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Unique Identifier: 94315646
Authors: Olopoenia LA. Mody V. Reynolds M.
Institution: Department of Medicine, Howard University Hospital, Washington, DC.
Title: Eikenella corrodens endocarditis in an intravenous drug user: case report and literature review. [Review] [10 refs]
Source: Journal of the National Medical Association. 86(4):313-5, 1994 Apr.
Abstract: A rare case of Eikenella corrodens endocarditis in an intravenous drug user is reported. Repeated blood cultures from the patient established the diagnosis of this infection. However, evaluation of the cardiac function using two-dimensional echocardiography with Doppler flow demonstrated a large pedunculated tricuspid vegetation. Also evident on this study was a dilated right ventricle with diminished contractility and regurgitation. Complete sterilization of the blood was achieved after a 2-week course of intravenous penicillin and gentamicin followed by an additional 4-week course of intravenous penicillin alone. Clinicians treating suspected IV drug users should be aware of the potential pathogenicity of this rare, facultative, anaerobic gram-negative bacillus (E corrodens). A combination of intravenous penicillin and aminoglycoside should be considered as the initial treatment followed by an additional course of intravenous penicillin for such patients with valvular vegetation. [References: 10]

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Unique Identifier: 93241031
Authors: Watanakunakorn C. Burkert T.
Institution: Department of Internal Medicine, St. Elizabeth Hospital Medical Center, Youngstown, Ohio 44501-1790.
Title: Infective endocarditis at a large community teaching hospital, 1980-1990. A review of 210 episodes. [Review] [88 refs]
Source: Medicine. 72(2):90-102, 1993 Mar.
Abstract: We studied 210 episodes of infective endocarditis in 204 patients. The prevalence of this disease in our series ranged from 0.32 to 1.30 (mean, 0.75) episodes per 1000 admissions per year. There were 115 male and 89 female patients, whose ages ranged from newborn to 91 years (median, 60-70). One-hundred-and-forty-eight episodes involved host valves and another 33 episodes occurred in intravenous drug users. There were 2 episodes of early and 27 episodes of late prosthetic valve endocarditis. Staphylococcus aureus accounted for 99 episodes (47.1%), alpha-hemolytic streptococci for 29 episodes (13.8%), enterococci for 11 episodes (5.2%), culture-negative endocarditis for 11 episodes (5.2%), and other organisms for 60 episodes (28.6%). Severe back pain was the chief complaint in 15 patients. 2-D echocardiography was performed in 164 episodes, results in 67 (40.9%) of which were positive. Valve surgery was performed in 29 episodes (23 host valves and 6 prosthetic valves). The overall mortality was 21.4%. Autopsy was performed in 22 of the 45 patients who died (48.9%). The mortality rate increased with age, (10.1% and 31.5% for patients < 60 years old and 60 years or older, respectively (p < 0.001). [References: 88]

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