Stroke in Patients with Infective Endocarditis: A 15-Year Single-Center Cohort Study

2018 ◽  
Vol 80 (3-4) ◽  
pp. 171-178 ◽  
Author(s):  
Gui-fang Cao ◽  
Wei Liu ◽  
Qi Bi
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Hemorrhagic Stroke ◽  
Hospital Deaths ◽  
Independent Risk Factors ◽  
The Mean ◽  
Medical University ◽  
The Relationship ◽  
Rheumatic Valvular Disease ◽  
Mitral Valve Vegetation

Objective: To explore the relationship between infective endocarditis (IE) and stroke. Methods: The clinical data of patients diagnosed with IE from January 2003 to December 2017 in Beijing Anzhen Hospital Affiliated to Capital Medical University were retrospectively analyzed. Results: A total of 861 patients (mean age: 40.79 ± 16.27 [SD]) with IE was recruited. Vegetations were confirmed in 97.32% of all the patients, among whom 296 were diagnosed with congenital heart disease and another 53 with rheumatic valvular disease. The most common pathogens were Streptococcus, Staphylococcus, and various types of fungi (13.12, 7.31, and 1.16% respectively). Out of the 138 patients diagnosed with stroke, 101 cases were of ischemic stroke, 23 cases were of hemorrhagic stroke, and 12 cases were of concurrent ischemic and hemorrhagic stroke. There were 31 patients who had infarction lesions in more than 2 vascular systems. The mean age of stroke patients was significantly higher than that of patients without stroke (45.76 ± 17.88 vs. 39.83 ± 15.77, p = 0.000). The incidence of mitral valve vegetation (57.24 vs. 43.01%, p = 0.002), atrial fibrillation (4.34 vs. 1.38%, p = 0.018), fungal infection (2.89 vs. 0.83%, p = 0.038) in patients with stroke was significantly higher than those without stroke. Mitral valve vegetation (OR 1.648; 95% CI 1.113–2.442) and age (OR 1.019; 95% CI 1.007–1.032) were independent risk factors for stroke in IE patients. Stroke increased the risk of hospital deaths (OR 7.673 95%CI 3.634–16.202). Conclusion: Stroke is a common complication of IE. Mitral valve vegetation and old age may incerease the risk of stroke in patients with IE.

Infective endocarditis due to Streptococcus agalactiae giant mitral valve vegetation

2013 ◽  
pp. 1096-1096 ◽  
Author(s):  
Lech Paluszkiewicz ◽  
Jochen Börgermann ◽  
Edyta Płońska-Gościniak ◽  
Jan Gummert
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Streptococcus Agalactiae ◽  
Mitral Valve Vegetation

scholarly journals Intraoperative diagnosis of mitral valve endocarditis secondary to Paenibacillus provencensis

2017 ◽  
Vol 99 (2) ◽  
pp. e54-e55 ◽  
Author(s):  
A-C Pinho-Gomes ◽  
A Nasir ◽  
R Mosca ◽  
S Mirza ◽  
I Kadir
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Gene Sequencing ◽  
Transoesophageal Echocardiography ◽  
16S Rdna Gene ◽  
Intraoperative Diagnosis ◽  
First Case ◽  
Mitral Valve Vegetation ◽  
16S Rdna Gene Sequencing

We report the first case of infective endocarditis caused by Paenibacillus provencensis. A mitral valve vegetation was incidentally discovered by intraoperative transoesophageal echocardiography in a 70-year-old woman undergoing aortic valve replacement. The precise identification of the causative agent was by means of genotypic characterisation with 16S rDNA gene sequencing. The patient was successfully treated with a 6-week course of antibiotics postoperatively, following debridement of the valve vegetation.

scholarly journals Successful surgical treatment approach for mitral valve vegetation of infective endocarditis after severe soft tissue infection with mediastinitis.

