Neurologic Complications of Bacterial Endocarditis

Pruitt, Amy A.; Rubin, Robert H.; Karchmer, Adolf W.; Duncan, Gary W.

doi:10.1097/00005792-197807000-00004

Cited by 379 publications

(158 citation statements)

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“…Several reports on haemorrhagic side effects of anticoagulant therapy in IE patients suffering cerebral complications have been published [5,6,10,16]. Experimental studies on anticoagulant effects in IE pathogenesis are few [17,18] and empirical data do not support the initiation of anticoagulant therapy once IE is diagnosed.…”

Section: Discussionmentioning

confidence: 99%

“…Ischemic stroke with focal neurological symptoms is the most frequently reported cerebral complication in IE but also well-documented are more complex syndromes with varying combinations of focal neurological signs, meningism and encephalopathy in the same patient as well as silent cerebral embolism [5,14,24,25]. Autopsy data have indicated that embolic meningoencephalitis is the fundamental neuropathological change in IE [26] and a continuum between vascular and infectious cerebral complications in endocarditis has been suggested [27,28] Staphylococcus aureus aetiology was a major risk factor for CVC in our study as has been shown previously [22].…”

Section: Discussionmentioning

confidence: 99%

“…A high risk of cerebral haemorrhage was seen in most studies [1,2] and the addition of anticoagulant therapy was shown unnecessary when adequate penicillin doses were administered [3]. Anticoagulants as a part of IE therapy was discouraged [4,5] but later the recommendations to some extent was modified in patients with other indications for anticoagulant therapy [6].…”

Section: Introductionmentioning

confidence: 99%

“…Current guidelines are based on experiences from the early years of IE treatment, retrospective studies mainly involving patients with prosthetic valve endocarditis (PVE) [10][11][12], and the opinions of authorities in the field [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Warfarin therapy and incidence of cerebrovascular complications in left-sided native valve endocarditis

Snygg‐Martin

Rasmussen

Hassager

et al. 2010

Eur J Clin Microbiol Infect Dis

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Anticoagulant therapy has been anticipated to increase risk of cerebrovascular complications (CVC) in native valve endocarditis (NVE). This study investigates the relationship between ongoing oral anticoagulant therapy and incidence of symptomatic CVC in left-sided NVE. In a prospective cohort study CVC incidence was compared between NVE patients with and without ongoing warfarin. Among 587 NVE episodes, 48 (8%) occurred in patients on warfarin. A symptomatic CVC was seen in 144 (25%) patients with only 3 on warfarin.CVC were significantly less frequent in patients on warfarin (6% vs. 26 %, OR 0.20, p=0.006).No increase in haemorrhagic lesions was detected in patients on warfarin. Staphylococcus aureus aetiology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Warfarin therapy and incidence of cerebrovascular complications in left-sided native valve endocarditis

Snygg‐Martin

Rasmussen

Hassager

et al. 2010

Eur J Clin Microbiol Infect Dis

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“…Na maioria dos casos, os resultados neonatais são favoráveis, embora possa ocorrer parto prematuro e restrição de crescimento intrauterino 8,9 . A gestação não parece afetar a atividade inflamatória da doença e as complicações maternas estão relacionadas com a resposta cardiovascular à gestação, trabalho de parto e parto.…”

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13. Endocardite infecciosa na gravidez

Rombaldi¹

2009

Arq. Bras. Cardiol.

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Arq Bras Cardiol 2009; 93(6 supl.1): e110-e178 -Evolução na gestaçãoA maioria das publicações mais recentes descreve evolução materna favorável, embora tenham sido descritas algumas complicações, tais como o surgimento de hipertensão e a insuficiência cardíaca (as mais comuns), além de hemorragia cerebral e hemoptise maciça 7,8,10 . Na maioria dos casos, os resultados neonatais são favoráveis, embora possa ocorrer parto prematuro e restrição de crescimento intrauterino 8,9 . A gestação não parece afetar a atividade inflamatória da doença e as complicações maternas estão relacionadas com a resposta cardiovascular à gestação, trabalho de parto e parto. As oscilações da pressão sistólica é que se associam com mais frequência ao surgimento de insuficiência cardíaca e hemorragia cerebral 10 .As pacientes com doença de Takayasu devem ser avaliadas antes da concepção, com o objetivo de realizar cirurgia vascular ou intervenção vascular percutânea, se indicadas, e fora do período da gestação. Além disso, durante a gestação e o parto, deve ser feito um controle adequado da pressão arterial, a fim de evitar as complicações maternas referidas, sem comprometer o desenvolvimento fetal por hipoperfusão placentária 9 . Recomendações 1) Os corticosteroides são o tratamento de escolha para o controle da atividade inflamatória da doença e seu uso está indicado durante a gestação quando a paciente engravida na fase aguda da doença ou quando o diagnóstico é realizado durante a gestação 8,9,10 (IC).2) O parto vaginal é aconselhado, e com o uso de fórcipe, a fim de abreviar o segundo estágio do trabalho de parto, quando necessário 9 (IC).3) O parto cesáreo deve ser realizado quando há indicação obstétrica ou em situações de hipertensão ou insuficiência cardíaca refratárias ao tratamento clínico 9 (IC).

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Hemophilus endocarditis. Two patients with complications

Parker¹

1983

Archives of Internal Medicine

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Two cases of Hemophilus endocarditis were diagnosed in our hospital during a six-month period. Although both patients were in good health until the onset of their endocarditis, both had brain emboli and required emergency heart-valve surgery. Falsely low incidences of this disease have been reported, since Hemophilus sp are difficult to isolate. Additionally, these organisms are consistently associated with large vegetations and have a greater than 50% incidence of embolization. It is this higher incidence of embolization that leads us to conclude that prophylactic surgery should be considered in selected patients.

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Neurologic Complications of Bacterial Endocarditis

Cited by 379 publications

References 0 publications

Warfarin therapy and incidence of cerebrovascular complications in left-sided native valve endocarditis

Warfarin therapy and incidence of cerebrovascular complications in left-sided native valve endocarditis

13. Endocardite infecciosa na gravidez

Hemophilus endocarditis. Two patients with complications

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