A case of subcutaneous phaeohyphomycosis due to Exophiala jeanselmei, probably the first reported in New Zealand, is presented. This infection initially presented as two asymptomatic swellings overlying the left wrist of a 70 year old farmer with chronic respiratory and cardiovascular disease. A two month course of ketoconazole therapy proved ...

Although still considered to be a rare and mostly fatal illness, the reported incidence of neonatal bacterial endocarditis has increased during the past decade. This parallels the establishment of intensive supportive management of severely ill newborns with multiple medical problems. An extremely difficult diagnostic problem with protean manifestations, the presence ...

A 43-year-old woman who had Candida endocarditis with saddle embolism underwent mitral valve replacement and resection of infected aorta. Only 7 persons with fungal endocarditis with saddle embolism have been reported in the literature, and all of them died. We report a case of successful treatment of this lethal complication ...

The case of a young shepherd with Brucella melitensis aortic valve endocarditis is presented. His illness ran an afebrile course and was also complicated by disseminated intravascular coagulation (DIC), nephritis, hepatitis and peritonitis, all of which responded well to supportive measures and a combination of tetracycline, trimethoprim-sulphamethoxazole and amikacin sulphate. ...

Staphylococcus schleiferi is a new species of coagulase-negative staphylococcus first described in April 1988 (J. Freney, Y. Brun, M. Bes, H. Meugnier, F. Grimont, P. A. D. Grimont, C. Nervi, and J. Fleurette, Int. J. Syst. Bacteriol. 38:168-172, 1988). There are few data in the literature on its pathogenicity. We ...

We report a case of brucella endocarditis on a native aortic valve causing severe aortic regurgitation, uncontrolled heart failure and disseminated intravascular coagulopathy. The diagnosis was proven by positive serology, isolation of Brucella melitensis from preoperative blood cultures and excised valve. The patient was successfully treated with valve replacement and ...

A case report is presented of a child in whom there was gross tricuspid insufficiency due to marked dysplasia of the tricuspid valve. This patient received prosthetic valve replacement in tricuspid position with excellent post-operative improvement. To the best of our knowledge, this is the first case report of a ...

This report describes the first documented case of Erysipelothrix rhusiopathiae endocarditis in Latin America. The patient was a 51-years-old male, moderate alcoholic, with a previous history of aortic failure. He was used to fishing and cooking as a hobby and had his left hand wounded by a fish-bone. The disease ...

We report a case of infective endocarditis due to Cardiobacterium Hominis. This organism has rarely been recognized in the past as a human pathogen on the cardiac valves. This patient escaped early diagnosis, but he was successfully treated with parenteral ampicillin followed by elective aortic and mitral valve replacement. The ...

Cor triatriatum presenting in adulthood is extremely rare. This paper reports a case of cor triatriatum initially masquerading as mitral stenosis, which was later complicated by myxomatous mitral valve degeneration with severe regurgitation, which necessitated mitral valvular replacement. To the authors' knowledge, such a combination has not been reported in ...

This article summarizes the management of 22 cases of pyoderma gangrenosum over the past four years at the hospital of the University of Pennsylvania, Philadelphia. Eighteen patients with pyoderma gangrenosum were studied using the most sensitive routine laboratory method for detection of monoclonal immunoglobulins, immunofixation electrophoresis. Four cases of IgA ...

Tunnelled silicone rubber right atrial catheters are commonly used to administer long-term total parenteral nutrition (TPN), cancer chemotherapeutic agents, and antimicrobial agents. The indwelling devices potentiate platelet-fibrin thrombi formation, providing a nidus for infection. Although many episodes of sepsis associated with thrombotic tunnelled catheters respond to antimicrobial therapy alone, a ...

This article reports a case of leaflet embolization of a mitral Edwards-Duromedics prosthesis. The patient had abrupt onset of acute pulmonary edema and was initially treated medically for 3 days. Fluoroscopy showed only one freely moving leaflet and the other was (incorrectly) assumed to be blocked in the closed position. ...

A case of endocarditis associated with six entrapped endocardial pacer leads is presented. Because of many failed attempts at removing them by conservative measures, cardiopulmonary bypass was needed; concomitant redo coronary bypass grafts were done. To our knowledge, this represents a unique case, the like of which has not been ...

The enterococci, members of the group D streptococci and the predominant aerobic streptococci of the gastrointestinal and female genital tracts, have long been recognized as significant pathogens in infective endocarditis. Over the past 2 decades, enterococci have become increasingly important nosocomial pathogens, related to their intrinsic resistance to many antibiotics, ...

To better understand the microbiology, anatomy, and demography of infectious endocarditis, we devised a prospective statewide reporting system to study these infections. Because our study design required accurate diagnosis, reliable case reporting, and a high probability of physician-to-case exposure, we enlisted the help of cardiologists, cardiovascular surgeons, and infectious disease ...

