No abstract available.
Aged ; Anti-Bacterial Agents/therapeutic use ; Aortic Valve/*microbiology/surgery/ultrasonography ; Cross Infection/diagnosis/*microbiology/therapy ; Diffusion Magnetic Resonance Imaging ; Endocarditis, Bacterial/diagnosis/*microbiology/therapy ; Heart Valve Prosthesis Implantation ; Humans ; Klebsiella Infections/diagnosis/*microbiology/therapy ; Klebsiella pneumoniae/drug effects/*enzymology/pathogenicity ; Male ; Microbial Sensitivity Tests ; Predictive Value of Tests ; Sepsis/diagnosis/*microbiology/therapy ; Treatment Outcome ; beta-Lactamases/*metabolism

Infective endocarditis (IE) has been increasingly diagnosed in patients without previously detected predisposing heart disease, but its clinical features have yet to be fully determined. A recent single-center study including echocardiographic images and surgical findings investigated the incidence of undiagnosed, clinically silent valvular or congenital heart diseases and healthcare-associated infective endocarditis (HAIE). The study confirmed that a large proportion of patients with IE have no previous history of heart disease. Analysis of underlying disease in these patients showed that undetected mitral valve prolapse was the most common disease, followed by an apparently structurally normal valve. The patients who developed IE of apparently structurally normal valves had different clinical characteristics and worse outcomes. IE involving a structurally normal valve was associated with both nosocomial and non-nosocomial HAIE, whereas community-acquired IE was more frequent than HAIE. The pathophysiologic mechanism involving the development of non-HAIE or community-acquired IE due to predominantly staphylococcal infection in an apparently structurally normal valve is not yet clearly understood. Structurally normal valves are not necessarily free of regurgitation or abnormal turbulence and, given the dynamic nature and fluctuating hemodynamic effects of conditions such as poorly controlled hypertension, end-stage renal disease, and sleep apnea, further investigation is necessary to evaluate the potential role of these diseases in the development of IE. An apparently normal-looking valve is associated with IE development in patients without previously recognized predisposing heart disease, warranting repartition of at-risk groups to achieve better clinical outcomes.
Adult ; Aged ; Community-Acquired Infections/diagnosis/*epidemiology/microbiology/physiopathology/therapy ; Cross Infection/diagnosis/*epidemiology/microbiology/physiopathology/therapy ; Echocardiography, Doppler, Color ; Endocarditis, Bacterial/diagnosis/*epidemiology/microbiology/physiopathology/therapy ; Female ; Heart Valves/*microbiology/physiopathology/ultrasonography ; Humans ; Incidence ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Risk Factors

No abstract available.
Anti-Bacterial Agents/therapeutic use ; Biopsy ; Echocardiography, Doppler, Color ; Echocardiography, Transesophageal ; Endocarditis, Bacterial/complications/diagnosis/drug therapy/*microbiology ; Fluorescent Antibody Technique ; Heart Septal Defects, Ventricular/*complications/diagnosis/surgery ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Pulmonary Valve Stenosis/*complications/diagnosis ; Purpura, Schoenlein-Henoch/diagnosis/drug therapy/*etiology ; Risk Factors

Since microbial gene sequencing was utilized for etiologic diagnosis of culture-negative endocarditis, cases of Bartonella endocarditis have been reported in various countries. Herein we report the first case of Bartonella quintana endocarditis, which was confirmed for the first time in Korea by 16S rRNA gene sequencing from the excised valve. A 75-yr-old woman was hospitalized due to dyspnea. Echocardiography demonstrated large oscillating vegetation at the aortic valve. Blood culture was negative. She underwent valve replacement and sequencing of the 16S rRNA gene from excised valve identified Bartonella quintana. She was successfully treated with combined use of ceftriaxone and gentamicin.
Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use ; Aortic Valve/pathology ; Bartonella quintana/genetics/*isolation & purification ; Ceftriaxone/therapeutic use ; Drug Therapy, Combination ; Dyspnea/etiology ; Echocardiography ; Endocarditis, Bacterial/*diagnosis/drug therapy/microbiology ; Female ; Gentamicins/therapeutic use ; Humans ; RNA, Ribosomal, 16S/genetics ; Republic of Korea ; Sequence Analysis, RNA

No abstract available.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/pharmacology/therapeutic use ; Ceftriaxone/pharmacology/therapeutic use ; Echocardiography ; Endocarditis, Bacterial/*diagnosis/drug therapy/microbiology ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Infant, Newborn ; Male ; Microbial Sensitivity Tests ; Micrococcaceae/drug effects/*isolation & purification ; Middle Aged ; RNA, Ribosomal, 16S/chemistry/metabolism ; Republic of Korea