Infective and inflammatory cardiac conditions

2010 ◽  
pp. 191-224
Author(s):  
Juan Carlos Kaski
Keyword(s):  
Clinical Practice ◽  
Infective Endocarditis ◽  
Heart Valves ◽  
Antimicrobial Prophylaxis ◽  
Current Clinical Practice ◽  
Cardiac Tissues ◽  
Prosthetic Valves ◽  
Fungal Endocarditis ◽  
Culture Negative

Infective endocarditis 192 Treatment of endocarditis 194 Enterococcal endocarditis 204 Endocarditis caused by HACEK organisms 210 Fungal endocarditis 212 Culture-negative endocarditis 214 Antimicrobial prophylaxis 218 Pericarditis 220 Myocarditis 223 Infective endocarditis is an infection of the endocardium which usually involves the heart valves. In current clinical practice, endocarditis encompasses a heterogeneous collection of infections that may involve native cardiac tissues, prosthetic valves, pacing systems, and a variety of intracardiac implants. Endocarditis is mainly caused by bacteria, but fungi are occasionally implicated....

scholarly journals Native versus Prosthetic Valve Histoplasma capsulatum Infective Endocarditis: A Case Report and Systemic Literature Review Comparing Patient Presentation, Treatment Modalities, Clinical Outcomes, and Diagnostic Laboratory Testing

2021 ◽  
Author(s):  
Bobby L Boyanton Jr. ◽  
Harry Boamah ◽  
Carl B Lauter
Keyword(s):  
Infective Endocarditis ◽  
Literature Review ◽  
Antifungal Therapy ◽  
Laboratory Testing ◽  
Prosthetic Valve ◽  
Histoplasma Capsulatum ◽  
Treatment Modalities ◽  
Diagnostic Laboratory ◽  
Prosthetic Valves ◽  
Fungal Endocarditis

Abstract Histoplasma capsulatum is a rare cause of fungal endocarditis that affects both native and prosthetic valves. It is associated with a high mortality rate if not diagnosed early and treated with a combination of antifungal therapy and surgical intervention. We present a case of a 47-year-old man with histoplasmosis infective endocarditis. He was successfully treated with antifungal therapy and surgical replacement of the infected bioprosthetic aortic valve. Our systemic literature review includes fifty-two articles encompassing sixty individual cases of H. capsulatum infective endocarditis from 1940 to 2020. Patient presentations, diagnostic laboratory testing accuracy, treatment modalities and patient outcomes, comparing and contrasting native and prosthetic valve infection, are described.

Infective Endocarditis

2014 ◽  
pp. 18-26
Author(s):  
Anju Nohria
Keyword(s):  
Heart Failure ◽  
Infective Endocarditis ◽  
Heart Valves ◽  
Interventricular Septum ◽  
Inflammatory Cells ◽  
Chordae Tendineae ◽  
Systemic Complications ◽  
Fungal Endocarditis ◽  
Mycotic Aneurysms ◽  
Endocardial Surface

Infective endocarditis (IE) is an infection of the endocardial surface of the heart. It is characterized by one or more vegetations, which comprise a mass of platelets, fibrin, microorganisms, and inflammatory cells. IE primarily involves the heart valves (native or prosthetic). Other structures may also be involved, including the interventricular septum, the chordae tendineae, the mural endocardium, or intracardiac devices such as a pacemaker. The most common infective causes are bacterial; however, fungal endocarditis can be seen in patients who are immunocompromised. There is controversy about the existence of viral endocarditis. Valvular involvement in IE may lead to congestive heart failure, conduction abnormalities, and myocardial abscesses. Systemic complications in IE include embolization of both sterile and infected emboli, abscess formation, and mycotic aneurysms.

scholarly journals Infective Endocarditis in Children — New Approach in Antimicrobial Prophylaxis

2016 ◽  
Vol 1 (1) ◽  
pp. 9-11
Author(s):  
Rodica Togănel
Keyword(s):  
Infective Endocarditis ◽  
Heart Valves ◽  
Task Force ◽  
Antimicrobial Prophylaxis ◽  
Bacterial Endocarditis ◽  
New Approach ◽  
Secondary Damage ◽  
Risk Patients ◽  
European Society Of Cardiology ◽  
Significant Mortality

Abstract Infective endocarditis (IE) is an infection of the endocardium and/or heart valves with the formation of a thrombus and secondary damage of the involved tissue, with significant mortality and severe complications. The prevention of bacterial endocarditis is of great controversy. Antimicrobial prophylaxis is usable in the prevention of endocarditis by killing bacteria before or after their extension to the damaged endocardium. No human studies offer strong evidence to support the efficacy of antibiotic prophylaxis so far, thus it could be potentially dangerous. Therefore, the European Society of Cardiology (ESC) may need to reconsider and update the previous guidelines with the proposal of reducing the prophylactic approach of IE. The 2015 Task Force recommends prophylaxis for highest risk patients undergoing highest risk procedures, focused on prevention rather than prophylaxis of IE, especially in nosocomial endocarditis.

scholarly journals Pediatric infective endocarditis initially presenting as hemorrhagic stroke

2020 ◽  
Vol 60 (3) ◽  
pp. 167-72
Author(s):  
Emir Yonas ◽  
Raymond Pranata ◽  
Vito Damay ◽  
Nuvi Nusarintowati
Keyword(s):  
Infective Endocarditis ◽  
Heart Valves ◽  
Hemorrhagic Stroke ◽  
Prognostic Markers ◽  
Antimicrobial Prophylaxis ◽  
Common Complication ◽  
Patients At Risk ◽  
Considerable Controversy ◽  
Frequent Site ◽  
The Brain

