The study describes 153 necropsy cases of infective endocarditis (IE) encountered in a university hospital over a period of 23 years (1970-1992), with necropsy incidence of 0.63%. The average age of patients at the time of death was 51.7 years. Both the incidence and the average age tended to increase during the period studied. The location of infective vegetations was mostly in the left heart and univalvular (mitral in 41%, aortic in 33%). The mitral valves involved by IE were otherwise normal in 62%; the aortic valves were normal in 33%. The spectrum of microorganisms yielded by postmortem cultivations is compared with that obtained by blood cultures during life. Staphylococcus aureus comprised 60% of all positive clinical blood cultures and 40% of all organisms grown postmortally. Gram-negative bacilli, streptococci and mycoses appeared as further important etiologic agents. Discussed in more detail are the subgroups of tricuspid valve IE (5% of all cases), IE in patients on chronic hemodialysis (17%), and IE involving prosthetic valves (9%).
- MeSH
- Endocarditis, Bacterial pathology MeSH
- Child MeSH
- Adult MeSH
- Endocarditis microbiology pathology MeSH
- Infant MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Mycoses pathology MeSH
- Myocardium pathology MeSH
- Child, Preschool MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Infant MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Child, Preschool MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- English Abstract MeSH
- Journal Article MeSH
Isolated infectious endocarditis of the pulmonary valve is a rare condition and represents 1,5-2% of all cases of infectious endocarditis. We present a case of a 37year-old woman without any relevant medical history. The woman was hospitalized with hallmarks of severe sepsis and bilateral pneumonia; she died several hours after admission with progressive multiorgan failure and disseminated intravascular coagulopathy. Microbiologic examination approved Staphylococcus aureus as the etiological agent. The autopsy showed isolated endocarditis of the pulmonary valve, without any known predisposing factor. Literary data refer single cases or small groups of patients with isolated pulmonary infectious endocarditis. The clinical suspicion of this rare disease in differential diagnosis of febrile conditions is an essential factor in prognosis of afflicted persons. The crucial diagnostic methods for infectious endocarditis are echocardiography and CT examination.
- Keywords
- infectious endocarditis - pulmonary valve - Staphylococcus aureus - sepsis.,
- MeSH
- Endocarditis, Bacterial * diagnostic imaging MeSH
- Adult MeSH
- Echocardiography MeSH
- Endocarditis * diagnostic imaging MeSH
- Humans MeSH
- Pulmonary Valve * diagnostic imaging microbiology MeSH
- Staphylococcal Infections * diagnostic imaging MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- MeSH
- Endocarditis, Bacterial * MeSH
- Humans MeSH
- Mouth Diseases * MeSH
- Sepsis MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- MeSH
- Endocarditis, Bacterial blood classification complications diagnosis etiology mortality MeSH
- Infections MeSH
- Humans MeSH
- Kidney Diseases complications MeSH
- Prognosis MeSH
- Endocarditis, Subacute Bacterial diagnosis MeSH
- Terminology as Topic MeSH
- Age Factors MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
A 64-year old female patient with polymorbidity, including diabetes, was admitted to our clinic with a suspicion of silent myocardial infarction. However, no acute coronary lesion was subsequently confirmed. Transthoracal echocardiography performed just after the admission suggested infective endocarditis. The diagnosis was difficult due to a lack of collaboration by the patient who was disoriented and confused. Because of the suspicion ofendocarditis, a therapy with antibiotics was started immediately and the diagnosis was confirmed by oesophageal echocardiography and heart MR performed after the patient was stabilized. An early diagnosis and an intensive antibiotic treatment are crucial for the management of the frequently fatal infective endocarditis.
- MeSH
- Endocarditis, Bacterial complications diagnosis diagnostic imaging MeSH
- Early Diagnosis MeSH
- Diagnosis, Differential MeSH
- Echocardiography MeSH
- Myocardial Infarction diagnosis MeSH
- Middle Aged MeSH
- Humans MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
In a 10-month-old infant with purulent pneumococcal meningitis without structural heart disease acute infectious endocarditis developed. Echocardiographic examination revealed vegetations on both cusps of the mitral valve. With regard to the age and critical condition of the infant, in the acute stage surgical removal of the vegetations, was not indicated. During long-term intravenous antibiotic therapy the vegetations on the mitral valve and clinical and laboratory manifestations of endocarditis disappeared. The valve was, however, devastated and the child developed severe mitral insufficiency. Because of progressive cardiac failure which could not be controlled by drugs, at the age of 19 months a plastic operation of the mitral valve had to be performed after which the haemodynamics and clinical condition improved markedly.
- MeSH
- Endocarditis, Bacterial * diagnosis microbiology therapy MeSH
- Infant MeSH
- Humans MeSH
- Pneumococcal Infections * diagnosis microbiology therapy MeSH
- Check Tag
- Infant MeSH
- Humans MeSH
- Female MeSH
- Publication type
- English Abstract MeSH
- Journal Article MeSH
- Case Reports MeSH
Infective endocarditis can be divided from practical point of view into native valve endocarditis and prosthetic valve endocarditis. With regard to aquired endocarditis, endocarditis in intravenous drug abusers can be separetly differentiated. Echocardiography and microbio-logical cultures are essential for dia-gnosis. Treatment consists of antibio-tic therapy and often surgical procedure is required. We present a case report of an intravenous drug abuser with a tricuspid valve endocarditis, successfully treated with antibio-tic therapy and a following surgical valve repair.
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Endocarditis, Bacterial etiology therapy MeSH
- Substance Abuse, Intravenous complications MeSH
- Humans MeSH
- Staphylococcal Infections complications drug therapy MeSH
- Tricuspid Valve diagnostic imaging microbiology surgery MeSH
- Ultrasonography MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Names of Substances
- Anti-Bacterial Agents MeSH
BACKGROUND: Infective endocarditis still remains a cardiological menace. However, the type of predisposing diseases has changed: the incidence of rheumatic heart disease in advanced countries has declined, advances made in the surgical and medicamentous treatment of inborn heart disease are the reasons why we are encountering, with increasing frequency, infective endocarditis which develops on their background. METHODS AND RESULTS: The objective of the investigation was to assess the frequency of infective endocarditis and predisposing diseases. During the time interval between 1987 and 1991 16 patients (50% younger than 50 years) were hospitalized with the diagnosis of infective endocarditis. Rheumatic valvular damage and inborn heart disease were the predisposing factor in 25%. All patients were younger than 30 years (mean 24, range 18-30), and half the patients suffered from defects of the ventricular septum. Other defects were tetralogy of Fallot and inborn aortic stenosis. In 10% of the patients infective endocarditis developed on the background of a mitral valve prolapse with regurgitation. Echocardiographic examination confirmed the diagnosis in almost 70% by revealing vegetation. Bacteriological examination revealed the agent in 60%, most frequently it was Streptococcus viridans. The mortality rate in the group was 13%. CONCLUSIONS: The recorded incidence of infective endocarditis, 1.5 pro mille, is consistent with data in the literature. Corrected and not corrected heart disease plays an important role as predisposing disease. Despite the opportunity of intensive antibiotic treatment, the mortality remains high--13%.
- MeSH
- Endocarditis, Bacterial complications MeSH
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Heart Defects, Congenital complications MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Publication type
- English Abstract MeSH
- Journal Article MeSH
- MeSH
- Aspergillosis diagnosis MeSH
- Endocarditis, Bacterial diagnosis MeSH
- Child MeSH
- Endocarditis diagnosis MeSH
- Humans MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Publication type
- English Abstract MeSH
- Journal Article MeSH
- Case Reports MeSH
