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Yamazato T, Munakata H, Okita Y. Management of cardiopulmonary bypass in patients with ischemic and hemorrhagic strokes in surgery for active infective endocarditis. Indian J Thorac Cardiovasc Surg 2024; 40:61-68. [PMID: 38827558 PMCID: PMC11139828 DOI: 10.1007/s12055-023-01642-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 06/04/2024] Open
Abstract
Stroke and intracranial hemorrhage (ICH) are serious complications that are difficult to manage during surgery for active infectious endocarditis (AIE). Relevant society guidelines still recommend delaying the cardiac surgery for AIE with ICH for 4 weeks. Some early studies indicated that the mortality rate decreases when cardiac surgery for ICH is delayed. In contrast, some reported that surgical intervention should not be delayed if an early operation is demanded, even in patients with ICH. The current literature on early vs. late surgery for infectious endocarditis (IE) with ICH is conflicting. Changing the cardiopulmonary bypass (CPB) strategy might be necessary to improve the surgical outcomes of IE with ICH. Some studies reported that cardiac surgery using nafamostat mesylate (NM) as an alternative anticoagulant during CPB was performed successfully. The combination of NM and low-dose heparin was beneficial for early surgery in patients with AIE complicated by cerebral infarction and ICH, without worsening cerebral lesions. In this report, we review and discuss the management of CPB in patients with ischemic and hemorrhagic stroke during surgery for AIE.
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Affiliation(s)
- Takahiro Yamazato
- Department of Cardiovascular Surgery, Okinawa Nanbu Prefectural Medical Center and Children’s Medical Center, Haebaru, Okinawa 901-1193 Japan
| | - Hiroshi Munakata
- Department of Cardiovascular Surgery, Okinawa Nanbu Prefectural Medical Center and Children’s Medical Center, Haebaru, Okinawa 901-1193 Japan
| | - Yutaka Okita
- Department of Cardiovascular Surgery, Takatsuki General Hospital, Takatsuki, Osaka Japan
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Ishibashi H, Enomoto Y, Takaoka S, Aoki K, Nagai H, Yamagata K, Ishibashi-Kanno N, Uchida F, Fukuzawa S, Tabuchi K, Bukawa H, Suzuki Y, Yanagawa T. Analysis of predictors of fever after aortic valve replacement: Diabetic patients are less likely to develop fever after aortic valve replacement, a single-centre retrospective study. J Perioper Pract 2024:17504589241232503. [PMID: 38590001 DOI: 10.1177/17504589241232503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
BACKGROUND Postoperative temperature dysregulation affects the length of hospital stay and prognosis. This study evaluated the factors that influence the occurrence of fever in patients after aortic valve replacement surgery. METHODS Eighty-seven consecutive patients who underwent aortic valve replacement surgery were included. Patients' age, sex and body mass index; presence of diabetes mellitus; operation time; blood loss; blood transfusion volume; preoperative and postoperative laboratory findings; presence or absence of oral function management; and fever >38°C were retrospectively analysed through univariate and multiple logistic regression analyses. RESULTS Among the variables, only diabetes mellitus status was significantly associated with fever ⩾38°C. Postoperatively, patients with diabetes mellitus were significantly less likely to develop fever above 38°C and a fever rising to 38°C. CONCLUSIONS This study shows that the presence of comorbid diabetes mellitus decreases the frequency of developing fever >38°C after aortic valve replacement surgery.
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Affiliation(s)
- Hiroshi Ishibashi
- Doctoral program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
- Department of Cardiology, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Yoshiharu Enomoto
- Department of Cardiovascular Surgery, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Shohei Takaoka
- Department of Oral and Maxillofacial Surgery, University of Tsukuba Hospital, Tsukuba, Japan
| | - Kazuhiro Aoki
- Department of Cardiology, National Hospital Organization Tokyo National Hospital, Tokyo, Japan
| | - Hiroki Nagai
- Department of Oral and Maxillofacial Surgery, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Kenji Yamagata
- Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Naomi Ishibashi-Kanno
- Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Fumihiko Uchida
- Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Satoshi Fukuzawa
- Department of Oral and Maxillofacial Surgery, University of Tsukuba Hospital, Tsukuba, Japan
| | - Katsuhiko Tabuchi
- Department of Molecular and Cellular Physiology, School of Medicine, Shinshu University, Matsumoto, Japan
| | - Hiroki Bukawa
- Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yasuyuki Suzuki
- Department of Cardiovascular Surgery, Ibaraki Prefectural Central Hospital, Kasama, Japan
- Department of Cardiovascular Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Toru Yanagawa
- Department of Oral and Maxillofacial Surgery, Ibaraki Prefectural Central Hospital, Kasama, Japan
- Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
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3
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Zhou MX, Viozzi CF, Heneberk O, Lee SK, Klarich KW, Salinas TJ. Oral Health Clearance Outcomes for Cardiovascular Surgery. Mayo Clin Proc Innov Qual Outcomes 2024; 8:121-130. [PMID: 38384717 PMCID: PMC10879629 DOI: 10.1016/j.mayocpiqo.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
Objective To determine the risk of morbidity and mortality in patients receiving dental extractions before planned cardiovascular surgery (CVS) and examine factors that may affect the chance of oral health clearance. Patients and Methods A retrospective medical record review was performed of patients who underwent dental screening before CVS from January 1, 2015, to December 31, 2021, at a major medical institution. A total of 496 patients met the inclusion criteria and were divided into 2 groups. Group 1 patients were cleared to advance to planned CVS (n=390). Group 2 patients were not cleared for surgery and subsequently underwent dental extractions before planned CVS (n=106). Results Six patients (5.7%) experienced postoperative complications after dental extraction that resulted in an emergency room visit. No deaths occurred after dental extraction before CVS. However, 4 patients died within 30 days of CVS, 3 from Group 1 (0.77%) and 1 from Group 2 (0.94%). Dental extraction before planned CVS showed a borderline significant association with death based on unadjusted (P=.06) and age-adjusted analysis (P=.05). Patients who reported seeing a dentist routinely had a significantly higher chance of oral health clearance (P <.001). No differences were noted between the 2 groups with regard to age, sex, or 30-day hospital readmission rate. Conclusion Patients who had dental extractions completed before planned CVS may be at an increased risk of mortality. Further studies are needed to examine this relationship. Emphasis should be on prioritization of routine dental visits before planned CVS.
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Affiliation(s)
- Miao Xian Zhou
- Department of Dental Specialties, Mayo Clinic, Rochester, MN
| | | | - Ondřej Heneberk
- Department of Dentistry, University Hospital, Hradec Kralove, Czech Republic
| | - Sarah K. Lee
- Department of Dental Specialties, Mayo Clinic, Rochester, MN
| | - Kyle W. Klarich
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
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4
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Omori K, Kitagawa H, Takada M, Maeda R, Nomura T, Kubo Y, Shigemoto N, Ohge H. Fosfomycin as salvage therapy for persistent methicillin-resistant Staphylococcus aureus bacteremia: A case series and review of the literature. J Infect Chemother 2024; 30:352-356. [PMID: 37922987 DOI: 10.1016/j.jiac.2023.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/05/2023] [Accepted: 10/31/2023] [Indexed: 11/07/2023]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia can be persistent and refractory; however, the optimal approach for its treatment has not been determined. Although fosfomycin (FOM) has been shown to have synergistic effects with anti-MRSA agents in vitro, clinical experience with FOM combination therapy is limited. Thus, we present cases of persistent MRSA bacteremia that improved with the addition of FOM. In case 1, a 48-year-old man with prosthetic vascular graft infection developed persistent MRSA bacteremia despite vancomycin (VCM) and daptomycin (DAP) administration. On day 46, after the first positive blood culture, we added FOM to DAP. The blood culture became negative on day 53. In case 2, an 85-year-old woman presented with pacemaker-related MRSA bacteremia. She was treated with VCM, followed by DAP and DAP plus rifampicin. However, the bacteremia persisted for 32 days because of difficulties in immediate pacemaker removal. After adding FOM to DAP, the blood culture became negative on day 38. In case 3, a 57-year-old woman developed persistent MRSA bacteremia due to pulmonary valve endocarditis and pulmonary artery thrombosis after total esophagectomy for esophageal cancer. The bacteremia continued for 50 days despite treatment with DAP, followed by VCM, VCM plus minocycline, DAP plus linezolid (LZD), and VCM plus LZD. She was managed conservatively because of surgical complications. After adding FOM to VCM on day 51, the blood culture became negative on day 58. FOM combination therapy may be effective in eliminating bacteria and can serve as salvage therapy for refractory MRSA bacteremia.