2021 ◽  
Author(s):  
Kenichiro Uchida ◽  
Yosuke Takahashi ◽  
Toshihiko Shibata ◽  
Yasumitsu Mizobata
Keyword(s):  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Soft Tissue ◽  
Mitral Valve ◽  
Soft Tissue Infection ◽  
Treatment Approach ◽  
Mitral Valvuloplasty ◽  
Right Thoracotomy ◽  
Severe Soft Tissue ◽  
Mitral Valve Vegetation

Transesophageal echocardiography is mandatory if you do suspect infective endocarditis. By approaching via a small right thoracotomy, vegetectomy and mitral valvuloplasty following severe mediastinitis were successfully accomplished without any complications.

scholarly journals Infective Endocarditis with Multiple Mycotic Aneurysms Mimicking Vasculitis: A Case Report

2012 ◽  
Vol 23 (3) ◽  
pp. e67-e68 ◽  
Author(s):  
Ji Hyeon Park ◽  
Hye Ryoun Jang ◽  
Jung Eun Lee ◽  
Wooseong Huh ◽  
Dae Joong Kim ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mycotic Aneurysm ◽  
Skin Lesions ◽  
Neurological Complications ◽  
Blood Cultures ◽  
Renal Infarction ◽  
Viridans Streptococci ◽  
Mycotic Aneurysms ◽  
Mitral Valve Vegetation

The manifestation of infective endocarditis often resembles vasculitis. Approximately one in five infective endocarditis cases are referred initially to a nephrologist because of abnormal renal function or abnormal urinalysis; therefore, infection should be ruled out before diagnosing vasculitis.A case involving a patient with infective endocarditis who presented with migrating skin lesions, renal infarction and multiple pseudoaneurysms is reported. Echocardiography revealed mitral valve vegetation and viridans streptococci were identified in peripheral blood cultures. Although mitral valve annuloplasty and an aneurysm ligation operation were performed with proper antibiotic treatment, the remaining mycotic aneurysm progressed and caused neurological complications. The patient was cured completely after reoperation.

scholarly journals Correlation between Mitral Valve Area and Right Ventricle Function based on TAPSE (Tricuspid Annular Plane Systolic Excursion) Parameter in Mitral Stenosis Patient

2018 ◽  
Vol 4 (2) ◽  
pp. 73
Author(s):  
Hashina Zulfa ◽  
Erika Maharani ◽  
Hasanah Mumpuni
Keyword(s):  
Mitral Valve ◽  
Right Ventricle ◽  
Mitral Stenosis ◽  
Right Ventricle Function ◽  
Mitral Valve Area ◽  
Spearman Correlation Test ◽  
The Mean ◽  
The Relationship ◽  
Ventricle Function ◽  
Valve Area

Background: Mitral stenosis is the most common mitral valve disease found in Indonesia. Mechanical obstruction of blood flow from left atrium to left ventricle is compensated by pressure elevation in the left atrium and pulmonary circulation. It leads to right ventricle dysfunction which can be scored using TAPSE (Tricuspid Annular Plane Systolic Excursion) Parameter.Aim: The goal of this study is to assess the relationship between mitral valve area and right ventricle function based on TAPSE parameter in mitral stenosis patient.Methods: This study was conducted in Dr. Sardjito Hospital from May until July 2017. This was a part of mitral stenosis registry study. The parameter used was planimetry mitral valve area and TAPSE from echocardiography. The relationship between mitral valve area and TAPSE score we reanalyzed using Spearman correlation test in SPSS software.Results: The total sample included in this study was 132 people, consisted of thirty-eight (28.79%) males and ninety-four (71.21%) females. The range of the subjects’age was 18 68 year oldand the mean was 43.31±11.13 year old. The body mass index median was 21.24 (14.24–35.38) kg/m2. The subjects were dominated by severe degree mitral stenosis patients, those were ninety-three (70.45%) people, followed by moderate degree patients, those were thirty-two (24.24%) people, and mild degree patients, those were seven (5.30%) people. Twenty-eight (21.21%) people had isolated mitral stenosis. The mitral valve area median was 0.8 (0.27–1.90) cm2. The TAPSE score range was 6–30 mm and the mean was 17.48±4.58 mm. The result from Spearman correlation test showed that the relationship strength between mitral valve area and TAPSE score were very weak (r=0.167) with significant p-value (p=0.028).Conclusion: There is a statistically significant positive relationship with very weak strength between mitral valve area and TAPSE score as a right ventricle function parameter in mitral stenosis patients (r = 0.167, p = 0.028).

