1.Effectiveness of Mechanical Embolectomy for Septic Embolus in the Cerebral Artery Complicated with Infective Endocarditis.
Gimoon KANG ; Tae Ki YANG ; Joon Hyouk CHOI ; Sang Taek HEO
Journal of Korean Medical Science 2013;28(8):1244-1247
There has been a controversy over data of thrombolytic and endovascular surgical treatment about cerebral infarction secondary to infective endocarditis. We report a woman who received early mechanical embolectomy as a treatment of acute stroke with infective endocarditis. A 35-yr-old woman was hospitalized due to right hemiparesis. Brain image showed cerebral infarction at the middle cerebral artery and echocardiography demonstrated vegetation at the mitral valve. She was successfully treated with embolectomy and parenteral antibiotics without any neurologic sequelae. This report shows that the early retrieve of septic cerebral emboli can be a helpful treatment of acute stroke associated with endocarditis.
Adult
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Anti-Bacterial Agents/therapeutic use
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Cerebral Arteries/radiography/*surgery
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Embolectomy
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Endocarditis/complications/*diagnosis/drug therapy
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Female
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Humans
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Intracranial Embolism/surgery
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Mitral Valve/ultrasonography
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Streptococcus/isolation & purification
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Stroke/*diagnosis/etiology/surgery
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Tomography, X-Ray Computed
2.Surgical Treatment of Native Valve Aspergillus Endocarditis and Fungemic Vascular Complications.
Kyoung Min RYU ; Pil Won SEO ; Sam Hyun KIM ; Seongsik PARK ; Jae Wook RYU
Journal of Korean Medical Science 2009;24(1):170-172
Systemic infection with Aspergillus is an opportunistic disease that affects mainly immunocompromised hosts, and is associated with a high mortality rate. It typically occurs in patients with several predisposing factors, but Aspergillus endocarditis of native valves is rare and experience in diagnosis and treatment is limited. We report a case of native valve endocarditis caused by Aspergillus. A 35-yr-old male patient who underwent pericardiocentesis four months previously for pericardial effusion of unknown etiology presented with right leg pain and absence of the right femoral artery pulse. Cardiac echocardiography revealed severe mitral insufficiency with large mobile vegetations, and computed tomographic angiography showed embolic occlusion of both common iliac arteries. We performed mitral valve replacement and thromoembolectomy, and Aspergillus was identified as the vegetation. We started intravenous amphotericin B and oral itraconazole, but systemic complications developed including superior mesenteric artery aneurysm and gastrointestinal bleeding. After aggressive management, the patient was discharged 78 days post surgery on oral itraconazole. He was well at 12 months post discharge but died in a traffic accident 13 months after discharge.
Administration, Oral
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Adult
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Amphotericin B/administration & dosage
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Antifungal Agents/administration & dosage
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Aspergillosis/complications/*diagnosis/drug therapy
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Aspergillus/isolation & purification
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Endocarditis/*diagnosis/surgery/ultrasonography
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Heart Valve Diseases/*diagnosis/microbiology/surgery
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Humans
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Itraconazole/administration & dosage
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Male
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Postoperative Complications/microbiology
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Tomography, X-Ray Computed
3.Native valve endocarditis due to extended spectrum beta-lactamase producing Klebsiella pneumoniae.
Hyun Ae JUNG ; Young Eun HA ; Damin KIM ; Jihyun PARK ; Cheol In KANG ; Doo Ryeon CHUNG ; Seung Woo PARK ; Ki Ik SUNG ; Jae Hoon SONG ; Kyong Ran PECK
The Korean Journal of Internal Medicine 2014;29(3):398-401
No abstract available.
Aged
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Anti-Bacterial Agents/therapeutic use
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Aortic Valve/*microbiology/surgery/ultrasonography
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Cross Infection/diagnosis/*microbiology/therapy
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Diffusion Magnetic Resonance Imaging
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Endocarditis, Bacterial/diagnosis/*microbiology/therapy
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Heart Valve Prosthesis Implantation
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Humans
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Klebsiella Infections/diagnosis/*microbiology/therapy
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Klebsiella pneumoniae/drug effects/*enzymology/pathogenicity
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Male
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Microbial Sensitivity Tests
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Predictive Value of Tests
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Sepsis/diagnosis/*microbiology/therapy
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Treatment Outcome
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beta-Lactamases/*metabolism