ro13-9904 and Heart-Diseases

Current guidelines recommend either ampicillin plus ceftriaxone (AC) or amoxicillin/ampicillin plus gentamicin (AG) with an equivalent class IB recommendation in Enterococcus faecalis endocarditis. However, previous observational studies suggest that AC might be favourable in terms of adverse events.. To investigate whether AC is non-inferior to AG, and if it is associated with less adverse events.. In June 2021, a systematic literature search using the databases PubMed/MEDLINE, CDSR, CENTRAL, CCAs, EBM Reviews, Web of Science and LILACS was conducted by two independent reviewers. Studies were considered eligible if (P) patients included were ≥ 18 years of age and had IE with E. faecalis, (I) treatment with AC was compared to (C) treatment with AG and (O) outcomes on in-hospital mortality, nephrotoxicity and adverse events requiring drug withdrawal were reported. Odds ratios and 95% confidence intervals were calculated using random-effects models with the Mantel-Haenszel method, the Sidik-Jonkman estimator for τ. Treatment with AC was non-inferior to AG, as depicted by no significant differences in-hospital mortality, 3-month mortality, relapses or treatment failure. Furthermore, AC was associated with a lower prevalence of nephrotoxicity (OR 0.45 [0.26-0.77], p = 0.0182) and drug withdrawal due to adverse events (OR 0.11 [0.03-0.46], p = 0.0160) than AG.. Treatment with AC was non-inferior to treatment with AG, and it was associated with a reduced prevalence of nephrotoxicity and drug withdrawal due to adverse events. Thus, combination therapy with AC appears favourable over AG in patients with E. faecalis IE.

Topics: Amoxicillin; Ampicillin; Anti-Bacterial Agents; Ceftriaxone; Drug Therapy, Combination; Endocarditis; Endocarditis, Bacterial; Enterococcus faecalis; Gentamicins; Gram-Positive Bacterial Infections; Heart Diseases; Humans; Renal Insufficiency

We report a case of acute rheumatic fever with severe pancarditis occurring simultaneously with probable acute post-streptococcal glomerulonephritis in a previously well, Australian Aboriginal, 29-year-old male. These autoimmune streptococcal sequelae are usually considered pathogenetically distinct, and concurrence has not previously been reported from this high-burden setting. We hypothesize that a single type of infecting group A

Topics: Adult; Anti-Bacterial Agents; Anti-Inflammatory Agents; Ceftriaxone; Floxacillin; Glomerulonephritis; Heart Diseases; Humans; Male; Prednisolone; Rheumatic Fever

Cardiac tumors and tumor-like lesions are uncommon; most are true neoplasms. We here report a case of a pericoronary tumor-like lesion surrounding the right coronary artery in a 39-year-old man who presented with fever and chest pain. Although clarithromycin was administered for 1 week, his fever persisted. Helicobacter cinaedi (H. cinaedi) was isolated from blood cultures and found to be sensitive to ceftriaxone. A computed tomography scan showed a tumor-like lesion with no (18)F-fl uorodeoxyglucose uptake surrounding the right coronary artery. After administration of ceftriaxone, the tumor-like lesion diminished in size according to meticulous computed tomography examinations. We therefore concluded that it was caused by H. cinaedi infection. The patient has been followed up closely for 1 year and remains asymptomatic.

Topics: Adult; Anti-Bacterial Agents; Ceftriaxone; Coronary Vessels; Diagnosis, Differential; Granuloma, Plasma Cell; Heart Diseases; Helicobacter; Helicobacter Infections; Humans; Injections, Intravenous; Magnetic Resonance Imaging, Cine; Male; Tomography, X-Ray Computed

Topics: Anti-Infective Agents; Ceftriaxone; Constriction, Pathologic; Diagnosis, Differential; Edema; Emotions; Heart; Heart Diseases; Humans; Male; Middle Aged; Trimethoprim, Sulfamethoxazole Drug Combination; Whipple Disease; Wit and Humor as Topic

Topics: Amoxicillin; Anti-Bacterial Agents; Arthritis; Ceftriaxone; Doxycycline; Heart Diseases; Humans; Lyme Disease; Nervous System Diseases