Infective endocarditis refers to infection of the heart valves. While its incidence is low, it may cause serious complications. Despite advances in its management and diagnosis, this condition still retains high mortality and significant morbidity. Considerable controversy remains regarding antimicrobial prophylaxis to prevent infective endocarditis in patients with congenital heart disease. Neurologic complications are the second most common complication in patients with infective endocarditis, occurring in approximately 33% of cases.1 These include encephalopathy, meningitis, stroke, brain abscess, cerebral hemorrhage, and seizures. The vegetation formed as a consequence of endocarditis may dislodge and cause embolization. Vegetation size alone is an unreliable marker for embolization risk, however, size, in addition to location, mobility, infecting agent, and presence of antiphospholipid antibodies have the potential to be prognostic markers. The brain is the most frequent site of embolization. Furthermore, advances in medical approaches have resulted in an increase of patients at risk of endocarditis due to the now common and widely available indwelling intravascular approaches in medicine. In this report, we present a case of infective endocarditis in a child first presenting with hemorrhagic stroke.1,2

Infective endocarditis: Importance of molecular biological techniques in etiological diagnosis

2016 ◽  
Vol 88 (11) ◽  
pp. 62-67 ◽  
Author(s):  
E O Kotova ◽  
E A Domonova ◽  
Yu L Karaulova ◽  
A S Milto ◽  
A S Pisaryuk ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Heart Valves ◽  
Venous Blood ◽  
Bacteriological Examination ◽  
Etiological Diagnosis ◽  
Causative Agents ◽  
Pathogen Dna ◽  
Dna Pcr ◽  
Culture Negative ◽  
Molecular Biological Techniques

Aim. To investigate the specific features of conventional bacteriological methods and current molecular biological techniques for the etiological diagnosis of infective endocarditis (IE). Subjects and methods. Examinations were made in 53 patients treated at City Clinical Hospital Sixty-Four, Moscow Healthcare Department, in 2012—2015 who underwent simultaneous bacteriological and molecular biological (polymerase chain reaction (PCR) or PCR with further sequencing) examinations of blood or resected cardiac valve tissues. Results. The investigation included 53 patients (31 men; median age, 62 years) with IE (Duke 2009); its primary form was observed in 32 (60.4%) patients. Blood bacteriological tests and PCR assays were positive in 28 (52.8%) and 34 (64.2%) patients, respectively. There were concordant results in 21 of the 28 positive blood culture cases and discordant results in 7 (25%); at the same time 3 cases showed a compete discordance in the detected causative agents (the growth of Enterococcus spp. was revealed by bacteriological examination and that of Staphylococcus spp., Streptococcus spp., and Escherichia coli by DNA PCR) and a pathogen could not be identified by DNA PCR in 4 patients who had positive blood bacteriological results. The positive PCR results for cocci and fungi were obtained in 10 of the 25 (47.2%) examinees with culture-negative IE. Rare causative agents were not revealed. The tissues obtained from 8 resected damaged heart valves displayed a wider spectrum of pathogens than did blood samples, which was associated with the formation of bacterial films. Conclusion. The etiological agent of IE was revealed in venous blood by bacteriological examination in 52.8% of the examinees, by PCR in 64.2%, and by either in 71.7%. There were concordant and discordant results in 67.9 and 32.1% of the patients, respectively; among whom 18.9% were found to have pathogen DNA revealed by PCR in culture-negative IE.

Ankle Brachial Pressure Index and compression application: Review summary

2019 ◽  
Vol 27 (2) ◽  
pp. 74-77
Author(s):  
Victoria Team ◽  
Georgina Gethin ◽  
John D Ivory ◽  
Kimberley Crawford ◽  
Ayoub Bouguettaya ◽  
...  
Keyword(s):  
Content Analysis ◽  
Clinical Practice ◽  
Venous Insufficiency ◽  
Arterial Disease ◽  
Leg Ulcers ◽  
Current Clinical Practice ◽  
Ankle Brachial Pressure Index ◽  
Arterial Circulation ◽  
Pressure Index ◽  
Peripheral Arterial

Venous leg ulcers (VLUs) are a significant complication amongst persons with chronic venous insufficiency (CVI) that frequently follow a cycle of healing and recurrence. Current clinical practice guidelines (CPGs) recommend applying below knee compression to improve VLU healing. Compression could be applied if the Ankle Brachial Pressure Index (ABPI) rules out significant arterial disease, as sufficient peripheral arterial circulation is necessary to ensure safe compression use. We conducted a content analysis of 13 global CPGs on the accuracy of recommendations related to ABPI and compression application. Eight CPGs indicated that compression is recommended when the ABPI is between 0.8 and 1.2 mmHg. However, this review found there is disagreement between 13 global VLU CPGs, with a lack of clarity on whether or not compression is indicated for patients with ABPIs between 0.6 and 0.8 mmHg. Some CPGs recommend reduced compression for treatment of VLUs, while others do not recommend any type of compression at all. This has implications for when it is safe to apply compression, and the inconsistency in evidence indicates that specialist advice may be required at levels beyond the ABPI “safe” range listed above.

Role of niacin in current clinical practice

2019 ◽  
Vol 110 (1) ◽  
Author(s):  
Abhishek Sharma ◽  
Nidhi Madan
Keyword(s):  
Clinical Practice ◽  
Current Clinical Practice
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