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Affiliation(s)
- Keitaro Omori
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan; Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Division of Infection Control, Hiroshima University Hospital, Hiroshima, Japan.
| | - Hiroki Kitagawa
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan; Division of Infection Control, Hiroshima University Hospital, Hiroshima, Japan; Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Takada
- Division of Pharmacy, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Ryuto Maeda
- Division of Pharmacy, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Toshihito Nomura
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan; Division of Infection Control, Hiroshima University Hospital, Hiroshima, Japan
| | - Yuko Kubo
- Division of Infection Control, Hiroshima University Hospital, Hiroshima, Japan
| | - Norifumi Shigemoto
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan; Division of Infection Control, Hiroshima University Hospital, Hiroshima, Japan; Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Translational Research Center, Hiroshima University, Hiroshima, Japan
| | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan; Division of Infection Control, Hiroshima University Hospital, Hiroshima, Japan
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Mitsutake K, Shinya N, Seki M, Ohara T, Uemura K, Fukunaga M, Sakai J, Nagao M, Sata M, Hamada Y, Kawasuji H, Yamamoto Y, Nakamatsu M, Koizumi Y, Mikamo H, Ukimura A, Aoyagi T, Sawai T, Tanaka T, Izumikawa K, Takayama Y, Nakamura K, Kanemitsu K, Tokimatsu I, Nakajima K, Akine D. Antimicrobial therapy and outcome of methicillin-resistant Staphylococcus aureus endocarditis: A retrospective multicenter study in Japan. J Infect Chemother 2024:S1341-321X(24)00068-0. [PMID: 38432557 DOI: 10.1016/j.jiac.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/08/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND MRSA (methicillin-resistant Staphylococcus aureus)-infective endocarditis (IE) is associated with high morbidity and mortality. This study aimed to assess data from patients with MRSA-IE across multiple facilities in Japan, with a specific focus on antimicrobial therapy and prognosis. METHODS This retrospective study enrolled patients with a confirmed diagnosis of IE attributed to MRSA, spanning the period from January 2015 to April 2019. RESULTS Sixty-four patients from 19 centers were included, with a median age of 67 years. The overall mortality rate was 28.1% at 30 days, with an in-hospital mortality of 45.3%. The most frequently chosen initial anti-MRSA agents were glycopeptide in 67.2% of cases. Daptomycin and linezolid were selected as initial therapy in 23.4% and 17.2% of cases, respectively. Approximately 40% of all patients underwent medication changes due to difficulty in controlling infection or drug-related side effects. Significant prognostic factors by multivariable analysis were DIC for 30-day mortality and surgical treatment for 30-day and in-hospital mortality. For vancomycin as initial monotherapy, there was a trend toward a worse prognosis for 30-day and in-hospital mortality (OR, 6.29; 95%CI, 1.00-39.65; p = 0.050, OR, 3.61; 95%CI, 0.93-14.00; p = 0.064). Regarding the choice of initial antibiotic therapy, statistical analysis did not show significant differences in prognosis. CONCLUSION Glycopeptide and daptomycin were the preferred antibiotics for the initial therapy of MRSA-IE. Antimicrobial regimens were changed for various reasons. Prognosis was not significantly affected by choice of antibiotic therapy (glycopeptide, daptomycin, linezolid), but further studies are needed to determine which antimicrobials are optimal as first-line agents.
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Affiliation(s)
- Kotaro Mitsutake
- Department of Infectious Diseases and Infection Control, Saitama International Medical Center, Saitama Medical University, 397-1, Hidaka, Saitama, 350-1298, Japan.
| | - Natsuki Shinya
- Department of Infectious Diseases and Infection Control, Saitama International Medical Center, Saitama Medical University, 397-1, Hidaka, Saitama, 350-1298, Japan
| | - Masafumi Seki
- Department of Infectious Diseases and Infection Control, Saitama International Medical Center, Saitama Medical University, 397-1, Hidaka, Saitama, 350-1298, Japan; Department of Infectious Diseases, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan
| | - Takahiro Ohara
- Division of Geriatric and Community Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan
| | - Kohei Uemura
- Department of Biostatistics and Bioinformatics, Interfaculty Initiative in Information Studies, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan
| | - Masato Fukunaga
- Department of Cardiology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita, Kitakyushu, Fukuoka, 802-8555, Japan
| | - Jun Sakai
- Department of Infectious Disease and Infection Control, Saitama Medical University Hospital, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Miki Nagao
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto City, Kyoto, 606-8507, Japan
| | - Makoto Sata
- National Cerebral and Cardiovascular Center Division of Pulmonology and Infection Control, 6-1, Kishibe Shinmachi, Suita, Osaka, 564-8565, Japan
| | - Yohei Hamada
- Department of Infectious Disease and Hospital Epidemiology, Saga University Hospital, 5-1-1 Nabeshima, Saga, 849-0937, Japan
| | - Hitoshi Kawasuji
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Masashi Nakamatsu
- Department of Infection Control, University of the Ryukyus Hospital, 207 Aza-Uehara, Nishihara, Nakagami-gun, Okinawa, 903-0215, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Iwasaku, Ganmata, Nagakute, Aichi, 480-1195, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Iwasaku, Ganmata, Nagakute, Aichi, 480-1195, Japan
| | - Akira Ukimura
- Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, 2-7 Daigaku-cho, Takatsuki, Osaka, 569-0801, Japan
| | - Tetsuji Aoyagi
- Department of Clinical Microbiology and Infection, Tohoku University Graduate School of Medicine, Department of Comprehensive Infectious Diseases, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Toyomitsu Sawai
- Nagasaki Harbor Medical Center, Department of Respiratory Medicine, 6-39 Shinchi-cho, Nagasaki City, Nagasaki, 850-0842, Japan
| | - Takeshi Tanaka
- Infection Control and Education Center, Nagasaki University Hospital, 1 Chome-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Koichi Izumikawa
- Infection Control and Education Center, Nagasaki University Hospital, 1 Chome-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Yoko Takayama
- Department of Infection Control and Infectious Diseases Research and Development Center for New Medical Frontiers Kitasato University School of Medicine, 1-15-1, Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Kiwamu Nakamura
- Department of Infection Control, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima, 960-1295, Japan
| | - Keiji Kanemitsu
- Department of Infection Control, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima, 960-1295, Japan
| | - Issei Tokimatsu
- Department of Medicine, Division of Clinical Infectious Diseases, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Kazuhiko Nakajima
- Department of Infection Prevention and Control, Hyogo Medical University, 1-1, Mukogawa, Nishinomiya, Hyogo, 663-850, Japan
| | - Dai Akine
- Division of Clinical Infectious Diseases, School of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
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Li X, Li D, Han D. Rapid diagnosis of Aspergillus fumigatus endocarditis using mNGS assay: A case report and review of the literature. Diagn Microbiol Infect Dis 2024; 108:116171. [PMID: 38176300 DOI: 10.1016/j.diagmicrobio.2023.116171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/22/2023] [Accepted: 12/31/2023] [Indexed: 01/06/2024]
Abstract
Fungal endocarditis is caused mainly by Candida albicans and Aspergillus spp. and was first reported in the 1950s. Natural-valve endocarditis caused by Aspergillus is relatively uncommon. In this case, a 56-year-old male patient was admitted to the hospital on account of a cough accompanied by chills and fever and ineffective self-medication. Infective endocarditis was initially suspected based on echocardiography (indicating right atrial growth) and clinical manifestations. However, routine pathogen detections were always negative. The patient's condition was identified as Aspergillus fumigatus endocarditis (AFE) and was treated with targeted therapy, considering the detection of significant AFE sequences in the blood through metagenomic next-generation sequencing (mNGS). On this basis, the paper further summarizes the clinical manifestations, diagnosis, treatments, and outcomes of AFE endocarditis cases reported in recent years, aiming to provide a reference to better understand this rare infective disease and guide medical practitioners in choosing the right diagnostic and therapeutic strategy.
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Affiliation(s)
- Xiaowei Li
- Department of Laboratory Medicine, Changzhi People's Hospital, the Affiliated Hospital of Shanxi Medical University, China
| | - Dandan Li
- Department of Laboratory Medicine, Changzhi People's Hospital, the Affiliated Hospital of Shanxi Medical University, China
| | - Dongsheng Han
- Department of Laboratory Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, China; Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, China; Institute of Laboratory Medicine, Zhejiang University, China.
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7
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Tanabe J, Wada H, Suehiro S, Yoshitomi H, Endo A, Yamazaki K, Tanabe K. A case of prosthetic valve endocarditis with increased vegetation size despite appropriate antibiotic therapy. J Echocardiogr 2024:10.1007/s12574-024-00645-z. [PMID: 38418698 DOI: 10.1007/s12574-024-00645-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 03/02/2024]
Affiliation(s)
- Junya Tanabe
- Division of Cardiology, Faculty of Medicine, Shimane University, 89-1 Enya-Cho, Izumo, Japan.
| | - Hiromi Wada
- Department of Cardiovascular Surgery, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Shoichi Suehiro
- Department of Cardiovascular Surgery, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Hiroyuki Yoshitomi
- Division of Cardiology, Faculty of Medicine, Shimane University, 89-1 Enya-Cho, Izumo, Japan
| | - Akihiro Endo
- Division of Cardiology, Faculty of Medicine, Shimane University, 89-1 Enya-Cho, Izumo, Japan
| | - Kazuhiro Yamazaki
- Department of Cardiovascular Surgery, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Kazuaki Tanabe
- Division of Cardiology, Faculty of Medicine, Shimane University, 89-1 Enya-Cho, Izumo, Japan
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Takahashi G, Watanabe T, Satoh T. Infective Endocarditis Caused by Streptococcus sanguinis Resulting in Stroke, Ruptured Infected Pseudoaneurysm of Superior Mesenteric Artery, and Rapidly Progressive Glomerulonephritis. Intern Med 2024; 63:413-417. [PMID: 37344426 PMCID: PMC10901719 DOI: 10.2169/internalmedicine.2017-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/11/2023] [Indexed: 06/23/2023] Open
Abstract
A 71-year-old-man was admitted to our hospital with a cerebral embolism and diagnosed with infective endocarditis (IE) caused by Streptococcus sanguinis. Mitral valve replacement was performed. About one month later, he experienced sudden abdominal pain and shock due to a ruptured infected mesenteric artery pseudoaneurysm. Forty-four days after abdominal surgery, he presented with rapidly progressive glomerulonephritis with anti-glomerular basement membrane antibodies. He was treated with plasma exchange and prednisolone, and his renal function gradually improved. Since postoperative complications often occur within a few years after surgery for IE, careful follow-up is important, even after antimicrobial therapy and valve surgery.
