Objective To analyze the clinical features of hemodialysis patients complicated by infective endo carditis. Methods The clinical features of six such patients admitted to Peking Union Medical College Hospital during ...Objective To analyze the clinical features of hemodialysis patients complicated by infective endo carditis. Methods The clinical features of six such patients admitted to Peking Union Medical College Hospital during the year 1990 to 2009 were analyzed. All of them were diagnosed based on Chinese Children Diagnostic Criteria for Infective Endocarditis. Results The average age of the six patients was 52.3±19.3 years old. Four were males. Vascular accesses at the onset of infective endocarditis were as follows： permanent catheters in three, temporary catheters in two, and arteriovenous fistula in one. Three were fbund with mitral valve involvement, two with aor tic valve involvement, and one with both. Five vegetations were found by transthoracic echocardiography, and one by transesophageal echocardiography. Four had positive blood culture results. The catheters were all removed. Four of the patients were improved by antibiotics treatment, in which two were still on hemodialy sis in the following 14-24 months and the other two were lost to follow-up. One patient received surgery, but died of heart failure alter further hemodialysis for three months. One was well on maintenance hemodi alvsis for three months after surgery. Conclusions Infective endocarditis should be suspected when hemodialysis patients suffer from long-term fever, for which prompt blood culture and transthoracic echocardiography confirmation could be performed. Transesophageal echocardiography could be considered even when transthoracic echocardiography produces negative findings. With catheters removed, lull course of appropriate sensitive antibiotics and surgery if indicated could improve the outcome of chronic hemodialysis patients complicated by infective cndocarditis.展开更多
Objective To forecast the future burden and its attributable risk factors of infective endocarditis(IE).Methods We analyzed the disease burden of IE and its risk factors from 1990 to 2019 using the Global Burden of Di...Objective To forecast the future burden and its attributable risk factors of infective endocarditis(IE).Methods We analyzed the disease burden of IE and its risk factors from 1990 to 2019 using the Global Burden of Disease 2019 database and projected the disease burden from 2020 to 2030 using a Bayesian age-period-cohort model.Results By 2030,the incidence of IE will increase uncontrollably on a global scale,with developed countries having the largest number of cases and developing countries experiencing the fastest growth.The affected population will be predominantly males,but the gender gap will narrow.The elderly in high-income countries will bear the greatest burden,with a gradual shift to middle-income countries.The incidence of IE in countries with middle/high-middle social-demographic indicators(SDI) will surpass that of high SDI countries.In China,the incidence rate and the number of IE will reach 18.07 per 100,000 and 451,596 in 2030,respectively.IEassociated deaths and heart failure will continue to impose a significant burden on society,the burden on women will increase and surpass that on men,and the elderly in high-SDI countries will bear the heaviest burden.High systolic blood pressure has become the primary risk factor for IE-related death.Conclusions This study provides comprehensive analyses of the disease burden and risk factors of IE worldwide over the next decade.The IE-associated incidence will increase in the future and the death and heart failure burden will not be appropriately controlled.Gender,age,regional,and country heterogeneity should be taken seriously to facilitate in making effective strategies for lowering the IE disease burden.展开更多
A 43-year-old man with a history of rheumatoid heart disease developed endocarditis.Blood culture showed endocarditis was caused by Kodamaea ohmeri and the susceptibility test showed the yeast species were susceptible...A 43-year-old man with a history of rheumatoid heart disease developed endocarditis.Blood culture showed endocarditis was caused by Kodamaea ohmeri and the susceptibility test showed the yeast species were susceptible to itraconazole,amphotericin B,and voriconazole,but susceptible-dose dependent to fluconazole,and resistant to 5-flucytosine.Treated with surgery and anti-fungi agents,the patient recovered from endocarditis.This is the first case of K.ohmeri fungemia found in Chinese from mainland.More and more evidence indicate that K.ohmeri is an important opportunistic pathogen for human beings.展开更多
