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  1. Article: Extracardiac manifestations of bacterial endocarditis.

    Heffner, J E

    The Western journal of medicine

    1979  Volume 131, Issue 2, Page(s) 85–91

    Abstract: ... can go unnoticed.A review of the various extracardiac manifestations of bacterial endocarditis suggests ... Bacterial endocarditis is an elusive disease that challenges clinicians' diagnostic capabilities ... a subarachnoid hemorrhage from a congenital aneurysm. (2) The symptoms of bacterial endocarditis may be constitutional ...

    Abstract Bacterial endocarditis is an elusive disease that challenges clinicians' diagnostic capabilities. Because it can present with various combinations of extravalvular signs and symptoms, the underlying primary disease can go unnoticed.A review of the various extracardiac manifestations of bacterial endocarditis suggests three main patterns by which the valvular infection can be obscured. (1) A major clinical event may be so dramatic that subtle evidence of endocarditis is overlooked. The rupture of a mycotic aneurysm may simulate a subarachnoid hemorrhage from a congenital aneurysm. (2) The symptoms of bacterial endocarditis may be constitutional complaints easily attributable to a routine, trivial illness. Symptoms of low-grade fever, myalgias, back pain and anorexia may mimic a viral syndrome. (3) Endocarditis poses a difficult diagnostic dilemma when it generates constellations of findings that are classic for other disorders. Complaints of arthritis and arthralgias accompanied by hematuria and antinuclear antibody may suggest systemic lupus erythematosus; a renal biopsy study showing diffuse proliferative glomerulonephritis may support this diagnosis. The combination of fever, petechiae, altered mental status, thrombocytopenia, azotemia and anemia may promote the diagnosis of thrombotic thrombocytopenic purpura. When the protean guises of bacterial endocarditis create these clinical difficulties, errors in diagnosis occur and appropriate therapy is delayed. Keen awareness of the varied disease presentations will improve success in managing endocarditis by fostering rapid diagnosis and prompt therapy.
    MeSH term(s) Bone Diseases/etiology ; Endocarditis, Bacterial/complications ; Endocarditis, Bacterial/immunology ; Endocarditis, Bacterial/pathology ; Hematologic Diseases/etiology ; Humans ; Kidney Diseases/etiology ; Lung Diseases/etiology ; Muscular Diseases/etiology ; Nervous System Diseases/etiology ; Skin Diseases/etiology ; Splenic Diseases/etiology
    Language English
    Publishing date 1979-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 189235-6
    ISSN 1476-2978 ; 0093-0415 ; 0008-1264
    ISSN (online) 1476-2978
    ISSN 0093-0415 ; 0008-1264
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  2. Article ; Online: Unusual extracardiac manifestations of isolated native tricuspid valve endocarditis.

    Wilczynska, M / Khoo, J P / McCann, G P

    BMJ case reports

    2010  Volume 2010

    Abstract: Isolated native tricuspid valve endocarditis (TVE) in non-intravenous drug users is a very rare ...

    Abstract Isolated native tricuspid valve endocarditis (TVE) in non-intravenous drug users is a very rare condition. We describe an unusual presentation of Enterococcus faecalis TVE associated with spondylodiscitis, positive cytoplasmic antineutrophil cytoplasmic antibodies and antiproteinase-3 antibodies vasculitic rash in an otherwise healthy patient with no history of intravenous drug use or underlying cardiac abnormalities. A high index of clinical suspicion is required in patients presenting with unusual features and pyrexia of unknown origin. Simple tests including serial blood cultures and echocardiography may help to establish the correct diagnosis and commence appropriate treatment.
    MeSH term(s) Aged ; Anti-Bacterial Agents/therapeutic use ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/diagnosis ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy ; Autoantibodies/blood ; Discitis/diagnosis ; Discitis/drug therapy ; Drug Therapy, Combination ; Echocardiography, Transesophageal ; Endocarditis, Bacterial/diagnosis ; Endocarditis, Bacterial/drug therapy ; Enterococcus faecalis ; Fever of Unknown Origin/drug therapy ; Fever of Unknown Origin/etiology ; Gram-Positive Bacterial Infections/diagnosis ; Gram-Positive Bacterial Infections/drug therapy ; Humans ; Intracellular Signaling Peptides and Proteins ; Lumbar Vertebrae/pathology ; Magnetic Resonance Imaging ; Male ; Proteins/immunology ; Thoracic Vertebrae/pathology ; Tricuspid Valve/pathology
    Chemical Substances Anti-Bacterial Agents ; Autoantibodies ; Intracellular Signaling Peptides and Proteins ; Proteins ; cytoplasmic antiproteinase
    Language English
    Publishing date 2010-11-29
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr.11.2009.2502
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Complement activation in infective endocarditis: correlation with extracardiac manifestations and prognosis.