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Affiliation(s)
- Go Takahashi
- Division of Internal Medicine, Health Co-op. Watari Hospital, Japan
| | - Tomoyuki Watanabe
- Division of Cardiology and Internal Medicine, Health Co-op. Watari Hospital, Japan
| | - Takeshi Satoh
- Division of Rehabilitation, Internal Medicine, Health Co-op. Watari Hospital, Japan
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9
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Ueda K, Inokoshi M, Kubota K, Yamaga E, Minakuchi S. Factors influencing postoperative bleeding after dental extraction in older adult patients receiving anticoagulation therapy. Clin Oral Investig 2023; 28:22. [PMID: 38147161 DOI: 10.1007/s00784-023-05424-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/21/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVES To investigate factors influencing postoperative bleeding occurrence after dental extraction in older patients receiving anticoagulation therapy. MATERIALS AND METHODS This retrospective study included patients aged ≥ 65 years receiving one of the following anticoagulants: apixaban, edoxaban, rivaroxaban, and warfarin. Patients who underwent one to multiple tooth extractions in the geriatric dentistry clinic at Tokyo Medical and Dental University Hospital between August 1, 2016, and November 30, 2020, were included. The outcome variable was postoperative bleeding occurrence. Logistic regression analysis was performed with the following ten factors as explanatory variables: age, sex, maximum systolic blood pressure during the extraction, type of local anesthesia, vertical incision, osteotomy, usage of surgical splints, the mesiodistal width of the extracted tooth on a radiograph, use of antiplatelet agents, and history of diabetes requiring medication. RESULTS Among 395 participants (mean age, 82.3 ± 6.5 years) included in this study, 75 patients experienced postoperative bleeding after tooth extraction. Logistic regression analysis revealed that the odds ratios for the vertical incision (18.400, p < 0.001), osteotomy (3.630, p = 0.00558), usage of surgical splints (1.860, p = 0.0395), and the mesiodistal width of the extracted tooth on a radiograph (1.060, p = 0.0261) were statistically significant. CONCLUSIONS For dental extraction in older patients receiving anticoagulants, postoperative bleeding is more likely to occur in patients with vertical incision, osteotomy, and posterior or multiple tooth extractions. CLINICAL RELEVANCE Dentists should consider suturing and adjunctive hemostatic procedures for patients undergoing vertical incision, osteotomy, and multiple tooth extractions while receiving anticoagulation therapy to minimize the risk of postoperative bleeding.
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Affiliation(s)
- Kaori Ueda
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8549, Japan
| | - Masanao Inokoshi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8549, Japan.
| | - Kazumasa Kubota
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8549, Japan
- Kubota Dental Clinic, 1-16-2 Iguchi, Mitaka, Tokyo, 181-0011, Japan
| | - Eijiro Yamaga
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8549, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8549, Japan
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10
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Nakata K, Moriyama S, Takaki J, Takeo M, Doi H, Matsumura T, Fukui T. Pseudoaneurysm of mitral-aortic intervalvular fibrosa with rupture: a case report. Surg Case Rep 2023; 9:210. [PMID: 38044395 PMCID: PMC10694109 DOI: 10.1186/s40792-023-01789-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/26/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Mitral-aortic intervalvular fibrosa (MAIVF) is a fibrous region connecting the anterior mitral leaflet (AML) and aortic valve. Pseudoaneurysm of the MAIVF is a rare condition that has been reported as a sequela of infective endocarditis (IE) and surgical trauma. Here, we report a case of a ruptured pseudoaneurysm of the MAIVF, along with some literature reviews. CASE PRESENTATION A 65-year-old man diagnosed with moderate aortic regurgitation five years previously had a fever of unknown origin. He suddenly developed headache and apraxia and was transported to our hospital. He was diagnosed with intracranial hemorrhage and admitted. One week after admission, echocardiography revealed aorto-mitral discontinuity and protrusion with severe regurgitant flow from left ventricular outflow tract to the left atrium. The AML was suspected to have ruptured. However, intraoperatively, the AML structure was preserved. A ruptured pseudoaneurysm of the MAIVF was also observed. Therefore, we successfully performed pseudoaneurysm repair using a bovine pericardial patch, aortic valve replacement, and mitral annuloplasty. CONCLUSIONS P-MAIVF is a rare but potentially life-threatening complication of IE, for which timely diagnosis and prompt appropriate therapeutic intervention are required. In the present case, although neither obvious active IE nor history of previous IE could be identified, healed IE was considered based on the clinical course. The patient had intracranial hemorrhage (ICH) with well-controlled heart failure and underwent elective surgical repair more than one month after the onset of ICH, while the clinical course after the surgical procedure was uneventful.
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Affiliation(s)
- Kosuke Nakata
- Department of Cardiovascular Surgery, Kumamoto Rosai Hospital, 1670 Takehara-Machi, Yatsushiro, Kumamoto, 866-8533, Japan.
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan.
| | - Shuji Moriyama
- Department of Cardiovascular Surgery, Kumamoto Rosai Hospital, 1670 Takehara-Machi, Yatsushiro, Kumamoto, 866-8533, Japan
| | - Jun Takaki
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Masahiro Takeo
- Department of Cardiology, Kumamoto Rosai Hospital, Yatsushiro, Kumamoto, Japan
| | - Hideki Doi
- Department of Cardiology, Kumamoto Rosai Hospital, Yatsushiro, Kumamoto, Japan
| | - Toshiyuki Matsumura
- Department of Cardiology, Kumamoto Rosai Hospital, Yatsushiro, Kumamoto, Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
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11
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Tamura Y, Abe T. Infective endocarditis associated with atopic dermatitis. Clin Case Rep 2023; 11:e8321. [PMID: 38130851 PMCID: PMC10733789 DOI: 10.1002/ccr3.8321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/15/2023] [Accepted: 11/26/2023] [Indexed: 12/23/2023] Open
Abstract
Infective endocarditis caused by atopic dermatitis is common in young patients and has a high potential for causing embolism. Because of the high risk of mediastinitis postoperatively, minimally invasive cardiac surgery could be effective.
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Affiliation(s)
- Yamato Tamura
- Department of Cardiovascular SurgeryNara Prefectural Seiwa Medical CenterNaraJapan
| | - Takehisa Abe
- Department of Cardiovascular SurgeryNara Prefectural Seiwa Medical CenterNaraJapan
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12
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Kunming P, Ying H, Chenqi X, Zhangzhang C, Xiaoqiang D, Xiaoyu L, Xialian X, Qianzhou L. Vancomycin associated acute kidney injury in patients with infectious endocarditis: a large retrospective cohort study. Front Pharmacol 2023; 14:1260802. [PMID: 38026976 PMCID: PMC10679345 DOI: 10.3389/fphar.2023.1260802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Abstract
Background: Vancomycin remains the cornerstone antibiotic for the treatment of infective endocarditis (IE). Vancomycin has been associated with significant nephrotoxicity. However, vancomycin associated acute kidney injury (AKI) has not been evaluated in patients with IE. We conducted this large retrospective cohort study to reveal the incidence, risk factors, and prognosis of vancomycin-associated acute kidney injury (VA-AKI) in patients with IE. Methods: Adult patients diagnosed with IE and receiving vancomycin were included. The primary outcome was VA-AKI. Results: In total, 435 of the 600 patients were enrolled. Of these, 73.6% were male, and the median age was 52 years. The incidence of VA-AKI was 17.01% (74). Only 37.2% (162) of the patients received therapeutic monitoring of vancomycin, and 30 (18.5%) patients had reached the target vancomycin trough concentration. Multiple logistic regression analysis revealed that body mass index [odds ratio (OR) 1.088, 95% CI 1.004, 1.179], duration of vancomycin therapy (OR 1.030, 95% CI 1.003, 1.058), preexisting chronic kidney disease (OR 2.291, 95% CI 1.018, 5.516), admission to the intensive care unit (OR 2.291, 95% CI 1.289, 3.963) and concomitant radiocontrast agents (OR 2.085, 95% CI 1.093, 3.978) were independent risk factors for VA-AKI. Vancomycin variety (Lai Kexin vs. Wen Kexin, OR 0.498, 95% CI 0.281, 0.885) were determined to be an independent protective factor for VI-AKI. Receiver operator characteristic curve analysis revealed that duration of therapy longer than 10.75 days was associated with a significantly increased risk of VA-AKI (HR 1.927). Kidney function was fully or partially recovered in 73.0% (54) of patients with VA-AKI. Conclusion: The incidence of VA-AKI in patients with IE was slightly higher than in general adult patients. Concomitant contrast agents were the most alarmingly nephrotoxic in patients with IE, adding a 2-fold risk of VA-AKI. In patients with IE, a course of vancomycin therapy longer than 10.75 days was associated with a significantly increased risk of AKI. Thus, closer monitoring of kidney function and vancomycin trough concentrations was recommended in patients with concurrent contrast or courses of vancomycin longer than 10.75 days.
