rifampin and Heart-Valve-Diseases

Coagulase negative staphylococci are the principal cause of prosthetic valve endocarditis but are a rare cause of native valve infections. However, the incidence of native valve endocarditis is increasing. Staphylococcus capitis is a coagulase negative staphylococcus with the capacity to cause endocarditis on native heart valves. Two cases of native valve endocarditis caused by S capitis are presented; both in patients with aortic valve disease. The patients were cured with prolonged intravenous vancomycin and rifampicin and did not need surgery during the acute phase of the illness. Five of the six previously described cases of endocarditis caused by this organism occurred on native valves and responded to medical treatment alone.

Topics: Adult; Anti-Bacterial Agents; Antibiotics, Antitubercular; Aortic Valve; Endocarditis, Bacterial; Heart Valve Diseases; Humans; Male; Middle Aged; Rifampin; Staphylococcal Infections; Vancomycin

Topics: Adult; Anti-Bacterial Agents; Computed Tomography Angiography; Echocardiography; Endocarditis; Floxacillin; Fluorodeoxyglucose F18; Heart Septal Defects, Ventricular; Heart Valve Diseases; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Male; Positron-Emission Tomography; Prosthesis-Related Infections; Pulmonary Atresia; Pulmonary Valve; Radiopharmaceuticals; Rifampin

Topics: Aged; Aortic Valve; Arthroplasty, Replacement, Knee; Ciprofloxacin; Cloxacillin; Collagen; Fluoroquinolones; Heart Valve Diseases; Humans; Male; Prosthesis-Related Infections; Rifampin; Tendinopathy

To study the characteristics of patients with Propionibacterium acnes prosthetic valve endocarditis (PVE) who required surgery.. A single-centre retrospective cohort study was conducted during a 7-year period. Patients with definite infective P. acnes endocarditis, according to the modified Duke criteria, were included. An extended culture protocol was applied. Information on medical health status, surgery, antibiotic treatment and mortality was obtained.. Thirteen patients fulfilled the criteria for P. acnes endocarditis (0.53% of 2466 patients with valve replacement in a 7-year period). All patients were male and had a previous valve replacement. The health status of patients was poor at diagnosis of P. acnes PVE. Most patients (11 of 13, 85%) were admitted with signs of heart failure due to a significant paravalvular leak; 2 of 13 (15%) patients presented with septic emboli. Twelve patients needed redo surgery, whereas one could be treated with antibiotic therapy only. The time between the index surgery and presentation with P. acnes PVE varied between 5 and 135 months (median 26.5 months). Replacement and reconstruction of the dysfunctional valve and affected anatomical structures was mainly performed with a mechanical valve (n = 5, 42%) or a (bio-) Bentall prosthesis (n = 6, 50%). Antibiotic therapy consisted of penicillin with or without rifampicin for 6 weeks after surgery. The mortality in this series was low (n = 1, 8%) and no recurrent endocarditis was found during a median follow-up of 38 months.. Propionibacterium acnes PVE is a rare complication after valve surgery. Redo surgery is often required. Treatment of the dysfunctional prosthetic aortic valve most often consists of root replacement, in combination with antibiotic therapy.

Topics: Adult; Aged; Anti-Bacterial Agents; Communicable Diseases; Endocarditis, Bacterial; Female; Gram-Positive Bacterial Infections; Heart Valve Diseases; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Male; Middle Aged; Propionibacterium acnes; Prosthesis-Related Infections; Retrospective Studies; Rifampin

Topics: Abscess; Adolescent; Allografts; Aorta; Aortic Rupture; Aortic Valve; Aortic Valve Insufficiency; Bicuspid Aortic Valve Disease; Cardiac Surgical Procedures; Chest Pain; Drug Resistance, Bacterial; Dyspnea; Endocarditis; Gentamicins; Heart Murmurs; Heart Valve Diseases; Humans; Male; Nafcillin; Pericardial Effusion; Rifampin; Staphylococcal Infections; Staphylococcus lugdunensis; Vancomycin; Vascular Grafting

We report the case of a 64-year-old male patient with a prosthetic aortic valve who presented with clinical features of endocarditis confirmed by transoesophageal echocardiography. His blood cultures were positive for a very rare and newly described organism-Kytococcus schroeteri. The patient underwent aortic valve replacement and a 6-week course of intravenous antibiotics. This is the fifth reported case of endocarditis associated with this organism.

