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1.
Rev. bras. parasitol. vet ; 28(4): 661-670, Oct.-Dec. 2019. graf
Article de Anglais | LILACS | ID: biblio-1057968

RÉSUMÉ

Abstract We report the first documented case of endocarditis associated with Bartonella clarridgeiae in a dog in Latin America. Infective vegetative valvular aortic endocarditis was diagnosed in a 10-year-old male mixed breed dog. The dog presented grade V/VI systolic and diastolic murmur, hyperthermia, and progressive weight loss. Cardiomegaly and presence of diffuse alveolar pattern in the lung fields were observed in the thorax radiography evaluation. Irregular and hyperechogenic structures adhered to the aortic leaflets, causing obstruction of the left ventricular outflow tract and severe aortic insufficiency, were observed in the echocardiography evaluation. A vegetative, whitish, hardened structure measuring 1.0 cm in diameter was observed in aortic semilunar valve at necropsy. Based on a combination of pre-enrichment insect-based medium liquid culture, quantitative real-time and conventional PCR assays based on nuoG and gltA genes, respectively, followed by sequencing and phylogenetic inferences, B. clarridgeiae DNA was detected in the patient's aortic valve lesions. Clinical, echocardiographic, anatomopathologic and molecular features supported the diagnosis of severe aortic vegetative endocarditis possibly caused by B. clarridgeiae in a dog in Brazil.


Resumo Relatamos o primeiro caso documentado de endocardite associada à Bartonella clarridgeiae em um cão na América Latina. Endocardite aórtica valvar vegetativa infecciosa foi diagnosticada em um cão sem raça definida de 10 anos de idade. O cão apresentou sopro sistólico e diastólico de grau V / VI, hipertermia e perda progressiva de peso. Cardiomegalia e presença de padrão alveolar difuso nos campos pulmonares foram observados na avaliação radiográfica do tórax. Estruturas irregulares e hiperecogênicas aderidas aos folhetos aórticos, causando obstrução da via de saída do ventrículo esquerdo e insuficiência aórtica grave, foram observadas na avaliação ecocardiográfica. À necropsia, foi observada uma estrutura vegetativa, esbranquiçada e endurecida medindo 1,0 cm de diâmetro na válvula semilunar aórtica. Por meio de uma combinação de cultura líquida baseada em meio de pré-enriquecimento de inseto, ensaios de PCR quantitativa em tempo real e convencional baseados nos genes nuoG e gltA, respectivamente, seguidos de sequenciamento e inferências filogenéticas, DNA de B. clarridgeiae foi detectado no tecido valvular lesionado do paciente. O diagnóstico de endocardite vegetativa aórtica grave, possivelmente causado por B. clarridgeiae em um cão no Brasil, foi apoiado por características clínicas, ecocardiográficas, anatomopatológicas e moleculares.


Sujet(s)
Animaux , Mâle , Chiens , Valve aortique/microbiologie , Bartonella/génétique , Infections à Bartonella/médecine vétérinaire , Maladies des chiens/microbiologie , Endocardite/médecine vétérinaire , Bartonella/classification , Infections à Bartonella/diagnostic , Indice de gravité de la maladie , Issue fatale , Maladies des chiens/diagnostic , Endocardite/diagnostic , Endocardite/microbiologie
2.
Rev. chil. infectol ; Rev. chil. infectol;33(2): 229-231, abr. 2016. ilus
Article de Espagnol | LILACS | ID: lil-784873

RÉSUMÉ

We present a case report of a infective endocarditis by Corynebacterium pseudodiphtheriticum in a young patient eight years old with bicuspid aortic valve that led to a severe neurological embolism and death. Corynebacterium pseudodiphtheriticum is part of the nasopharyngeal and skin flora. However, there are cases reported of endocarditis usually associated with immunocompromised patients that mostly presented a poor clinical outcome.


