Humans ; Endocarditis, Bacterial/surgery* ; Arthritis/etiology* ; Endocarditis/surgery*

Aneurysm, Infected/surgery* ; Endocarditis/surgery* ; Endocarditis, Bacterial/surgery* ; Humans ; Intracranial Aneurysm/surgery*

Aged ; Aortic Valve ; pathology ; surgery ; Endocarditis ; complications ; surgery ; Endocarditis, Bacterial ; complications ; surgery ; Female ; Glomerulonephritis ; etiology ; Humans

Adult ; Endocarditis/surgery* ; Endocarditis, Bacterial/surgery* ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Young Adult

The epidemiology of Group B streptococcal disease has been changing. Since the 1990s, early-onset neonatal and maternal peripartum infections have decreased, due to the administration of prophylactic intrapartum antibiotics. On the other hand, invasive Group B streptococcal infections have increased in nonpregnant adults, especially in elderly persons and in those with chronic immunosuppressive diseases, such as diabetes mellitus, liver cirrhosis, and malignancies. Although infective endocarditis is an uncommon manifestation of invasive Streptococcus agalactiae infection, it usually leads to cardiac surgery, due to heart failure associated with rapid valve destruction and the formation of emboli. Several cases of endocarditis due to S. agalactiae have appeared in the literature, but there have been few reports in Korea. We present a case of S. agalactiae infective endocarditis in an elderly patient with advanced gastric cancer, successfully treated with intravenous antibiotics and cardiac surgery.
Adult ; Aged ; Anti-Bacterial Agents ; Diabetes Mellitus ; Endocarditis ; Endocarditis, Bacterial ; Hand ; Heart Failure ; Humans ; Korea ; Liver Cirrhosis ; Peripartum Period ; Stomach Neoplasms ; Streptococcal Infections ; Streptococcus ; Streptococcus agalactiae ; Thoracic Surgery

The epidemiology of Group B streptococcal disease has been changing. Since the 1990s, early-onset neonatal and maternal peripartum infections have decreased, due to the administration of prophylactic intrapartum antibiotics. On the other hand, invasive Group B streptococcal infections have increased in nonpregnant adults, especially in elderly persons and in those with chronic immunosuppressive diseases, such as diabetes mellitus, liver cirrhosis, and malignancies. Although infective endocarditis is an uncommon manifestation of invasive Streptococcus agalactiae infection, it usually leads to cardiac surgery, due to heart failure associated with rapid valve destruction and the formation of emboli. Several cases of endocarditis due to S. agalactiae have appeared in the literature, but there have been few reports in Korea. We present a case of S. agalactiae infective endocarditis in an elderly patient with advanced gastric cancer, successfully treated with intravenous antibiotics and cardiac surgery.
Adult ; Aged ; Anti-Bacterial Agents ; Diabetes Mellitus ; Endocarditis ; Endocarditis, Bacterial ; Hand ; Heart Failure ; Humans ; Korea ; Liver Cirrhosis ; Peripartum Period ; Stomach Neoplasms ; Streptococcal Infections ; Streptococcus ; Streptococcus agalactiae ; Thoracic Surgery

American Heart Association ; Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Cardiac Surgical Procedures ; Child ; Drug Resistance, Bacterial ; Drug Therapy, Combination ; Endocarditis ; drug therapy ; surgery ; Endocarditis, Bacterial ; drug therapy ; surgery ; Humans ; Practice Guidelines as Topic ; United States

Endocarditis related to pacemaker-lead infection is a rare complication characterized by infection on the pacemaker electrode tip, tricuspid valve, or the fibrotic endocardial areas that are in contact with the electrode tip. However, it is a serious, potentially life-threatening complication. We experienced a case of pacemaker endocarditis in a 39-year old male patient in whom a permanent pacemaker had been inserted four years before. The diagnosis was made by the demonstration of vegetations on the electrode tip of the pacemaker, that was detected by transthoracic echocardiography and isolation of methicillin-resistant Staphylococcus epidermidis from blood culture. The patient was managed with antibiotics for six weeks and the infected electrode was removed by open heart surgery.
Adult ; Anti-Bacterial Agents ; Diagnosis ; Echocardiography ; Electrodes ; Endocarditis* ; Humans ; Male ; Methicillin Resistance ; Staphylococcus epidermidis ; Thoracic Surgery ; Tricuspid Valve

Endocarditis related to pacemaker-lead infection is a rare complication characterized by infection on the pacemaker electrode tip, tricuspid valve, or the fibrotic endocardial areas that are in contact with the electrode tip. However, it is a serious, potentially life-threatening complication. We experienced a case of pacemaker endocarditis in a 39-year old male patient in whom a permanent pacemaker had been inserted four years before. The diagnosis was made by the demonstration of vegetations on the electrode tip of the pacemaker, that was detected by transthoracic echocardiography and isolation of methicillin-resistant Staphylococcus epidermidis from blood culture. The patient was managed with antibiotics for six weeks and the infected electrode was removed by open heart surgery.
Adult ; Anti-Bacterial Agents ; Diagnosis ; Echocardiography ; Electrodes ; Endocarditis* ; Humans ; Male ; Methicillin Resistance ; Staphylococcus epidermidis ; Thoracic Surgery ; Tricuspid Valve

Infective endocarditis carries high risk of morbidity and mortality. Rapid diagnosis and effective treatment are essential to good patient outcome. However, nonspecific symptoms and various clinical manifestations make early diagnosis difficult. Here we report on an unusual case of infective endocarditis initially presenting as acute pyelonephritis (APN). A 44-year-old female with a history of heart surgery was admitted for fever and both flank pain. The patient had undergone dental extraction 3 weeks prior to admission. Her lab work and physical examination revealed pyuria, positive bacterial culture of both blood and urine, costovertebral knocking tenderness, and CT findings consistent with APN, leading to her initial diagnosis as APN. Despite treatment with antibiotics, her symptoms did not improve while further physical examination revealed newly developed Osler's nodes and Janeway lesions. Echocardiography showed vegetation of the aortic valve with severe aortic regurgitation. She was diagnosed as a case of infective endocarditis and was treated successfully.
Adult ; Anti-Bacterial Agents ; Aortic Valve ; Aortic Valve Insufficiency ; Diagnosis ; Early Diagnosis ; Echocardiography ; Endocarditis* ; Endocarditis, Bacterial ; Female ; Fever ; Flank Pain ; Humans ; Mortality ; Physical Examination ; Pyelonephritis* ; Pyuria ; Staphylococcus aureus ; Thoracic Surgery