1
|
Quiring R, Burke V. Escherichia coli prosthetic valve endocarditis from a non-genitourinary source. IDCases 2021; 26:e01329. [PMID: 34815936 PMCID: PMC8592857 DOI: 10.1016/j.idcr.2021.e01329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 11/17/2022] Open
Abstract
E. coli is an infrequent cause of infective endocarditis due to is limited ability to adhere to heart valves. There is a notable increase in the share of total cases of E. coli infective endocarditis due to prosthetic valve infections. There is an increased recognition of non-genitourinary sources of E. coli prosthetic valve endocarditis. The overall mortality rate is declining for E. coli prosthetic valve endocarditis cases.
Escherichia coli (E. coli) is a rare cause of infective endocarditis due to its lack of traditional virulence factors that promote endocardial adherence. Previous case reports of E. coli infective endocarditis demonstrate specific risk factors to include advanced age over 70, female sex, diabetes, immunosuppression, and intravascular or cardiac devices. Antecedent genitourinary infection is the most common source. We present a case of a 55-year-old Honduran man with a recent bioprosthetic mitral valve replacement and tricuspid valve repair who presented with one month of subjective fevers, night sweats, anorexia, and significant weight loss. After extensive work-up, the patient was diagnosed with E. coli infective endocarditis secondary to E. coli growth in blood cultures and a transesophageal echocardiogram (TEE) revealing a vegetation on his prosthetic mitral valve. An indolent gastrointestinal source was suspected to be the source of infection with imaging only notable for mild periappendiceal stranding concerning for a possible site of antecedent inflammation. He was treated with a 6-week course of ceftriaxone and gentamicin inpatient and then discharged on trimethoprim-sulfamethoxazole suppressive therapy with serial echocardiographic follow-up given the persistent small vegetation on repeat echocardiogram. Our case report and review of ten recent cases of prosthetic valve endocarditis described in the literature illustrates several common features of the epidemiology, presentation, and management of E. coli prosthetic valve endocarditis including more commonly reported non-genitourinary sources of bacteremia, a trend towards more frequent surgical interventions, and a declining mortality rate.
Collapse
Key Words
- AI, Aortic insufficiency
- AMI, Acute myocardial infarction
- AMK, Amikacin
- AMP, Ampicillin
- AV, Aortic valve
- AVR, Aoritc valve replacement
- CEF, Cefalexin
- CIP, Ciprofloxacin
- CTX, Ceftriaxone
- E. coli, Escherichia coli
- EF, Ejection Fraction
- Escherichia coli
- GENT, Gentamicin
- GI, Gastrointestinal
- GU, Genitourinary
- HACEK, Haemophilus species, Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae
- IE, Infective Endocarditis
- IMP, Imipenem
- Infective endocarditis
- M, Man
- MR, Mitral regurgitation
- MV, Mitral valve
- MVR, Mitral valve replacement
- OFL, Oflofloxacin
- PVE, Prosthetic valve endocarditis
- Prosthetic valve
- SD, Standard deviation
- SUL, Sulbactam
- TV, Tricuspid valve
- UTI, Urinary tract infections
- Unk, Unknown
- W, Woman
- WMA, Wall motion abnormalities Infective endocarditis
Collapse
Affiliation(s)
- Robert Quiring
- Louisiana State University Health Sciences Center School of Medicine, 2020 Gravier Street, New Orleans, LA 70112, USA
| | - Victoria Burke
- Louisiana State University Health Sciences Center School of Medicine, Department of Infectious Disease, 1542 Tulane Avenue Suite 331A, Box T4M-2, New Orleans, LA 70112, USA
| |
Collapse
|
2
|
Saboe A, Sakasasmita S, Hartantri Y, Maryani E, Hadar AK, Sudjud RW, Azis A, Chaidir L, Nugraha HG, Hasan M, Cool CJ, Alisjahbana B, Akbar MR. A case of endocarditis and spondylodiscitis associated with Mycobacterium tuberculosis. IDCases 2021; 26:e01313. [PMID: 34745887 PMCID: PMC8550988 DOI: 10.1016/j.idcr.2021.e01313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 11/23/2022] Open
Abstract
Tuberculosis (TB) is a global health problem, in which the majority of cases occur in population-dense developing countries. Despite advances in various diagnostic TB modalities, extrapulmonary TB remains a challenge due to complexities related to its diagnostic approach. Hereby, we present a rare case of endocarditis and spondylodiscitis associated with Mycobacterium tuberculosis (MTB). This case report highlighted the challenges faced in diagnosing blood culture-negative infective endocarditis (BCNIE). We also emphasized the importance of considering MTB as etiology of BCNIE, particularly in endemic TB areas.
