Isolated Atrial Septal Defect Complicated by Tricuspid Valve Infective Endocarditis.

Infective endocarditis (IE) associated with atrial septal defect (ASD) is extremely rare. However, tricuspid regurgitation (TR) secondary to right ventricular overload is a potential cause of IE, and once it occurs, the development of a paradoxical embolism may lead to fatal complications. We herein report the case of a 50-year-old woman who was admitted due to a persistent fever resistant to antibiotics. Echocardiography showed secundum ASD, moderate TR and a mobile vegetation measuring 15×10 mm attached to the tricuspid valve. Given the risk of developing a paradoxical embolism, urgent surgery was successfully performed.

Gerbode type defect and third degree atrioventricular block in association with bacterial endocarditis in a dog.

Gerbode type defects are rare left ventricular outflow tract-right atrial communications in people that may be congenital or acquired; they have been reported only once previously in dogs. Acquired forms in humans have been reported secondary to bacterial endocarditis, trauma, and valve replacement surgery, among other causes. We report a case of left ventricular outflow tract to right atrium and right ventricle communications (Gerbode type defect) in association with aortic and tricuspid valve bacterial endocarditis in a geriatric dog. The dog also developed third degree atrioventricular block and had underlying subaortic stenosis. The authors hypothesize that the Gerbode type defect in this case was acquired secondary to invasion and destruction of the membranous interventricular septum due to bacterial endocarditis.

Left ventricular outflow tract-right atrial communication (Gerbode type defect) associated with bacterial endocarditis in a dog.

Left ventricular (LV) outflow tract-right atrial (RA) communication associated with bacterial endocarditis is described in a 6-year-old intact male Great Pyrenees dog with a 4- to 5-day history of fever, lethargy, weight loss, severe regenerative anemia, and asplenia. Typical vegetative mural endocardial lesions were observed grossly. Histologic evaluation revealed small gram-negative coccobacilli that were consistent with Bordetella avium-like organisms. These bacteria were associated with severe endocardial inflammation characterized by neutrophilic infiltration, extensive necrosis of endocardium, and fibrin deposition. LV-RA shunt (Gerbode defect) is a rare cardiac defect in humans that can be either congenital or, more rarely, secondary to septic endocarditis, valve replacement procedures, or thoracic trauma. B. avium-like organisms causing septicemia and endocarditis in immunocompromised and asplenic human patients have been described. To our knowledge, no previous descriptions of Gerbode defect associated with bacterial endocarditis in domestic animals have been reported in veterinary literature.

Atrial septal defect presenting with Brucella endocarditis.

Brucella endocarditis, although a rare complication of brucellosis, is the main case of death attributable to this disease. An atrial septal defect (ASD) presenting with endocarditis in an adult is also extremely rare. We report the case of a male patient who presented with an infective endocarditis and was found to have an ASD. The diagnosis was proven by means of positive serology and isolation of Brucella melitensis from blood cultures and excised vegetation arising from the border of the ASD. The patient was successfully treated by means of excision of the vegetation and specific antibiotic therapy for 3 months.

Recurrent vertebral osteomyelitis and psoas abscess caused by Streptococcus constellatus and Fusobacterium nucleatum in a patient with atrial septal defect and an occult dental infection.

We describe a case in which recurrent vertebral osteomyelitis and psoas abscess due to Streptococcus constellatus and Fusobacterium nucleatum developed in a patient with a previously unrecognized atrial septal defect with bidirectional shunts. Disease recurrence was ascribed to the presence of dental disease, which served as the source of infection. To the best of our knowledge, this is the first case in which vertebral osteomyelitis and psoas abscess have been associated with atrial septal defect.

Herpesvirus hominis: isolation from human trigeminal ganglion.

Herpesvirus hominis was isolated from the trigeminal ganglion obtained at autopsy from 1 of 22 patients with no clinical evidence of active herpetic disease, and from one patient with malignant lymphoma who died with herpes zoster on the abdomen, pulmonary cytomegalic inclusion disease, and possible oral herpes simplex. Virus was isolated by cocultivation of explants of ganglion with monolayers of Vero green monkey kidney cells and required 3 weeks of culture before viral cytopathic effects were evident. These observations support the concept that latent infection of sensory ganglia may be the source of virus in recurrent herpetic disease in man.