Presentation
Embolic events were present in 2 cases. CONCLUSION--In group B a significant number of patients (p < 0.05) were older than 50 years and presented his symptoms as an acute illness. [bases.bireme.br]
Symptoms Most patients present with a fever that lasts several days to 2 weeks. Nonspecific symptoms are common. Cough, shortness of breath, joint pain, diarrhea, and abdominal or flank pain may be present. [healthcentral.com]
Snapshot A 50-year-old man presents to the emergency room for a fever that has persisted for several days. He denies any history of intravenous drug use or any congenital heart disease. [medbullets.com]
[…] satisfied Vascular abnormalities; embolism, aneurysm, infarcts, conjunctival haemorrhage, intracranial haemorrhage etc You can then assess whether infective endocarditis is present or not: IE definitely present: 2 major criteria present OR 1 major criteria [almostadoctor.co.uk]
In less than 4 per cent of cases, 1 usually when the disease occurs in childhood, vegetations may be present only within the right chambers of the heart on such sites as the tricuspid valve, pulmonary valve, interventricular septal defect or patent ductus [annals.org]
Entire Body System
- Fever
Guidelines for the use of antimicrobial agents in neutropenic patients with unexplained fever. J Infect Dis 1990; 161:381—396. معلومات المراجع [books.google.com]
RESULTS--Group A--9 patients aged 8-58 years, 3 men, all them with cardiac murmurs, fever and anemia, 5 with splenomegaly. Hemocultures were done in 7 patients and positive in 1. [bases.bireme.br]
[…] of unknown origin endocarditis prophylaxis may be required before dental procedures Presentation Symptoms persistent fevers (the most common symptom) shortness of breath systemic symptoms weakness fever malaise Physical exam new murmur on auscultation [medbullets.com]
Diagnosis Endocarditis is suspected in a patient with a heart murmur and unexplained fever for at least one week, and in an intravenous drug abuser with a fever, even in the absence of hearing a murmur. [healthcentral.com]
Once the fever and the worst of the symptoms have gone away, the patient may be able to continue antibiotic therapy at home. [medical-dictionary.thefreedictionary.com]
- Chills
The symptoms of acute IE usually begin with fever (102°–104°F), chills, fast heart rate, fatigue, night sweats, aching joints and muscles, persistent cough or swelling in the feet, legs or abdomen. [heart.org]
Consultant: Volume 47 - Issue 2 - February 2007 For a week, a 39-year-old woman with a history of intravenous heroin use had generalized pain, fever, chills, and a nonproductive cough. [consultant360.com]
Other symptoms include chills, weakness, cough, trouble breathing, headaches, aching joints, and loss of appetite. Emboli may also cause a variety of symptoms, depending on their location. [medical-dictionary.thefreedictionary.com]
Other constitutional symptoms include chills, sweats, loss of appetite, and malaise [2]. Although a new or changed regurgitant murmur is the most common cardiac finding on physical examination, this may be absent in right-sided endocarditis. [journalofethics.ama-assn.org]
Common signs and symptoms of endocarditis include: Flu-like symptoms, such as fever and chills A new or changed heart murmur, which is the heart sounds made by blood rushing through your heart Fatigue Aching joints and muscles Night sweats Shortness of [mayoclinic.org]
- Rigor
Cardiac / renal failure can develop rapidly (50-70%) Haematuria secondary to renal failure present in about 70% of patients Rigors Night sweats Splinter haemorrhages (10-20%) Red lines that run vertically along the nails. [almostadoctor.co.uk]
[…] based on course of untreated disease: acute, subacute, chronic Newer classification system is based on causative organism Also classify based on native valve or prosthetic valve endocarditis Clinical features Vague constitutional symptoms such as fever, rigors [pathologyoutlines.com]
The patient presented with fever with chills and rigors 2 weeks after the induced abortion. She remained febrile for 1.5 months and did not respond to therapy. After subsequent investigations, she was found to have TV endocarditis. [atmph.org]
A 33-year-old male, intravenous drug abuser presented with history of fever, rigors, night sweats, cough, pleuritic chest pain, hemoptysis, and worsening dyspnea of two months duration. [heartviews.org]
