• Title/Summary/Keyword: 감염성 심내막염

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Successful Treatment of Left Atrial Auricular Abscess -A case report - (좌심방이-농양의 수술적 치료 -치험 1예 -)

  • 이정렬;김준성;배은정;노정일;안규리
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.272-274
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    • 2004
  • We report an unusual case of left atrial auricular abscess which was successfully treated by surgical resection, treatment with antibiotics and mediastinal irrigation. A 9-year-old female patient with previous history of urinary tract infection was admitted because of persistent fever. Echocardiography and magnetic resonance imaging revealed massive pericardial effusion and a mass lesion at the left upper cardiac border. Pericardiocentesis isolated Staphylococcus aureus on culture. The patient underwent mass removal under cardiopulmonary bypass. The mass was located within the left atrial auricular wall with fibropurulent abscess formation inside. Postoperative mediastinal irrigation was performed. Pathologic examination of the mass showed organized thrombi with chronic fibrosing mural endocarditis. She discharged on the 21st postoperative day without complication.

Complete genome sequence of Cutibacterium acnes KCOM 1861 isolated from a human jaw osteomyelitis lesion (사람 악골 골수염에서 분리된 Cutibacterium acnes KCOM 1861의 유전체 염기서열 해독)

  • Park, Soon-Nang;Roh, Hanseong;Lim, Yun Kyong;Kook, Joong-Ki
    • Korean Journal of Microbiology
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    • v.53 no.2
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    • pp.126-128
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    • 2017
  • Cutibacterium acnes (formerly Propionibacterium acnes) is an anaerobic, Gram-positive rod and that is a normal flora of human skin and mucosal surface as well as an opportunistic pathogen related to acnes vulgaris, sarcoidosis, brain abscess, endocarditis, periodontitis, and endodontic infections. C. acnes KCOM 1861 (= ChDC B594) was isolated from a human jaw osteomyelitis lesion. Here, we present the complete genome sequence of C. acnes KCOM 1861.

A case of vancomycin-induced drug hypersensitivity syndrome (반코마이신 투여 후 발생한 약물 과민성 증후군 1예)

  • Min, Kyung Sun;Choi, Woo Yeon;Song, Eun Song;Han, Dong Kyun;Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1228-1231
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    • 2008
  • Drug hypersensitivity syndrome (DHS) has rarely been reported in association with vancomycin treatment. Here, we describe an 11-year-old girl who developed fever and a maculopapular rash on day 18 of intravenous vancomycin for treatment of infective endocarditis. The patient presented with fever, a maculopapular skin rash, hepatitis, and acute renal failure caused by vancomycin-induced DHS. The symptoms resolved in less than 24 h after withdrawal of vancomycin and treatment with corticosteroids. We present this case of DHS associated with vancomycin.

Follow-up in Adult after Total Repair of Tetralogy of Fallot (수술 후 성인 Fallot 4징 환자의 임상적 고찰)

  • Jang, Gi Young;Kim, Sun Young;Moon, Joo Ryung;Huh, Joon;Kang, I-Seok;Park, Seung Woo;Jun, Tae Gook;Park, Pyo Won;Lee, Heung Jae
    • Clinical and Experimental Pediatrics
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    • v.46 no.7
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    • pp.661-667
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    • 2003
  • Purpose : This study was performed to find the chief clinical problems associated with the ages of adult patients of tetralogy of Fallot(TOF) who had undergone total correction. Methods : Of the 30 patients who were registered at the Grown-Up Congenital Heart Disease (GUCH) Clinic of Samsung Medical Center for TOF, a retrospective investigation was carried out on 28 patients who underwent total correction. Results : Mean age at retrospective study was 30.8(range : 16-53) years old. Age at total correction was 15.8(range : 2-49) years old. Problems after corrective surgery were assessed. They were arrhythmia, pulmonary valve regurgitation, left pulmonary artery stenosis, residual ventricular septal defect, mitral valve regurgitation, tricuspid valve regurgitation, right ventricle outflow tract obstruction, aortic valve regurgitation, infective endocarditis and protein losing enteropathy. After repair of TOF, such arrhythmias as atrial arrhythmia and AV conduction disturbances were observed in some patients. Cardiomegaly was found significantly in the subjects with arrhythmia(P<0.05), and arrhythmia was less observed in patients who underwent surgery at a young age. Eight patients required a reoperation; the main indications were residual ventricular septal defect, right ventricle outflow tract obstruction and peripheral pulmonary artery stenosis. Conclusion : The majority of the patients seemed to live normal lives after Tetralogy of Fallot repair. However, as residual anatomic and functional abnormalities exist postoperatively, continued careful follow-up is needed to detect and correct structural and functional abnormalities.

