scholarly journals Pooled analysis of 1270 infective endocarditis cases in Turkey

2019 ◽  
Vol 13 (02) ◽  
pp. 93-100 ◽  
Author(s):  
Arman Vahabi ◽  
Funda Gül ◽  
Sabina Garakhanova ◽  
Hilal Sipahi ◽  
Oğuz Reşat Sipahi
Keyword(s):  
Infective Endocarditis ◽  
Prosthetic Valve Endocarditis ◽  
Pooled Analysis ◽  
Etiologic Agent ◽  
National Database ◽  
Coagulase Negative Staphylococci ◽  
History Of ◽  
National Databases ◽  
Culture Negative ◽  
Overall Mortality

Introduction: Despite developments in medicine, infective endocarditis (IE) is still associated with significant morbidity and mortality. In this study it was aimed to systematically review the infective endocarditis literature published or presented from Turkey. Methods: To find the published series, one national database (Ulakbim), and three international databases (Scopus, Pubmed and Sci-e) were searched between 31 October-3 November 2014. also, abstracts of congresses by three national congresses were searched for studies regarding infective endocarditis. Results: Data for 1270 patients (38.3% female, mean age 46.2, 28% prosthetic valve endocarditis) with a diagnosis of infective endocarditis were obtained from 21 reports (18 published articles and three congress abstracts). Of the 18 articles, four were in peer-reviewed medical journals indexed in national databases and 14 were in international databases. There was an underlying heart disease in 51.9% and history of dental procedure was 6.7%. Fever, heart murmur and fatigue were present in 94%, 71.4% and 69% respectively. most commonly involved site was mitral valve (43.3%), followed by aortic (33.8%) and tricuspid valve (6.4%). Staphylococcus aureus, coagulase-negative staphylococci and enterococci comprised the 22.8%, 9.7% and 7.5% of the cases while 31.1% were culture-negative. Overall mortality was 23.4%. When we compared series related to years 2008 and before and 2009 and after, the mortality rates were (24.1%-224/931) vs (20.1%-32/159), respectively (p = 0,31). Conclusion: Infective endocarditis is still associated with significant mortality. S. aureus seems to be the most common etiologic agent. There was a slight decrease in the recent years in mortality.

scholarly journals Infective Endocarditis – An Observational Study

2015 ◽  
Vol 21 (2) ◽  
pp. 87-94
Author(s):  
Brindusa Tilea ◽  
Simona Teches ◽  
S. Voidazan ◽  
Klara Brinzaniuc ◽  
I. Tilea
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Observational Study ◽  
Prosthetic Valve Endocarditis ◽  
Etiologic Agent ◽  
Clinical Aspects ◽  
Coagulase Negative Staphylococci ◽  
Streptococcus Gallolyticus ◽  
Prosthetic Valves

Abstract Introduction: Despite all the progresses made in the management of infectious and cardiovascular diseases, the incidence of infective endocarditis remains high. Aim: the assessment of etiological, clinical, therapeutic aspects in patients with endocarditis. Material and method: A retrospective observational study in 40 patients with infective endocarditis was conducted, over a period of 5 years. Parameters related to demographic, risk factors, clinical aspects, nature and location of valve damage, bacteriological and therapeutic parameters were assessed. Echocardiography was used to confirm the location of the endocarditis; the aetiology of the disease was identified through the isolation of bacteria from blood cultures by using an automatic BacT/ALERT® system. Results: Patients’ age ranged between 31 - 84 years old. The disease was present predominantly in male patients (67.5%). 70% of the patients were positively diagnosed with endocarditis and 30% with possible endocarditis; the most frequent localization was the native valves in 75% of the cases, compared to the localization in the prosthetic valves, 25%; the aortic valve was involved in 60% of the cases, mitral valve in 40% of the patients. Aetiology of endocarditis was confirmed in 55% of cases as follows: Enterococcus fecalis, speciae, Staphylococcus epidermidis, Escherichia coli, Streptococcus gallolyticus, coagulase-positive methicillin resistant Staphylococcus aureus, coagulasepositive methicillin sensitive Staphylococcus aureus, Staphylococcus lungdunensis, coagulase-negative staphylococci, Streptococcus gordonii, viridans, agalactiae. Antibiotic treatment was administered according to the antibiogram in 55% of the cases. Conclusions: Staphylococcus speciae was the most frequent etiologic agent both in case of native and prosthetic valve endocarditis, with aortic valve predominance.