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Affiliation(s)
- Pan Kunming
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Huang Ying
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai Medical Center of Kidney Disease, Institute of Kidney Disease and Dialysis, Shanghai, China
- Department of Nephrology, Zhongshan Hospital, Fudan University, Xiamen, China
| | - Xu Chenqi
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai Medical Center of Kidney Disease, Institute of Kidney Disease and Dialysis, Shanghai, China
| | - Chen Zhangzhang
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ding Xiaoqiang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai Medical Center of Kidney Disease, Institute of Kidney Disease and Dialysis, Shanghai, China
| | - Li Xiaoyu
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xu Xialian
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai Medical Center of Kidney Disease, Institute of Kidney Disease and Dialysis, Shanghai, China
| | - Lv Qianzhou
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, China
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13
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Shirakawa M, Fujii M, Onoda S, Yamashita H, Kawase Y, Bessho R. Successful surgical experience for acute severe aortic valve regurgitation with acquired Gerbode defect: A case report. Int J Surg Case Rep 2023; 112:108988. [PMID: 37898007 PMCID: PMC10667874 DOI: 10.1016/j.ijscr.2023.108988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 10/18/2023] [Accepted: 10/21/2023] [Indexed: 10/30/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE The incidence of acquired Gerbode defect has been increasing due to advances in cardiac imaging technology, and some closure methods have been introduced. PRESENTATION OF CASE A 58-year-old man developed cardiogenic shock due to acute severe aortic valve regurgitation with an acquired Gerbode defect caused by infective endocarditis. Emergency surgery was performed. A large patch with a 0.4 mm extended-polytetrafluoroethylene (e-PTFE) sheet covered with autologous pericardium was used to close the Gerbode defect, and a bioprosthetic valve was used for aortic valve replacement. CLINICAL DISCUSSION Large patch closure with 0.4 mm e-PTFE sheet and autologous pericardium for fragile Gerbode defect caused by infective endocarditis might be effective with regard to sturdiness, good fitting to the tissue, and excellent resistance to bacteria. CONCLUSION We encountered a rare case of cardiogenic shock due to acute severe aortic valve regurgitation and acquired Gerbode defect caused by infective endocarditis. In our case, large-patch closure for perforation in a fragile membranous septum was effective.
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Affiliation(s)
- Makoto Shirakawa
- Cardiovascular Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, Japan; Cardiovascular Surgery, Hanyu General Hospital, 446 Shimoiwase, Hanyu-city, Saitama 348-8505, Japan.
| | - Masahiro Fujii
- Cardiovascular Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, Japan
| | - Sho Onoda
- Cardiovascular Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, Japan
| | - Hiromasa Yamashita
- Cardiovascular Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, Japan
| | - Yasuhiro Kawase
- Cardiovascular Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, Japan
| | - Ryuzo Bessho
- Cardiovascular Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, Japan
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14
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Ichinose M, Ogiwara M, Ozaki M, Nishino Y, Tanaka K. Cardiac surgery for a right atrial myxoma with traumatic intracranial hemorrhage: a case report. J Cardiothorac Surg 2023; 18:295. [PMID: 37848921 PMCID: PMC10580516 DOI: 10.1186/s13019-023-02402-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/30/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND The timing of cardiac surgery with cardiopulmonary bypass (CPB) for intracranial hemorrhage is controversial. CASE PRESENTATION We report the case of an 82-year-old woman who was transferred to our hospital because of a head injury. Brain computed tomography (CT) revealed traumatic intracranial hemorrhage, and transthoracic echocardiography revealed a giant right atrial myxoma. After confirming the disappearance of intracranial hemorrhage on brain CT, cardiac surgery with CPB was performed, which was uneventful. CONCLUSIONS For an uneventful surgery, the optimal timing of cardiac surgery with CPB in patients with giant right atrial myxoma and intracranial hemorrhage should be based on brain CT.
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Affiliation(s)
- Maki Ichinose
- Department of Anesthesiology, Showa General Hospital, Tokyo, Japan.
| | - Masanori Ogiwara
- Division of Cardiovascular Surgery, Showa General Hospital, Tokyo, Japan
| | - Masahiko Ozaki
- Division of Cardiovascular Surgery, Showa General Hospital, Tokyo, Japan
| | - Yoshifumi Nishino
- Division of Cardiovascular Surgery, Showa General Hospital, Tokyo, Japan
| | - Kensuke Tanaka
- Department of Anesthesiology, Showa General Hospital, Tokyo, Japan
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15
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Said J, Budny B, Sappington A, Caza T, Rifai AO, Rifai S, Denig KM. Glomerulonephritis Associated With Infected Cardiac Pacemaker Lead Mimics Infective Endocarditis-Associated Glomerulonephritis With Resolution After Lead Removal: A Case Report and Literature Review. Cureus 2023; 15:e46471. [PMID: 37927672 PMCID: PMC10624229 DOI: 10.7759/cureus.46471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
The incidence of cardiac pacemaker lead infections is increasing due to the rise in cardiac implantable device use. These infections mimic infective endocarditis (IE) and cause a variety of complications. However, there is a scarcity of knowledge regarding glomerulonephritis (GN) resulting from cardiac pacemaker-lead infections. This report describes a 71-year-old female who presented with GN associated with a cardiac pacemaker-lead infection. The patient was successfully treated with intravenous (IV) antibiotics, IV steroids, and early surgical removal of the cardiac pacemaker lead, resulting in the resolution of GN. Current guidelines do not address cardiac pacemaker lead infection-associated GN as an indication for lead removal. Given the success of our treatment approach and the rising incidence of cardiac pacemaker infections, we suggest the consideration of early surgical removal of the cardiac lead, in conjunction with antibiotics and steroids, for the treatment of cardiac lead infection associated with GN. Further research is necessary to determine the prevalence and optimal management of this complication.
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Affiliation(s)
- Jaime Said
- Medicine, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Bridget Budny
- Medicine, Alabama College of Osteopathic Medicine, Dothan, USA
| | | | - Tiffany Caza
- Nephropathology, Arkana Laboratories, Little Rock, USA
| | - Ahmad O Rifai
- Nephrology, The Virtual Nephrologist, Inc., Lynn Haven, USA
| | - Sarah Rifai
- Medicine, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Kristin M Denig
- Nephrology, The Virtual Nephrologist, Inc., Panama City, USA
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16
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Takei Y, Suzuki R, Shibasaki I, Tokura M, Nasuno T, Yazawa H, Wada M, Saito F, Toyoda S, Fukuda H. Transcatheter aortic valve-in-surgical aortic valve for a patient with repeated healed endocarditis: a case report. Surg Case Rep 2023; 9:155. [PMID: 37665417 PMCID: PMC10477146 DOI: 10.1186/s40792-023-01739-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/27/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Transcatheter valve replacement is contraindicated in patients with active infective endocarditis. However, few reports suggest that it could be beneficial for high-risk surgical patients with healed infective endocarditis. Here, we report a case of a surgical transcatheter aortic valve in a patient with healed repeated prosthetic valve endocarditis using a stentless valve. CASE PRESENTATION A 79-year-old female who underwent the Bentall procedure using a stentless valve and coronary artery bypass grafting for annuloaortic ectasia 22 years ago was hospitalized for stage II bioprosthetic valve failure. The patient had a history of prosthetic valve endocarditis three times: the first and second prosthetic valve endocarditis occurred 15 years ago, and the third prosthetic valve endocarditis occurred 3 years ago. The causative organisms were Campylobacter fetus and Enterococcus faecalis. With appropriate antibiotic therapy, the lesion was localized and healed completely without valve destruction; however, the patient developed rapid aortic regurgitation. Based on a review of the patient's history of prosthetic valve endocarditis, the absence of signs of infection, and clinical findings of transesophageal echocardiography and computed tomography, a diagnosis of structural valve deterioration with healed infective endocarditis was made. Subsequently, a transcatheter aortic valve in a surgical aortic valve using a balloon-expandable type was performed, because the patient had a high surgical risk of 12.7%. The patient's postoperative course was uneventful. At the 1-year follow-up, there were no signs of infection or valve abnormalities. CONCLUSIONS Transcatheter valve replacement can be a treatment option for high-risk surgical patients with healed limited lesions in infective endocarditis.
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Affiliation(s)
- Yusuke Takei
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan.
| | - Ryujiro Suzuki
- Department of Cardiovascular Medicine, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Ikuko Shibasaki
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Michiaki Tokura
- Department of Cardiovascular Medicine, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Takahisa Nasuno
- Department of Cardiovascular Medicine, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Hiroko Yazawa
- Department of Cardiovascular Medicine, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Mayo Wada
- Department of Cardiovascular Medicine, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Fumiya Saito
- Department of Cardiovascular Medicine, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
| | - Hirotugu Fukuda
- Department of Cardiac and Vascular Surgery, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan
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17
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Sakuma Y, Ogawa M, Nakagawa C, Momota K, Kaji E, Matsumura K, Morinaga S, Nogami K, Ikeda M. Dental Treatment Under General Anesthesia With Nasal Intubation in a Patient With Selective Immunoglobulin A Deficiency. Anesth Prog 2023; 70:140-141. [PMID: 37850675 PMCID: PMC11080969 DOI: 10.2344/anpr-70-02-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/14/2021] [Indexed: 10/19/2023] Open
Abstract
Immunoglobulin A (IgA) deficiency is one of the most common immune disorders characterized by increased susceptibility to infections, especially involving the respiratory tract and mucosal surfaces of the mouth, gingiva, and nasal sinus. Because dental surgery and general anesthesia may pose an increased risk for systemic infections, management of IgA-deficient patients requires caution during dental procedures and intubated general anesthesia. We report a 5-year-old female patient with IgA deficiency who underwent extraction of 18 deciduous teeth under general anesthesia. Antibiotic prophylaxis and antiseptic mouthwash were used perioperatively to reduce bacteremia risks. Nasotracheal intubation was carefully performed after applying topical disinfectants and epinephrine-containing gauze packing into the nasal cavity to minimize trauma. The patient was carefully monitored overnight in the hospital and discharged without any signs or symptoms of infection the next day. Dental anesthesia providers must be aware of the potential implications for safe practice when managing patients with IgA deficiency.