Se presenta el caso clínico de una endocarditis infecciosa por Corynebacterium pseudodiphtheriticum en un niño de 8 años, portador de una valvulopatía aórtica bicúspide, que falleció por una embolia cerebral grave. Corynebacterium pseudodiphtheriticum forma parte de la microbiota de la piel y nasofaringe. Sin embargo, se han descrito casos de endocarditis en pacientes inmunocomprometidos, asociados, en su mayoría, a una mala evolución clínica.


Sujet(s)
Humains , Mâle , Enfant , Corynebacterium/isolement et purification , Infections à Corynebacterium/microbiologie , Endocardite bactérienne/microbiologie , Valve aortique/malformations , Valve aortique/microbiologie , Échographie , Issue fatale , Infections à Corynebacterium/imagerie diagnostique , Endocardite bactérienne/imagerie diagnostique , Maladie de la valve aortique bicuspide , Valvulopathies/complications , Valvulopathies/microbiologie
3.
Rev. bras. ter. intensiva ; 28(1): 83-86, jan.-mar. 2016. tab, graf
Article de Portugais | LILACS | ID: lil-780007

RÉSUMÉ

RESUMO A endocardite pneumocócica é uma entidade rara, cuja incidência se situa entre 1% e 3% dos casos de endocardite de válvula nativa. Esta patologia tem um prognóstico naturalmente adverso, com elevada mortalidade. Relata-se predileção pela válvula aórtica, de forma que é frequente que se apresente com insuficiência cardíaca. Apresentamos o caso de uma paciente do sexo feminino com 60 anos de idade e história pregressa de sinusite, admitida com diagnóstico de pneumonia. Após rápida deterioração, com sinais de choque séptico, ela foi transferida para a unidade de terapia intensiva. O ecocardiograma transesofágico revelou grave refluxo aórtico, devido à presença de vegetações valvares. As hemoculturas foram positivas para Streptococcus pneumoniae. A paciente foi submetida à cirurgia cardíaca e apresentou múltiplas complicações pós-operatórias. Apesar disso, apresentou lenta, porém completa recuperação. A endocardite infecciosa deve ser afastada em caso do surgimento de qualquer suspeita, e a ecocardiografia deve ser realizada precocemente nos pacientes com resposta insuficiente aos vasopressores e inotrópicos. Pacientes com endocardite pneumocócica se beneficiam de uma abordagem agressiva, com realização precoce da intervenção cirúrgica.


ABSTRACT Pneumococcal endocarditis is a rare entity, corresponding to 1 to 3% of native valve endocarditis cases. It has a typically adverse prognosis, with high mortality. There is a reported predilection for the aortic valve; thus, a common presentation is acute left heart failure. We present a case of a 60-year-old woman with a history of sinusitis, who was admitted with the diagnosis of pneumonia. She rapidly deteriorated with signs of septic shock and was transferred to the critical care unit. The transesophageal echocardiogram revealed severe aortic regurgitation due to valve vegetations. Blood cultures were positive for Streptococcus pneumoniae. She underwent cardiac surgery and had multiple postoperative complications. Nonetheless, the patient made a slow and complete recovery. Infectious endocarditis should be ruled out if any suspicion arises, and echocardiography should be performed in an early stage in patients with poor response to vasopressors and inotropes. Patients with pneumococcal endocarditis benefit from an aggressive approach, with performance of early surgery.


Sujet(s)
Humains , Femelle , Insuffisance aortique/diagnostic , Infections à pneumocoques/diagnostic , Endocardite bactérienne/diagnostic , Valvulopathies/diagnostic , Valve aortique/chirurgie , Valve aortique/microbiologie , Valve aortique/anatomopathologie , Insuffisance aortique/chirurgie , Insuffisance aortique/microbiologie , Infections à pneumocoques/microbiologie , Choc septique/physiopathologie , Streptococcus pneumoniae/isolement et purification , Échocardiographie transoesophagienne , Endocardite bactérienne/microbiologie , Valvulopathies/chirurgie , Valvulopathies/microbiologie , Adulte d'âge moyen
4.
Rev. bras. ter. intensiva ; 27(2): 185-189, Apr-Jun/2015. graf
Article de Portugais | LILACS | ID: lil-750773