FULMINANT myocarditis complicated with refractory cardiogenic shock carries a very high mortality （76%）. Herein we report our experi-ence in treating a 23-year-old Chinese woman with fulminant myocarditis complicate...FULMINANT myocarditis complicated with refractory cardiogenic shock carries a very high mortality （76%）. Herein we report our experi-ence in treating a 23-year-old Chinese woman with fulminant myocarditis complicated with cardiogenic shock, who was rescued by extracorporeal membrane oxygenation （ECMO）.展开更多
THE incidence of isolated right heart infective endocarditis （IE） is far less common than that of left heart. Clinical presentation is often associated with pulmonary manifestations. The main symptoms include high f...THE incidence of isolated right heart infective endocarditis （IE） is far less common than that of left heart. Clinical presentation is often associated with pulmonary manifestations. The main symptoms include high fever, chest pain, and dyspnea due to septic pulmonary emboli. Degenerative valvular disease, congenital heart diseases, prosthetic valves, long-term hemodialysis, diabetes mellitus predispose patients at increased risk of IE.1 In young persons, IE may be associated with intravenous drug abuse.2 This report dealt with a young patient who had none of the risk factors mentioned above. He was diagnosed and treated for lung abscess and septemia for one and a half months. Further investigation unveiled infective vegetation on tricuspid valve. Following surgical resection of the vegetation, fever and respiratory symptoms completely remitted. The mechanism of the IE occurred on the normal native tricuspid valve is proposed.展开更多
Prosthetic valve endocarditis （PVE） after Transcatheter Aortic Valve Implantation （TAVI） has been reported to occur with an incidence of 0.3% 3.1% per patient-year and it is associated with high mortality rates. W...Prosthetic valve endocarditis （PVE） after Transcatheter Aortic Valve Implantation （TAVI） has been reported to occur with an incidence of 0.3% 3.1% per patient-year and it is associated with high mortality rates. We report a PVE occurring early, i.e., 26 days post transfemoral TAVI with the use of Edward-Sapien-XT S3 prosthesis 26 mm because of severe symptomatic aortic tory included a coronary and stenosis. His past medical his- peripheral arterial disease and a total knee replacement in 2010. Our patient, a 77-year old female, was admitted with signs of septic arthritis of the left knee and was febrile.展开更多
1 Introduction Transcatheter aortic valve implantation （TAVI） constitutes an established treatment in inoperable or high perioperative risk patients with severe aortic stenosis, demonstrating similar mortality rates...1 Introduction Transcatheter aortic valve implantation （TAVI） constitutes an established treatment in inoperable or high perioperative risk patients with severe aortic stenosis, demonstrating similar mortality rates （at 30 days and 1 year） with surgical aortic valve replacement （SAVR）. Various complications have been reported during TAVI, weeks or months post procedure. The most frequent causes of transcatheter heart valve （THV） failure are paravalvular regurgitation, infective endocarditis （IE）, thrombosis and late valve Migration.展开更多
The anaerobic bacteria can cause infections in different parts of the body, including appendicitis, cholecystitis, otitis media, oral infections, endocarditis, endometritis, brain abscess, myocardial necrosis, osteomy...The anaerobic bacteria can cause infections in different parts of the body, including appendicitis, cholecystitis, otitis media, oral infections, endocarditis, endometritis, brain abscess, myocardial necrosis, osteomyelitis, peritonitis, empyema, salpingitis, septic arthritis, liver abscess, sinusitis, intestinal surgery or post-traumatic wound infections, and bacteremia, such as pelvic inflammatory disease. This paper analyzes the experimental method of anaerobic bacteria to human urinary system through the influence of literature.展开更多
