The perplexing clinical course of a 23-year-old black male with isolated gonococcal pulmonary valvular endocarditis is presented. M-mode echocardiography provided the first clue to the presence of pulmonary valvular vegetations and the proper diagnosis. Since Neisseria gonorrhea appears to have a particular affinity for the pulmonary valve, the presence of isolated pulmonary valvular endocardit...

Infective endocarditis is an endovascular microbial infection of cardiovascular structures, including large intrathoracic vessels and intracardiac foreign bodies. The characteristic lesions consist of vegetations composed of platelets, fibrin, microorganisms, and inflammatory cells, as well as leaflet disruption. The commonly accepted pathogenetic theory is herein reported, from endothelial inj...

A 46-year-old man with a history of cigarette smoking was referred to our hospital for further evaluation of infective endocarditis. He had a history of fever of 45 days’ duration. Previously in workup for fever, the patient had undergone transthoracic echocardiography, showing vegetations on the aortic and mitral valves, hence his referral to our hospital. On physical examination, he was febri...

In the last 50 years, the incidence of infective endocarditis (IE) has remained between 2 and 6 per 100.000 individuals in the general population per year and its mortality has fluctuated between 10% and 30%, depending on the type of pathogen. Historically, chronic rheumatic heart disease had being the primary risk factor for IE but in the last years, new at-risk groups have emerged like indivi...

Background: Sub-acute bacterial endocarditis (SBE) rarely presents with features of a small vessel vasculitis. Patients with SBE can also develop multiple serological abnormalities including ANCA. In this report, we present a case of infective endocarditis mimicked ANCA associated glomerulonephritis.Case presentation: A 57-year old male with a clinical picture of rapidly progressive renal failu...

AIMS Secondary involvement of the mitral valve is well documented in primary aortic valve endocarditis. A poorly considered, but probably important causative mechanism, involving both left-sided valves, is 'mitral kissing vegetation'. This results from large aortic vegetations prolapsing into the left ventricular outflow tract and making contact with the ventricular aspect of the anterior mitra...

OBJECTIVES Our aim was to determine the diagnostic value of transesophageal echocardiography in right-sided endocarditis. BACKGROUND Recent studies have demonstrated that transesophageal echocardiography is superior to transthoracic echocardiography in the detection of vegetations associated with left-sided endocarditis. Its diagnostic value in right-sided endocarditis has not been establishe...

The endocardial vegetation which is formed in the course of bacterial endocarditis (BE) contains tissue factor (TF)-dependent procoagulant activity. Earlier studies showed that monocytes are the main source of TF in the vegetations. The TF activity (TFA) of vegetations isolated from Streptococcus sanguis-infected rabbits depended on the numbers of bacteria as well as monocytes in the vegetation...

We present the case of a patient with vegetations on a pacing lead from a pacemaker implanted 13 years previously. A new surgical technique for removal of infected leads was developed to avoid the increased risk of septic pulmonary embolism. The electrode with vegetations was removed without cardiopulmonary bypass using the direct surgical approach described.

Endocarditis was produced in rabbits with a methicillin-resistant Staphylococcus epidermidis isolate. Subpopulations resistant to other semisynthetic penicillins and cephalosporins were detected in the isolate. Their presence was probably responsible for the increase in minimum bactericidal concentrations and minimum inhibitory concentrations when tests with high inocula, rather than low inocul...