The Role of the Coagulase-negative Staphylococci (CoNS) in Infective Endocarditis; A Narrative Review from 2000 to 2020

2020 ◽  
Vol 21 (12) ◽  
pp. 1140-1153 ◽  
Author(s):  
Mohammad A. Noshak ◽  
Mohammad A. Rezaee ◽  
Alka Hasani ◽  
Mehdi Mirzaii
Keyword(s):  
Foreign Body ◽  
Infective Endocarditis ◽  
Prosthetic Valve ◽  
Human Life ◽  
Prosthetic Valve Endocarditis ◽  
Surgical Site Infections ◽  
Coagulase Negative Staphylococci ◽  
Native Valve ◽  
Native Valve Endocarditis

Coagulase-negative staphylococci (CoNS) are part of the microbiota of human skin and rarely linked with soft tissue infections. In recent years, CoNS species considered as one of the major nosocomial pathogens and can cause several infections such as catheter-acquired sepsis, skin infection, urinary tract infection, endophthalmitis, central nervous system shunt infection, surgical site infections, and foreign body infection. These microorganisms have a significant impact on human life and health and, as typical opportunists, cause peritonitis in individuals undergoing peritoneal dialysis. Moreover, it is revealed that these potential pathogens are mainly related to the use of indwelling or implanted in a foreign body and cause infective endocarditis (both native valve endocarditis and prosthetic valve endocarditis) in patients. In general, approximately eight percent of all cases of native valve endocarditis is associated with CoNS species, and these organisms cause death in 25% of all native valve endocarditis cases. Moreover, it is revealed that methicillin-resistant CoNS species cause 60 % of all prosthetic valve endocarditis cases. In this review, we describe the role of the CoNS species in infective endocarditis, and we explicated the reported cases of CoNS infective endocarditis in the literature from 2000 to 2020 to determine the role of CoNS in the process of infective endocarditis.

scholarly journals Myocarditis in Crohn’s disease: a case report

2020 ◽  
Vol 4 (4) ◽  
pp. 1-6
Author(s):  
Lucy McGrath-Cadell ◽  
Nicole K Bart ◽  
Linda Lin ◽  
Simon Ghaly ◽  
Cameron J Holloway
Keyword(s):  
Crohn’S Disease ◽  
Infective Endocarditis ◽  
Crohn's Disease ◽  
Blood Cultures ◽  
Empirical Treatment ◽  
Diagnostic Process ◽  
Treatment Paradigm ◽  
History Of ◽  
Culture Negative ◽  
Valvular Lesions

Abstract Background Mobile valvular masses are often considered pathognomonic for infective endocarditis. We present a case of a young patient with mobile valvular masses in the context of myocarditis likely secondary to active ileal Crohn’s disease. Cardiac magnetic resonance (CMR) imaging was crucial in diagnosing and monitoring our patient. Case summary A 27-year-old woman presented with pleuritic chest pain, dyspnoea, and a 3-day history of fevers. She also reported a 2-month history of intermittent visual loss in her right eye. She had a history of histologically proven ileal Crohn’s disease, diagnosed 5 months prior. She was haemodynamically unstable on presentation. Abnormalities on a transthoracic echocardiogram necessitated a transoesophageal echocardiogram. After blood cultures were sent, the patient was commenced on empirical treatment for infective endocarditis with gentamicin and flucloxacillin. Eight days after her initial presentation, all blood cultures remained negative and she was changed to empirical treatment for culture negative endocarditis with ceftriaxone and vancomycin, according to local protocol. Despite 8 days of treatment for infective endocarditis she remained febrile. A CMR was organized on Day 9 and this showed myocarditis, which changed the treatment paradigm. She responded swiftly to steroids and anti-coagulation. Discussion In this case, echo-dense valvular lesions are not pathognomonic for infective endocarditis and a careful diagnostic process involving multi-modality imaging, including CMR, occurred to arrive at a diagnosis of myocarditis likely secondary to Crohn’s disease.