Objectives： Infectious tricuspid endocarditis is known to simply require antibiotherapy and to have good prognosis in most cases. Few studies focused on severe episodes managed in ICU. We aimed to describe clinical a...Objectives： Infectious tricuspid endocarditis is known to simply require antibiotherapy and to have good prognosis in most cases. Few studies focused on severe episodes managed in ICU. We aimed to describe clinical and microbiological features, and fmal outcome of infectious tricuspid endocarditis managed in ICU. Methods： From 1 January 2009 to 31 August 2017, all patients hospitalized in intensive care unit with infectious tricuspid endocarditis were enrolled. Key findings： We collected 15 episodes of infectious tricuspid endocarditis. Median age was of 39 years. Risk factors were： intravenous drug users （n = 10）, pace maker （n = 1）, vascular device （n = 2）, none （n = 2）. Median SAPS II, APACHE II and SOFA on admission were 21, 10 and 2 respectively. Organ failures on admission were： acute respiratory failure （n = 10）, sepsis （n = 7）, coma （n = 1） and acute kidney injury （n = 8）. The most frequent causative pathogen was Staphylococcus Aureus. Antibiotherapy failure happened in 10 patients from whom 8 underwent cardiac surgery （53.3%）. Most frequent complications were acute kidney injury （n = 14） and withdrawal syndrom. Infectious tricuspid endocarditis relapse on bioprosthesis occurred within 2 intravenous drug users after hospital discharge. Overall in-hospital mortality was 40%. Conclusions： Infectious tricuspid endocarditis in ICU is fitted with poor prognosis and high need to cardiac surgery. Special care should be provided to intravenous drug users to prevent relapse.展开更多
The present study reports a case of a young patient who presented for 3 months dyspnea, edema of lower limbs, fever and important weight loss. She evolved with acute fever, hematemesis and focal seizures. An echocardi...The present study reports a case of a young patient who presented for 3 months dyspnea, edema of lower limbs, fever and important weight loss. She evolved with acute fever, hematemesis and focal seizures. An echocardiogram was performed demonstrating file presence of interventricular, interatrial, and extensive echogenic imaging and of poorly defined borders throughout the septal cusp of the tricuspid valve, suggestive of vegetation, chest tomography that observed several foci of pulmonary abscess and blood culture evidencing the presence of Staphylococcus aureus. She was treated with Vancomycin, Meropenem and Amphotericin, along with clinical support. She underwent surgery to exchange the tricuspid valve for a biological prosthesis, evolving with clinical improvement and receiving discharge from hospital.展开更多
Infective endocarditis(IE) remains a serious disease. Aorta-to-right atrium fistula is a rare but very serious complication of IE and predicts a higher mortality. This report describes a 50-year-old man with endocardi...Infective endocarditis(IE) remains a serious disease. Aorta-to-right atrium fistula is a rare but very serious complication of IE and predicts a higher mortality. This report describes a 50-year-old man with endocarditis,vegetation,perforation of noncoronary sinus,and formation of two aorta-to-right atrium fistulas with native valves detected by transthoracic echocardiography. This disease is lethal despite developments in cardiac imaging and antibacterial therapy. Early diagnosis,aggressive antibacterial therapy,and surgical treatment may improve the prognosis.展开更多
基金Supported by the grant from the National Natural Science Foundation of China (30700373)
文摘Objective To analyze the clinical features of hemodialysis patients complicated by infective endo carditis. Methods The clinical features of six such patients admitted to Peking Union Medical College Hospital during the year 1990 to 2009 were analyzed. All of them were diagnosed based on Chinese Children Diagnostic Criteria for Infective Endocarditis. Results The average age of the six patients was 52.3±19.3 years old. Four were males. Vascular accesses at the onset of infective endocarditis were as follows： permanent catheters in three, temporary catheters in two, and arteriovenous fistula in one. Three were fbund with mitral valve involvement, two with aor tic valve involvement, and one with both. Five vegetations were found by transthoracic echocardiography, and one by transesophageal echocardiography. Four had positive blood culture results. The catheters were all removed. Four of the patients were improved by antibiotics treatment, in which two were still on hemodialy sis in the following 14-24 months and the other two were lost to follow-up. One patient received surgery, but died of heart failure alter further hemodialysis for three months. One was well on maintenance hemodi alvsis for three months after surgery. Conclusions Infective endocarditis should be suspected when hemodialysis patients suffer from long-term fever, for which prompt blood culture and transthoracic echocardiography confirmation could be performed. Transesophageal echocardiography could be considered even when transthoracic echocardiography produces negative findings. With catheters removed, lull course of appropriate sensitive antibiotics and surgery if indicated could improve the outcome of chronic hemodialysis patients complicated by infective cndocarditis.
