Infective Endocarditis
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Author(s):  
Kaoru Hattori ◽  
Mimiko Tabata ◽  
Tohru Nojiri ◽  
Atsushi Kurata

Abstract Background Aortic valve involvement is rare in patients with Behçet’ s disease (BD); however, recurrent prosthetic valve detachment after valve surgery has frequently been reported. We report a rare case of Behçet’s aortitis involving the aortic valve, mimicking active infective endocarditis (IE) with perivalvular abscess. Case summary A 16-year-old boy, with an unknown case of BD, presented with pyrexia of unknown origin, severe aortic valve regurgitation, vegetation, and perivalvular abscess in the aortic valve. All cultures tested negative for microorganisms. As we suspected IE, aortic valve replacement was performed. After the initial surgery, recurrent prosthetic valve detachment and pseudoaneurysm formation occurred, which resulted in the diagnosis of BD. The patient underwent a modified Bentall procedure (MBP), in which the valve conduit was proximally sutured to the left ventricular outflow tract instead of the aortic annulus. Immunosuppressive therapy was initiated on the 10th postoperative day. His condition became stable, and additional surgery was not required. Discussion The echocardiographic findings of Behçet’s aortitis involving the aortic valve resemble those of aortic valve IE. MBP, combined with effective immunosuppressive therapy, may be useful in preventing prosthetic valve detachment.


2021 ◽  
Author(s):  
Takashi Narai ◽  
Takayuki Tamura ◽  
Nobuyuki Fujii ◽  
Yusei Harada ◽  
Soh Watanabe ◽  
...  

Author(s):  
Ruchi Bhandari ◽  
R. Constance Wiener ◽  
Christopher Waters ◽  
Cassandra Bambrick ◽  
Ruchi Bhandari

Patients with opioid use disorder are more likely to get coronavirus disease 2019 (COVID-19). Cardiovascular diseases frequently present in COVID-19 patients and can increase their susceptibility to invasive infectious diseases, such as infective endocarditis (IE). This study examines the difference in IE incidence following COVID-19 diagnosis between individuals with and without non-medical opioid use. De-identified electronic medical records data were retrieved from TriNetX, a web-based database. Patients in the U.S., aged 18-60 years, with a diagnosis of COVID-19 during January 2020 - January 2021 were included in this study. Development of IE was determined within three months after COVID-19 diagnosis. Logistic regression was conducted to estimate the risk of developing IE between COVID-19 patients with and without opioid use after propensity score matching. COVID-19 patients with non-medical opioid use had 6.8 times the risk of developing IE compared with COVID-19 patients without opioid use (95% CI: 5.44, 8.56; p<0.0001) after propensity score matching. Findings suggest a significant risk of IE among COVID-19 patients with a history of non-medical opioid use. It provides objective evidence to account for baseline opioid use in the risk assessment of IE among COVID-19 patients.


2021 ◽  
pp. 1-6
Author(s):  
Cheryl Zhiya Chong ◽  
Robin Cherian ◽  
Perryn Ng ◽  
Tiong Cheng Yeo ◽  
Lieng Hsi Ling ◽  
...  

Cureus ◽  
2021 ◽  
Author(s):  
Mina Said ◽  
Ekta Tirthani

2021 ◽  
Vol 14 (7) ◽  
Author(s):  
Ali Akbar Heydari ◽  
Abas Eslami ◽  
Maliheh Dadgarmoghaddam

