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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 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 II: Clinical features and Diagnostic Tests01:25

Endocarditis II: Clinical features and Diagnostic Tests

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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...
2
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

2
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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Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

2
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
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Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

3
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Implantation of Total Artificial Heart in Congenital Heart Disease
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Intractable late onset pacemaker endocarditis and complications case report.

Gaelle Ghazal1, Michel Boueiz1, Georgio El Koubayati1

  • 1Internal Medicine, Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon.

Heliyon
|November 18, 2024
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Summary

Late-onset pacemaker endocarditis caused by Serratia marcescens infection required open-heart surgery. This case highlights the need for prompt diagnosis and surgical intervention for cardiac implantable electronic device infections.

Keywords:
CIED infectionsCardiac implantable electronic devicesCase reportEndocarditisEpicardial pacemakerInterdisciplinary managementPacemakersSerratia marcescensSurgical interventionTricuspid valve

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Surgical Intervention

Background:

  • Cardiac implantable electronic devices (CIEDs) have transformed cardiac care but are susceptible to infections, with reported rates from 1% to 15%.
  • CIED infections, particularly endocarditis, can lead to severe complications and necessitate aggressive treatment strategies.

Observation:

  • A 50-year-old female with a 20-year-old pacemaker presented with fever and purulent discharge.
  • Diagnostic tests confirmed Serratia marcescens infection, which persisted despite antibiotic therapy.
  • Echocardiography revealed tricuspid valve vegetations, indicating endocarditis.

Findings:

  • The patient underwent open-heart surgery for complete lead removal, tricuspid valvuloplasty, and epicardial pacemaker implantation.
  • Surgical intervention was curative, resolving the late-onset pacemaker endocarditis.
  • This case underscores the challenges associated with Serratia marcescens CIED infections.

Implications:

  • Emphasizes the critical role of interdisciplinary management in optimizing outcomes for CIED infections.
  • Highlights the necessity of early diagnosis and prompt, comprehensive surgical approaches for successful treatment.
  • Reinforces that even with antibiotic therapy, surgical intervention may be the only curative option for complex CIED infections.