RÉSUMÉ

RESUMO Este artigo relata o caso de um homem caucasiano de 43 anos de idade com nefropatia terminal em tratamento com hemodiálise e apresentando endocardite infecciosa das válvulas aórtica e tricúspide. O quadro clínico foi dominado pelo comprometimento neurológico, devido à embolia cerebral e a componentes hemorrágicos. Uma tomografia computadorizada tóraco-abdominal revelou um êmbolo séptico pulmonar. O paciente foi submetido à antibioticoterapia empírica utilizando ceftriaxona, gentamicina e vancomicina, sendo o tratamento modificado para flucloxacilina e gentamicina após o isolamento de S. aureus nas hemoculturas. A equipe multidisciplinar determinou que o paciente deveria ser submetido à substituição de válvulas após estabilização da hemorragia intracraniana; contudo, no oitavo dia após a hospitalização, o paciente entrou em parada cardíaca causada por embolia séptica pulmonar maciça, vindo a falecer. Apesar do risco de agravamento da lesão hemorrágica cerebral, em pacientes de alto risco deveria ser considerado realizar precocemente uma intervenção cirúrgica.


ABSTRACT This is a case report of a 43-year-old Caucasian male with end-stage renal disease being treated with hemodialysis and infective endocarditis in the aortic and tricuspid valves. The clinical presentation was dominated by neurologic impairment with cerebral embolism and hemorrhagic components. A thoracoabdominal computerized tomography scan revealed septic pulmonary embolus. The patient underwent empirical antibiotherapy with ceftriaxone, gentamicin and vancomycin, and the therapy was changed to flucloxacilin and gentamicin after the isolation of S. aureus in blood cultures. The multidisciplinary team determined that the patient should undergo valve replacement after the stabilization of the intracranial hemorrhage; however, on the 8th day of hospitalization, the patient entered cardiac arrest due to a massive septic pulmonary embolism and died. Despite the risk of aggravation of the hemorrhagic cerebral lesion, early surgical intervention should be considered in high-risk patients.


Sujet(s)
Humains , Mâle , Adulte , Embolie pulmonaire/anatomopathologie , Dialyse rénale/méthodes , Endocardite bactérienne/anatomopathologie , Valvulopathies/anatomopathologie , Valve aortique/microbiologie , Valve aortique/anatomopathologie , Embolie pulmonaire/complications , Embolie pulmonaire/microbiologie , Infections à staphylocoques/microbiologie , Infections à staphylocoques/anatomopathologie , Infections à staphylocoques/traitement médicamenteux , Staphylococcus aureus/isolement et purification , Valve atrioventriculaire droite/microbiologie , Valve atrioventriculaire droite/anatomopathologie , Issue fatale , Endocardite bactérienne/microbiologie , Endocardite bactérienne/traitement médicamenteux , Arrêt cardiaque/étiologie , Valvulopathies/microbiologie , Valvulopathies/traitement médicamenteux , Défaillance rénale chronique/thérapie , Antibactériens/usage thérapeutique
5.
Braz. j. infect. dis ; Braz. j. infect. dis;18(5): 561-564, Sep-Oct/2014. tab
Article de Anglais | LILACS | ID: lil-723074

RÉSUMÉ

Rothia aeria is an uncommon pathogen mainly associated with endocarditis in case reports. In previous reports, endocarditis by R. aeria was complicated by central nervous system embolization. In the case we report herein, endocarditis by R. aeria was diagnosed after acute self-limited diarrhea. In addition to the common translocation of R. aeria from the oral cavity, we hypothesize the possibility of intestinal translocation. Matrix-assisted laser desorption ionization-time of flight mass spectrometry and genetic sequencing are important tools that can contribute to early and more accurate etiologic diagnosis of severe infections caused by Gram-positive rods.