Background: Staphylococcus aureus is an important cause of resistant infection with high mortality and morbidity. Objectives: We aimed to evaluate the clinical characteristics and comorbidities of patients with S. aureus infection to define the predictors of adverse outcomes. Methods: In this cross-sectional study, patients (aged ≥ 15 years) with positive S. aureus blood cultures were included. Their demographic and clinical characteristics were recorded, and their association with the main adverse outcomes (methicillin-resistant S. aureus [MRSA], infective endocarditis, source of infection, and the final outcome were analyzed using SPSS software version 16. Results: The male-to-female ratio was 54/51. The mean age was 55.13 years (women: 58.45 ± 20.4 and men: 53.6 ± 17.6). Of 105 cases analyzed, 40% had hospital-, 25.7% community-, and 34.3% healthcare-associated bacteremia. The median duration of hospital admission was 13 days. Thirty-two percent had MRSA, differently based on the source of infection (P = 0.029). Twenty-eight patients had infective endocarditis, differently based on the source of infection, prosthetics, considerable foci of infection, and receipt of blood and its derivatives (P < 0.05). Most patients with neurological and end-stage renal disease (both P = 0.001) did not have infective endocarditis. Finally, 61.9% of the patients were discharged with good condition, 38.1% died, and 9% left the hospital before a definite diagnosis. Conclusions: Vascular catheters and cardiovascular diseases, including hypertension, are among the most common factors associated with S. aureus bacteremia, and it is necessary to carefully examine the presence of these factors, as well as infective endocarditis in these patients.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Shafiq A. Alemad ◽  
Abdulsalam M. Halboup ◽  
Khaled Aladeeb ◽  
Mohamed Al-Saleh ◽  
Nuha Al-Kufiley

Abstract Introduction Coinfection with dengue and hepatitis A is rare and challenging for physicians since their clinical features can be overlapping. These infections are self-limiting but can become complicated by subsequent infective endocarditis. We report a case of infective endocarditis following a coinfection with dengue and hepatitis A. Case presentation A 17-year-old Yemeni male patient was admitted to the hospital complaining of yellowish discoloration of the skin and sclera associated with dark urine and a diffuse skin rash on the trunk and upper limbs followed by intermittent high-grade fever. Coinfection was confirmed by hepatitis A immunoglobulin M and dengue immunoglobulin M. At the time of diagnosis, white blood cells were normal, with mild neutrophilia and thrombocytopenia along with elevated C-reactive protein. Five days later, the patient was readmitted to the emergency department, complaining of high-grade fever, fatigue, myalgia, nausea, and vomiting. A systolic heart murmur was heard, and infective endocarditis was confirmed by the visualization of two vegetations on the mitral valve and coagulase-negative staphylococci after blood culture. Supportive therapies were initiated for hepatitis A and dengue fever, whereas infective endocarditis was treated with antibiotics for 4 weeks. The patient recovered completely from dengue, hepatitis A, and infective endocarditis. Conclusion In endemic areas, it is reasonable to screen for coinfection with dengue and hepatitis A since they are superimposed on each other. Subacute infective endocarditis may occur following initial dengue and hepatitis A coinfection, especially among patients with rheumatic heart disease. An echocardiogram is a pivotal workup for evaluating a patient with persistent fever of unknown origin.


Heart ◽  
2021 ◽  
pp. heartjnl-2021-319661
Author(s):  
Pablo Elpidio Garcia Granja ◽  
Javier Lopez ◽  
Isidre Vilacosta ◽  
Carmen Saéz ◽  
Gonzalo Cabezón ◽  
...  

ObjectiveTo evaluate the prognostic impact of urgent cardiac surgery on the prognosis of left-sided infective endocarditis (LSIE) and its relationship to the basal risk of the patient and to the surgical indication.Methods605 patients with LSIE and formal surgical indication were consecutively recruited between 2000 and 2020 among three tertiary centres: 405 underwent surgery during the active phase of the disease and 200 did not despite having indication. The prognostic impact of urgent surgery was evaluated by multivariable analysis and propensity score analysis. We studied the benefit of surgery according to baseline mortality risk defined by the ENDOVAL score and according to surgical indication.ResultsSurgery is an independent predictor of survival in LSIE with surgical indication both by multivariable analysis (OR 0.260, 95% CI 0.162 to 0.416) and propensity score (mortality 40% vs 66%, p<0.001). Its greatest prognostic benefit is seen in patients at highest risk (predicted mortality 80%–100%: OR 0.08, 95% CI 0.021 to 0.299). The benefit of surgery is especially remarkable for uncontrolled infection indication (OR 0.385, 95% CI 0.194 to 0.765), even in combination with heart failure (OR 0.220, 95% CI 0.077 to 0.632).ConclusionsSurgery during active LSIE seems to significantly reduce in-hospital mortality. The higher the risk, the higher the improvement in outcome.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Melissa B. Weimer ◽  
Caroline G. Falker ◽  
Nikhil Seval ◽  
Marjorie Golden ◽  
Sarah C. Hull ◽  
...  

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