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Related Concept Videos

Endocarditis I: Introduction01:25

Endocarditis I: Introduction

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Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
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Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

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Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
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Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

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Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

38
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
38
Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic01:26

Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic

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Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
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Experimental Endocarditis Model of Methicillin Resistant Staphylococcus aureus MRSA in Rat
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Non-HACEK gram-negative bacilli endocarditis: a multicentre retrospective case-control study.

Marine Sebillotte1, David Boutoille2, Charles Declerck3

  • 1Maladies infectieuses et Réanimation médicale, Hôpital Pontchailllou, Centre Hospitalier Universitaire, Rennes, Rennes, France.

Infectious Diseases (London, England)
|June 24, 2023
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Summary

Infective endocarditis (IE) caused by non-HACEK gram-negative bacilli (GNB) is rare but serious, often linked to healthcare exposure or intravenous drug use. This condition carries a high mortality rate, particularly in patients with significant comorbidities.

Keywords:
EndocarditisEscherichia coligram-negative bacillihealthcare-associatedintravenous drug use

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Infective endocarditis (IE) caused by non-HACEK gram-negative bacilli (GNB) is not well-understood and may be increasing.
  • This study characterizes non-HACEK GNB IE, a potentially emerging complication in modern medicine.

Purpose of the Study:

  • To investigate the characteristics, risk factors, and outcomes of infective endocarditis caused by non-HACEK gram-negative bacilli.
  • To compare non-HACEK GNB IE with IE caused by other bacteria.

Main Methods:

  • An observational retrospective case-control study was conducted.
  • Adult patients diagnosed with definite or possible non-HACEK GNB IE between 2007 and 2020 in six French hospitals were included.
  • Two controls (IE due to other bacteria) were matched for each case based on hospital site and diagnosis date.

Main Results:

  • Non-HACEK GNB accounted for 2.4% of all IE cases, predominantly affecting older males.
  • Primary pathogens included Escherichia coli, Klebsiella sp., and Serratia marcescens, with 10% being multidrug-resistant.
  • Non-HACEK GNB IE was independently associated with intravenous drug use, active neoplasia, haemodialysis, and healthcare-associated infections.
  • The urinary tract was the most common source of infection, and recent invasive procedures were frequent.
  • Non-HACEK GNB IE showed a lower risk of embolism but a high one-year mortality rate (36%), with comorbidities like malignant hemopathy and cirrhosis increasing mortality risk.

Conclusions:

  • Non-HACEK GNB are infrequent causes of IE, typically occurring in patients with complex comorbidities such as end-stage renal disease or neoplasia, or in intravenous drug users.
  • Healthcare-associated IE is a significant proportion of non-HACEK GNB IE cases.
  • The high mortality rate underscores the severity of this condition and the need for targeted management strategies.