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Affiliation(s)
- Yuho Sakuma
- Section of Anesthesiology, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan
| | - Mika Ogawa
- Section of Anesthesiology, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan
| | - Chie Nakagawa
- Section of Anesthesiology, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan
| | - Kodai Momota
- Section of Anesthesiology, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan
| | - Emi Kaji
- Section of Anesthesiology, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan
| | - Kingo Matsumura
- Section of Anesthesiology, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan
| | - Saori Morinaga
- Section of Anesthesiology, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan
| | - Kentaro Nogami
- Section of Anesthesiology, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan
| | - Mizuko Ikeda
- Section of Anesthesiology, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan
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18
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Alsaeed A, Alhaddad MJ, AlKhalaf AA, Alkhudair A, Alqannas N. Successful Treatment of Infective Endocarditis With Oral Antibiotics: A Case Report. Cureus 2023; 15:e43514. [PMID: 37719561 PMCID: PMC10500962 DOI: 10.7759/cureus.43514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Infective endocarditis (IE) is a serious and potentially life-threatening infection of the heart valves. It is commonly treated with prolonged courses of intravenous antibiotics, and in some cases, surgical intervention may also be necessary. While the use of oral antibiotics in the treatment of IE is generally limited, there are select cases where they may be considered as an alternative treatment option. Here, we report a case of staphylococcal right-sided IE successfully treated with oral antibiotics (linezolid and rifampicin). Our case highlights the potential for oral antibiotics to be used as step-down therapy for select patients with IE.
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Affiliation(s)
- Ali Alsaeed
- Infectious Disease, Dammam Medical Complex, Dammam, SAU
| | | | | | - Ashraf Alkhudair
- Saud Albabtain Cardiac Center, Dammam Medical Complex, Dammam, SAU
| | - Naif Alqannas
- Saud Albabtain Cardiac Center, Dammam Medical Complex, Dammam, SAU
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19
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Kuwauchi S, Hosono M, Uetsuki T, Kawazoe K. A surgical case of infected cardiac myxoma. SAGE Open Med Case Rep 2023; 11:2050313X221144514. [PMID: 37228570 PMCID: PMC10204046 DOI: 10.1177/2050313x221144514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/22/2022] [Indexed: 05/27/2023] Open
Abstract
A 60-year-old woman presented with a fever of unknown origin. Echocardiography revealed a large left atrial tumor protruding into the left ventricle during diastole. Laboratory investigation showed an elevated white blood cell count, C-reactive protein concentration, and interleukin-6 concentration. Magnetic resonance imaging showed hyperacute microinfarcts and multiple old lacunar infarcts. Surgery was performed under suspicion of cardiac myxoma. A dark red jelly-like tumor with an irregular surface was removed. Histopathological examination revealed cardiac myxoma, the surface of which was covered with fibrin and bacterial masses. Preoperative blood culture was positive for Streptococcus vestibularis. These findings were compatible with a diagnosis of infected cardiac myxoma. We used an antibiotic therapeutic regimen for infective endocarditis, and the patient was discharged home on postoperative day 31. Prompt diagnosis and treatment, including effective and efficient antibiotic therapy and complete tumor resection, increased the chance of a better outcome in patients with infected cardiac myxoma.
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Affiliation(s)
- Shintaro Kuwauchi
- Shintaro Kuwauchi, Department of Cardiovascular
Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka 573-1010, Japan.
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20
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Kim Y, Ishikawa K, Kawai F, Mori N. First case report of splenomegaly with splenic infarction due to aortic graft infection. BMC Cardiovasc Disord 2023; 23:237. [PMID: 37147614 PMCID: PMC10161471 DOI: 10.1186/s12872-023-03259-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 04/24/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Diagnosis of aortic graft infections (AGI) is challenging. Here, we report a case of AGI with splenomegaly and splenic infarction. CASE PRESENTATION A 46-year-old man who underwent total arch replacement for Stanford type A acute aortic dissection one year prior presented to our department with fever, night sweat, and a 20-kg weight loss over several months. Contrast-enhanced computed tomography (CT) revealed splenic infarction with splenomegaly, fluid collection, and thrombus around the stent graft. Positron emission tomography-CT (PET-CT) revealed abnormal 18F-fluorodeoxyglucose uptake in the stent graft and spleen. Transesophageal echocardiography revealed no vegetations. The patient was diagnosed with an AGI and underwent graft replacement. Blood and tissue cultures in the stent graft yielded Enterococcus faecalis. After the surgery, the patient was successfully treated with antibiotics. CONCLUSIONS Splenic infarction and splenomegaly are the clinical findings of endocarditis but are rare in graft infection. These findings could be helpful to diagnose graft infections, which is often challenging.
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Affiliation(s)
- Yuntae Kim
- Department of Infectious Diseases, St. Luke's International Hospital, 9-1, Akashi-Cho, Chuo-Ku, Tokyo, Japan.
| | - Kazuhiro Ishikawa
- Department of Infectious Diseases, St. Luke's International Hospital, 9-1, Akashi-Cho, Chuo-Ku, Tokyo, Japan
| | - Fujimi Kawai
- Library, Center for Academic Resources, St. Luke's International University, Chuo-Ku, Tokyo, Japan
| | - Nobuyoshi Mori
- Department of Infectious Diseases, St. Luke's International Hospital, 9-1, Akashi-Cho, Chuo-Ku, Tokyo, Japan
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21
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Sharma M, Davis AP. Adding Fuel to the Fire: Infective Endocarditis and the Challenge of Cerebrovascular Complications. Curr Cardiol Rep 2023; 25:349-356. [PMID: 36971959 DOI: 10.1007/s11886-023-01856-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/09/2023] [Indexed: 05/16/2023]
Abstract
PURPOSE OF REVIEW Infective endocarditis is a deadly disease and made more deadly by neurologic complications. We review the cerebrovascular complications of infective endocarditis and focus our discussion on medical and surgical management. RECENT FINDINGS While management of stroke in the setting of infective endocarditis differs from standard stroke treatment, mechanical thrombectomy has proven safe and successful. Optimal timing of cardiac surgery in the setting of stroke remains an area of debate, but additional observational studies continue to add more detail to the discussion. Cerebrovascular complications in the setting of infective endocarditis remain a high stakes clinical challenge. Timing of cardiac surgery in IE complicated by stroke exemplifies these dilemmas. While more studies have suggested that earlier cardiac surgery is likely safe for those with small ischemic infarcts, there remains a need for more data defining optimal timing of surgery in all forms of cerebrovascular involvement.
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Affiliation(s)
- Malveeka Sharma
- Department of Neurology, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Box 359775, Seattle, WA, 98104-2420, USA
| | - Arielle P Davis
- Department of Neurology, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Box 359775, Seattle, WA, 98104-2420, USA.
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Yoshihara S. Evaluation of causal heart diseases in cardioembolic stroke by cardiac computed tomography. World J Radiol 2023; 15:98-117. [PMID: 37181820 PMCID: PMC10167814 DOI: 10.4329/wjr.v15.i4.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/08/2023] [Accepted: 03/30/2023] [Indexed: 04/26/2023] Open
Abstract
Cardioembolic stroke is a potentially devastating condition and tends to have a poor prognosis compared with other ischemic stroke subtypes. Therefore, it is important for proper therapeutic management to identify a cardiac source of embolism in stroke patients. Cardiac computed tomography (CCT) can detect the detailed visualization of various cardiac pathologies in the cardiac chambers, interatrial and interventricular septum, valves, and myocardium with few motion artifacts and few dead angles. Multiphase reconstruction images of the entire cardiac cycle make it possible to demonstrate cardiac structures in a dynamic manner. Consequently, CCT has the ability to provide high-quality information about causal heart disease in cardioembolic stroke. In addition, CCT can simultaneously evaluate obstructive coronary artery disease, which may be helpful in surgical planning in patients who need urgent surgery, such as cardiac tumors or infective endocarditis. This review will introduce the potential clinical applications of CCT in an ischemic stroke population, with a focus on diagnosing cardioembolic sources using CCT.
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Affiliation(s)
- Shu Yoshihara
- Department of Diagnostic Radiology, Iwata City Hospital, Iwata 438-8550, Shizuoka, Japan
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23
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Jain A, Subramani S, Gebhardt B, Hauser J, Bailey C, Ramakrishna H. Infective Endocarditis-Update for the Perioperative Clinician. J Cardiothorac Vasc Anesth 2023; 37:637-649. [PMID: 36725476 DOI: 10.1053/j.jvca.2022.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 12/28/2022] [Indexed: 01/07/2023]
Abstract
Infective endocarditis is a common pathology routinely encountered by perioperative physicians. There has been a need for a comprehensive review of this important topic. In this expert review, the authors discuss in detail the incidence, etiology, definition, microbiology, and trends of infective endocarditis. The authors discuss the clinical and imaging criteria for diagnosing infective endocarditis and the perioperative considerations for the same. Other imaging modalities to evaluate infective endocarditis also are discussed. Furthermore, the authors describe in detail the clinical risk scores that are used for determining clinical prognostic criteria and how they are tied to the current societal guidelines. Knowledge about native and prosthetic valve endocarditis, with emphasis on the timing of surgical intervention-focused surgical approaches and analysis of current outcomes, are critical to managing such patients, especially high-risk patients like those with heart failure, patients with intravenous drug abuse, and with internal pacemakers and defibrillators in situ. And lastly, with the advancement of percutaneous transcatheter valves becoming a norm for the management of various valvular pathologies, the authors discuss an in-depth review of transcatheter valve endocarditis with a focus on its incidence, the timing of surgical interventions, outcome data, and management of high-risk patients.
