Form Of Infective Endocarditis Research Articles

Stroke location, characterization, severity, and outcome in mitral vs aortic valve endocarditis.

To characterize the incidence and clinical features of patients with infective endocarditis (IE) and stroke. The authors reviewed the records of 707 patients diagnosed with definite or possible IE between January 1984 and November 1999. Stroke was confirmed by application of strict definitions and classified by type, pathophysiology, vascular territory, and severity. The authors determined mortality rates for the initial hospitalization and 12 months after admission. Strokes occurred in 68 (9.6%) of 707 patients with IE, 38 (17%) of 218 patients with mitral valve endocarditis (MVE), 14 (9%) of 149 patients with aortic valve endocarditis (AVE), and 16 (5%) of 340 patients with other forms of IE (OR for MVE vs AVE = 2.0, 95% CI 1.1 to 3.9). Among the patients with MVE or AVE and stroke, there were no significant relationships between site of vegetation and length of hospitalization, stroke severity, mortality during the initial hospitalization, or 12-month mortality. Fifty-two percent of patients with stroke and IE died within 1 year of admission. The overall incidence of stroke in patients with IE (9.6%) is lower than previous reports (21 to 39%). Patients with MVE had a greater risk of stroke than patients with AVE. Fifty-two percent of patients died within 1 year of admission for IE.

Association of brucella endocarditis with intracerebral haemorrhage

We describe a case of brucella endocarditis which was strongly suspected on clinical grounds and subsequently confirmed by bacteriological, serological and echocardiographic investigations. The endocarditis, in a 42-year-old Saudi male, was complicated by intracerebral haemorrhage, presumably from a ruptured mycotic aneurysm. Although such a complication is well documented in other forms of infective endocarditis, it has not been reported in brucellosis.

Intrathecal Alcohol for Relief of Pain

<h3>Objective</h3> The primary objective was to assess the characteristics and prognosis of pyogenic spondylodiscitis (PS) in patients with infective endocarditis (IE). The secondary objectives were to assess the factors associated with occurrence of PS. <h3>Methods</h3> Prospective case–control bi-centre study of 1755 patients with definite IE with (n=150) or without (n=1605) PS. Clinical, microbiological and prognostic variables were recorded. <h3>Results</h3> Patients with PS were older (mean age 69.7±18 vs 66.2±14; p=0.004) and had more arterial hypertension (48% vs 34.5%; p&lt;0.001) and autoimmune disease (5% vs 2%; p=0.03) than patients without PS. The lumbar vertebrae were the most frequently involved (84 patients, 66%), especially L4–L5. Neurological symptoms were observed in 59% of patients. Enterococci and <i>Streptococcus gallolyticus</i> were more frequent (24% vs 12% and 24% vs 11%; p&lt;0001, respectively) in the PS group. The diagnosis of PS was based on contrast-enhanced MRI in 92 patients, bone CT in 88 patients and ¹⁸F-FDG PET/CT in 56 patients. In-hospital (16% vs 13.5%, p=0.38) and 1-year (21% vs 22%, p=0.82) mortalities did not differ between patients with or without PS. <h3>Conclusions</h3> PS is a frequent complication of IE (8.5% of IE), is observed in older hypertensive patients with enterococcal or <i>S. gallolyticus</i> IE, and has a similar prognosis than other forms of IE. Since PS is associated with specific management, multimodality imaging including MRI, CT and PET/CT should be used for early diagnosis of this complication of endocarditis.