scholarly journals Implication of serum zinc level with duration and clinical type of vitiligo

2016 ◽  
Vol 6 (2) ◽  
pp. 99
Author(s):  
Sohail Mirza ◽  
Mohammad Eakub Ali ◽  
Lubna Khondker ◽  
Md. Shirajul Islam Khan ◽  
Nadia Islam ◽  
...  
Keyword(s):  
Large Scale ◽  
Serum Zinc ◽  
Cross Sectional Study ◽  
Zinc Level ◽  
Serum Zinc Level ◽  
Cross Sectional ◽  
The Mean ◽  
The Difference ◽  
Medical University ◽  
The Relationship

<p><strong>Background:</strong> Vitiligo is a common dermatological disorder characterized by acquired, idiopathic, progressive, hypomelanosis of the skin and hair, with total absence of melanocytes microscopically. <strong></strong></p><p><strong>Objective:</strong> The study was conducted to find out the relationship between serum zinc level and clinical spectrum of vitiligo. <strong></strong></p><p><strong>Methods:</strong> A cross sectional study conducted in the departmenl of Dermatology and Venereology and department of Biochemistry, Bang­abandbu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh and the period of study was from May 2010 to October 2011. <strong></strong></p><p><strong>Results:</strong> The mean difference of sernm zinc level in male and female of both groups were significant (p&lt;0.05) but the mean serum zinc level was not significantly different (p&gt;0.05) among various clinical types ofvitiligo. ln case oflocalized vitiligo mean serum zinc level was 755.3 ± 288.6, in case of acrofacial viriligo mean serum zinc level was 821.4 ± 259.6 and in case of generalized vitiligo mean sernm zinc level was 771.6 ± 222.2. The difference of mean sernm zinc level observed between family history positive and negative group were not statistically significant (p&gt;0.05). The difference of mean senun zinc level was also not statistically significant (p&gt;0.05) among &lt;1 year, 1-10 years and 11-20 years duration groups of vitiligo patients. A negative correlation (r = -0.227) was observed between duration of symptom with senun zinc level in this study.<strong> </strong></p><p><strong>Conclusion:</strong> This study showed low level of serum zinc in vitiligo patients. Large-scale studies are needed to confirm these findings and multicenter study should be carried out to reveal the accurate pattern of zinc status in vitiligo.</p>

Heart valve disease (mitral valve disease): mitral stenosis

2016 ◽  
Author(s):  
Bogdan A. Popescu ◽  
Shantanu P. Sengupta ◽  
Niloufar Samiei ◽  
Anca D. Mateescu
Keyword(s):  
Mitral Valve ◽  
Mitral Stenosis ◽  
Three Dimensional ◽  
Reference Method ◽  
Valve Disease ◽  
Heart Valve Disease ◽  
Mean Pressure ◽  
The Mean ◽  
The Relationship ◽  
Echocardiographic Findings

The most common cause of mitral stenosis (MS) is rheumatic fever followed by degenerative MS. Echocardiography is the key method to diagnose and evaluate MS. Echocardiographic findings are closely related to aetiology. In rheumatic disease echocardiography shows thickening of leaflet tips with restricted opening caused by commissural fusion resulting in ‘doming’ of the mitral valve in diastole. Quantitation of MS severity includes measuring mitral valve area (MVA) by planimetry (anatomical area, by two-/three-dimensional echo), or by the pressure half-time (PHT) method (functional area, by Doppler), and the mean pressure gradient. Planimetry is considered the reference method to determine MVA as it is relatively load independent. The PHT method is widely used due to its simplicity, but different factors influence the relationship between PHT and MVA. Other indices of MS severity are rarely used in clinical practice. Echocardiography also helps in the assessment of consequences of MS, and of associated valvular lesions. Exercise Doppler is recommended when there is discrepancy between the resting echocardiography findings and the clinical picture. Echocardiography is crucial in determining the timing and type of intervention in patients with MS. When considering percutaneous mitral commissurotomy (PMC) valve morphology should be comprehensively evaluated for mobility, thickness, calcifications, and subvalvular apparatus. The echo findings may determine the suitability for PMC, guide the procedure, and assess its results.

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