    Messias-Reason, I J / Hayashi, S Y / Nisihara, R M / Kirschfink, M

    Clinical and experimental immunology

    2001  Volume 127, Issue 2, Page(s) 310–315

    Abstract: ... with extracardiac manifestations and clinical prognosis. Twenty patients with IE, 14 healthy controls and 15 ... response, but when exacerbated may cause tissue injuries. In infective endocarditis (IE) patients tend ... 02) and C3adesArg (P < 0.03) levels were associated with pulmonary manifestations. In addition, C3d ...

    Abstract In an infectious process complement activation is necessary for a proper immune and inflammatory response, but when exacerbated may cause tissue injuries. In infective endocarditis (IE) patients tend to develop high titres of circulating immune complexes (CIC) that activate complement. The aim of this study was to evaluate for the first time complement activation in IE for possible correlation with extracardiac manifestations and clinical prognosis. Twenty patients with IE, 14 healthy controls and 15 patients presenting mitral and aortic valve lesions (with no signs of either infection or other associated diseases), were studied. Plasma levels of C3adesArg, SC5b-9, C1rs-C1Inh and C3b(Bb)P were determined by ELISA and C3d by double decker immunoelectrophoresis. C3 and C4 levels were assayed by turbidimetry and CIC by ELISA. Elevation of plasma levels of all complement activation products, with the exception of C3b(Bb)P, indicated a significant classical pathway activation in IE patients when compared to controls (C3d: P < 0.00004; C3adesArg: P < 0.03, SC5b-9: P < 0.01, C1rs-C1Inh: P < 0.00007). CIC levels were significantly increased (P < 0.005) and C3 reduced in IE patients (P < 0.05). Elevated C3d (P < 0.02) and C3adesArg (P < 0.03) levels were associated with pulmonary manifestations. In addition, C3d was significantly elevated in the patients who died when compared to those who had a good recovery (P < 0.02). Our data demonstrate the activation of the complement classical pathway, most probably mediated by CIC, in IE and suggests C3d and C3adesArg as possible markers for extracardiac lesion and severity of the disease.
    MeSH term(s) Adolescent ; Adult ; Aged ; Antigen-Antibody Complex/blood ; Bacteremia/complications ; Central Nervous System Diseases/etiology ; Complement Activation ; Complement C3d/analysis ; Complement Membrane Attack Complex/analysis ; Endocarditis, Bacterial/blood ; Endocarditis, Bacterial/complications ; Endocarditis, Bacterial/immunology ; Endocarditis, Bacterial/mortality ; Female ; Humans ; Kidney Diseases/etiology ; Lung Diseases/etiology ; Male ; Middle Aged ; Prognosis ; Rheumatoid Factor/blood ; Splenomegaly/etiology
    Chemical Substances Antigen-Antibody Complex ; Complement Membrane Attack Complex ; Complement C3d (80295-45-0) ; Rheumatoid Factor (9009-79-4)
    Language English
    Publishing date 2001-08-07
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 218531-3
    ISSN 1365-2249 ; 0009-9104 ; 0964-2536
    ISSN (online) 1365-2249
    ISSN 0009-9104 ; 0964-2536
    DOI 10.1046/j.1365-2249.2002.01772.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.B 337: Show issues Location:
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