Sujet(s)
Adulte , Humains , Mâle , Valve aortique/malformations , Endocardite bactérienne/microbiologie , Infections bactériennes à Gram positif/diagnostic , Valvulopathies/microbiologie , Valve aortique/microbiologie , Translocation bactérienne , Endocardite bactérienne/diagnostic , Infections bactériennes à Gram positif/microbiologie , Valvulopathies/diagnostic
6.
Yonsei med. j ; Yonsei med. j;: 1253-1259, 2014.
Article de Anglais | WPRIM | ID: wpr-210336

RÉSUMÉ

PURPOSE: This study was conducted to evaluate the surgical outcomes of active infective endocarditis with aortic root abscess formation. MATERIALS AND METHODS: Between February 1999 and June 2012, 49 patients underwent surgery for active endocarditis with aortic root abscess. The infected valve was native in 29 patients and prosthetic in 20 patients. The patients' mean age was 50+/-14 years, and 36 patients were male. Surgery was urgent/emergent in 15 patients (31%). The abscess involved the aortic annulus (11), left ventricular outflow tract (18), fibrous trigone (16), and mitral annulus (4). In all patients, wide debridement of abscess and aortic valve replacement with or without patch reconstruction of aortic root or annulus was performed. RESULTS: There were 6 (12%) operative deaths. Causes of early mortality were sepsis (2) and multi-organ failure (4). On postoperative echocardiogram, there was significant improvement of left ventricular dimension (LVEDD, from 58.8+/-11.8 mm to 52.6+/-8.2 mm, p<0.001); however, LV ejection fraction was significantly decreased (from 61.4+/-12.0% to 49.8+/-16.5%, p<0.001). The mean follow-up duration was 68.7+/-40.4 months. There was no late death or recurrent endocarditis during follow up. New York Heart Association functional class significantly improved from 3.2+/-0.7 to 1.2+/-0.4 (p<0.001). Kaplan-Meier estimated survival at 10 years was 87.2%. CONCLUSION: Surgical treatment for active endocarditis with aortic root abscess is still challenging, and was associated with high operative mortality. Nevertheless, long-term survival was excellent with good functional capacity after recovery from the early postoperative period.


Sujet(s)
Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Abcès/chirurgie , Valve aortique/microbiologie , Débridement , Endocardite/chirurgie , Études de suivi , Prothèse valvulaire cardiaque/microbiologie , Implantation de valve prothétique cardiaque/effets indésirables , Complications peropératoires/épidémiologie , Estimation de Kaplan-Meier , Complications postopératoires/épidémiologie , Études rétrospectives
8.
Rev. argent. microbiol ; Rev. argent. microbiol;45(1): 50-3, mar. 2013.
Article de Espagnol | LILACS, BINACIS | ID: biblio-1171768

RÉSUMÉ

We herein present the case of an adult male patient who consulted for lower extremity edema, a 2- month history of fever and oppressive chest pain radiating to the left arm. He referred neither contact with breeding animals nor consumption of unpasteurized dairy products. A diagnosis of endocarditis was confirmed by cardiac studies. Since the empirical treatment with cephalotin, ampicillin and gentamicin failed, the patient underwent aortic valve replacement. A total of four blood cultures were positive with a gram-negative rod. Bacterial identification was performed using the API 20 NE technique (bioMÞrieux), the Phoenix automated method (BD) and conventional biochemical tests which were unable to classify the isolate as to genus and species. The strain was sent to the INEI-ANLIS "Dr. Carlos G. Malbrán" where it was identified as Brucella canis. The antimicrobial treatment was switched to doxycycline, rifampicin and trimethoprim-sulfamethoxazole with good evolution of the patient. The clinical significance of this case report lies in the possible failure of the empiric antibiotic therapy administered for endocarditis, since B. canis did not respond to the conventional antimicrobial treatment for this pathology.