Topics: Actinomycetales; Actinomycetales Infections; Anti-Bacterial Agents; Aortic Valve; Drug Therapy, Combination; Endocarditis, Bacterial; Gentamicins; Heart Valve Diseases; Humans; Male; Middle Aged; Prosthesis-Related Infections; Rifampin; Vancomycin

We retrospectively evaluated 105 patients at the Mayo Clinic between 1970 and 2006 with native valve endocarditis who underwent acute valve surgery. The objective was to determine if outcomes differed based on whether they had received an antibiotic regimen recommended for native valve endocarditis or one for prosthetic valve endocarditis. Fifty-two patients had streptococcal and 53 had staphylococcal infections. Patients with each type of infection were divided into two groups: the first received postoperative monotherapy (with a beta-lactam or vancomycin), and the second received combination therapy (with an aminoglycoside for streptococcal infection, and gentamicin and/or rifampin for staphylococcal infection). The duration and types of antibiotics given pre- and postoperatively, valve cultures results, antibiotic-related adverse events, relapses, and mortality rates within 6 months of surgery were analyzed. Cure rates were similar regardless of the regimen administered. With the small number of patients in each group, a multicenter study with a larger cohort of patients is needed to better define optimal postoperative treatment regimens in this population.

Topics: Adult; Aged; Aminoglycosides; Anti-Bacterial Agents; beta-Lactams; Drug Therapy, Combination; Endocarditis, Bacterial; Female; Heart Valve Diseases; Humans; Male; Middle Aged; Retrospective Studies; Rifampin; Staphylococcal Infections; Streptococcal Infections; Treatment Outcome; Vancomycin

Bartonella quintana is a gram-negative microorganism, which may lead to infective endocarditis especially in compromised patients. The major concern about this pathogen is the diagnosis and detection. Furthermore, the treatment of the infection has been a challenge for physicians. In this report, we present a 71-year-old patient with Bartonella quintana aortic valve endocarditis from the view of diagnosis and treatment aspects.

Topics: Aged; Anti-Bacterial Agents; Aortic Valve; Bartonella Infections; Bartonella quintana; Doxycycline; Endocarditis, Subacute Bacterial; Heart Valve Diseases; Humans; Male; Rifampin

Staphylococcus aureus is a common cause of native valve infective endocarditis (IE). Rifampin is often added to traditional therapy for the management of serious S. aureus infections. There are no large, prospective studies documenting the safety and efficacy of adjunctive therapy with rifampin for treatment of native valve S. aureus IE. We reviewed all cases of definite native valve S. aureus IE confirmed by modified Duke criteria in a large urban hospital between 1 January 2004 and 31 December 2005. A retrospective cohort analysis was used to assess the impact of the addition of rifampin to standard therapy. There were 42 cases of S. aureus IE treated with the addition of rifampin and 42 controls. Cases received a median of 20 days of rifampin (range, 14 to 48 days). Rifampin-resistant S. aureus isolates developed in nine cases who received rifampin before clearance of bacteremia (56%), while significant hepatic transaminase elevations also occurred in nine cases, all of whom had hepatitis C infection. Unrecognized significant drug-drug interactions with rifampin occurred frequently (52%). Cases were more likely to have a longer duration of bacteremia (5.2 versus 2.1 days; P < 0.001) and were less likely to survive (79% versus 95%; P = 0.048) than controls. Our results suggest that the potential for hepatotoxicity, drug-drug interactions, and the emergence of resistant S. aureus isolates warrants a careful risk-benefit assessment before adding rifampin to standard antibiotic treatment of native valve S. aureus IE until further clinical studies are performed.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacteremia; Cohort Studies; Drug Interactions; Drug Resistance, Bacterial; Endocarditis, Bacterial; Female; Heart Valve Diseases; Humans; Liver; Male; Middle Aged; Retrospective Studies; Rifampin; Staphylococcal Infections; Staphylococcus aureus

Topics: Anti-Bacterial Agents; Aortic Valve; Brain Abscess; Drug Therapy, Combination; Endocarditis, Bacterial; Female; Floxacillin; Gentamicins; Heart Valve Diseases; Humans; Middle Aged; Mitral Valve; Rifampin; Staphylococcal Infections; Tomography, X-Ray Computed; Treatment Outcome

Topics: Aortic Valve; Bartonella henselae; Cat-Scratch Disease; Doxycycline; Drug Therapy, Combination; Endocarditis, Bacterial; Gentamicins; Heart Valve Diseases; Humans; Male; Middle Aged; Mitral Valve; Rifampin; Ultrasonography

Wangiella dermatitidis is an infrequently encountered dematiacious fungus that usually causes localized infections of the skin and subcutaneous tissues. This report presents the first well-documented case of natural valve infection caused by this organism as it occurred in intravenous drug abuser. His course has been complicated by relapsing infection of two aortic prostheses and dissemination to the vertebral spine. Treatment with a combination of amphotericin B, rifampin, and ketoconazole has arrested the progression of his infection. The microbiologic features and existing clinical information regarding this fungus are reviewed and in vitro susceptibility data for the present isolate are presented.

Topics: Adult; Amphotericin B; Aortic Valve; Drug Therapy, Combination; Endocarditis; Heart Valve Diseases; Heroin Dependence; Humans; Ketoconazole; Male; Mitosporic Fungi; Mycoses; Recurrence; Reoperation; Rifampin