[…] phenomena: glomerulonephritis which allows for blood and albumin to enter the urine, [7] Osler's nodes (painful subcutaneous lesions in the distal fingers), Roth's spots on the retina, positive serum rheumatoid factor Other signs may include night sweats, rigors [en.wikipedia.org]
Cardiovascular
- Heart Disease
Keywords: Endocarditis, daptomycin, MRSA, congenital heart disease DOI: 10.3233/JPI-130391 Journal: Journal of Pediatric Infectious Diseases, vol. 8, no. 3, pp. 139-142, 2013 Received 30 October 2012 | Accepted 6 February 2013 | Published: 2013 [content.iospress.com]
Candida risk factors rheumatic heart disease IV drug use immunosuppression prosthetic heart valve congenital heart disease Etiology Pathogenesis endothelial damage on the surface of the cardiac valve can cause a thrombus to form factors include turbulent [medbullets.com]
Conditions predisposing to native valve endocarditis are rheumatic heart disease (where the mitral valve is frequently involved followed by the aortic valve), congenital heart disease (commonly patent ductus arteriosus, ventricular septal defect, and [atmph.org]
Diseases listed under high risk include: Prior endocarditis Unrepaired cyanotic congenital heart diseases Completely repaired congenital heart disease in their first 6 months Prosthetic heart valves Incompletely repaired congenital heart diseases Cardiac [en.wikipedia.org]
heart diseases [ 1 ]. [cardiovascularultrasound.biomedcentral.com]
Workup
[…] consistent with IE Echocardiogram results consistent with IE but not meeting major echocardiographic criteria A definitive clinical diagnosis can be made based on the following: 2 major criteria 1 major criterion and 3 minor criteria 5 minor criteria See Workup [emedicine.medscape.com]
Microbiology
- Blood Culture Positive
Diagnosis 5.1 Clinical features 5.2 Laboratory findings 5.3 Imaging techniques 5.3.1 Echocardiography 5.3.2 Multislice computed tomography 5.3.3 Magnetic resonance imaging 5.3.4 Nuclear imaging 5.4 Microbiological diagnosis 5.4.1 Blood culture–positive [escardio.org]
positive for infectious organisms Blood cultures that are positive for microorganisms, which are taken 12 hours apart 3 blood cultures positive on separate occasions that are taken at least 1 hour apart Abnormalities in echocardiogram showing either a [dovemed.com]
The Duke Criteria for the Clinical Diagnosis of Infectious Endocarditis Major criteria Positive blood culture Two separate blood cultures positive for microorganism consistent with infectious endocarditis (viridans Streptococcus, Streptococcus bovis, [aafp.org]
If CRP and WCC are normal, yet you have a positive blood culture, the positive culture is likely due to contamination. [almostadoctor.co.uk]
[…] with IE Blood cultures persistently positive for one of these organisms, from cultures drawn more than 12 hours apart Three or more separate blood cultures drawn at least 1 hour apart Major echocardiographic criteria include the following: Echocardiogram [emedicine.medscape.com]
Colonoscopy
- Polyps
Infection often reflects underlying abnormalities of the large bowel (eg, ulcerative colitis, polyps, cancer). The organisms are sensitive to penicillin. [emedicine.medscape.com]
Treatment
Postoperative antibiotic treatment A full course of antimicrobial treatment should be completed regardless of the duration of treatment prior to surgery, for at least seven to 15 days postoperatively. [inmo.ie]
In our case, the diagnosis and treatment of right-sided infective endocarditis without any inducement were extremely difficult. [scirp.org]
If a stable patient has suspected IE but is already on antibiotic treatment, consideration should be given to stopping treatment and performing three sets of blood cultures off antibiotics. [patient.info]
Most patients with uncomplicated IE become afebrile in 3 to 5 days with appropriate antibiotic treatment. Surveillance cultures should be obtained 48 to 72 hours after treatment begins to ensure eradication of the organism. [journalofethics.ama-assn.org]
[…] patient also had right heart failure that failed to respond to treatment). [revespcardiol.org]
Prognosis
Outcome after discharge: follow-up and long-term prognosis 11.1 Recurrences: relapses and reinfections 11.2 Short-term follow-up 11.3 Long-term prognosis 12. [escardio.org]
Surgery may be required in some cases Untreated Intravenous Drug Abuse Endocarditis can lead to an extremely poor prognosis and is almost always be fatal. With appropriate early diagnosis and treatment, the outcomes are better. [dovemed.com]