scholarly journals Right-sided endocarditis from Staphylococcus lugdunensis in a patient with tetralogy of Fallot

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Bradford III Becken ◽  
Jacob Kilgore ◽  
Elizabeth Thompson ◽  
M. Anthony Moody
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Tetralogy Of Fallot ◽  
Pediatric Patients ◽  
Coagulase Negative Staphylococcus ◽  
Coagulase Negative Staphylococci ◽  
Staphylococcus Lugdunensis ◽  
Enterococcal Species ◽  
Viridans Group Streptococci ◽  
Culture Negative

Infective endocarditis is often caused by bacterial pathogens and can affect native and prosthetic tissue. Common pathogens in pediatric patients include Staphylococcus aureus, viridans group streptococci, enterococcal species and coagulase-negative staphylococci, though culture-negative cases are not uncommon. Coagulase-negative staphylococci present a conundrum to clinicians due to the potential of culture contamination. While Staphylococcus lugdunensis is a coagulase-negative staphylococcus, it is an emerging cardiotropic pathogen that presents similarly to Staphylococcus aureus. Here we report a case of a child with repaired tetralogy of Fallot found to have right-sided infective endocarditis caused by Staphylococcus lugdunensis.

Pyrexia of Unknown Origin (PUO)

2019 ◽  
Author(s):  
Mark Melzer
Keyword(s):  
Infective Endocarditis ◽  
Lupus Erythematosus ◽  
Bacterial Infections ◽  
Unknown Origin ◽  
Coagulase Negative Staphylococci ◽  
Pyrexia Of Unknown Origin ◽  
Hospital Patients ◽  
Intravascular Devices ◽  
Abdominal Infections ◽  
Culture Negative

Petersdorf and Beeson defined pyrexia of unknown origin (PUO) in 1961. It is defined as an illness more than three weeks’ duration, with a fever > 38.3°C on several occasions and failure to reach a diagnosis after one week of in-patient investigation. Additional categories have now been added. These include: ● Nosocomial PUO in hospital patients: This is defined as fever of 38.3°C on several occasions caused by a process not present or incubating on admission, where initial cultures are negative and diagnosis remains unknown after three days of investigations. Fever is often related to hospital factors such as surgery, use of biomedical devices (e.g. intravascular devices/urinary catheters), C. difficile infection, and decubitus ulcers related to immobilization. ● HIV- associated PUO: This is defined as fever (as in Nosocomial PUO) for four weeks as an outpatient or three days as an in- patient. The commonest causes of fever are typical and atypical mycobacterial infections, cryptococcosis, and Cytomegalovirus (CMV). Lymphoma may cause fever in up to 25% of cases. ● Neutropenic PUO: This includes patients with a fever (as in Nosocomial PUO) with neutrophils < 1.0 x 109/L, with initial negative cultures and an uncertain diagnosis after three days. Bacterial infection is the commonest cause and should be treated empirically. The causes of a PUO can be categorized as infection (30–40%), neoplasia (20–30%), collagen-vascular and autoimmune diseases (10–20%), and miscellaneous (10–20%). The commonest causes of localized bacterial infections causing PUO are infective endocarditis, intra- abdominal or pelvic infections, oral cavity infections, osteomyelitis, and infected peripheral vessels. These conditions include: ● Infective endocarditis (IE): ■ Organisms associated with indolent onset (e.g. Streptococcus viridans, Enterococcus species, coagulase- negative staphylococci). ■ HACEK organisms (e.g. Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella). ■ Culture-negative endocarditis (e.g. Chlamydia, Coxiella, or Bartonella). ■ Non- infective endocarditis: ● Marantic endocarditis, associated with malignancy. ● Libman Sacks endocarditis, associated with systemic lupus erythematosus (SLE). ● Intra-abdominal infections. ■ Abscesses: ● Hepatic (GI tract or biliary in origin). ● Splenic (associated with IE). ● Sub-phrenic (associated with previous surgery). ● Pancreatic (post-pancreatitis).

