Bartonella quintana, past, present, and future of the scourge of World War I.

During World War I, a mysterious new disease affected soldiers on both sides of battle field. The first reports described a relapsing fever of unknown origin with body lice being suggested as the vector. The outbreak affected >1 000 000 people, mostly soldiers fighting in front-line trenches. Shortly afterward, the illness was known as Trench fever, of which the causal infectious agent is currently classified as Bartonella quintana.

[Severe infective endocarditis through the history]. / Les endocardites aiguës infectieuses sévères à travers l'histoire.

The history of infective endocarditis (IE) is a good example of medical progress. Initially incurable, endocarditis, when diagnosed, was synonym of death. After significant diagnostic progress, thanks to Osler's contribution especially, the first surgeries and antibacterial drugs obtained very few successful cures. We had to wait until Flamming's discovery to observe frequent cures thanks to antibiotics. Surgery manages to push possibilities of cure a bit further. However, paravalvular extensions, described since the first surgical case of IE, was a real technical matter. Thus, the second half of 20th century was devoted to overcoming this surgical challenge. In this historical review, we describe the story of severe IE, especially with paravalvular involvement, by highlighting major progress - clinical and surgical, that allows its current management.

The tale of infective endocarditis: fatal then curable but rarely preventable.

The story of infective endocarditis (IE) is a miracle of medical progress. In retrospect, it seems as a logical and orderly progression of remarkable events leading to the nearly complete conquest of the disease. IE was almost uniformly fatal until the 1st cures by surgery, followed by frequent cures with antibiotics, further improved when combined with valve surgery. Most recently, it has become almost a new disease with a change in the offending organisms, a change in the type of afflicted patients and the infection of implanted medical devices. Despite therapeutic success, prevention of IE has been elusive. In this review, the authors tell the story by highlighting major events, illustrating interconnections among branches of science that brought the authors to their present state and describing some well-known patients. For this summary, the authors are indebted to the more detailed descriptions of the IE history readily available for interested readers.

Ecocardiografia nas doenças não-coronárias / Role of echocardiography in noncoronary diseases

A ecocardiografia representa hoje técnica não-invasiva de investigação diagnóstica amplamente empregada na avaliação de pacientes portadores de valvopatias, de cardiomiopatias não relacionadas a doença arterial coronária, assim como de indivíduos apresentando doenças do pericárdio. A ecocardiografia caracteriza-se por ser método de investigação cardíaca anatômica não-invasiva, não-radioativa, apresentando alta reprodutibilidade, fácil acesso, baixo custo e grande correlação com métodos invasivos hemodinâmicos de aferição de pressões cardíacas...

Extracardiac manifestations of infective endocarditis and their historical descriptions.

In his landmark "Gulstonian Lectures on Malignant Endocarditis," published in 1885, William Osler commented, "Few diseases present greater difficulties in the way of diagnosis than malignant endocarditis, difficulties which in many cases are practically insurmountable." At that time, the fields of microbiology and blood cultures were in their infancy, and the diagnosis was made premortem in just half the patients with the condition. After Osler's report, extracardiac physical findings became essential clues to earlier diagnosis. Today, infective endocarditis is most commonly suggested from the history and often clinched by an echocardiogram and blood cultures. Although prized physical manifestations are much less frequent now, they still do occur and may be an invaluable clue that leads to earlier, more effective treatment. The investigators review these extracardiac findings along with their historical descriptions: splinter hemorrhages, emboli, Osler's nodes, Janeway and Bowman lesions of the eye, Roth spots, petechiae, and clubbing.

Sir A. E. Garrod, congenital heart disease in Down syndrome, and the doctrine of fetal endocarditis.

Archibald Garrod was apparently the first to document congenital heart disease as a component of Down syndrome. This arose from his interest in fetal endocarditis, a theoretical cause of cardiac malformations, in vogue roughly from 1840-1940, that drew its strength from analogies with rheumatic heart disease in adults. Garrod's discovery sheds light not only on nineteenth century ideas about teratology, but also on his methodology, genius, and approaches that, in many ways, foreshadowed the techniques that guided his later work on inborn errors.

Centenary of the first correct antemortem diagnosis of coronary thrombosis by Adam Hammer (1818--1878): English translation of the original report.

William Heberden (1710--1801), in 1768, described angina pectoris, the classic symptom of ischemic heart disease, 150 years after the discovery of the coronary circulation by William Harvey (1578-1657). Another 110 years had elapsed before the first antemortem diagnosis (confirmed at autopsy) of coronary thrombosis was reported by Adam Hammer in 1878. The patient was a 34 year old man who died some 19 hours after a sudden collapse. Although the patient's clinical features were atypical (such as the absence of angina and the presence of complete heart block) and the autopsy showed vegetative aortic endocarditis that appeared to be causally related to the thrombotic coronary occlusion, Hammer's astute and carefully reasoned bedside diagnosis was history-making and deserves to be so recognized.