Sujet(s)
Brucella canis/isolement et purification , Brucellose/microbiologie , Endocardite bactérienne/microbiologie , Adulte , Argentine/épidémiologie , Bactériémie/microbiologie , Brucella canis/effets des médicaments et des substances chimiques , Brucellose/chirurgie , Brucellose/épidémiologie , Brucellose/traitement médicamenteux , Association triméthoprime-sulfaméthoxazole/usage thérapeutique , Douleur thoracique/étiologie , Doxycycline/usage thérapeutique , Oedème/étiologie , Endocardite bactérienne/chirurgie , Endocardite bactérienne/épidémiologie , Endocardite bactérienne/traitement médicamenteux , Multirésistance bactérienne aux médicaments , Fièvre/étiologie , Humains , Implantation de valve prothétique cardiaque , Mâle , Rifampicine/usage thérapeutique , Association thérapeutique , Techniques de typage bactérien , Valve aortique/chirurgie , Valve aortique/microbiologie
9.
Yonsei med. j ; Yonsei med. j;: 142-146, 2009.
Article de Anglais | WPRIM | ID: wpr-52280

RÉSUMÉ

Human brucellosis has a broad spectrum of clinical manifestations, which includes endocarditis, a focal complication that is uncommon yet responsible for the majority of associated deaths. The most successful treatment outcomes of Brucella endocarditis have been reported with usage of both antimicrobial agents and surgery. However, there are few reports on the treatment of Brucella endocarditis using antibiotics only. We report the first case in Korea of Brucella endocarditis with aortic valve vegetations and an accompanying splenic abscess, which were treated successfully with antibiotic therapy alone.


Sujet(s)
Animaux , Bovins , Humains , Mâle , Adulte d'âge moyen , Abcès/microbiologie , Valve aortique/microbiologie , Brucella abortus , Brucellose/diagnostic , Industrie laitière , Endocardite/microbiologie , Corée , Maladies professionnelles/microbiologie , Rate/microbiologie , Zoonoses
10.
Arq. bras. cardiol ; Arq. bras. cardiol;91(2): 72-76, ago. 2008. ilus
Article de Anglais, Portugais | LILACS, SES-SP | ID: lil-488905

RÉSUMÉ

FUNDAMENTO: A grande diversidade de apresentações anatômicas encontradas em pacientes com endocardite infecciosa, especialmente nos que desenvolvem abscessos do anel aórtico ou fistulas intracardíacas, tem sido um complicador para o tratamento cirúrgico dessa doença. Por esse motivo, os cirurgiões têm desenvolvido opções táticas para sua correção. A consciência geral de que a retirada do tecido infectado promove uma limpeza radical, o aparecimento de colas biológicas que facilitam o fechamento dos abscessos e o surgimento de novos substitutos valvares melhoraram o resultado do tratamento. OBJETIVO: Demonstrar mais uma opção no tratamento do abscesso aórtico, para casos selecionados, tubo valvulado em posição infra-coronariana. MÉTODOS: Empreendemos a técnica em três pacientes: em dois, empregamos tubo valvulado com prótese mecânica, e em um, com prótese biológica. Dois pacientes necessitaram procedimentos associados com troca da valva mitral em um deles e plástica da valva tricúspide no outro. Todos eram reoperações de próteses em posição aórtica. RESULTADOS: A evolução cirúrgica e pós-operatória imediata foi satisfatória com os três recebendo alta da Unidade de Terapia Intensiva para o quarto. Um dos pacientes evoluiu para óbito durante a internação em razão de co-morbidades graves que já apresentava no pré-operatório, relacionadas a varizes de esôfago e comprometimento hepático. Os outros dois apresentam boa evolução no pós-operatório tardio. CONCLUSÃO: Acreditamos que essa opção seja mais uma alternativa para o tratamento de abscessos com grande comprometimento de estruturas do anel aórtico e da continuidade mitro-aórtica.