Collapse
Key Words
- AML, Anterior mitral leaflet
- BCNIE, Blood culture-negative infective endocarditis
- Blood culture-negative infective endocarditis (BCNIE)
- CRP, C-reactive protein
- DNA, Deoxyribonucleic acid
- DOI, Day of illness
- EPTB, Extrapulmonary tuberculosis
- HIV, Human immunodeficiency virus
- IE, Infective endocarditis
- MR, Mitral regurgitation
- MRI, Magnetic resonance imaging
- MTB, Mycobacterium tuberculosis
- PML, Posterior mitral leaflet
- RT-PCR
- RT-PCR, Real-time- polymerase chain reaction
- TB, Tuberculosis
- TTE, Transthoracic echocardiography
- extrapulmonary tuberculosis
- pyrosequencing method
- tuberculous endocarditis
Collapse
Affiliation(s)
- Aninka Saboe
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Sylvie Sakasasmita
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Yovita Hartantri
- Infection and Tropical Medicine Division, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Euis Maryani
- Cardiothoracic and Vascular Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Abdul Kadir Hadar
- Department of Orthopedic Surgery, Faculty of Medicine, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Reza Widianto Sudjud
- Cardiovascular and Thoracic Anesthesiology Division, Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Afiati Azis
- Department of Anatomical Pathology, Faculty of Medicine, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Lidya Chaidir
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Harry Galuh Nugraha
- Department of Radiology, Faculty of Medicine, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Melawati Hasan
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Charlotte Johanna Cool
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Bachti Alisjahbana
- Infection and Tropical Medicine Division, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Mohammad Rizki Akbar
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, Indonesia
| |
Collapse
|
3
|
Paolini C, Mugnai G, Dalla Valle C, Volpiana A, Ferraglia A, Frigo AC, Bilato C. Effects and clinical implications of sacubitril/valsartan on left ventricular reverse remodeling in patients affected by chronic heart failure: A 24-month follow-up. Int J Cardiol Heart Vasc 2021; 35:100821. [PMID: 34179333 PMCID: PMC8213880 DOI: 10.1016/j.ijcha.2021.100821] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/10/2021] [Accepted: 06/03/2021] [Indexed: 12/11/2022]
Abstract
Background Compared to angiotensin inhibition, angiotensin-neprilysin "blockade" improves mortality and reduces hospitalizations in patients with heart failure (HF) with reduced ejection fraction (EF). Sacubitril/valsartan is known to influence left ventricular (LV) reverse remodeling with systolic function improvement, although underlying mechanisms remain partially unclear. Our objectives were to evaluate whether sacubitril/valsartan promotes LV remodeling and improves LV ejection fraction (LVEF) (above the 35% threshold by echocardiographic evaluation) and to identify predictors of reverse remodeling in a real-world setting. Methods New York Heart Association (NYHA) class II-III patients with EF ≤ 35% were consecutively enrolled. All patients were on optimal medical therapy on the initiation of sacubitril/valsartan therapy. Full clinical and multi-parametric echocardiographic evaluation, electrocardiogram, and laboratory tests were performed at baseline and after 3, 6, 12, and 24 months. Results In total, 69 patients were recruited from July 2016 to August 2018. Reverse remodeling was observed in 57.7% (30/52) of patients, occurring within 3, 6, 12, and 24 months in 2, 11, 13, and 4 patients, respectively. Twenty-four (46%) patients showed LVEF improvement above the threshold of 35% during follow-up, occurring in 1, 10, 9, and 4 patients within 3, 6, 12, and 24 months, respectively. Primitive dilated cardiomyopathy and female gender were identified as significant predictors of reverse remodeling. NYHA class was improved in both remodeling and non-remodeling patients. Conclusion Sacubitril/valsartan promotes favorable cardiac remodeling and significantly improves LVEF in a significant proportion of HF patients within 24 months, both in NYHA class II and III patients with HF.