文摘Objective To forecast the future burden and its attributable risk factors of infective endocarditis(IE).Methods We analyzed the disease burden of IE and its risk factors from 1990 to 2019 using the Global Burden of Disease 2019 database and projected the disease burden from 2020 to 2030 using a Bayesian age-period-cohort model.Results By 2030,the incidence of IE will increase uncontrollably on a global scale,with developed countries having the largest number of cases and developing countries experiencing the fastest growth.The affected population will be predominantly males,but the gender gap will narrow.The elderly in high-income countries will bear the greatest burden,with a gradual shift to middle-income countries.The incidence of IE in countries with middle/high-middle social-demographic indicators(SDI) will surpass that of high SDI countries.In China,the incidence rate and the number of IE will reach 18.07 per 100,000 and 451,596 in 2030,respectively.IEassociated deaths and heart failure will continue to impose a significant burden on society,the burden on women will increase and surpass that on men,and the elderly in high-SDI countries will bear the heaviest burden.High systolic blood pressure has become the primary risk factor for IE-related death.Conclusions This study provides comprehensive analyses of the disease burden and risk factors of IE worldwide over the next decade.The IE-associated incidence will increase in the future and the death and heart failure burden will not be appropriately controlled.Gender,age,regional,and country heterogeneity should be taken seriously to facilitate in making effective strategies for lowering the IE disease burden.
文摘A 43-year-old man with a history of rheumatoid heart disease developed endocarditis.Blood culture showed endocarditis was caused by Kodamaea ohmeri and the susceptibility test showed the yeast species were susceptible to itraconazole,amphotericin B,and voriconazole,but susceptible-dose dependent to fluconazole,and resistant to 5-flucytosine.Treated with surgery and anti-fungi agents,the patient recovered from endocarditis.This is the first case of K.ohmeri fungemia found in Chinese from mainland.More and more evidence indicate that K.ohmeri is an important opportunistic pathogen for human beings.
文摘FULMINANT myocarditis complicated with refractory cardiogenic shock carries a very high mortality （76%）. Herein we report our experi-ence in treating a 23-year-old Chinese woman with fulminant myocarditis complicated with cardiogenic shock, who was rescued by extracorporeal membrane oxygenation （ECMO）.
文摘THE incidence of isolated right heart infective endocarditis （IE） is far less common than that of left heart. Clinical presentation is often associated with pulmonary manifestations. The main symptoms include high fever, chest pain, and dyspnea due to septic pulmonary emboli. Degenerative valvular disease, congenital heart diseases, prosthetic valves, long-term hemodialysis, diabetes mellitus predispose patients at increased risk of IE.1 In young persons, IE may be associated with intravenous drug abuse.2 This report dealt with a young patient who had none of the risk factors mentioned above. He was diagnosed and treated for lung abscess and septemia for one and a half months. Further investigation unveiled infective vegetation on tricuspid valve. Following surgical resection of the vegetation, fever and respiratory symptoms completely remitted. The mechanism of the IE occurred on the normal native tricuspid valve is proposed.
文摘Prosthetic valve endocarditis （PVE） after Transcatheter Aortic Valve Implantation （TAVI） has been reported to occur with an incidence of 0.3% 3.1% per patient-year and it is associated with high mortality rates. We report a PVE occurring early, i.e., 26 days post transfemoral TAVI with the use of Edward-Sapien-XT S3 prosthesis 26 mm because of severe symptomatic aortic tory included a coronary and stenosis. His past medical his- peripheral arterial disease and a total knee replacement in 2010. Our patient, a 77-year old female, was admitted with signs of septic arthritis of the left knee and was febrile.
