Case of eustachian valve endocarditis and the importance of synergistic antibiotic therapy

A 46-year-old woman with a history of end-stage renal disease on chronic haemodialysis presented with 1 week of fever, chills, altered mental status and hand pain. She was febrile and ill-appearing on presentation with a pulse rate of 102 beats per minute. She had a tunnelled dialysis catheter in her right neck. Hand examination demonstrated a swollen, erythematous and tender wrist. Cardiovascular examination demonstrated no murmurs. CT of the hand showed abscesses involving the left forearm. Blood and abscess cultures grew methicillin-resistant Staphylococcus aureus (MRSA). Transesophageal echocardiography (TEE) showed a 1.0×1.0 cm mobile vegetation involving the eustachian valve (EV), confirming EV endocarditis. She remained bacteraemic for 18 days despite being on vancomycin with appropriate blood levels. Vancomycin was switched to daptomycin and ceftaroline, which cleared her cultures. Repeat TEE showed improved vegetation size. Our case highlights the rarity and management of EV endocarditis and the importance of synergy for treatment of persistent MRSA bacteraemia.

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441 Neurohumoral activity, heart failure and prognosis in patients with end stage renal disease treated by chronic haemodialysis

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(06)80303-6 ◽

2006 ◽

Vol 5 (1) ◽

pp. 105-105

Author(s):

J SPINAR ◽

O LUDKA ◽

J VITOVEC ◽

L SPINAROVA ◽

D SOBOTOVA ◽

...

Keyword(s):

Heart Failure ◽

Renal Disease ◽

End Stage Renal Disease ◽

Chronic Haemodialysis ◽

Stage Renal Disease ◽

End Stage

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Outcomes of Off-Pump versus On-Pump Coronary Artery Bypass Surgery in End-Stage Renal Disease Patients with a History of Myocardial Infarction

The Heart Surgery Forum ◽

10.1532/hsf98.20061073 ◽

2006 ◽

Vol 9 (5) ◽

pp. E774-E778 ◽

Cited By ~ 3

Author(s):

Graham Moore ◽

Gregory Trachiotis

Keyword(s):

Myocardial Infarction ◽

End Stage Renal Disease ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Artery Bypass ◽

Off Pump ◽

History Of ◽

Pump Coronary Artery Bypass ◽

Stage Renal Disease ◽

End Stage

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Electrocardiogram changes in patients with end stage renal disease on chronic haemodialysis

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20194624 ◽

2019 ◽

Vol 7 (11) ◽

pp. 4020

Author(s):

Kareem Mohsin Yousif ◽

Hamid Obaid Khadhim Al Jaaed

Keyword(s):

Renal Disease ◽

Social History ◽

End Stage Renal Disease ◽

Cross Sectional Study ◽

Premature Ventricular Complex ◽

Chronic Haemodialysis ◽

Ecg Changes ◽

Cross Sectional ◽

Stage Renal Disease ◽

End Stage

Background: End stage renal disease (ESRD) is irreversible loss of renal function which is physiologically defined by a GFR of less than 15 ml / minute. ESRD is associated with a higher incidence of coronary artery disease and serious arrhythmia especially ventricular arrhythmia. The goal of study is to determine whether ESRD and haemodialysis (HD)are associated with occurrence of significant electrocardiogram (ECG) changes or not.Methods: This is a cross-sectional study design which involved 22 patients with ESRD on regular HD in Al Sadre teaching hospital / Al Najaf. Both sexes was included in this study. All patients underwent full medical history and examination which included the following aspects: Age, Sex, Occupation, BP, HR, RBS, B.urea, S.creatinine , Serum electrolyte (Na+, K+, Cl-, Ca++), Lipid profile (Cholesterol , Triglyceride, HDL, LDL), Duration of CRF, Duration of dialysis, Social history including (smoking, alcohol) and Drug used by the patient. Resting EGC and Hotler ECG.Results: Eighteen patients exhibited emergence of simple ectopic activity premature atrial complex (PAC) and premature ventricular complex (PVC) events and four patients exhibited (ST,T changes). Potentially lethal arrhythmias and other serious ECG changes are not detected in our patient’s sample.Conclusion: In this study, neither ESRD nor haemodialysis were associated with development of serious ECG changes or emergence of significant arrhythmia.

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Crystal-Associated Colitis with Ulceration Leading to Hematochezia and Abdominal Pain

Case Reports in Gastroenterology ◽

10.1159/000446575 ◽

2016 ◽

Vol 10 (2) ◽

pp. 332-337 ◽

Cited By ~ 9

Author(s):

Meeta Desai ◽

Aaron Reiprich ◽

Nancy Khov ◽

Zhaohai Yang ◽

Abraham Mathew ◽

...

Keyword(s):

End Stage Renal Disease ◽

Acute Inflammation ◽

Mucosal Injury ◽

Mucosal Damage ◽

Lower Gi Bleeding ◽

History Of ◽

Radiation Colitis ◽

Exchange Resins ◽

Stage Renal Disease ◽

End Stage

Lower GI bleeding is a common cause for hospitalization in adults. Medication-associated mucosal injury is an important clinical entity that can result in significant morbidity and mortality. We present the case of a 45-year-old woman with a 3-month history of intermittent abdominal cramping and rectal bleeding. Her medical history was extensive and included end-stage renal disease and a remote history of endometrial carcinoma that was treated with radiation. Initial workup was concerning for ischemic and radiation colitis, however, histology was most consistent with acute inflammation and ulceration associated with crystal fragments. Sevelamer and cholestyramine are commonly used ion-exchange resins that have been associated with mucosal damage. Both medications were discontinued and her symptoms resolved. Our case highlights an underrecognized but important cause of hematochezia.

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