scholarly journals 696. Bartonella quintana Endocarditis, A Case Series

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S400-S400
Author(s):  
Thomas D Dieringer ◽  
Glen Huang ◽  
Paul R Allyn ◽  
Jeffrey Klausner
Keyword(s):  
Renal Failure ◽  
Infective Endocarditis ◽  
Los Angeles ◽  
Aortic Valve ◽  
Literature Review ◽  
Case Series ◽  
The United States ◽  
Aortic Insufficiency ◽  
Homeless Population ◽  
Bartonella Quintana

Abstract Background Homelessness has been a growing issue in the United States and worldwide. Bartonella quintana, the causative agent of “Trench fever”, is a well known illness among homeless populations in urban centers. While many cases of B. quintana are self limited, the disease can have advanced presentations including endocarditis. We present a short case series of three cases of B. quintana infective endocarditis (IE) in homeless individuals in Los Angeles and review the literature of cases of B. quintana IE in the homeless population. Methods Here we report three cases of B. quintana IE encountered in homeless individuals at the University of California, Los Angeles (UCLA) hospital system. A literature review was also conducted. PubMed was searched for published cases of human IE secondary to B. quintana in homeless individuals. Results All three patients were male with ages ranging from 39 to 57 years old with a history of homelessness and alcohol use. Presentations were subacute to chronic in nature consisting of constitutional symptoms as well as a range of symptoms corresponding with heart and renal failure. Each patient was found to have varying degrees of aortic insufficiency with either identified aortic valve vegetation or valvular thickening. Diagnosis was made with a combination of Bartonella serologies and whole genome sequencing PCR. All three patient’s courses were complicated by renal failure at varying points limiting the use of gentamicin for the full treatment course. Two patients ultimately underwent aortic valve replacement due to severe aortic insufficiency and completed therapy with doxycycline and rifampin. A single patient was discharged with plan to complete doxycycline and rifampin therapy however was lost to follow up. A literature review of 10 manuscripts describing 13 cases of B. quintana IE were identified. All the patients were male and the median age was 45. Six of the cases were in Europe and eight were in North America. All cases had left sided valve involvement (10 aortic, 6 mitral, 3 both valves). No cases of right sided IE were identified. Conclusion B. quintana IE should be considered in homeless patients with a clinical presentation concerning for IE. A combination of serology and PCR testing can be useful in diagnosis of this uncommon cause of infective endocarditis. Disclosures Jeffrey Klausner, MD, MPH, Nothing to disclose

scholarly journals The Gerbode defect: a case series

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Nicholas Sunderland ◽  
Ahmed El-Medany ◽  
Justin Temporal ◽  
Laura Pannell ◽  
Gemina Doolub ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Case Series ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Cardiac Complications ◽  
Low Grade ◽  
Care Needs ◽  
Intravenous Antibiotics ◽  
Gerbode Defect

Abstract Background  The Gerbode defect is a rare abnormal communication between the left ventricle (LV) and right atrium (RA). The lesion is either congenital or acquired. Acquired defects are largely iatrogenic or infective in origin. We present two cases of acquired Gerbode defects with similar clinical presentations but very different outcomes. Case summaries Patient 1 A 64-year-old male presented with features of decompensated cardiac failure and a low-grade temperature. Dehiscence of a recently implanted bioprosthetic aortic valve and high-velocity LV to RA jet (Gerbode defect) was found on echocardiography. Blood cultures grew Staphylococcus warneri and the diagnosis of infective endocarditis was established. The patient was treated with intravenous antibiotics and the aortic valve and Gerbode defect were successfully surgically repaired. Patient 2 An 81-year-old male presented after being found on the floor at home. On admission, he was clinically septic with evidence of decompensated heart failure. No clear infective focus was initially found. Transthoracic echocardiography revealed severe left ventricular impairment, with a normal bioprosthetic aortic valve. He was treated with intravenous antibiotics, but later deteriorated with evidence of embolic phenomena. Repeat echocardiography revealed a complex infective aortic root lesion with bioprosthetic valve dehiscence and flow demonstrated from the LV to RA. Unfortunately, the patient succumbed to the infection and cardiac complications. Discussion  The Gerbode defect is a rare but important complication of infective endocarditis and valve surgery. Care needs to be taken to assess for Gerbode defect shunts on echocardiogram, especially in the context of previous cardiac surgery.

Mobilizing a Community–Academic Partnership to Provide DIY Handwashing Stations to Skid Row Residents During COVID-19

2020 ◽  
Vol 22 (1) ◽  
pp. 9-12
Author(s):  
Graham DiGuiseppi ◽  
Callahan Corcoran ◽  
Todd Cunningham ◽  
Hoan Nguyen ◽  
Monique Noel ◽  
...  
Keyword(s):  
Los Angeles ◽  
The United States ◽  
Academic Community ◽  
Homeless Population ◽  
Community Partnership ◽  
Skid Row ◽  
Similar Work ◽  
Stable Housing ◽  
Do It Yourself ◽  
Novel Coronavirus

The coronavirus (COVID-19) pandemic is having a devastating impact on global health. In the United States and abroad, there is concern for how the novel coronavirus will affect vulnerable populations, including people experiencing homelessness. Individuals who lack stable housing are more likely to have preexisting health conditions and limited access to basic preventative hygiene practices such as handwashing and sanitizing. The situation has become critical in Los Angeles’ Skid Row neighborhood, where nearly 5,000 unhoused residents (13% of the city’s homeless population) reside on any given night. Community members’ concerns have mounted as social and health services in the area have decreased, and early efforts to prevent the transmission of coronavirus did not adequately address the lack of access to handwashing stations and hand sanitizing products. This Practice Note details an academic–community partnership that uses grassroots organizing to provide “do-it-yourself” handwashing stations to the Skid Row neighborhood. We describe how an academic–community partnership was mobilized to establish innovative practices in response to the coronavirus, offering lessons and recommendations for others hoping to do similar work.