BACKGROUND: Patients with infective endocarditis show a large diversity of anatomical presentations, which has been a complicating factor for the surgical treatment of this condition, especially in those who develop abscesses in the aortic ring or intracardiac fistulae. For this reason, surgeons have been developing tactical options to repair it. There is consensus around the fact that the removal of infected tissue promotes radical cleaning, and that the outcome of the treatment has been improved by the manufacture of biological glues which facilitate the closure of abscesses and by the creation of new valve replacements. OBJECTIVE:To demonstrate yet one more treatment option for aortic abscess for selected cases: a valved conduit placed in infra-coronary position. METHODS: We employed the technique in three patients: in two of them we employed a valved conduit with a mechanical prosthesis and in one of them a valved conduit with a biological prosthesis. Two patients needed associated procedures such as replacement of mitral valve in one of them and tricuspid valvoplasty in the other. All cases involved reoperation of prostheses in aortic position. RESULTS: The progression during surgery and in the early postoperative period was satisfactory and the three patients were discharged from the Intensive Care Unit and were sent to hospital rooms. One of the patients progressed to death during hospital stay due to severe comorbidities which were present in the preoperative period, and which related to esophageal varices and hepatic involvement. The other two progressed well in the late postoperative period. CONCLUSION: We believe that this option is yet one more alternative for the treatment of abscesses with great involvement of aortic ring structures and mitro-aortic continuity.


Sujet(s)
Adulte , Humains , Adulte d'âge moyen , Abcès/chirurgie , Valve aortique/chirurgie , Endocardite bactérienne/chirurgie , Valvulopathies/chirurgie , Valve aortique/microbiologie , Valvulopathies/microbiologie , Implantation de valve prothétique cardiaque , Réintervention , Résultat thérapeutique
11.
Rev. méd. Chile ; 136(1): 31-37, ene. 2008. graf, tab
Article de Espagnol | LILACS | ID: lil-483217

RÉSUMÉ

Background: Surgery for active endocarditis is indicated in cases of congestive heart failure (CHF), persistent sepsis, systemic embolization and paravalvular involvement. Aim: To assess and report the long term results of surgery in adult patients. Patients and methods: Retrospective review of clinical records and operative procedures of 32 patients aged 43± 13 years (28 women) subjected to reparative surgery for complications of endocarditis between 1993 to 2005. Results: In 25 percent of cases, endocarditis presented as a prolonged sepsis syndrome and in 31 percent as a CHF or both. The causative bacteria was Gram (+) in 53 percent and blood cultures were negative in 47 percent. Preoperative echocardiography showed vegetations in 56 percent of cases. An annular abscess, aortic valve rupture and bicuspid valve, was observed in 13 percent of patients. Post operative mortality was due to persistent sepsis and multiorganic dysfunction in 16 percent. Mean long term follow up was 43.8±47.2 months. Actuarial survival was 78 percent at 146 months. Conclusion: Surgical management of active endocarditis provides a good symptomatic recovery, with an excellent long term actuarial survival.


Sujet(s)
Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Valve aortique/chirurgie , Endocardite bactérienne/chirurgie , Valvulopathies/chirurgie , Prothèse valvulaire cardiaque/effets indésirables , Valve atrioventriculaire gauche/chirurgie , Infections dues aux prothèses/chirurgie , Valve aortique/microbiologie , Chili/épidémiologie , Endocardite bactérienne/microbiologie , Endocardite bactérienne/mortalité , Études de suivi , Prothèse valvulaire cardiaque/microbiologie , Valve atrioventriculaire gauche/microbiologie , Infections dues aux prothèses/mortalité , Réintervention , Études rétrospectives , Sepsie/mortalité , Sepsie/chirurgie , Résultat thérapeutique
13.
P. R. health sci. j ; P. R. health sci. j;25(3): 273-278, Sept. 2006.
Article de Anglais | LILACS | ID: lil-472196

