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Candida albicans tricuspid valve endocarditis in an intravenous drug addict: successful treatment with fluconazole.

https://arctichealth.org/en/permalink/ahliterature9251
Source
Scand J Infect Dis. 2005;37(4):310-1
Publication Type
Article
Date
2005
Author
Katarina Westling
Anders Thalme
Inger Julander
Author Affiliation
Department of Medicine, Division of Infectious Diseases, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden. Katarina.Westling@medhs.ki.se
Source
Scand J Infect Dis. 2005;37(4):310-1
Date
2005
Language
English
Publication Type
Article
Keywords
Antifungal Agents - therapeutic use
Candidiasis - diagnosis - epidemiology
Endocarditis - microbiology
Female
Fluconazole - therapeutic use
Heart Valve Diseases - microbiology
Humans
Middle Aged
Substance Abuse, Intravenous - complications
Sweden
Tricuspid Valve - microbiology
Abstract
An addicted, intravenous drug user was treated for Candida albicans tricuspid valve endocarditis with high dose fluconazole for 8 months, without relapse after 30 months.
PubMed ID
15804670 View in PubMed
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Early clinical course and long-term outcome of patients with infective endocarditis complicated by perivalvular abscess.

https://arctichealth.org/en/permalink/ahliterature189282
Source
CMAJ. 2002 Jul 9;167(1):19-24
Publication Type
Article
Date
Jul-9-2002
Author
Kwan-Leung Chan
Author Affiliation
University of Ottawa Heart Institute, Ont. kchan@ottawaheart.ca
Source
CMAJ. 2002 Jul 9;167(1):19-24
Date
Jul-9-2002
Language
English
Publication Type
Article
Keywords
Abscess
Adult
Aged
Aged, 80 and over
Echocardiography, Transesophageal
Endocarditis, Bacterial - complications - mortality - ultrasonography
Female
Heart Valve Diseases - microbiology - mortality - ultrasonography
Heart Valve Prosthesis
Humans
Male
Middle Aged
Ontario - epidemiology
Prognosis
Prosthesis-Related Infections - complications - mortality - ultrasonography
Abstract
Perivalvular abscess is an ominous development in patients with infective endocarditis. There is little information concerning the long-term outcome of these patients.
Patients admitted to a tertiary care centre in Ottawa between November 1987 and December 1995 because of infective endocarditis complicated by perivalvular abscess were identified by chart audit and by review of the transesophageal echocardiography database. The patients were followed for at least 4 years to determine cardiac complications, late cardiac surgery, long-term outcome and functional status.
Forty-three consecutive patients with infective endocarditis and perivalvular abscess (32 men and 11 women; mean age 56 [standard deviation 16] years) were identified; 17 had native valve endocarditis and 26 had prosthetic valve endocarditis. Of the 43 patients, 31 had cardiac surgery during the hospital stay; 6 died in hospital, and 10 died during follow-up. Twelve patients received medical treatment alone; none died in hospital, and 8 died during follow-up. The medically treated patients had less severe heart failure than the surgically treated patients (p = 0.12), but the 2 groups were similar in age and infective organisms. After a mean of 4.5 years of follow-up, the cumulative death rate was 57%; survival was similar among the medically and surgically treated patients. The survivors were younger than the nonsurvivors (p = 0.04). Complications of perivalvular abscess, including pseudoaneurysms and fistulae, were common, occurring in all medically treated patients and in 10 of the 24 surgically treated patients who had follow-up transesophageal echocardiography.
Patients with infective endocarditis and perivalvular abscess had a high rate of death after hospital discharge and a high incidence of complications of perivalvular abscess, despite early surgical intervention in most patients. Lower age was the only predictor of long-term survival.
Notes
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Comment In: CMAJ. 2002 Jul 9;167(1):38-912137076
PubMed ID
12137073 View in PubMed
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[Primary acute rheumatic fever in juveniles from an organized community].

