tetracycline and Endocarditis

Topics: Amphotericin B; Cephalothin; Diagnosis, Differential; Endocarditis; Endocarditis, Bacterial; Humans; Infections; Mycoses; Penicillins; Streptomycin; Tetracycline; Vancomycin

Sixteen cases of chronic Q fever are described. In eight there was a history of exposure to infection from farms or farm products. All had valvular heart disease, involving the mitral valve in nine and the aortic valve in seven. Infection occurred on a prosthetic valve in two patients. Arterial embolism was common. Venous thrombosis occured in three patients, and pulmonary embolism occurred in three other patients. Complement fixing antibodies to phase 1 antigen were found in a titre of 1:200 or greater in all except two patients. In one of these post-mortem examination revealed rickettsial bodies in mitral valve vegetations, and in the other Coxiella burneti was isolated from heart valve tissue. The majority presented with infective endocarditis but two presented primarily with liver disease. All patients had evidence of liver involvement and in one this led to death from cirrhosis. Abnormal tests of liver function, particularly hyperglobulinaemia, raised alkaline phsophatase and abnormal bromsulphthalein retention were found in all patients. Hepatic histology was abnormal in all eight patients in whom it was studied. The commonest features were mononuclear cell infiltration of the portal tracts and prominence of the sinusoidal Kupffer cells. Patchy focal necrosis of parenchymal cells, granulomata, fatty change, and eosinophilia of the sinusoidal walls were also noted in several patients and cirrhosis developed in one. Six patients had a purpuric rash, and in 12 there was thrombocytopenia. It is suggested that the presence of hepatomegaly and liver involvement and thrombocytopenia may help to differentiate Q fever endocarditis from bacterial endocarditis. Raised serum IgM and IgA levels occured frequently, but with only a moderate dominance of IgM. Sheep cell agglutination and latex fixation tests for rheumatoid factor were occasionally positive. Several features of the disease suggest the possibility that immune-complex mechanisms may play a role in chronic Q fever. Treatment was with prolonged courses of tetracycline usually combined with lincomycin. Seven patients underwent valve replacement surgery for haemodynamic reasons. Five patients died; two from heart failure, one from cirrhosis, one seven days after valve replacement and one from intraperitoneal haemorrhage following percutaneous liver biopsy. Three patients have survived for more than five years, and another six for more than three and a half years after diagnosis. Of these nine patients, th

Topics: Adult; Chronic Disease; Endocarditis; Female; Heart Valve Diseases; Hematologic Diseases; Humans; Hypergammaglobulinemia; Lincomycin; Liver Diseases; Male; Middle Aged; Q Fever; Tetracycline; Thrombocytopenia

Topics: Aortic Valve; Aortic Valve Insufficiency; Chlamydia; Complement Fixation Tests; Endocarditis; Heart Valve Prosthesis; Humans; Male; Microscopy, Electron; Middle Aged; Rifampin; Tetracycline

Topics: Androgen Antagonists; Antibiotics, Antineoplastic; Bleomycin; Coumarins; Cyproterone; Endocarditis; Humans; Male; Neoplasms; Paraphilic Disorders; Pneumonia; Pregnadienes; Structure-Activity Relationship; Tetracycline; Urinary Tract Infections; Vitiligo

Topics: Adult; Bronchiectasis; Bronchitis; Endocarditis; Female; Gallbladder Diseases; Humans; Injections, Intramuscular; Liver; Liver Function Tests; Lung Abscess; Male; Middle Aged; Penicillin Resistance; Penicillin V; Pneumonia; Pyelonephritis; Respiratory Tract Infections; Sepsis; Tetracycline; Tonsillitis

Topics: Adult; Endocarditis; Female; Humans; Lincomycin; Q Fever; Tetracycline

Topics: Endocarditis; Humans; Male; Middle Aged; Mitral Valve; Mitral Valve Stenosis; Penicillins; Q Fever; Rheumatic Heart Disease; Rickettsia; Serologic Tests; Tetracycline

Topics: Adolescent; Adult; Age Factors; Aged; Austria; Chloramphenicol; Diagnosis, Differential; Endocarditis; Female; Humans; Male; Meningitis; Middle Aged; Pneumonia, Viral; Psittacosis; Seasons; Sex Factors; Tetracycline

Topics: Anti-Bacterial Agents; Cardiac Surgical Procedures; Drug Therapy; Endocarditis; Endocarditis, Bacterial; Hexachlorophene; Humans; Leukocyte Count; Oxacillin; Penicillins; Postoperative Care; Preoperative Care; Staphylococcal Infections; Streptomycin; Surgical Wound Infection; Tetracycline; Thoracic Surgery

Topics: Adolescent; Ampicillin; Anti-Bacterial Agents; Drug Therapy; Endocarditis; Endocarditis, Subacute Bacterial; Haemophilus; Haemophilus parainfluenzae; Humans; Probenecid; Tetracycline

Topics: Acinetobacter; Anti-Bacterial Agents; Chlortetracycline; Colistin; Dihydrostreptomycin Sulfate; Drug Resistance; Drug Resistance, Microbial; Endocarditis; Endocarditis, Bacterial; Neomycin; Nitrofurantoin; Oxytetracycline; Pathology; Penicillins; Tetracycline