RÉSUMÉ

Coarctation of the Aorta is frequently associated with bicuspid aortic valve. This is a risk factor for infective endocarditis. Aneurysm of a sinus of Valsalva is a rare defect with a prevalence of 0.09. They are associated in 10of cases with a bicuspid aortic valve and less frequently with coarctation of the aorta and atrial septal defect. It is extremely rare the association of coarctation of the aorta with an atrial septal defect. This is one of the first cases reported in Puerto Rico of an adult patient with coarctation of the aorta in association with a bicuspid aortic valve, a ruptured aneurysm of a sinus of Valsalva and an atrial septal defect. The patient is a 22 year old male with coarctation of the aorta diagnosed since childhood who was admitted at the Cardiovascular Center of Puerto Rico with signs of heart failure due to infective endocarditis secondary to a teeth infection. Upon evaluation with transthoracic and transesophageal echos, he was found to have a coarctation at the aortic isthmus, aortic root dilatation, bicuspid aortic valve with vegetation, severe aortic and tricuspid regurgitation, aneurysm of the non coronary sinus of Valsalva with perforation to the right atrium, biatrial enlargement and a dilated right ventricle. Successful antibiotic treatment of endocarditis was achieved followed by surgical replacement of the aortic valve and ascending aorta with closure of the non coronary sinus of Valsalva was done. An secundum atrial septal defect was found and was also closed. Surgical correction of the coarctation of the aorta was postponed for a future time. The patient had a successful postsurgical recovery and was discharged home with anticoagulation treatment.


Sujet(s)
Humains , Mâle , Adulte , Anévrysme de l'aorte/complications , Coarctation aortique/complications , Communications interauriculaires/complications , Endocardite bactérienne/complications , Sinus de l'aorte/malformations , Malformations multiples , Antibactériens/usage thérapeutique , Anévrysme de l'aorte/diagnostic , Anévrysme de l'aorte/chirurgie , Coarctation aortique/diagnostic , Coarctation aortique/chirurgie , Communications interauriculaires/diagnostic , Communications interauriculaires/chirurgie , Échocardiographie-doppler couleur , Échocardiographie transoesophagienne , Endocardite bactérienne/diagnostic , Endocardite bactérienne/thérapie , Implantation de valve prothétique cardiaque , Sinus de l'aorte/chirurgie , Sinus de l'aorte , Résultat thérapeutique , Valve aortique/microbiologie , Valve aortique/chirurgie , Valve aortique
14.
Arq. neuropsiquiatr ; Arq. neuropsiquiatr;63(3A): 673-675, set. 2005. ilus
Article de Anglais | LILACS | ID: lil-409055

RÉSUMÉ

A associação de isquemia cerebral e endocardite por Streptococcus bovis é um evento raro, tendo sido publicados apenas 2 casos anteriormente. Nós relatamos o caso de um homem de 50 anos com endocardite por S. bovis que apresentou sinais isquêmicos nos lobos frontal, parietal e occipital. Este é o primeiro caso em que a hemianopsia precedeu o diagnóstico de endocardite. Inicialmente, o quadro foi confundido com vasculite. Posteriormente, foi confirmada a presença de vegetações na válvula aórtica e a hemocultura identificou S. bovis. Os eventos tromboembólicos foram controlados com o uso de antibióticos e a troca da válvula aórtica. Estudo videocolonoscópico não identificou nenhuma lesão, apesar de lesões colônicas serem descritas em até 70% dos casos de indivíduos com endocardite por S. bovis.


Sujet(s)
Humains , Mâle , Adulte d'âge moyen , Valve aortique/microbiologie , Encéphalopathie ischémique/étiologie , Endocardite bactérienne/complications , Streptococcus bovis , Infections à streptocoques/complications , Valve aortique/chirurgie , Bioprothèse , Encéphalopathie ischémique/traitement médicamenteux , Endocardite bactérienne/microbiologie , Endocardite bactérienne/thérapie , Prothèse valvulaire cardiaque , Imagerie par résonance magnétique , Infections à streptocoques/microbiologie , Infections à streptocoques/thérapie
15.
Rev. bras. cir. cardiovasc ; Rev. bras. cir. cardiovasc;16(1): 62-65, jan.-mar. 2001. ilus
Article de Portugais | LILACS | ID: lil-289383