A newly developed thrombus imaging agent, 67Ga-DFO-DAS-fibrinogen (67Ga-fibrinogen), was used for 22 studies in 20 cases of suspected deep venous thrombosis. Increased accumulation of 67Ga-fibrinogen in venous thrombi was depicted at 48 h after injection in 10 of the 15 cases (10 of 17 studies) who showed abnormal findings in ...

34 cases of Listeria monocytogenes endocarditis reported in the literature from 1950-1986 were reviewed. The male to female ratio was 2: 1. The average age was 49 years, and 35% of patients were 60 years of age or older. A single case of polymicrobial endocarditis was identified. There were 8 ...

Psychogenic habit cough--a condition that can be debilitating if it extends over a period of years--has been described in both pediatric and adolescent populations, but not in adults. The authors review the cases of 4 adult patients with this condition, review the available pediatric/adolescent literature, and make suggestions for the ...

Three cases of endocarditis due to nutritionally deficient (variant) streptococci are presented and the literature is reviewed. In all of the cases reviewed, the patient presented with an indolent subacute course. Prior heart disease was present in 90% of the patients, embolization occurred in 27%, relapse after therapy in 17%, ...

Comparing data relating to the estimated incidence of infective endocarditis and deaths due to this condition highlights the changing age and sex patterns over the last 50 years. Using these data it is estimated that about 20 cases per million population per year can now be expected many of whom ...

In this paper the major optometric, ophthalmologic, and orthoptic literature on the efficacy of vision therapy for amblyopia has been surveyed. Over the past four decades there are many examples of the successful treatment of amblyopia in the form of well documented individual case reports or large sample studies. Although ...

His bundle tachycardia is a rare arrhythmia in infants and children and is resistant to therapy. There is now sufficient evidence from reported cases and a further patient reported below to suggest that drug management of this arrhythmia is a reasonable alternative to His bundle ablation with life-long pacing from ...

We evaluated three cases of Pseudomonas aeruginosa corneoscleritis, one associated with the use of contaminated eyedrops; another in an elderly, debilitated patient; and the third in a patient who had previously undergone penetrating keratoplasty. In the first two cases, control of the infection was achieved by intensive antibiotic therapy alone. ...

A case of subacute bacterial endocarditis was caused by Cardiobacterium hominis in a 55-year-old man who had a history of rheumatic fever. A survey of the literature showed few reports dealing with the isolation of these organisms from human sources. Microbiologically, the chief distinguishing features of C. hominis are its ...

The second documented case of renal aspergilloma due to Aspergillus flavus is presented. The merits of the medical therapy that failed are discussed. Pathological examination showed a nidus of aspergillus around suture material persisting from a pyelolithotomy operation 2 years before in India. We argue that this was the reason ...

Twenty-five consecutive unequivocal cases of Staphylococcus aureus endocarditis in a single centre over 5 years were reviewed. Despite an unusually high proportion of prosthetic infections an early mortality of only 16% was observed. Analysis reveals that early diagnosis and prompt effective antibiotic chemotherapy were important factors in achieving this low ...

Q fever endocarditis, which is seen most often in Great Britain and Australia, has been rarely observed in the United States. A patient with an eight month febrile illness who had signs and symptoms of endocarditis and serologic studies diagnostic of Q fever endocarditis is reported. A history of extensive ...

Two cases of disseminated fungal infection due to Fusarium species, that occurred during a 4-month period, are reported. Both patients had a myeloproliferative disorder for which they had received intensive cytotoxic and immunosuppressive therapy, and both died despite treatment with amphotericin B. This report and review of the recent literature ...

All splenectomized individuals are at risk of developing pneumococcal sepsis, but most reports fail to mention how many patients are given prophylactic penicillin therapy. Fourteen reported cases of postsplenectomy bacterial sepsis in patients receiving prophylactic penicillin therapy are reviewed. In only five cases, the patients had penicillin-sensitive pneumococcal infection. Hence, ...

We have described a previously healthy medical student who had endocarditis due to Haemophilus paraphrophilus necessitating replacement of the mitral valve. We compared this case to the 11 previously reported cases of endocarditis caused by this organism, stressing the fastidious nature of the organism, its destructive nature, and its propensity ...

We report two patients with laryngeal manifestations of Wegener's granulomatosis to demonstrate the marked variability of presentation in this disease. The reported literature is reviewed and shows a similar spectrum with early and late onset of laryngeal granulomata, subglottic in location. Of all the patients with Wegener's granulomatosis reviewed, 8.5% ...

Infective endocarditis is an uncommon manifestation of group B streptococcal disease. Seven cases of group B streptococcal endocarditis are reported herein. Another fifty-five cases published in the literature since 1962 are reviewed: the male to female ratio was 1.4:1. The average age was 53.8 years, and 45% of patients were ...