Topics: Adolescent; Anti-Bacterial Agents; Bacteriological Techniques; Child; Chloramphenicol; Drug Resistance; Drug Resistance, Microbial; Endocarditis; Endocarditis, Bacterial; Erythromycin; Fever; Infant; Infant, Newborn; Leukocyte Count; Meningitis; Methicillin; Middle Aged; Mortality; Osteomyelitis; Penicillins; Sepsis; Staphylococcal Infections; Streptomycin; Tetracycline

Clinical and pathological features of two fatal cases of bacterial endocarditis with Candida albicans superinfection are described. One patient presented with combined Streptococcus viridans and Candida endocarditis of the aortic valve. The second patient, an addict to paregoric injected intravenously, developed Staphylococcus aureus of the tricuspid valve with eventual Candida endocarditis. The responsible organisms were identified from blood cultures during the hospital course, and by culture or tissue section of postmortem material. Candida endocarditis has emerged as a disease entity in the past 20 years. The incidence is increasing and patients with bacterial endocarditis are among those at risk. Antibiotic therapy appeared to facilitate the development of Candida endocarditis in these two cases.

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Aortic Valve; Candida albicans; Candidiasis; Dermatologic Agents; Endocarditis; Endocarditis, Bacterial; Heart Valve Diseases; Humans; Middle Aged; Pathology; Penicillins; Staphylococcal Infections; Staphylococcus aureus; Streptococcal Infections; Superinfection; Tetracycline; Tricuspid Valve; Viridans Streptococci

Topics: Amphotericin B; Anti-Bacterial Agents; Chloramphenicol; Colistin; Drug Resistance; Drug Resistance, Microbial; Endocarditis; Endocarditis, Bacterial; Enterobacter aerogenes; Enterobacteriaceae; Erythromycin; Escherichia coli Infections; Kanamycin; Penicillin G; Penicillins; Proteus Infections; Pseudomonas Infections; Ristocetin; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Vancomycin

Topics: Adolescent; Animals; Anti-Bacterial Agents; Cellulitis; Child; Endocarditis; Erythromycin; Female; Furunculosis; Fusidic Acid; Geriatrics; Humans; Infant; Meningitis; Osteomyelitis; Penicillins; Pneumonia; Pregnancy; Puerperal Infection; Pyelonephritis; Staphylococcal Infections; Streptomycin; Sulfonamides; Tetracycline; Wound Infection

Topics: Anti-Bacterial Agents; Bronchitis; Burns; Chloramphenicol; Endocarditis; Endocarditis, Subacute Bacterial; Gastroenterology; Glomerulonephritis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Kanamycin; Meningoencephalitis; Ophthalmia Neonatorum; Penicillins; Preventive Medicine; Rheumatic Diseases; Streptomycin; Sulfonamides; Tetracycline; Urinary Tract Infections

Topics: Bacteroides; Cardiac Surgical Procedures; Chloramphenicol; Drug Therapy; Endocarditis; Endocarditis, Bacterial; Erythromycin; Escherichia coli Infections; Klebsiella; Norway; Penicillins; Sepsis; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Sulfonamides; Surgical Wound Infection; Tetracycline; Thoracic Surgery

Topics: Anti-Bacterial Agents; Bacteria; Bacteriolysis; Blood; Chloramphenicol; Culture Media; Endocarditis; Endocarditis, Subacute Bacterial; Erythromycin; L Forms; Penicillins; Pharmacology; Research; Sepsis; Staphylococcus; Streptococcus; Streptomycin; Tetracycline

Topics: Amphotericin B; Anti-Bacterial Agents; Candidiasis; Chloramphenicol; Endocarditis; Endocarditis, Bacterial; Humans; Kanamycin; Penicillins; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Vancomycin

Topics: Alanine Transaminase; Anti-Bacterial Agents; Aspartate Aminotransferases; Clinical Enzyme Tests; Endocarditis; Endocarditis, Subacute Bacterial; Hemagglutination; Hemagglutination Tests; Laboratory Infection; Leptospira; Oxidoreductases; Penicillin G; Punctures; Streptomycin; Tetracycline; Weil Disease

Topics: Animals; Anti-Bacterial Agents; Bronchitis; Bronchopneumonia; Endocarditis; Endocarditis, Bacterial; Furunculosis; Humans; Lung Abscess; Plants, Medicinal; Pneumonia; Pyelitis; Pyelocystitis; Sepsis; Tetracycline

Topics: Anti-Bacterial Agents; Bacterial Infections; Drug Resistance; Drug Resistance, Microbial; Endocarditis; Endocarditis, Bacterial; Humans; Oleandomycin; Staphylococcal Infections; Streptococcal Infections; Tetracycline

Topics: Anti-Bacterial Agents; Bronchiectasis; Cholangitis; Coombs Test; Drug Hypersensitivity; Empyema; Endocarditis; Endocarditis, Bacterial; Hemagglutination; Humans; Osteomyelitis; Penicillins; Precipitin Tests; Pyelonephritis; Sepsis; Streptomycin; Tetracycline

Topics: Anti-Bacterial Agents; Endocarditis; Endocarditis, Bacterial; Micrococcus; Oleandomycin; Staphylococcus; Tetracycline

Topics: Anti-Bacterial Agents; Endocarditis; Endocarditis, Subacute Bacterial; Humans; Protein Synthesis Inhibitors; Tetracycline