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Affiliation(s)
- Ankit Jain
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia & Augusta University, Augusta, GA
| | - Sudhakar Subramani
- Department of Anesthesiology and Perioperative Medicine, University of Iowa, Iowa City, IA
| | - Brian Gebhardt
- Department of Anesthesiology and Perioperative Medicine, University of Massachusetts Memorial Medical Center, MA
| | - Joshua Hauser
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Caryl Bailey
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia & Augusta University, Augusta, GA
| | - Harish Ramakrishna
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
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24
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A case of infective endocarditis caused by Kocuria rosea in a non-compromised patient. J Cardiol Cases 2023; 27:89-92. [PMID: 36910031 PMCID: PMC9995668 DOI: 10.1016/j.jccase.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 10/02/2022] [Accepted: 10/18/2022] [Indexed: 11/18/2022] Open
Abstract
A 79-year-old male with no history of immunodeficiency was transferred to our hospital complaining of shortness of breath and general fatigue. He was diagnosed with recent myocardial infarction and underwent emergent percutaneous coronary intervention. However, the course of congestive heart failure was poor, and he required respiratory support and renal replacement therapy. Kocuria rosea was detected in blood culture obtained on admission, and then a follow-up echocardiogram revealed infective endocarditis. We administered ampicillin-sulbactam and performed urgent operation. The post-operative course was uneventful with 4-week administration of antimicrobial agents. Learning objectives Infective endocarditis caused by Kocuria rosea may also occur in non-compromised patients although K. rosea infections have been reported only in compromised hosts. This pathogen is sensitive to a variety of antibiotics. We selected ampicillin-sulbactam to treat infective endocarditis based on a sensitivity examination, and the patient's post-operative clinical course was uneventful. Ampicillin-sulbactam may be a useful treatment option.
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25
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Infective endocarditis in a cohort of adult CHD patients. Cardiol Young 2023; 33:190-195. [PMID: 35241206 DOI: 10.1017/s1047951122000403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND CHD increases the risk of infective endocarditis due to the substrate of prosthetic materials and residual lesions. However, lesion-specific and mortality risks data are lacking. We sought to analyse clinical course and mortality of infective endocarditis in a cohort of adult CHD. METHODS Retrospective analysis of all cases of proven and probable infective endocarditis (Duke's criteria) followed in our adult CHD clinic between 1970 and August, 2021. Epidemiological, clinical and imaging data were analysed. Predictors of surgical treatment and mortality were assessed using regression analysis. RESULTS During a mean follow-up of 15.8 ± 10.9 years, 96 patients had 105 infective endocarditis episodes, half with previous cardiac surgery (corrective or palliative). The most frequent diagnoses were: ventricular septal defect, bicuspid aortic valve, Tetralogy of Fallot and pulmonary atresia. The site of infection was identified by echocardiography in 82 episodes (91%), most frequently in aortic (n = 27), tricuspid (n = 15), and mitral (n = 13) valves. Blood cultures were positive in 79% of cases, being streptococci (n = 29) and staphylococci (n = 23) the predominant pathogens. Surgery was necessary in 40% and the in-hospital mortality was 10.5%, associated with heart failure (p < 0.001; OR 13.5) and a non-surgical approach (p = 0.003; OR 5.06). CONCLUSIONS In an adult CHD cohort, infective endocarditis was more frequent in patients with ventricular septal defect and bicuspid aortic valves, which contradicts the current guidelines that excludes them from prophylaxis. Surgical treatment is often required and mortality remains substantial. Prevention of this serious complication should be one of the major tasks in the care of adults with CHD.
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26
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Lim S, Yoo YM, Kim KH. No more tears from surgical site infections in interventional pain management. Korean J Pain 2023; 36:11-50. [PMID: 36581597 PMCID: PMC9812697 DOI: 10.3344/kjp.22397] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022] Open
Abstract
As the field of interventional pain management (IPM) grows, the risk of surgical site infections (SSIs) is increasing. SSI is defined as an infection of the incision or organ/space that occurs within one month after operation or three months after implantation. It is also common to find patients with suspected infection in an outpatient clinic. The most frequent IPM procedures are performed in the spine. Even though primary pyogenic spondylodiscitis via hematogenous spread is the most common type among spinal infections, secondary spinal infections from direct inoculation should be monitored after IPM procedures. Various preventive guidelines for SSI have been published. Cefazolin, followed by vancomycin, is the most commonly used surgical antibiotic prophylaxis in IPM. Diagnosis of SSI is confirmed by purulent discharge, isolation of causative organisms, pain/tenderness, swelling, redness, or heat, or diagnosis by a surgeon or attending physician. Inflammatory markers include traditional (C-reactive protein, erythrocyte sedimentation rate, and white blood cell count) and novel (procalcitonin, serum amyloid A, and presepsin) markers. Empirical antibiotic therapy is defined as the initial administration of antibiotics within at least 24 hours prior to the results of blood culture and antibiotic susceptibility testing. Definitive antibiotic therapy is initiated based on the above culture and testing. Combination antibiotic therapy for multidrug-resistant Gram-negative bacteria infections appears to be superior to monotherapy in mortality with the risk of increasing antibiotic resistance rates. The never-ending war between bacterial resistance and new antibiotics is continuing. This article reviews prevention, diagnosis, and treatment of infection in pain medicine.
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Affiliation(s)
- Seungjin Lim
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yeong-Min Yoo
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea
| | - Kyung-Hoon Kim
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea,Correspondence: Kyung-Hoon Kim Pain Clinic, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea, Tel: +82-55-360-1422, Fax: +82-55-360-2149, E-mail:
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27
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Miyawaki N, Okada T, Koyama T, Furukawa Y. Right-sided Infective Endocarditis with Ventricular Free Wall Vegetation Caused by Abiotrophia defectiva in a Patient with Unrepaired Ventricular Septal Defect. Intern Med 2022; 61:3373-3376. [PMID: 35431307 PMCID: PMC9751724 DOI: 10.2169/internalmedicine.9374-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
To our knowledge, there have been no reports of right-sided infective endocarditis (RSIE) with ventricular free wall vegetation caused by Abiotrophia defectiva. We herein report a case of RSIE caused by A. defectiva with ventricular free wall vegetation in a 27-year-old man with ventricular septal defect (VSD). Computed tomography showed multiple bilateral pulmonary nodular shadows. Transesophageal echocardiography (TEE) demonstrated right ventricular free wall vegetation at the jet stream. Blood culture revealed A. defectiva. These findings are consistent with a diagnosis of infective endocarditis and septic pulmonary embolism. Treatment with ceftriaxone and gentamicin and subsequent surgical VSD closure improved the patient's condition without recurrence.
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Affiliation(s)
- Norihisa Miyawaki
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Japan
| | - Taiji Okada
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Japan
| | - Tadaaki Koyama
- Department of Cardiothoracic Surgery, Kobe City Medical Center General Hospital, Japan
| | - Yutaka Furukawa
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Japan
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28
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Matsuzoe H, Sato S, Nishio R, Ozawa M, Matsumoto D, Takaishi H. Right ventricular mural infective endocarditis after traumatic tricuspid valve regurgitation in a 40-year-old man: A case report. J Cardiol Cases 2022; 27:63-66. [PMID: 36788950 PMCID: PMC9911922 DOI: 10.1016/j.jccase.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
As the clinical manifestations of traumatic tricuspid valve regurgitation vary according to the extent of tricuspid valve injury, this condition can often go unnoticed and be incidentally discovered. Here, we report the case of a 40-year-old man with patent foramen ovale, in which severe tricuspid regurgitation due to tricuspid valve prolapse was incidentally discovered following blunt chest trauma. Further examination revealed that the prolapse had also caused active right ventricular mural infective endocarditis. The patient had no relevant past medical history of chronic debilitating disease or immunosuppression. After evaluation by the cardiology team, emergent surgical tricuspid valvular repair was successfully performed. Learning objective Tricuspid valve prolapses resulting from chest trauma may occasionally lead to severe tricuspid regurgitation. Furthermore, this may cause active right ventricular infective endocarditis. In the present case, Staphylococcus aureus was detected in blood cultures, which is usually rapidly progressive and often leads to devastating consequences. Early surgical approach should be considered in cases of infection in the left atrium via patent foramen ovale.