Collapse
Key Words
- ACEi, Angiotensin-converting enzyme inhibitors
- ARBs, Angiotensin II receptor blockers
- ARNI, Angiotensin receptor-neprilysin inhibitor
- CI, Confidence interval
- CRT, Cardiac resynchronization therapy
- ESC, European Society of Cardiology
- GFR, Glomerular filtration rate
- HF, Heart failure
- HFrEF, Heart failure with reduced ejection fraction
- Heart failure
- ICD, Implantable cardioverter-defibrillator
- LA, Left atrium
- LV, Left ventricular
- LVEF, Left ventricular ejection fraction
- MR, Mitral regurgitation
- NYHA, New York Heart Association
- OMT, Optimal medical therapy
- OR, Odds ratio
- RAAS, Renin-angiotensin-aldosterone system
- Reverse remodeling
- Sacubitril/valsartan
Collapse
Affiliation(s)
- Carla Paolini
- Division of Cardiology, West Vicenza General Hospitals, Arzignano-Vicenza, Italy
| | - Giacomo Mugnai
- Division of Cardiology, West Vicenza General Hospitals, Arzignano-Vicenza, Italy
| | - Chiara Dalla Valle
- Division of Cardiology, West Vicenza General Hospitals, Arzignano-Vicenza, Italy
| | - Andrea Volpiana
- Division of Cardiology, West Vicenza General Hospitals, Arzignano-Vicenza, Italy
| | - Alessandra Ferraglia
- Division of Cardiology, West Vicenza General Hospitals, Arzignano-Vicenza, Italy
| | - Anna Chiara Frigo
- Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Claudio Bilato
- Division of Cardiology, West Vicenza General Hospitals, Arzignano-Vicenza, Italy
| |
Collapse
|
4
|
Abu Rmilah AA, Tahboub MA, Alkurashi AK, Jaber SA, Yagmour AH, Al-Souri D, Lewis BR, Nkomo VT, Erwin PJ, Reeder GS. Efficacy and safety of percutaneous mitral balloon valvotomy in patients with mitral stenosis: A systematic review and meta-analysis. Int J Cardiol Heart Vasc 2021; 33:100765. [PMID: 33889711 PMCID: PMC8050729 DOI: 10.1016/j.ijcha.2021.100765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/11/2021] [Accepted: 03/13/2021] [Indexed: 12/01/2022]
Abstract
Aims Percutaneous mitral balloon valvotomy PMBV is an acceptable alternative to Mitral valve surgery for patients with mitral stenosis. The purpose of this study was to explore the immediate results of PMBV with respect to echocardiographic changes, outcomes, and complications, using a meta-analysis approach. Methods MEDLINE, and EMBASE databases were searched (01/2012 to 10/2018) for original research articles regarding the efficacy and safety of PMBV. Two reviewers independently screened references for inclusion and abstracted data including article details and echocardiographic parameters before and 24–72 h after PMBV, follow-up duration, and acute complications. Disagreements were resolved by third adjudicator. Quality of all included studies was evaluated using the Newcastle-Ottawa Scale NOS. Results 44/990 references met the inclusion criteria representing 6537 patients. Our findings suggest that PMBV leads to a significant increase in MVA (MD = 0.81 cm2; 0.76–0.87, p < 0.00001), LVEDP (MD = 1.89 mmHg; 0.52–3.26, p = 0.007), LVEDV EDV (MD = 5.81 ml; 2.65–8.97, p = 0.0003) and decrease in MPG (MD = −7.96 mmHg; −8.73 to −7.20, p < 0.00001), LAP (MD = −10.09 mmHg; −11.06 to −9.12, p < 0.00001), and SPAP (MD = −15.55 mmHg; −17.92 to −13.18, p < 0.00001). On short term basis, the pooled overall incidence estimates of repeat PMBV, mitral valve surgery, post-PMBV severe MR, and post-PMBV stroke, and systemic thromboembolism were 0.5%, 2%, 1.4%, 0.4%, and 0.7%% respectively. On long term basis, the pooled overall incidence estimates of repeat PMBV, mitral valve surgery, post-PMBV severe MR, and post-PMBV stroke, systemic thromboembolism were 5%, 11.5%, 5.5%, 2.7%, and 1.7% respectively Conclusion PMBV represents a successful approach for patients with mitral stenosis as evidenced by improvement in echocardiographic parameters and low rate of complications.
Collapse
Key Words
- AF, Atrial fibrillation
- AHA/ACC, American Heart Association (AHA) and American College of Cardiology (ACC)
- Echocardiography
- LAD, Left atrial diameter
- LAP, Left atrial pressure
- LV EDP, Left ventricle end-diastolic pressure
- LV EDV, Left ventricle end-diastolic volume
- LV ESP, Left ventricle end-systolic pressure
- LV ESV, Left ventricle end-systolic volume
- MACCE, Major adverse cardiovascular and cerebrovascular events
- MD, Mean difference
- MPG, Mitral pressure gradient
- MR, Mitral regurgitation
- MS, Mitral stenosis
- MVA, Mitral valve area
- Mitral stenosis
- Mitral valve surgery
- NOS, New castle Ottawa scale
- PMBV, percutaneous mitral balloon valvotomy
- Percutaneous balloon mitral valvotomy
- Percutaneous balloon mitral valvuloplasty
- SR, sinus rhythm
Collapse
Affiliation(s)
- Anan A Abu Rmilah
- William J. von Liebig Center for Transplantation and Clinical Regeneration Mayo Clinic, Rochester, MN, USA.,Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mahmoud A Tahboub
- William J. von Liebig Center for Transplantation and Clinical Regeneration Mayo Clinic, Rochester, MN, USA
| | - Adham K Alkurashi
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Suhaib A Jaber
- Department of Internal Medicine, Al Hamadi Hospital, Riyadh, Saudi Arabia
| | | | - Deema Al-Souri
- Department of Internal Medicine, Med Star Washington Hospital Center, Washington DC, USA
| | - Bradley R Lewis
- Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Vuyisile T Nkomo
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Guy S Reeder
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|