Infective endocarditis uncovered a very rare congenital heart disease.
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ABSTRACT:
SUBMITTER: Jafari F
PROVIDER: S-EPMC8212014 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The present report describes a case of Bartonella henselae endocarditis affecting an adolescent with congenital heart disease. A teenager from Eastern Europe was referred to for surgical treatment of aortic endocarditis. She admitted close contact with cats. Blood culture was negative. Diagnosis of B henselae was established on direct PCR amplification and 16SrRNA gene sequencing of the aortic valve tissue and confirmed after 4 weeks by valve culture isolate. The patient underwent extended root replacement (the Ross-Konno operation) with a favourable outcome.
| S-EPMC3027999 | biostudies-literature
Project description:BackgroundBlood culture negative infective endocarditis (BCNIE) is often a diagnostic challenge in adult congenital heart disease patients leading to misdiagnosis, treatment delay and associated high mortality. Studies of BCNIE in adult congenital heart disease patients repaired with prosthetic cardiovascular grafts are limited.Case summaryWe report two cases of BCNIE where serology testing, multiple polymerase chain reaction testing of explanted valve material and multi-modality imaging including 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) were utilized not only to confirm the diagnosis but also to guide management strategy and inform prognosis. Both patients were treated successfully with cardiac surgery and prolonged anti-microbial therapy.DiscussionClinical presentation of BCNIE in repaired CHD patients is highly variable. The symptoms are often non-specific with subacute or chronic presentation. This may mislead initial diagnosis and subsequent management. Multi-modality imaging including PET/CT should be considered to support the diagnosis, define the extent of infection, decide the management strategy and inform prognosis in patients. A thorough history of animal exposure, and consideration of serology and multiple molecular testing to identify the causative organism, is critical in the management of BCNIE.
| S-EPMC8186933 | biostudies-literature
Project description:BackgroundCongenital heart disease (CHD) is a lifelong predisposing condition for infective endocarditis (IE). As a consequence of advances in pediatric care, the number of adults with CHD is now exceeding the number of children. The goal of the present study was to determine the cumulative incidence of IE in patients with CHD and detect temporal changes compared with controls.MethodsNationwide registry-based case-control study of patients with CHD born 1930-2017 matched with 10 random controls. Infective endocarditis episodes were linked using the Swedish 10-digit personal identification number.ResultsIn total, 89 541 patients with CHD and 890 470 matched controls were included. In patients with CHD, 1477 IE episodes were registered and 447 episodes in controls. Patients with CHD had 8.5% cumulative incidence of IE at age 87 years, compared with 0.7% in matched controls. Incidence rate of IE per 100 000 person-years was 65.5 (95% confidence interval [CI] 62.2-68.9) and 1.8 (95% CI: 1.7-2.0) in CHD patients and controls, respectively. By age 18 years, patients with CHD had an IE incidence similar to that of 81-year-old controls. Incidence of IE differed by age but not by birth year. Bacterial etiology was registered from 1997 in half of the IE episodes; among CHD IE cases, 43.3% were caused by streptococci and 29.8% by Staphylococcus aureus.ConclusionsInfective endocarditis remains an important complication in patients with CHD. Incidence correlate with age and the number of IE episodes are expected to increase as the CHD population grow older.
| S-EPMC8528398 | biostudies-literature
Project description:BackgroundRight-sided tricuspid valve (TV) endocarditis can be difficult to identify and may be under-recognized in the absence of traditional risk factors. While generally identified with aortic valve pathology, infective endocarditis that extends beyond the leaflets of the TV have been reported to cause conduction disease.Case summaryWe present the case of a 63-year-old patient who presented with haemodynamically unstable complete heart block requiring temporary venous pacemaker support. Despite the absence of traditional risk factors or significant valvular disease on transthoracic echocardiogram, she was found to be persistently bacteraemic and subsequent transoesophageal echocardiogram identified large vegetation on the septal leaflet of the TV. Conduction disease was noted to reverse with antibiotic therapy and resolution of bacteraemia.DiscussionAlthough rare, right-sided endocarditis involving the triangle of Koch may present with conduction disease due to local inflammation and mechanical compression. Conduction disease associated with right-sided disease appears to be readily reversible with medical therapy and temporary device support may be appropriate in the acute setting.
| S-EPMC8374981 | biostudies-literature
Project description: Not available
| S-EPMC9204469 | biostudies-literature
Project description: Not available
| S-EPMC6058410 | biostudies-literature
Project description:Infective endocarditis (IE) is a rare, life-threatening disease that has long-lasting effects even among patients who survive and are cured. IE disproportionately affects those with underlying structural heart disease and is increasingly associated with health care contact, particularly in patients who have intravascular prosthetic material. In the setting of bacteraemia with a pathogenic organism, an infected vegetation may form as the end result of complex interactions between invading microorganisms and the host immune system. Once established, IE can involve almost any organ system in the body. The diagnosis of IE may be difficult to establish and a strategy that combines clinical, microbiological and echocardiography results has been codified in the modified Duke criteria. In cases of blood culture-negative IE, the diagnosis may be especially challenging, and novel microbiological and imaging techniques have been developed to establish its presence. Once diagnosed, IE is best managed by a multidisciplinary team with expertise in infectious diseases, cardiology and cardiac surgery. Antibiotic prophylaxis for the prevention of IE remains controversial. Efforts to develop a vaccine that targets common bacterial causes of IE are ongoing, but have not yet yielded a commercially available product.
| S-EPMC5240923 | biostudies-literature
Project description: Not available
| S-EPMC7175796 | biostudies-literature
Project description:Optimal antimicrobial treatment of infective endocarditis requires identification and susceptibility patterns of pathogens. Sonication of explanted heart valves could increase the identification and culture of pathogens, as shown in prosthetic joint and pacemaker/ICD infections. We tested 26 explanted heart valves from 20 patients with active definite endocarditis for added diagnostic value of sonication to the standard microbiological workup in a prospective diagnostic proof of concept study. Two sonication protocols (broth enrichment vs. centrifugation) were compared in an additional 35 negative control valves for contamination rates. We selected sonication/centrifugation based on acceptable false positive rates (11.4%; 4/35). Sonication/enrichment yielded many false positive results in negative controls (28.6%; 10/35), mainly Propionibacterium acnes (next-generation sequencing excluded technical problems). Compared to direct culture only, adding sonication/centrifugation (including molecular testing) significantly increased the diagnostic yield from 6/26 to 17/26 valves (p?=?0.003). Most importantly, culture positives almost doubled (from 6 to 10), providing unique quantitative information about antimicrobial susceptibility. Even if direct molecular testing was added to the standard workup, sonication/centrifugation provided additional diagnostic information in a significant number of valves (8/26; 31%; p?=?0.013). We concluded that sonication/centrifugation added relevant diagnostic information in the workup of heart valves with infective endocarditis, with acceptable contamination rates.
| S-EPMC6113321 | biostudies-literature