https://arctichealth.org/en/permalink/ahliterature181464
Source
Klin Med (Mosk). 2003;81(12):25-30
Publication Type
Article
Date
2003
Author
L M Ermolina
Source
Klin Med (Mosk). 2003;81(12):25-30
Date
2003
Language
Russian
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Arthritis - microbiology
Cross Infection - epidemiology - microbiology
Digestive System - microbiology
Drug Administration Schedule
Endocarditis - microbiology
Female
Group Homes - statistics & numerical data
Heart Valve Diseases - microbiology
Humans
Male
Nasopharyngitis - complications - epidemiology - microbiology
Penicillins - administration & dosage
Recurrence - prevention & control
Rheumatic Fever - drug therapy - epidemiology - microbiology - prevention & control
Russia - epidemiology
Streptococcal Infections - complications - epidemiology
Thyroid Diseases - microbiology
Abstract
A closed population of juveniles was studied to follow-up manifestations of primary rheumatic fever. In line with other unfavourable factors, the onset of the disease within the first 6 months of the observation was due to cross streptococcal infection (foci of chronic nasopharyngeal infection were detected in 68.6% examinees, rheumatism debut after acute nasopharyngeal infection was in 91.0% patients). Persistence of streptococci was established in many blood counts in immunofluorescence reaction in 88.2% patients in acute disease, in more patients with lingering rheumatic process. Clinical manifestations include, aside from arthritis and rheumocarditis, frequent thyroid and gastrointestinal lesions. It is thought valid to raise the dose and duration of administration of penicillin in patients with primary rheumatic fever as it eradicates chronic infection foci, prevents recurrences, reduces the number of patients with a lingering course of the disease, with recurrences and valvular defects of the heart.
PubMed ID
14971152 View in PubMed
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Surgical management of infective endocarditis.

https://arctichealth.org/en/permalink/ahliterature170697
Source
J Heart Valve Dis. 2006 Jan;15(1):115-21
Publication Type
Article
Date
Jan-2006
Author
Davinder S Jassal
Ansar Hassan
Karen J Buth
Tomas G Neilan
Chris Koilpillai
Greg M Hirsch
Author Affiliation
Section of Cardiology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. umjassal@hotmail.com
Source
J Heart Valve Dis. 2006 Jan;15(1):115-21
Date
Jan-2006
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aortic Valve Insufficiency - surgery
Canada
Echocardiography
Echocardiography, Transesophageal
Endocarditis, Bacterial - surgery - ultrasonography
Female
Gram-Negative Bacterial Infections - surgery
Gram-Positive Bacterial Infections - surgery
Heart Failure - surgery
Heart Valve Diseases - microbiology - surgery
Heart Valve Prosthesis - adverse effects - microbiology
Heart Valve Prosthesis Implantation - adverse effects
Hospital Mortality
Humans
Male
Middle Aged
Mitral Valve Insufficiency - surgery
Prosthesis-Related Infections - etiology - ultrasonography
Research Design
Retrospective Studies
Survival Analysis
Treatment Outcome
Tricuspid Valve Insufficiency - surgery
Abstract
Although retrospective reviews evaluating the surgical management of infective endocarditis (IE) have been conducted in Europe and in the USA, few data exist regarding management of the condition in Canada. The study aim was to evaluate the surgical management of individuals with culture-positive active IE at a Canadian tertiary care university hospital.
A retrospective analysis was performed of 74 patients (53 males, 21 females; mean age 56 +/- 14 years) with a preoperative diagnosis of acute IE between 1995 and 2003 at the Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia. Preoperative clinical variables evaluated included the Duke criteria for endocarditis, correlation between preoperative echocardiographic imaging and intraoperative findings, and postoperative morbidity and mortality.
Native valve endocarditis (NVE) was present in 60 patients, and prosthetic valve endocarditis (PVE) in 14. All patients met the Duke criteria for endocarditis. Correlation between preoperative transesophageal echocardiography (TEE) and surgical findings (vegetations 63%, abscesses 96%, leaflet perforation 100%) was superior when compared with preoperative transthoracic echocardiography (vegetations 43%, abscesses 75%, leaflet perforation 89%). There were low rates of postoperative morbidity (reoperation 8%, stroke 5%). Overall in-hospital mortality was 14% (seven NVE, 12%; three PVE, 21%).
Herein is presented the largest and most current case series of patients treated surgically for active IE. The results demonstrate excellent agreement between preoperative TEE and intraoperative surgical findings in the current era of surgical management of this condition.
PubMed ID
16480022 View in PubMed
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