The aim of this article is to provide a comprehensive update on RSIE including epidemiology, pathogenesis, microbiology, diagnosis, management, and prognosis. No Reference information available - sign in for access. [ingentaconnect.com]
MANAGEMENT AND PROGNOSIS Uncomplicated TVE is successfully treated medically in 80% of patients, with only 20% needing surgical intervention[ 12, 29 ]. [wjgnet.com]
In cases in which endocarditis is caused by fungi, the prognosis is usually worse than for bacterial endocarditis. [drugs.com]
Etiology
Various factors may increase mortality and morbidity in RSIE such as tricuspid valve vegetation size, fungal etiology, and low CD4 cell count in HIV patients. [ingentaconnect.com]
Streptococcus viridans is the usual etiologic agent of SBE. The distinction between "acute" and "subacute" endocarditis has traditionally been made based on the pathogenic organism and clinical presentation. [fpnotebook.com]
[…] valve > tricuspid valve tricuspid valve disease is associated with intravenous (IV) drug use Staphylococcus aureus, Pseudomonas, Candida risk factors rheumatic heart disease IV drug use immunosuppression prosthetic heart valve congenital heart disease Etiology [medbullets.com]
[…] ventricular septal defect (VSD), vegetations can be found on the right ventricular side of the VSD, on the tricuspid valve or where the jet impinges on the right ventricular wall Vegetations found in coarctation usually occur distal to the obstruction Etiology [pathologyoutlines.com]
We report herein a case without any apparent etiologic factor contributing infective endocarditis, with special emphasis on treatment. [ispub.com]
Epidemiology
Epidemiological data reveal a rising incidence attributable to the global surge in the number of intravenous drug users and the increased use of central vascular catheters and implantable cardiac devices. [ingentaconnect.com]
Epidemiological Characteristics IDUs patients were the youngest and patients with cardiac devices the oldest. [journals.lww.com]
References [ 1 ] Yuan, S.M. (2014) Right-Sided Infective Endocarditis: Recent Epidemiologic Changes. [scirp.org]
[…] abscess formation • Mycotic aneurysm: : A term applied to fungal or bacterial infection within the wall of a vessel • Mycotic endocarditis: : Endocarditis caused by fungus Objectives After completing this article, readers should be able to: Discuss the epidemiology [pedsinreview.aappublications.org]
In addition, there is a lack of epidemiological studies documenting the burden of disease in terms of prevalence and related morbidity and mortality due to drug abuse in this region. [wjgnet.com]
Pathophysiology
Management of specific situations 12.1 Prosthetic valve endocarditis 12.1.1 Definition and pathophysiology 12.1.2 Diagnosis 12.1.3 Prognosis and treatment 12.2 Infective endocarditis affecting cardiac implantable electronic devices 12.2.1 Introduction [escardio.org]
[…] defibrillator, IVDA (right sided endocarditis), indwelling catheter Congenital heart disease: small ventricular septal defect, bicuspid aortic valve, coarctation of aorta, patent ductus arteriosus Uncommon with large VSD, mitral stenosis, atrial septal defect Pathophysiology [pathologyoutlines.com]
Pathoanatomic, pathophysiologic and clinical correlations in endocarditis (first of two parts). N Engl J Med. 1974 Oct 17. 291(16):832-7. [Medline]. Wang CC, Lee CH, Chan CY, Chen HW. [emedicine.medscape.com]
Often the endocarditis is less clinically severe in IV drug users Pathophysiology Endocardial damage leads to the formation of thrombi at the damaged site. The thrombus is made mainly of platelets and fibrin. [almostadoctor.co.uk]
Pathophysiology The development of infectious endocarditis requires the presence of bacteria or fungi in the blood and an intracardiac surface on which these microorganisms can attach. [aafp.org]
Prevention
We believe the very low infectivity of F. odoratum and its very slow growth in culture media prevented an early diagnosis. [ncbi.nlm.nih.gov]
Prevention Prevention, for IV drug users, comes with hygienic injecting practises. [blackpoppymag.wordpress.com]
[…] of systemic embolism 8.3.1 Embolic events in infective endocarditis 8.3.2 Predicting the risk of embolism 8.3.3 Indications and timing of surgery to prevent embolism in infective endocarditis 9. [escardio.org]
Prevention for those at risk usually involves awareness of the risks, and preventative antibiotics prior to certain surgical, dental and medical procedures. [heart.org]
Preventive antibiotics Certain dental and medical procedures may allow bacteria to enter your bloodstream. [mayoclinic.org]