RÉSUMÉ

A endocardite infecciosa (EI) acometendo próteses valvares é uma complicaçäo freqüente, sendo tratada geralmente com cirurgia, devido ao seu difícil controle clínico e má resposta à antibioticoterapia. Este relato descreve o caso de uma paciente com EI, acometendo simultaneamente as biopróteses aórtica (Ao) e mitral (Mi) após vinte e quatro meses de cirurgia de implantes valvares, submetida a tratamento cirúrgico conservador, e com resultado favorável. Discutem-se as vantagens deste procedimento em situaçöes específicas


Sujet(s)
Humains , Femelle , Adulte , Endocardite bactérienne/chirurgie , Implantation de valve prothétique cardiaque/effets indésirables , Valve atrioventriculaire gauche/chirurgie , Valve aortique/chirurgie , Endocardite bactérienne/étiologie , Valve atrioventriculaire gauche , Valve atrioventriculaire gauche/microbiologie , Valve aortique/microbiologie , Valve aortique
16.
Rev. argent. cardiol ; 64(supl. 5): 27-32, 1996. tab, graf
Article de Espagnol | LILACS | ID: lil-194146

RÉSUMÉ

Este estudio analizó las características de cuarenta episodios de endocarditis infecciosa en 38 pacientes con drogadicción intravenosa como factor predisponente. Tenían una edad promedio de 28,9 años; 90 por ciento eran de sexo masculino, con compromiso de válvula sana en 82,5 por ciento de los casos; 20 por ciento de los pacientes habían tenido un episodio o más de endocarditis previa; 77,5 por ciento tuvieron afectación derecha; el agente causal más frecuente fue el Staphylococcus aureus, con 70 por ciento de hemocultivos positivos y 90 por ciento de incidencia de HIV. Las complicaciones más frecuentes fueron la insuficiencia cardíaca y el tromboembolismo de pulmón.La mortalidad hospitalaria fue más elevada que la descripta habitualmente en esta población


Sujet(s)
Humains , Mâle , Femelle , Adolescent , Adulte , Adulte d'âge moyen , Endocardite bactérienne/complications , Endocardite bactérienne/diagnostic , Endocardite bactérienne/mortalité , Endocardite bactérienne/thérapie , Valve aortique/microbiologie , Valve atrioventriculaire gauche/microbiologie , Valve atrioventriculaire droite/microbiologie , VIH (Virus de l'Immunodéficience Humaine) , Mortalité hospitalière , Défaillance cardiaque , Embolie pulmonaire , Infections à staphylocoques , Troubles liés à une substance
17.
Rev. chil. infectol ; Rev. chil. infectol;13(4): 231-5, 1996.
Article de Espagnol | LILACS | ID: lil-207399

RÉSUMÉ

A male patient aged 32 developed infectious endocarditis on a congenital (and repaired) stenotic aortic valve defect. He presented with prolonged fever and wasting symptoms and also referred recurrent gingivitis. At admission, fever, systolic and diastolic aortic murmurs, and periodontitis were registered. Ultrasound imaging showed aortic vegetations reaching a maximal diameter of 49 mm and a severe aortic stenosis and insufficiency. Patient received treatment with vancomycin and gentamycin due to penicillin allergy but developed a progressive non-oliguric acute renal failure. Blood cultures revealed bacilli of uncertain gram stain that were recognized as gram negative bacilli and identified as Capnocytophaga sputigena at the National Reference Laboratory. Patient remained stable but murmurs increased and new imaging studies revealed the development of a unique septal abscess despite antibiotic therapy with intravenous ciprofloxacin. Intraoperative finding showed a perforated aortic coronary leaflet


Sujet(s)
Humains , Mâle , Adulte , Abcès/microbiologie , Capnocytophaga/isolement et purification , Endocardite bactérienne/microbiologie , Valve aortique/microbiologie , Capnocytophaga/pathogénicité , Ciprofloxacine , Bactéries à Gram négatif/effets des médicaments et des substances chimiques , Prothèse valvulaire cardiaque , Vancomycine
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