Surgical Experience of Aortic Root Abscess with Complete AV Block and Pseudoaneurysm (완전 방실 차단과 가성 동맥류를 동반한 만성 대동맥 근부농양 수술적 치험)

  • 한국남;오세진;구본권;김경환
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.868-871
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    • 2004
  • A 42 year old male was operated with aortic root abscess and pseudoaneurysm. Aortic valve vegetations which measured $8\times5$ cm and root abscess were removed and debrided. We reconstructed root and noncoronary sinus with autopericardium. Antibiotics were administered for 4 weeks. In general, Aortic root abscess recurs frequently and mortality is high. It is usually requires early surgical eradication with antibiotics medication.

Effect of Chlorhexidine on Causative Microorganisms of Infective Endocarditis in Oral Cavity (Chlorhexidine이 구강내 감염성 심내막염 유발 균주에 미치는 영향)

  • Sung-Woo Lee;Sung-Chang Chung;Young-Ku Kim
    • Journal of Oral Medicine and Pain
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    • v.21 no.1
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    • pp.123-131
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    • 1996
  • Bacteremia occurs in a wide variety of clinical procedures in oral cavity. Reduction of the number of causative microorganisms of infective endocarditis in oral cavity by local administration of antimicrobial agents decreases the magnitude of bacteremia and possibility of infective endocarditis. The effects of chlorhexidine on Streptococcus sanguis, Streptococcus mitis, Streptococcus mutans, Streptococcus oralis, Streptococcus gordonii, Staphylococcus aureus, and Staphylococcus epidermis were investigated by measurement of turbidity. The effects of 0.1% chlorhexidine gargling for 7 days on oral bacterial flora, total streptococci, S. mutans, S. aureus, and S. epidermis in whole saliv a of 7 healthy human subjects, were investigated by measurement of Colony Forming Units (CFU). The obtained results were as follows : 1. Chlorhexidine showed significant antimicrobial effects on Streptococcus snaguis, Streptococcus mitis, Streptococcus mutans, Streptococcus oralis, Streptococcus gordonii, Staphylococcus aureus, and Staphylococcus epidermis. However, the effects on S. sanguis and S. gordonii were not apparent compared with other microorganisms. 2. Oral gargling of 0.1% chlorhexidine decreased the CFU values of normal oral bacterial flora, total streptococci, S. mutans, S. aureus, and S. epidermis in whole saliva. The antimicrobial effects were significant after 4 days of chlorhexidine gargling. 3. Local antimicrobial administration in addition to systemic antibiotic prophylaxis can be highly recommended as an effective adjunct regimen for prevention of infective endocarditis.

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Surgical Treatment of Infective Endocarditis (감염성 심내막염에 대한 외과적치료)

  • Wang, Ok-Bo;Park, Ju-Cheol
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1055-1060
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    • 1992
  • Clinical experience of 21 patients with infective endocarditis was reviewed. Endocarditis involved the left-sided valve in 16 cases, the right-sided valve in 2, and PDA in the remaining 3 patients. Valve abnormalities included leaflet perforation in 9 patients, chordal rupture in 2,; annular abscess in 6; and aorticoleft atnal perforation in 2. Sixteen patients underwent valve replacement[aortic valve replacement in 7 patients, mitral replacement in 4 and double valve replacement in 5], two had VSD closure with pulmonary valve excision, three had ductus arteriousus closure. The patients were classified into two groups. I ] Healed endocarditis group: including the patients who had completed a planned cou-rseof antibiotic therapy[N=10], II ] Active endocarditis group: patients in which operations were performed prior to completetion of antibiotic treatment course[N=11]. The indications for operation included congestive heart failure, embolism, and persistent sepsis. Organisms were predominantly streptococcus[N=5] and staphylococcus [N=4] followed by candida, moraxella, and E-coli. By NYHA functional classification, all patients were in Class III or IV preoperatively. There was only one operative mortality in patient from group II. All patients substantially, improved postoperatively with NYHA classification in class I or II. This study shows that early surgical intervention in patients with active endocarditis has desirable outcome.

