Nervous system complications in bacterial endocarditis

Ziment, Irwin

doi:10.1016/0002-9343(69)90189-2

Cited by 104 publications

(21 citation statements)

References 66 publications

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“…4 Intracerebral hemorrhage due to ruptured mycotic aneurysm occurred more frequently than is reported. 1 Brain abscesses, meningitis and encephalopathy were in our study and were comparable to what is reported.…”

Section: Discussionmentioning

confidence: 92%

“…4 Stroke is the most common neurological complication occurring in patients with infective endocarditis (IE). 2 Intracranial hemorrhage is identified in 5% of cases 6 and cerebral infarctions in 14%-19% 3,5,7 other complications include acute meningitis, brain abscess, encephalopathy, seizures and headache.…”

Section: Sas Khan Ba Yaqub Sm Al Deeb Neurological Complications Omentioning

confidence: 99%

“…The incidence of neurological complications in infective endocarditis is 20%-40%. 4 Stroke is the most common neurological complication occurring in patients with infective endocarditis (IE).2 Intracranial hemorrhage is identified in 5% of cases 6 and cerebral infarctions in 14%-19% 3,5,7 other complications include acute meningitis, brain abscess, encephalopathy, seizures and headache. 1,3,5 Rarely, back pain with root lesion due to intervertebral disc infection or acute mononeuropathy may occur.…”

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Neurological Complications of Infective Endocarditis

Khan

1996

Ann Saudi Med

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We reviewed the files of 80 successive patients with native and prosthetic valve endocarditis admitted to Riyadh Armed Forces Hospital. Neurological complications (NC) occurred in 28 (35%) patients. The valves involved were mitral in 12 (43%), aortic in eight (29%), combined mitral and aortic lesions in six (21%), and others in two (7%). The common causative organisms were Streptococci in 12 (43%), Staphylococcus aureus and Staphylococcus epidermides, both occurring in four (14%). Compared to the 52 infective endocarditis patients with no neurological complications (NNC), the NC occurred more frequently in male patients, those with aortic valve lesion, those with atrial fibrillation, those with delayed therapy and those with causative organisms being Streptococci or Staphylococci. Eleven patients died (39%), 12 (43%) recovered with motor sequelae, six (21%) had seizure disorder, and five (18%) had full recovery. The frequency of neurological complications and mortality is comparable to those reported in the literature; however, the frequency of strokes was higher in our patients. The incidence of neurological complications in infective endocarditis is 20%-40%. 4 Stroke is the most common neurological complication occurring in patients with infective endocarditis (IE).2 Intracranial hemorrhage is identified in 5% of cases 6 and cerebral infarctions in 14%-19% 3,5,7 other complications include acute meningitis, brain abscess, encephalopathy, seizures and headache. 1,3,5 Rarely, back pain with root lesion due to intervertebral disc infection or acute mononeuropathy may occur.1,3 Despite the introduction of potent antimicrobial agents and new diagnostic and therapeutic procedures, the neurological complications remain high.1,3 We retrospectively reviewed 80 successive patients with IE who were admitted to Riyadh Armed Forces Hospital between 1981-1993, in order to evaluate the frequency, pattern, etiology and prognosis of neurological complications in patients with IE. Material and MethodsWe reviewed the files of all patients with a first attack of native or prosthetic valve endocarditis admitted to Riyadh Armed Forces Hospital between 1980 and 1993, The patients we included fulfilled two or more of the following criteria: 1) clinical picture suggestive of IE, such as persistent fever with heart murmurs; peripheral stigmata of IE, such as Roth's spots, conjunctival petechiae, Janeway's lesions, Osier's node and splenomegaly; and immunologic abnormalities such as rheumatoid factors, cryoglobulins, hyperglobulinemia or active urinary sediment; 2) two or more blood cultures growing organisms or positive serology in blood culture-negative IE; 3) direct evidence of IE by positive vegetations on echocardiogram or vegetations at surgery; and 4) exclusion of other causes of septicemia.Out of 150 charts reviewed, only 80 patients (54%) satisfied the inclusion criteria. We excluded patients with an obvious extracardiac source of septicemia and those with bacteremia who were treated presumptively as IE. Patients who were suspe...

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Section: Discussionmentioning

confidence: 92%

Section: Sas Khan Ba Yaqub Sm Al Deeb Neurological Complications Omentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Neurological Complications of Infective Endocarditis

Khan

1996

Ann Saudi Med

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“…Thus the climate of medical opinion that was perpetuated from work in the middle 1940s was that not only were anticoagulants unnecessary, but that their use was strongly contra-indicated in bacterial endocarditis (Gavey, 1951;Toohey, 1959;Ziment, 1969) because of an increased danger of haemorrhage in areas infarcted by emboli. In 1966, this view was challenged by Lerner and Weinstein (1966), who state that 'These drugs should be used for the same reasons that they are administered to persons who do not have endocarditis.'…”

Section: Introductionmentioning

confidence: 99%

The use of anticoagulants in bacterial endocarditis

Kanis

1974

Postgraduate Medical Journal

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Summary Early experience in the treatment of bacterial endocarditis with penicillin suggested that the addition of anticoagulants might improve results. This paper reports a patient with bacterial endocarditis who died from embolic cerebral damage after initiation of treatment with heparin. The evidence suggests that anticoagulants were responsible for her death and that bacterial endocarditis is a relative contra-indication to anticoagulant therapy.

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Mycotic aneurysm. Case report with novel sequential angiographic findings

Katz¹

1974

Archives of Internal Medicine

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Nervous system complications in bacterial endocarditis

Cited by 104 publications

References 66 publications

Neurological Complications of Infective Endocarditis

Neurological Complications of Infective Endocarditis

The use of anticoagulants in bacterial endocarditis

Mycotic aneurysm. Case report with novel sequential angiographic findings

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