ro13-9904 and Heart-Failure

There are a total of 8000 cases of infective endocarditis yearly in the United States. Central nervous system metastatic infections are not uncommon in infective endocarditis. Because ceftriaxone is highly bound to serum proteins, there is concern that the drug is highly bound to serum proteins, there is concern that the drug might not penetrate well in the core of an infected vegetation. To date, there are two published studies on the treatment of nonenterococcal streptococcal endocarditis by ceftriaxone in humans. Ceftriaxone appears to be an attractive alternative antibiotic therapy to conventional regimens in the treatment of streptococcal endocarditis.

Topics: Ambulatory Care; Aneurysm, Infected; Animals; Ceftriaxone; Costs and Cost Analysis; Drug Therapy, Combination; Echocardiography; Embolism; Endocarditis, Bacterial; Heart Failure; Humans; Staphylococcal Infections; Streptococcal Infections

Topics: Aged, 80 and over; Anti-Bacterial Agents; Anticoagulants; Aortic Valve Stenosis; Atrial Fibrillation; Autoantibodies; Autoimmune Diseases; Ceftriaxone; Combined Modality Therapy; Emergencies; Factor V; Factor V Deficiency; Female; Heart Failure; Humans; Partial Thromboplastin Time; Platelet Transfusion; Prednisone; Preoperative Care; Prothrombin Time; Pyrazoles; Pyridones; Transcatheter Aortic Valve Replacement; Urinary Tract Infections

Topics: Acute Disease; Adolescent; Anaphylaxis; Antigens, CD; Ceftriaxone; Fatal Outcome; Female; Gene Expression; Heart Failure; Hematologic Neoplasms; Humans; Leukemia, Mast-Cell; Mast Cells; Pneumonia, Bacterial; Respiratory Distress Syndrome

We describe the case of a 70-year-old woman who presented with symptoms of cardiac failure, and was found on clinical examination to have a purpuric rash over her lower extremities. Further evaluation of cardiac failure revealed tricuspid regurgitation with two large tricuspid valve vegetations. Blood cultures yielded a growth of Streptococcus viridans. She was treated with an intravenous ceftriaxone and gentamicin and made a complete recovery with resolution of the rash.

Topics: Aged; Anti-Bacterial Agents; Ceftriaxone; Endocarditis, Bacterial; Female; Gentamicins; Heart Failure; Humans; Purpura; Streptococcal Infections; Tricuspid Valve; Viridans Streptococci

Pulmonary edema is usually bilateral, but unilateral lobar pulmonary edema can also be encountered in clinical practice.. We describe a case of unilateral lobar pulmonary edema in a patient without known cardiac history. It was first presentation of underlying cardiac disease in our patient and was difficult to differentiate from pneumonia.. Unilateral pulmonary edema can mimic as pneumonia. Clinician should be aware of differential diagnosis of pulmonary edema, otherwise it can lead to unnecessary investigation and delay in starting definitive treatment.

Topics: Aged; Anti-Bacterial Agents; Cardiomyopathy, Alcoholic; Ceftriaxone; Clarithromycin; Diagnosis, Differential; Diuretics; Echocardiography, Doppler; Furosemide; Heart Failure; Humans; Male; Pulmonary Edema; Treatment Outcome

Although the presence of brucella endocarditis is encountered rarely, it is the most fetal complication of brucellosis, which is shown to affect the aortic valve primarily and the mitral valve secondarily. Involvement of the tricuspid valve is extremely rare. A 62-year-old female was admitted with complaints of fever, fatigue, difficulty in breathing, and swellings in her legs. A transthoracic echocardiogram was performed since acute right heart failure was considered due to her symptoms. The echocardiogram showed enlarged right heart chambers, serious tricuspid valve insufficiency, and a mass on the tricuspid valve compatible with a vegetation moving in and out of the right ventricle. Although no growths were observed in the blood culture, antibody titration for brucellosis was found to be 1/640 (+) in the serological examination. The patient was diagnosed with brucella endocarditis and placed on doxycycline, rifampicin, and ceftriaxone treatment for eight weeks. At the end of the eight-week treatment, the symptoms of right heart failure receded and the patient recovered from the endocarditis. Tricuspid valve brucella endocarditis should be considered in patients suffering from acute right heart failure accompanied by systemic infection findings since brucellosis is presently endemic in Turkey.

Topics: Acute Disease; Anti-Bacterial Agents; Brucellosis; Ceftriaxone; Diagnosis, Differential; Doxycycline; Echocardiography; Electrocardiography; Endocarditis, Bacterial; Female; Heart Failure; Humans; Middle Aged; Rifampin; Treatment Outcome; Tricuspid Valve

Here we describe a case of viral sepsis beyond the neonatal period caused by human parechovirus subtype 3 (HPeV-3), which manifested as cardio-respiratory failure, hepatitis, and necrotizing enterocolitis (NEC). HPeV-1 and 2 were originally classified as enteroviruses but the advent of sequence analysis led to them being recognized as a new genus in the picornavirus family. Subsequently, nine additional HPeV strains have been reported including HPeV-3 in 1999.(1) The spectrum of disease that these viruses may cause is still unknown, and they are rarely screened for in clinical practice.

Topics: Anti-Bacterial Agents; Blood Coagulation Disorders; Ceftriaxone; Enterocolitis, Necrotizing; Enzyme Inhibitors; Fever; Heart Failure; Hepatitis; Humans; Infant; Male; Parechovirus; Penicillanic Acid; Picornaviridae Infections; Piperacillin; Respiratory Insufficiency; Reverse Transcriptase Polymerase Chain Reaction; RNA, Viral; Sepsis; Sequence Analysis, RNA; Tazobactam

Topics: Aged; Anti-Bacterial Agents; Arthritis, Rheumatoid; Bacteremia; Bronchopneumonia; Ceftriaxone; Debridement; Dermatitis, Perioral; Diagnosis, Differential; Disseminated Intravascular Coagulation; Drug Therapy, Combination; Emphysema; Fasciitis, Necrotizing; Fatal Outcome; Female; Heart Failure; Humans; Metronidazole; Respiration, Artificial; Streptococcus agalactiae; Vancomycin

We describe a 66-year-old woman with infective endocarditis due to Cardiobacterium hominis whose condition, complicated by severe aortic regurgitation and congestive heart failure, necessitated aortic valve replacement despite treatment with ceftriaxone followed by ciprofloxacin. The blood isolate of C. hominis produced beta-lactamase and exhibited high-level resistance to penicillin (MIC, >==256 microgram/ml) and reduced susceptibility to vancomycin (MIC, 8 microgram/ml).

Topics: Aged; Aortic Valve; Aortic Valve Insufficiency; beta-Lactamases; Ceftriaxone; Ciprofloxacin; Endocarditis, Bacterial; Female; Gram-Negative Bacterial Infections; Gram-Negative Facultatively Anaerobic Rods; Heart Failure; Heart Valve Prosthesis Implantation; Humans; Microbial Sensitivity Tests; Penicillin Resistance; Penicillins; Taiwan; Vancomycin