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Myocardial Abscess with Coronary Artery Occlusion -One Case Report (우관상동맥 폐색을 초래한 심근 농양 -1례 보고-)

  • 이재익;김기봉
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.823-826
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    • 1997
  • Myocardial abscess usually occurs as a complication of infective endocarditis or overwhelming septicemia. Coronary artery occlusion caused by myocardial abscess has been rarely reported. A 61-year-old man presented with fever and chill that developed 6 weeks prior to admission. He had a history of cardiopulmonary resuscitation for ventricular fibrillation and cardiac arrest 4 weeks prior to admission. Echocardiography showed a 3xfcm sized mass in the area of the right atrioventricular groove and coronary angiography showed complete occlusion of the proximal right coronary artery. Under the diagnosis of myocardial infarction complicating myocardial abscess, debridement of abscess and coronary artery bypass grafting with right internal mammary artery to distal right coronary artery was performed. Culture from the abscess cavity demonstrated Salmonella arizona.

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INFECTIVE ENDOCARDITIS OF DENTAL ORIGIN: A CASE REPORT (치성기원으로 인한 감염성 심내막염: 증례보고)

  • Ahn, Shin-Young;Yang, Seok-Jin;Kim, Su-Gwan;Kim, Hak-Kyun;Lee, Hyo-Bin;Park, Joong-Yeop;Choi, Dong-Kook;Kim, Young-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.3
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    • pp.237-241
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    • 2006
  • Infective endocarditis remains an important, life-threatening infection despite improvements in diagnosis and management. Despite the decrease in rheumatic heart disease and the improvements in antibiotic prophylaxis, infective endocarditis has been reported with increasing frequency in the last few decades. Presumably, this is due to the rise in the incidence of intravenous drug users, carriers of prosthetic valves and other intracardiac devices, and the longer survival of patients with congenital heart disease. Despite the great advances in medical and surgical treatment, infective endocarditis is still a life-threatening disease with an estimated mortality of 27%. Infective endocarditis represents one of the few potentially fatal infections that may occur in a dental patient. Efforts to reduce the incidence of this disease usually take the form of appropriate antibiotic coverage before dental treatment, together with the establishment and maintenance of good oral health. This study is a case report of a patient who developed infective endocarditis after multiple tooth extractions due to chronic periodontitis of dental origin.

Surgical Treatment of Native Valve Endocarditis (감염성 심내막염의 외과적 치료)

  • Kim, Ae-Jung;Kim, Min-Ho;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.822-828
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    • 1995
  • This paper reports 15 native valve endocarditis cases had surgical operation in the past 10 years at the department of Cardiovascular and Thoracic Surgery, Chonbuk National University Hospital. In this study, 10 cases out of 15 were in class I or II by the New York Heart Association functional classification. None of the cases had a history of taking addictive drugs. Five cases were congenital heart disease, three cases were rheumatic heart disease and two cases were degenerative heart disease. Thus 10 cases had the underlying disease. All cases had antibiotics treatment for 3 to 6 weeks before operation. In the culture test, only four cases were positive in the blood culture and one case was positive in the excised valve culture. Organisms on blood and valve culture were Streptococcus epidermis, Streptococcus viridans, Staphylococcus aureus and Staphylococcus epidermidis. In the 10 cases without ventricular septal defect, the aortic valve was involved in four, mitral in four, both in two and involved valves in the 5 cases with ventricular septal defect were tricuspid in three, pulmonic in two. Eight cases had operation because they showed moderate congestive heart failure due to valvular insufficiency and vegetation with or without embolism. Seven cases had operation because they showed persistent or progressive congestive heart failure and/or uncontrolled infection. Five cases with ventricular septal defect underwent the closure of ventricular septal defect, vegetectomy and leaflet excision of the affected valves without valve replacement. In the cases without ventricular septal defect, the affected valves were replaced with St. Jude mechanical prosthesis. Postoperative complications were recurrent endocarditis in two, embolism in one, allergic vasculitis in two, spleen rupture in one and postpericardiotomy syndrome in one. At the first postoperative day, one case died of cerebral embolism. At the 11th postoperative month, one case died of recurrent endocarditis and paravalvular leakage in spite of a couple of aortic valve replacement. In the survived cases[13 cases in this study , all cases but one became class I or II by the New York Heart Association functional classification.

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