In an attempt to clarify the pathogenetic morphology of aortic regurgitation (AR) due to prolapse of the aortic valve (prolapsing AR) associated with ventricular septal defect (VSD), 201 specimens from Japanese autopsy series with isolated VSD were examined. Among these hearts, there were 128 cases (64%) of infundibular VSD (IVSD); ...

Left ventricular to right atrial (LV-RA) communications are rare septal defects. The majority of them are congenital in origin and acquired defects are exceedingly rare. The causes of acquired LV-RA communications include chest trauma, infective endocarditis, and valvar replacement. This report describes a case of direct LV-RA and interventricular communications ...

ALVT is a rare congenital lesion. The paravalvular tunnel causes a clinical picture of aortic regurgitation. An aortic regurgitant murmur is present since birth. The clinical diagnosis, often overlooked, is best confirmed by angiocardiography in the lateral view. Although 80% of reported cases present with congestive heart failure before age ...

Aspergillus endocarditis is associated with a very high mortality. Of approximately 67 cases reported in the English language literature, there have been only two known survivors. This report describes a patient with Aspergillus flavus endocarditis after mitral valve annuloplasty who recovered with combined surgical and antifungal therapy. This is the ...

Corynebacterium diphtheriae usually produces an infection limited to the respiratory tract and the organisms rarely invade the blood stream. We report the case of a 6-year-old girl who, 2 months after an unsuccessful repair of a ventricular septal defect, developed septicaemia with non-toxigenic C. diphtheriae. The organism appeared resistant to ...

Human infections due to group C streptococci are rare. We describe here a patient with endocarditis caused by this organism. A review of 16 other cases of group C streptococcal endocarditis reported in the literature suggests that this organism has a high potential for attachment to and destruction of normal ...

5-Fluorouracil (5-FU) has been reported to cause punctal-canalicular fibrosis with resultant severe epiphora. It is reported that the epiphora will often resolve when treatment ceases or is decreased. However, this report describes a case of punctal-canalicular fibrosis so severe that bilateral conjunctivodacryocystorhinostomies were necessary. This has not been previously reported ...

Trichosporon is a common cause of superficial mycotic infection but has rarely been associated with endocarditis. The case of a patient who had a peritoneovenous shunt for chronic intractable ascites due to Laennec liver cirrhosis is described. The shunt was revised on several occasions, and the last procedure was complicated ...

We studied the activity of cefotaxime both microbiologically and clinically. 138 blood cultures positive for gram-positive cocci were evaluated (90 strains of Staphylococcus aureus, 25 of Streptococcus faecalis, 13 of Streptococcus alpha and ten of Streptococcus mutans). Cefotaxime showed good activity against all strains with the exception of S. mutans, ...

Actinobacillus actinomycetemcomitans is a very uncommon cause of infectious endocarditis. The organism was first described in 1912. Thjotta and Sydnes reported its isolation in pure culture from a long standing abscess which had developed after tooth extraction. Subsequently this organism was found to be part of the normal flora, and ...

Three cases of Staphylococcus aureus tricuspid valve endocarditis are reported; each was preceded by a gynaecological event. In 2 cases there was no overt pelvic sepsis and there had been no operative or instrumental intervention, but in the 3rd pelvic inflammatory disease was present, probably not as a result of ...

The first two cases of Actinobacillus actinomycetemcomitans endocarditis in Israel are reported. One involved a 67 year old woman with mitral insufficiency and the other, a 48 year old alcoholic male with bioprosthetic mitral valve. The organism grew in three of seven and seven of fourteen blood culture specimens, taken ...

A case of right-sided endocarditis clearly associated with the presence of a right atrial catheter is presented, and the literature on septicemia and endocarditis associated with central venous and pulmonary artery catheterization is reviewed. In the majority of cases of catheter-associated endocarditis reported in the literature, diagnosis has been made ...

Two similar cases of a lethal mechanical complication after mitral valve replacement by a Björk-Shiley prosthesis are reported. In both cases the smaller outlet strut spontaneously fractured at the site of juncture welds. The tilting disc was embolized into the aorta, the patients died of acute congestive heart failure.

A case of malfunctioning Beall prosthetic mitral valve causing severe heart failure is presented. The unusual aspect of this malfunction was the finding of disc dislodgment despite the absence of pathology in the disc itself. The dislodgment was caused by excessive tissue ingrowth around the suture ring. The need for ...

Neisseria subflava is a rare cause of bacterial endocarditis. Only seven cases have been identified in the world literature if strict criteria as to organism classification and of endocarditis are applied to individual case reports. The first reported case in an intravenous drug user is described. In addition, findings on ...

Antimicrobial prophylaxis of bacterial endocarditis is widely recommended for patients with mitral valve prolapse who undergo procedures that may cause bacteremia. The benefits and risks of this practice have been analyzed on the basis of published data and response to a questionnaire survey of leading authorities on bacterial endocarditis. Among ...