Bacteriana/etiologia , Endocardite Bacteriana/terapia , Endocardite Bacteriana Subaguda/etiologia , Endocardite Bacteriana Subaguda/terapia , Enterococcus faecalis , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/etiologia , Infecções por Bactérias Gram-Positivas/terapia , Humanos , Masculino , Micoses/diagnóstico , Micoses/etiologia , Micoses/terapia , Penicilinas/administração & dosagem , Vancomicina/administração & dosagemRESUMO
We report the successful surgical intervention in two cases of aortic valve bacterial endocarditis after scorpion stings. Infective endocarditis developed in both patients several weeks after they suffered repeated scorpion stings. Both patients had similar, but uncommon features: (1) the isolated organisms were unusual causes of infective endocarditis (streptococcus group G and Streptococcus milleri), (2) annular abscesses developed that required either aortic root replacement with a homograft or annular patch repair with pericardium, and (3) complete heart block developed postoperatively, requiring permanent pacemaker implantation. Both patients completed a 6-week postoperative course of antibiotic therapy and are without recurrent infection.
Assuntos
Endocardite Bacteriana Subaguda/etiologia , Picadas de Escorpião/complicações , Adulto , Animais , Valva Aórtica/microbiologia , Valva Aórtica/cirurgia , Bioprótese , Endocardite Bacteriana Subaguda/diagnóstico , Endocardite Bacteriana Subaguda/microbiologia , Endocardite Bacteriana Subaguda/terapia , Próteses Valvulares Cardíacas/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Picadas de Escorpião/terapia , Escorpiões , Streptococcus milleri (Grupo)/isolamento & purificação , Resultado do TratamentoRESUMO
Transient bacteremia associated with various endoscopic procedures is a well-documented phenomenon. Clinically important bacteremias are very rarely seen, however, this malady has significant morbidity in susceptible patients with valvular heart disease, liver cirrhosis, malignancy and immune deficiency. This bacteremia is a complication that is generally observed secondary to upper endoscopy and other associated invasive procedures in at risk patients, and the more serious manifestations include spontaneous bacterial peritonitis, septic arthritis, meningitis, brain abscess and infective endocarditis. Infective endocarditis is an extremely rare complication of gastrointestinal endoscopy, and it has been convincingly documented in only seven cases. We report a case of native valve endocarditis due to Streptococcus intermedius in a patient with valvular heart disease as a consequence of routine upper endoscopy.
Assuntos
Endocardite Bacteriana Subaguda/etiologia , Endoscopia Gastrointestinal/efeitos adversos , Infecções Estreptocócicas/etiologia , Streptococcus intermedius/isolamento & purificação , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Campylobacter fetus is a rare cause of bone and joint infection. We report a new case in a patient who also had endocarditis due to the same organism. This type of infection usually occurs in immunocompromised hosts. Investigations in our patient found a cancer of the prostate.
Assuntos
Artrite Infecciosa/patologia , Infecções por Campylobacter/patologia , Campylobacter fetus/isolamento & purificação , Idoso , Idoso de 80 Anos ou mais , Artrite Infecciosa/etiologia , Infecções por Campylobacter/complicações , Campylobacter fetus/crescimento & desenvolvimento , Campylobacter fetus/patogenicidade , Endocardite Bacteriana Subaguda/etiologia , Endocardite Bacteriana Subaguda/patologia , Necrose da Cabeça do Fêmur/complicações , Necrose da Cabeça do Fêmur/patologia , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/patologia , Humanos , Hospedeiro Imunocomprometido , Masculino , Neoplasias da Próstata/complicações , Neoplasias da Próstata/imunologia , Neoplasias da Próstata/patologia , RadiografiaRESUMO
We report the first documented case of Gemella haemolysans endocarditis in the United States in a patient following denture fixation. G. haemolysans was isolated form the patient's blood cultures. The patient was treated with ampicillin for 6 weeks with significant clinical improvement. This case highlights the fact that endocarditis prophylaxis should be considered in denture fixation for high risk patients.
Assuntos
Endocardite Bacteriana Subaguda/microbiologia , Staphylococcaceae/patogenicidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Endocardite Bacteriana Subaguda/tratamento farmacológico , Endocardite Bacteriana Subaguda/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Staphylococcaceae/isolamento & purificação , Infecções Estafilocócicas/tratamento farmacológicoRESUMO
Transient bacteremia associated with various endoscopic procedures is a well-documented phenomenon. Clinically important bacteremias are very rarely seen, however, this malady has significant morbidity in susceptible patients with valvular heart disease, liver cirrhosis, malignancy and immune deficiency. This bacteremia is a complication that is generally observed secondary to upper endoscopy and other associated invasive procedures in at risk patients, and the more serious manifestations include spontaneous bacterial peritonitis, septic arthritis, meningitis, brain abscess and infective endocarditis. Infective endocarditis is an extremely rare complication of gastrointestinal endoscopy, and it has been convincingly documented in only seven cases. We report a case of native valve endocarditis due to Streptococcus intermedius in a patient with valvular heart disease as a consequence of routine upper endoscopy.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Endocardite Bacteriana Subaguda/etiologia , Endoscopia Gastrointestinal/efeitos adversos , Infecções Estreptocócicas/etiologia , Streptococcus intermedius/isolamento & purificaçãoAssuntos
Endocardite Bacteriana Subaguda/etiologia , Infecção Focal Dentária , Doenças das Valvas Cardíacas/etiologia , Aneurisma Intracraniano/etiologia , Adulto , Endocardite Bacteriana Subaguda/microbiologia , Feminino , Infecção Focal Dentária/complicações , Infecção Focal Dentária/microbiologia , Bacilos Gram-Negativos Anaeróbios Facultativos/isolamento & purificação , Doenças das Valvas Cardíacas/microbiologia , Doenças das Valvas Cardíacas/cirurgia , Hemiplegia/etiologia , Humanos , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/cirurgiaAssuntos
Endocardite Bacteriana/diagnóstico , Doenças das Valvas Cardíacas/diagnóstico , Doença Aguda , Técnicas Bacteriológicas , Diagnóstico Diferencial , Endocardite Bacteriana/etiologia , Endocardite Bacteriana Subaguda/diagnóstico , Endocardite Bacteriana Subaguda/etiologia , Doenças das Valvas Cardíacas/etiologia , HumanosRESUMO
Infective endocarditis (IE) is a pathologic condition of native or prosthetic heart valves or endocardium, which may result in valve destruction and congestive heart failure. It occurs more frequently in men than in women, and there is an increased trend in the elderly. The following conditions predispose patients to IE: congenital and rheumatic heart disease, calcification or stenosis of a valve, prosthetic valve surgery, a previous episode of endocarditis, poor dentition, parenteral drug abuse, and placement of intravascular lines or devices. Effective treatment frequently involves a combination of intense antibiotic therapy and surgical repair. Risk of death from IE is related to age over 60, diagnosis of staphylococcal infection, involvement of an aortic or prosthetic valve, and the presence of any of the following sequelae of endocarditis: congestive heart failure, embolic phenomenon, and neurologic deficit. Clinicians should suspect endocarditis in patients presenting with fever of unknown origin and who are at risk for endocarditis. Timely evaluation with transthoracic or transesophageal echocardiography may identify patients in the early stages of endocarditis and direct the patient to definitive therapy. Early treatment of native and prosthetic valve endocarditis may decrease its overall morbidity and mortality. This case study illustrates some of the challenges in effectively managing prosthetic valve endocarditis.