Prosthetic valve endocarditis due to Cardiobacterium hominis occurring after upper gastrointestinal endoscopy
Article Abstract:
Endocarditis is an inflammation of the inner lining of the heart that results from a number of causes. When brought on by bacterial infection, the heart valves usually become involved. This type of infection can be deadly in a patient who has had a valve replaced with a prosthetic (artificial) valve. Antibiotics are given to such patients as a preventive measure when they undergo procedures that are likely to cause bacteria to circulate in the blood (bacteremia). The case of a patient with prosthetic valve endocarditis caused by the bacterium Cardiobacterium hominis is reported. The bacteria were believed to have entered the circulation when the patient underwent endoscopic examination of the upper gastrointestinal tract. Neither the bacteria nor the procedure involved here are commonly associated with endocarditis. The patient was a 55-year-old man complaining of progressive weakness. His aortic valve had been replaced by a prosthetic valve a few years earlier. Four days prior to admission, he had undergone a gastrointestinal endoscopic procedure. Initial examination did not show signs of endocarditis. Echocardiograms (heart imaging produced by ultrasound) produced evidence of abnormalities. Blood cultures tested positive for Cardiobacterium hominis and antibiotic therapy was begun. Subsequent blood cultures were negative. Echocardiography could not detect any abscesses, but electrocardiograph (EKG) readings continued to show abnormalities. Cardiac catheterization was done to further evaluate the problem. The patient's prosthetic valve was discovered to have been damaged by the infection, and it was subsequently replaced. These findings indicate that certain cardiac patients should receive antibiotic therapy when undergoing gastrointestinal endoscopy, as a prophylactic measure against bacterial endocarditis. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Diclazuril for cryptosporidiosis in AIDS
Article Abstract:
Cryptosporidiosis is a diarrheal disease caused by the protozoon Cryptosporidium. This infection may become severe and life-threatening in patients with acquired immunodeficiency syndrome (AIDS). The effectiveness of the drugs spiramycin and zidovudine in treating cryptosporidial diarrhea has not been assessed. The drug diclazuril has been shown to be active against the protozoa Isospora belli. A case is described of a 25-year-old AIDS patient with cryptosporidiosis who was successfully treated with diclazuril. The patient had a nine-year history of intravenous drug abuse, infection with the human immunodeficiency virus, and hepatitis B, inflammation of the liver due to infection with hepatitis B virus. He was admitted because of abdominal cramps, pain, and diarrhea. He had decreased levels of potassium, calcium, phosphorus, and magnesium; elevated levels of the enzyme transaminase; and reduced numbers of CD4 cells, a type of immune cell whose levels are generally low in AIDS patients. Examination of the feces confirmed infestation with Cryptosporidium. The patient was treated with zidovudine (for AIDS), kaolin, and diclazuril. The diarrhea improved after five days of treatment with diclazuril and the protozoan organism was completed eliminated at two-months follow-up. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Prevalence of cryptosporidiosis in patients undergoing endoscopy: evidence for an asymptomatic carrier state
Article Abstract:
Cryptosporidium is a parasite that frequently produces an illness characterized by severe diarrhea, abdominal pain, flatulence, nausea and fever. Many patients who have had cryptosporidium-related diarrhea continue to pass oocysts (larvae) of the organism for up to two months after the original illness, despite an absence of symptoms. This suggests the possibility of an asymptomatic carrier state. Patients who were undergoing upper endoscopy (examination of the stomach with a tube containing an optical device) were selected for this study. The 169 patients were immune competent (normal immunologic status) and none of them had diarrhea. Samples of fluid from the duodenal portion of the intestine were analyzed; 12.7 percent of the patients tested positive for the cryptosporidium organism. The parasite was found in stool samples of 46.7 percent of these patients. Such a high incidence of cryptosporidium in asymptomatic patients would seem to indicate the existence of an asymptomatic carrier state for this cryptosporidium. A carrier state might explain the recent evidence of wide-spread exposure to this organism in the general population. Further research is needed to determine the epidemiology and pathogenic mechanism of this parasite.
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1989
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