文摘1 Introduction Transcatheter aortic valve implantation （TAVI） constitutes an established treatment in inoperable or high perioperative risk patients with severe aortic stenosis, demonstrating similar mortality rates （at 30 days and 1 year） with surgical aortic valve replacement （SAVR）. Various complications have been reported during TAVI, weeks or months post procedure. The most frequent causes of transcatheter heart valve （THV） failure are paravalvular regurgitation, infective endocarditis （IE）, thrombosis and late valve Migration.
文摘The anaerobic bacteria can cause infections in different parts of the body, including appendicitis, cholecystitis, otitis media, oral infections, endocarditis, endometritis, brain abscess, myocardial necrosis, osteomyelitis, peritonitis, empyema, salpingitis, septic arthritis, liver abscess, sinusitis, intestinal surgery or post-traumatic wound infections, and bacteremia, such as pelvic inflammatory disease. This paper analyzes the experimental method of anaerobic bacteria to human urinary system through the influence of literature.
文摘Objectives： Infectious tricuspid endocarditis is known to simply require antibiotherapy and to have good prognosis in most cases. Few studies focused on severe episodes managed in ICU. We aimed to describe clinical and microbiological features, and fmal outcome of infectious tricuspid endocarditis managed in ICU. Methods： From 1 January 2009 to 31 August 2017, all patients hospitalized in intensive care unit with infectious tricuspid endocarditis were enrolled. Key findings： We collected 15 episodes of infectious tricuspid endocarditis. Median age was of 39 years. Risk factors were： intravenous drug users （n = 10）, pace maker （n = 1）, vascular device （n = 2）, none （n = 2）. Median SAPS II, APACHE II and SOFA on admission were 21, 10 and 2 respectively. Organ failures on admission were： acute respiratory failure （n = 10）, sepsis （n = 7）, coma （n = 1） and acute kidney injury （n = 8）. The most frequent causative pathogen was Staphylococcus Aureus. Antibiotherapy failure happened in 10 patients from whom 8 underwent cardiac surgery （53.3%）. Most frequent complications were acute kidney injury （n = 14） and withdrawal syndrom. Infectious tricuspid endocarditis relapse on bioprosthesis occurred within 2 intravenous drug users after hospital discharge. Overall in-hospital mortality was 40%. Conclusions： Infectious tricuspid endocarditis in ICU is fitted with poor prognosis and high need to cardiac surgery. Special care should be provided to intravenous drug users to prevent relapse.
文摘The present study reports a case of a young patient who presented for 3 months dyspnea, edema of lower limbs, fever and important weight loss. She evolved with acute fever, hematemesis and focal seizures. An echocardiogram was performed demonstrating file presence of interventricular, interatrial, and extensive echogenic imaging and of poorly defined borders throughout the septal cusp of the tricuspid valve, suggestive of vegetation, chest tomography that observed several foci of pulmonary abscess and blood culture evidencing the presence of Staphylococcus aureus. She was treated with Vancomycin, Meropenem and Amphotericin, along with clinical support. She underwent surgery to exchange the tricuspid valve for a biological prosthesis, evolving with clinical improvement and receiving discharge from hospital.
文摘Infective endocarditis(IE) remains a serious disease. Aorta-to-right atrium fistula is a rare but very serious complication of IE and predicts a higher mortality. This report describes a 50-year-old man with endocarditis,vegetation,perforation of noncoronary sinus,and formation of two aorta-to-right atrium fistulas with native valves detected by transthoracic echocardiography. This disease is lethal despite developments in cardiac imaging and antibacterial therapy. Early diagnosis,aggressive antibacterial therapy,and surgical treatment may improve the prognosis.