Infective endocarditis

2012 ◽  
Keyword(s):  
Infective Endocarditis ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Endocarditis Prophylaxis ◽  
Culture Negative ◽  
Variable Presentation

Presentation of endocarditis 188Diagnosis of endocarditis 190Investigation of endocarditis 192Antibiotics in endocarditis 194Stopping endocarditis treatment 196Culture-negative endocarditis 198Prosthetic valve endocarditis 200Surgery for endocarditis 202Endocarditis prophylaxis 206Outpatient review 208• Highly variable presentation—depends on intracardiac pathology, virulence of organism, and extracardiac involvement....

scholarly journals Staphylococcus lugdunensisEndocarditis Complicated by Embolism in an 18-Year-Old Woman with Mitral Valve Prolapse

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Rosaria Pecoraro ◽  
Antonino Tuttolomondo ◽  
Gaspare Parrinello ◽  
Antonio Pinto ◽  
Giuseppe Licata
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Common Iliac Artery ◽  
Antibiotic Sensitivity ◽  
Prosthetic Valve Endocarditis ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococci ◽  
Staphylococcus Lugdunensis ◽  
Mitral Valve Leaflet ◽  
History Of

Staphylococcus lugdunensisis a coagulase-negativestaphylococcus(CNS). It is a major cause of prosthetic valve endocarditis; mitral valve prolapse (MVP) has emerged as a prominent predisposing structural cardiac abnormality. We describe a case ofStaphylococcus lugdunensisendocarditis in an 18-year-old woman with preexisting mitral valve prolapse complaining of fever, a one-month history of continuous-remittent fever ( 38.6°C). The transthoracic echocardiogram revealed large vegetation on the anterior mitral valve leaflet flopping from the atrial side to the ventricular side. Five sets of blood cultures were positive for coagulase-negative staphylococci. During hospitalization, after two weeks of antibiotic therapy, the patient complained of sudden pain in her right leg associated with numbness. Lower limb arterial Doppler ultrasound showed an arterial thrombosis of right common iliac artery. Transfemoral iliac embolectomy was promptly performed and on septic embolusS. lugdunensiswith the same antibiotic sensitivity and the same MIC values was again isolated. Our patient underwent cardiac surgery: triangular resection of the A2 with removal of infected tissue including vegetation. Our case is an example of infective endocarditis byS. lugdunensison native mitral valve in a young woman of 18 with anamnesis valve prolapse.

scholarly journals The Regularity of the Site of Impaction in Recurrent Gallstone Ileus: A Systematic Review and Meta-Analysis of Reported Cases

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Nasser A. N. Alzerwi ◽  
Bandar Idrees ◽  
Saeed Alsareii ◽  
Yaser Aldebasi ◽  
Afnan Alsultan
Keyword(s):  
Mortality Rate ◽  
Older Women ◽  
Meta Analysis ◽  
Gallstone Ileus ◽  
Final Analysis ◽  
Pooled Analysis ◽  
Paired Data ◽  
History Of ◽  
High Index Of Suspicion ◽  
Overall Mortality

Objective. Due to the rarity of recurrent gallstone ileus (RGSI), its epidemiological and clinical features are elusive. With a focus on mortality and the site of impaction, this study consolidates the key clinical characteristics of index GSI (IGSI) and RGSI. Methods. A meta-analysis of cases reported on RGSI was performed. Risk factors for mortality and site of impaction were examined, and a subgroup analysis was performed for age, sex, and site of impaction (jejunum, ileum, or others). Results. In the final analysis, 50 (56 individual cases) studies were included. The paired data for the site of impaction was available for 45 patients. Women accounted for 87.3% of all RGSI cases included in the pooled analysis. The median age (interquartile range, IQR) of the patients was 70 (63–76) years, and the median time of recurrence (IQR) was 20.5 (8.5–95.5) days. The overall mortality rate was 11.8%, without correlation between the mortality rate and age, the time of recurrence, or the site of impaction. The region in which the stone was found in RGSI and IGSI was similar in most cases p = 0.002 . Logistic regression also revealed a higher probability of stone impaction in the ileum in RGSI if it was the site of impaction in IGSI. In most cases, enterolithotomy was the preferred method. Conclusions. A high index of suspicion for RGSI should be maintained for older women with a history of GSI. The region where the stone was impacted during IGSI should be investigated first in such patients.