scholarly journals Dressler’s like pericarditis with pericardial effusion is the presenting feature of infective endocarditis

2018 ◽  
Vol 15 (1) ◽  
pp. 43-44
Author(s):  
Biswajit Majumder ◽  
Sharmistha Chatterjee ◽  
Rakesh Sarkar ◽  
Pritam Kumar Chatterjee
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Renal Failure ◽  
Infective Endocarditis ◽  
Pericardial Effusion ◽  
Aortic Valve ◽  
Medical Therapy ◽  
Surgical Intervention ◽  
Autoimmune Reaction ◽  
Pericardial Involvement

Summary: Infective Endocarditis (IE) being primarily the disease of valves and endocardium may occasionally be complicated with pericardial involvement in the form of pericarditis and pericardial effusion (PE). Pericarditis may be observed incidentally at the time of diagnosing IE and rarely does it remain the presenting feature of IE .The pericardial effusion may be attributed to ruptured aortic abscess extending into the pericardial space, autoimmune reaction, renal failure, HIV and congestive heart failure (CHF). Here we are presenting a 42 year old male having IE with vegetation in both mitral and aortic valve along with large sterile pericardial effusion was treated successfully by the medical therapy alone with favorable outcome. IE presenting with large exudative pericardial effusion being treated without any surgical intervention with substantial resolution of effusion has not been reported so far in medical literature.Nepalese Heart Journal 2017;12(2): 43-44.

scholarly journals Type A Quadricuspid Aortic Valve Infective Endocarditis Complicated by Multiple Aortocardiac Fistulae: Case Report and Brief Literature Review

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Amine Ghalem ◽  
Mohammed Bachrif ◽  
Anass Hbali ◽  
Mostapha Beghi ◽  
Nabila Ismaili ◽  
...  
Keyword(s):  
Case Report ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Literature Review ◽  
Aortic Dissection ◽  
Female Patient ◽  
Type A ◽  
Quadricuspid Aortic Valve ◽  
Urgent Surgery

Aortocardiac fistulae (ACF) are exceptionally due to infective endocarditis; they are usually congenital, posttraumatic, or complicate aortic dissection. In infective endocarditis setting, their presence should prompt urgent surgery as patients can deteriorate rapidly. We report the case of a 78-year-old female patient with the first ever reported quadricuspid aortic valve infective endocarditis complicated by multiple aortocardiac fistulae. Additionally, we provide a brief review of ACF, in infective endocarditis and quadricuspid aortic valve.

Long-term outcomes in 3 cases of quadricuspid aortic valve, using a new classification system: A case series and literature review

2019 ◽  
Vol 36 (3) ◽  
pp. 595-597 ◽  
Author(s):  
Toshimitsu Tsugu ◽  
Mitsushige Murata ◽  
Jin Endo ◽  
Takashi Kawakami ◽  
Hikaru Tsuruta ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Literature Review ◽  
Classification System ◽  
Case Series ◽  
Quadricuspid Aortic Valve ◽  
Long Term Outcomes ◽  
New Classification ◽  
System A

scholarly journals Cancer care for the homeless population: a literature review

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Gil-Salmerón ◽  
C Gutiérrez-Schiavon
Keyword(s):  
Cancer Screening ◽  
Literature Review ◽  
Cancer Care ◽  
Adult Population ◽  
The United States ◽  
Homeless Population ◽  
Community Based ◽  
Treatment Services ◽  
Screening Strategies ◽  
Unequal Access

Abstract Background The last global survey in 2005 of the United Nations estimated that 100 million people were homeless. Cancer is becoming one of the most important public health problems worldwide, but specifically, the prevalence of cancer-related mortality for the homeless population has been reported to be double compared to the average adult population. To date, health research pays insufficient attention to studying cancer and improving the delivery of cancer care for the homeless population. Methods A systematic literature review of relevant databases was employed to identify all the quantitative studies addressing cancer care for the homeless population in English, Spanish, French and Portuguese. A total of 11,740 publications were identified. Results A total of 17 studies were included in this literature review. The majority of the studies were based on the United States (n = 13; 76.5%). Nearly half of the studies targeted the general homeless population (n = 9; 52.9%), and most studies specifically targeted homeless women (n = 6; 35.3%). The majority of studies examined specific types of cancer (n = 13; 76,5%). By type of cancer explored, breast cancer (n = 4; 23.5%) and cervical cancer (n = 4; 23.5%) were the most researched. Screening is the most prevalent topic investigated (n = 14; 82.4%). Studies report unequal access and utilization of cancer screening services as well as advanced stages of cancer when diagnosed. Additionally, longer delays to treatment have been reported. On the other hand, community-based screening strategies have proven to be effective in increasing screening rates. Conclusions Currently, American researchers appear to be leading exponents of cancer research on the homeless population and most of the research is focused on cancer screening. In this regard, community-based screening strategies have proven to be effective in reducing health inequalities for this vulnerable group but less is known when a positive case is diagnosed for this population. Key messages Cancer is a major disease burden worldwide and evidence shows higher mortality rates among the homeless population but unequal access and utilization of cancer screening and treatment services. Community cancer screening programmes for the homeless population should be internationally adopted and specific cancer care pathways meeting their needs after cancer diagnose should be provided.

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