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Affiliation(s)
- Hiroki Matsuzoe
- Department of Cardiovascular Medicine, Yodogawa Christian Hospital, Osaka, Japan,Corresponding author at: Department of Cardiovascular Medicine, Yodogawa Christian Hospital, 1-7-50, Kunijima, Higashiyodogawa-ku, Osaka 533-0024, Japan.
| | - Shunsuke Sato
- Department of Cardiovascular Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - Ryo Nishio
- Department of Cardiovascular Medicine, Yodogawa Christian Hospital, Osaka, Japan
| | - Makito Ozawa
- Department of Cardiovascular Medicine, Yodogawa Christian Hospital, Osaka, Japan
| | - Daisuke Matsumoto
- Department of Cardiovascular Medicine, Yodogawa Christian Hospital, Osaka, Japan
| | - Hiroshi Takaishi
- Department of Cardiovascular Medicine, Yodogawa Christian Hospital, Osaka, Japan
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29
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Ohte N, Ishizu T, Izumi C, Itoh H, Iwanaga S, Okura H, Otsuji Y, Sakata Y, Shibata T, Shinke T, Seo Y, Daimon M, Takeuchi M, Tanabe K, Nakatani S, Nii M, Nishigami K, Hozumi T, Yasukochi S, Yamada H, Yamamoto K, Izumo M, Inoue K, Iwano H, Okada A, Kataoka A, Kaji S, Kusunose K, Goda A, Takeda Y, Tanaka H, Dohi K, Hamaguchi H, Fukuta H, Yamada S, Watanabe N, Akaishi M, Akasaka T, Kimura T, Kosuge M, Masuyama T. JCS 2021 Guideline on the Clinical Application of Echocardiography. Circ J 2022; 86:2045-2119. [DOI: 10.1253/circj.cj-22-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Nobuyuki Ohte
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
| | | | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hiroshi Itoh
- Department of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Science
| | - Shiro Iwanaga
- Department of Cardiology, Saitama Medical University International Medical Center
| | - Hiroyuki Okura
- Department of Cardiology, Gifu University Graduate School of Medicine
| | | | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Toshihiko Shibata
- Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine
| | - Toshiro Shinke
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Yoshihiro Seo
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
| | - Masao Daimon
- The Department of Clinical Laboratory, The University of Tokyo Hospital
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, Hospital of University of Occupational and Environmental Health
| | - Kazuaki Tanabe
- The Fourth Department of Internal Medicine, Shimane University Faculty of Medicine
| | | | - Masaki Nii
- Department of Cardiology, Shizuoka Children's Hospital
| | - Kazuhiro Nishigami
- Division of Cardiovascular Medicine, Miyuki Hospital LTAC Heart Failure Center
| | - Takeshi Hozumi
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Satoshi Yasukochi
- Department of Pediatric Cardiology, Heart Center, Nagano Children’s Hospital
| | - Hirotsugu Yamada
- Department of Community Medicine for Cardiology, Tokushima University Graduate School of Biomedical Sciences
| | - Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University
| | - Masaki Izumo
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
| | - Katsuji Inoue
- Department of Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine
| | | | - Atsushi Okada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Shuichiro Kaji
- Department of Cardiovascular Medicine, Kansai Electric Power Hospital
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Akiko Goda
- Department of Cardiovascular and Renal Medicine, Hyogo College of Medicine
| | - Yasuharu Takeda
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Hidekazu Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | | | - Hidekatsu Fukuta
- Core Laboratory, Nagoya City University Graduate School of Medical Sciences
| | - Satoshi Yamada
- Department of Cardiology, Tokyo Medical University Hachioji Medical Center
| | - Nozomi Watanabe
- Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center
| | | | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University
| | - Takeshi Kimura
- Department of Cardiology, Kyoto University Graduate School of Medicine
| | - Masami Kosuge
- Division of Cardiology, Yokohama City University Medical Center
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30
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Macheda G, El Helali N, Péan de Ponfilly G, Kloeckner M, Garçon P, Maillet M, Tolsma V, Mory C, Le Monnier A, Pilmis B. Impact of therapeutic drug monitoring of antibiotics in the management of infective endocarditis. Eur J Clin Microbiol Infect Dis 2022; 41:1183-1190. [PMID: 35984543 DOI: 10.1007/s10096-022-04475-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/18/2022] [Indexed: 11/24/2022]
Abstract
Treatment of infective endocarditis (IE) is based on high doses of antibiotics with a prolonged duration. Therapeutic drug monitoring (TDM) allows antibiotic prescription optimization and leads to a personalized medicine, but no study evaluates its interest in the management of IE. We conducted a retrospective, bicentric, descriptive study, from January 2007 to December 2019. We included patients cared for IE, defined according to Duke's criteria, for whom a TDM was requested. Clinical and microbiological data were collected after patients' charts review. We considered a trough or steady-state concentration target of 20 to 50 mg/L. We included 322 IE episodes, corresponding to 306 patients, with 78.6% (253/326) were considered definite according to Duke's criteria. Native valves were involved in 60.5% (185/306) with aortic valve in 46.6% (150/322) and mitral in 36.3% (117/322). Echocardiography was positive in 76.7% (247/322) of cases. After TDM, a dosage modification was performed in 51.5% (166/322) (decrease in 84.3% (140/166)). After initial dosage, 46.3% (82/177) and 92.8% (52/56) were considered overdosed, when amoxicillin and cloxacillin were used, respectively. The length of hospital stay was higher for patient overdosed (25 days versus 20 days (p = 0.04)), and altered creatinine clearance was associated with overdosage (p = 0.01). Our study suggests that the use of current guidelines probably leads to unnecessarily high concentrations in most patients. TDM benefits predominate in patients with altered renal function, but probably limit adverse effects related to overdosing in most patients.
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Affiliation(s)
- G Macheda
- Service de Maladies Infectieuses Et Tropicales, Centre Hospitalier Annecy Genevois, Annecy, France
| | - N El Helali
- Plateforme de Dosage Des Anti-Infectieux, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - G Péan de Ponfilly
- Institut Micalis UMR 1319, Université Paris-Saclay, INRAeChâtenay Malabry, AgroParisTech, France.,Service de Microbiologie Clinique, GH Paris Saint-Joseph, 75014, Paris, France.,Laboratoire de Bactériologie, Département des Agents infectieux, CHU Saint Louis-Lariboisière-Fernand Widal, APHP, 75010, Paris, France
| | - M Kloeckner
- Service de Cardiologie, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - P Garçon
- Service de Cardiologie, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - M Maillet
- Service de Maladies Infectieuses Et Tropicales, Centre Hospitalier Annecy Genevois, Annecy, France
| | - V Tolsma
- Service de Maladies Infectieuses Et Tropicales, Centre Hospitalier Annecy Genevois, Annecy, France
| | - C Mory
- Plateforme de Dosage Des Anti-Infectieux, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - A Le Monnier
- Institut Micalis UMR 1319, Université Paris-Saclay, INRAeChâtenay Malabry, AgroParisTech, France.,Service de Microbiologie Clinique, GH Paris Saint-Joseph, 75014, Paris, France.,Laboratoire de Bactériologie, Département des Agents infectieux, CHU Saint Louis-Lariboisière-Fernand Widal, APHP, 75010, Paris, France
| | - B Pilmis
- Institut Micalis UMR 1319, Université Paris-Saclay, INRAeChâtenay Malabry, AgroParisTech, France. .,Equipe Mobile de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, Paris, France.
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31
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Ohuchi H, Kawata M, Uemura H, Akagi T, Yao A, Senzaki H, Kasahara S, Ichikawa H, Motoki H, Syoda M, Sugiyama H, Tsutsui H, Inai K, Suzuki T, Sakamoto K, Tatebe S, Ishizu T, Shiina Y, Tateno S, Miyazaki A, Toh N, Sakamoto I, Izumi C, Mizuno Y, Kato A, Sagawa K, Ochiai R, Ichida F, Kimura T, Matsuda H, Niwa K. JCS 2022 Guideline on Management and Re-Interventional Therapy in Patients With Congenital Heart Disease Long-Term After Initial Repair. Circ J 2022; 86:1591-1690. [DOI: 10.1253/circj.cj-22-0134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hideo Ohuchi
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, National Cerebral and Cardiovascular Center
| | - Masaaki Kawata
- Division of Pediatric and Congenital Cardiovascular Surgery, Jichi Children’s Medical Center Tochigi
| | - Hideki Uemura
- Congenital Heart Disease Center, Nara Medical University
| | - Teiji Akagi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences
| | - Atsushi Yao
- Division for Health Service Promotion, University of Tokyo
| | - Hideaki Senzaki
- Department of Pediatrics, International University of Health and Welfare
| | - Shingo Kasahara
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences
| | - Hajime Ichikawa
- Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Hirohiko Motoki
- Department of Cardiovascular Medicine, Shinshu University School of Medicine
| | - Morio Syoda
- Department of Cardiology, Tokyo Women’s Medical University
| | - Hisashi Sugiyama
- Department of Pediatric Cardiology, Seirei Hamamatsu General Hospital
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | - Kei Inai
- Department of Pediatric Cardiology and Adult Congenital Cardiology, Tokyo Women’s Medical University
| | - Takaaki Suzuki
- Department of Pediatric Cardiac Surgery, Saitama Medical University
| | | | - Syunsuke Tatebe
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Tomoko Ishizu
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba
| | - Yumi Shiina
- Cardiovascular Center, St. Luke’s International Hospital
| | - Shigeru Tateno
- Department of Pediatrics, Chiba Kaihin Municipal Hospital
| | - Aya Miyazaki
- Division of Congenital Heart Disease, Department of Transition Medicine, Shizuoka General Hospital
| | - Norihisa Toh
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences
| | - Ichiro Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yoshiko Mizuno
- Faculty of Nursing, Tokyo University of Information Sciences
| | - Atsuko Kato
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center
| | - Koichi Sagawa
- Department of Pediatric Cardiology, Fukuoka Children’s Hospital
| | - Ryota Ochiai
- Department of Adult Nursing, Yokohama City University
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health and Welfare
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | | | - Koichiro Niwa
- Department of Cardiology, St. Luke’s International Hospital
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32
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Takizawa K, Ozasa K, Matsumoto K, Nakata J, Noma N. Infective Endocarditis With Secondary Headache: A Case Report. Cureus 2022; 14:e26791. [PMID: 35967166 PMCID: PMC9366033 DOI: 10.7759/cureus.26791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 11/20/2022] Open
Abstract
Secondary headache is a symptom of an underlying disease. Infective endocarditis (IE) is a serious infection of the heart tissue. Herein, we present a rare case of IE, with a secondary headache. The patient presented with persistent headache, fever of 39°C, myalgia, and painful erythema of the plantar surface of the foot. The headache progressively worsened over a few weeks. She was diagnosed with secondary headache, and sepsis was suspected. Blood culture revealed the presence of Streptococcus viridans, leading to a diagnosis of IE. Postoperatively, the patient recuperated without any complications. Headaches can be secondary to other conditions. Therefore, comprehensive assessment and accurate diagnosis are essential. Dentists must be aware that headache is a concomitant symptom of IE.