Pathogen influence on epidemiology, diagnostic evaluation and management of infective endocarditis

Heart ◽  
2020 ◽  
Vol 106 (24) ◽  
pp. 1878-1882
Author(s):  
Khawaja M Talha ◽  
Daniel C DeSimone ◽  
M Rizwan Sohail ◽  
Larry M Baddour
Keyword(s):  
At Risk ◽  
Infective Endocarditis ◽  
Clinical Course ◽  
Prosthetic Valve Endocarditis ◽  
Target Population ◽  
Significant Shift ◽  
The Past ◽  
Risk Patients ◽  
History Of ◽  
Viridans Group Streptococci

Infective endocarditis (IE) is uncommon and has, in the past, been most often caused by viridans group streptococci (VGS). Due to the indolent nature of these organisms, the phrase ‘subacute bacterial endocarditis’, so-called ‘SBE’, was routinely used as it characterised the clinical course of most patients that extended for weeks to months. However, in more recent years, there has been a significant shift in the microbiology of IE with the emergence of staphylococci as the most frequent pathogens, and for IE due to Staphylococcus aureus, the clinical course is acute and can be associated with sepsis. Moreover, increases in IE due to enterococci have occurred and have been characterised by treatment-related complications and worse outcomes. These changes in pathogen distribution have been attributed to a diversification in the target population at risk of IE. While prosthetic valve endocarditis and history of IE remain at highest risk of IE, the rise in prevalence of injection drug use, intracardiac device implantations and other healthcare exposures have heavily contributed to the existing pool of at-risk patients. This review focuses on common IE pathogens and their impact on the clinical profile of IE.

scholarly journals P1247 Bilateral endogenous endophthalmitis as the initial presentation of hacek prosthetic valve infective endocarditis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E Parr ◽  
C Mcaloon ◽  
A Morley-Davis ◽  
P Ridley ◽  
S Duckett
Keyword(s):  
Infective Endocarditis ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Transoesophageal Echocardiography ◽  
Endogenous Endophthalmitis ◽  
Reactive Protein ◽  
First Case ◽  
Black Spots ◽  
Aortic Root Abscess ◽  
History Of

Abstract Summary A 75 year old lady with a prosthetic aortic valve (St Jude mechanical AVR) presented to ophthalmology with a one month history of black spots in the vision of her left eye with a further episode in her right eye two weeks later, leading to a diagnosis of bilateral endogenous endopthalmitis and was admitted to hospital. There was no history of trauma and the chest and abdominal examination was normal. The erythrocyte sedimentation rate (40) and C reactive protein (45.8) were elevated. She had several sets of blood cultures, which were positive for Aggregatibacter actinomycetemcomitans, a HACEK organism and was started on empirical Ceftriaxone. The transthoracic echocardiography was normal. However, the suspicion of Infective Endocarditis (IE) was high, therefore a transoesophageal echocardiography was performed and showed an aortic root abscess (Image 1). An urgent computerised aortogram was performed. Following a planned two week period of intravenous antibiotics the patient was taken to theatre to have a redo AV valve replacement and root repair. Following a prolonged period on intensive care and a six week course of pathogen directed antibiotic therapy she was then fit enough to be discharged. Conclusion We present the first case in the literature of a HACEK Prosthetic Valve endocarditis presenting with bilateral endogenous endophthalmitis. Abstract P1247 Figure. TOE image of Absess

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