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33
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Hussein H, Montesinos-Guevara C, Abouelkheir M, Brown RS, Hneiny L, Amer YS. Quality appraisal of antibiotic prophylaxis guidelines to prevent infective endocarditis following dental procedures: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:562-572. [DOI: 10.1016/j.oooo.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/16/2022] [Accepted: 07/19/2022] [Indexed: 11/29/2022]
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34
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Thornhill MH, Crum A, Rex S, Campbell R, Stone T, Bradburn M, Fibisan V, Dayer MJ, Prendergast BD, Lockhart PB, Baddour LM, Nicholl J. Infective endocarditis following invasive dental procedures: IDEA case-crossover study. Health Technol Assess 2022; 26:1-86. [PMID: 35642966 DOI: 10.3310/nezw6709] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Infective endocarditis is a heart infection with a first-year mortality rate of ≈ 30%. It has long been thought that infective endocarditis is causally associated with bloodstream seeding with oral bacteria in ≈ 40-45% of cases. This theorem led guideline committees to recommend that individuals at increased risk of infective endocarditis should receive antibiotic prophylaxis before undergoing invasive dental procedures. However, to the best of our knowledge, there has never been a clinical trial to prove the efficacy of antibiotic prophylaxis and there is no good-quality evidence to link invasive dental procedures with infective endocarditis. Many contend that oral bacteria-related infective endocarditis is more likely to result from daily activities (e.g. tooth brushing, flossing and chewing), particularly in those with poor oral hygiene. OBJECTIVE The aim of this study was to determine if there is a temporal association between invasive dental procedures and subsequent infective endocarditis, particularly in those at high risk of infective endocarditis. DESIGN This was a self-controlled, case-crossover design study comparing the number of invasive dental procedures in the 3 months immediately before an infective endocarditis-related hospital admission with that in the preceding 12-month control period. SETTING The study took place in the English NHS. PARTICIPANTS All individuals admitted to hospital with infective endocarditis between 1 April 2010 and 31 March 2016 were eligible to participate. INTERVENTIONS This was an observational study; therefore, there was no intervention. MAIN OUTCOME MEASURE The outcome measure was the number of invasive and non-invasive dental procedures in the months before infective endocarditis-related hospital admission. DATA SOURCES NHS Digital provided infective endocarditis-related hospital admissions data and dental procedure data were obtained from the NHS Business Services Authority. RESULTS The incidence rate of invasive dental procedures decreased in the 3 months before infective endocarditis-related hospital admission (incidence rate ratio 1.34, 95% confidence interval 1.13 to 1.58). Further analysis showed that this was due to loss of dental procedure data in the 2-3 weeks before any infective endocarditis-related hospital admission. LIMITATIONS We found that urgent hospital admissions were a common cause of incomplete courses of dental treatment and, because there is no requirement to record dental procedure data for incomplete courses, this resulted in a significant loss of dental procedure data in the 2-3 weeks before infective endocarditis-related hospital admissions. The data set was also reduced because of the NHS Business Services Authority's 10-year data destruction policy, reducing the power of the study. The main consequence was a loss of dental procedure data in the critical 3-month case period of the case-crossover analysis (immediately before infective endocarditis-related hospital admission), which did not occur in earlier control periods. Part of the decline in the rate of invasive dental procedures may also be the result of the onset of illness prior to infective endocarditis-related hospital admission, and part may be due to other undefined causes. CONCLUSIONS The loss of dental procedure data in the critical case period immediately before infective endocarditis-related hospital admission makes interpretation of the data difficult and raises uncertainty over any conclusions that can be drawn from this study. FUTURE WORK We suggest repeating this study elsewhere using data that are unafflicted by loss of dental procedure data in the critical case period. TRIAL REGISTRATION This trial is registered as ISRCTN11684416. FUNDING This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 28. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Martin H Thornhill
- Academic Unit of Oral and Maxillofacial Medicine, Surgery and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.,Department of Oral Medicine, Atrium Health, Carolinas Medical Center, Charlotte, NC, USA
| | - Annabel Crum
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Saleema Rex
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Richard Campbell
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Tony Stone
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Mike Bradburn
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Veronica Fibisan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Mark J Dayer
- Department of Cardiology, Taunton and Somerset NHS Foundation Trust, Taunton, UK
| | | | - Peter B Lockhart
- Department of Oral Medicine, Atrium Health, Carolinas Medical Center, Charlotte, NC, USA
| | - Larry M Baddour
- Division of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Jon Nicholl
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Maeda K, Hirai Y, Nashi M, Yamamoto S, Taniike N, Takenobu T. Clinical features and antimicrobial susceptibility of oral bacteria isolated from the blood cultures of patients with infective endocarditis. J Dent Sci 2022; 17:870-875. [PMID: 35756779 PMCID: PMC9201522 DOI: 10.1016/j.jds.2021.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/13/2021] [Indexed: 11/16/2022] Open
Abstract
Background/purpose The epidemiology of infective endocarditis (IE) is under constant change due to the aging society and increases in antimicrobial-resistant pathogens. However, IE remains severe. This study aimed to review the current clinical characteristics of IE and the antimicrobial susceptibility of oral bacteria (OB) isolated from blood cultures to implement appropriate antimicrobial prophylaxis. Materials and methods We retrospectively investigated the clinical features of 180 patients with IE in whom OB and pathogens except OB (eOB) were identified as causative microorganisms via blood cultures. The susceptibility of the OB group to eight antibiotics was examined by broth microdilution. Results Among causative microorganisms, the isolation rate of staphylococci was slightly higher than that of OB; however, the difference was not significant (36.7% vs. 33.8%, p = 0.3203). The number of patients with underlying cardiac disease was significantly higher in the OB group than in the eOB group (53.7% vs. 34.1%, p = 0.0113). Only one ampicillin-resistant OB was detected (2.0%). OBs were significantly less susceptible to clarithromycin and azithromycin than to ampicillin (98.0% vs. 66.7% and 98.0% vs. 60.0%, p = 0.0003 and p = 0.0003, respectively). Moreover, OBs were significantly less susceptible to clarithromycin and azithromycin than to clindamycin (66.7% vs. 88.2% and 60.0% vs. 88.2%, p = 0.0301 and p = 0.0217, respectively). Conclusion OBs were susceptible to ampicillin. However, the susceptibility of OBs to clarithromycin and azithromycin was significantly lower than that to ampicillin and clindamycin. These results are important and should help decisions regarding guide antimicrobial prophylaxis.
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Affiliation(s)
- Keigo Maeda
- Department of Oral and Maxillofacial Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
- Department of Fixed Prosthodontics and Occlusion, Osaka Dental University, Osaka, Japan
- Corresponding author. Department of Oral and Maxillofacial Surgery, Kobe City Medical Center General Hospital, 2-1-1, Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan. Fax: +81 78 302 7537.
| | - Yuzo Hirai
- Department of Oral and Maxillofacial Surgery, Nishi-Kobe Medical Center, Kobe, Japan
| | - Masanori Nashi
- Department of Oral and Maxillofacial Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shinsuke Yamamoto
- Department of Oral and Maxillofacial Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Naoki Taniike
- Department of Oral and Maxillofacial Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Toshihiko Takenobu
- Department of Oral and Maxillofacial Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
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A case of infective endocarditis mimicking antineutrophil cytoplasmic antibody-associated vasculitis. J Cardiol Cases 2022; 26:32-34. [DOI: 10.1016/j.jccase.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/02/2022] [Accepted: 02/10/2022] [Indexed: 11/24/2022] Open
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Muramatsu K, Kawada N, Naganuma H, Ishiwari K, Amagaya S. Recurrent nonbacterial thrombotic endocarditis the day after mitral valve replacement. J Cardiol Cases 2022; 25:119-122. [DOI: 10.1016/j.jccase.2021.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/21/2021] [Accepted: 07/28/2021] [Indexed: 11/24/2022] Open
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38
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Suehiro Y, Nomura R, Matayoshi S, Otsugu M, Iwashita N, Nakano K. Evaluation of the collagen-binding properties and virulence of killed Streptococcus mutans in a silkworm model. Sci Rep 2022; 12:2800. [PMID: 35181690 PMCID: PMC8857238 DOI: 10.1038/s41598-022-06345-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 01/18/2022] [Indexed: 11/10/2022] Open
Abstract
Streptococcus mutans, a major pathogen of dental caries, is also known as a causative agent of cardiovascular disease. A 120 kDa collagen-binding protein (Cnm) of S. mutans is an important contributor to the pathogenicity of cardiovascular disease. Although dead bacteria have been detected in cardiovascular specimens by molecular biological methods, the pathogenicity of the bacteria remains unknown. Here, we analyzed the pathogenicity of killed S. mutans by focusing on collagen-binding ability and the effects on silkworms. In live S. mutans, Cnm-positive S. mutans had high collagen-binding activity, while Cnm-negative S. mutans had no such activity. After treatment with killed Cnm-positive S. mutans, amoxicillin-treated bacteria still had collagen-binding ability, while lysozyme-treated bacteria lost this ability. When live and amoxicillin-treated S. mutans strains were administered to silkworms, the survival rates of the silkworms were reduced; this reduction was more pronounced in Cnm-positive S. mutans infection than in Cnm-negative S. mutans infection. However, the administration of any of the lysozyme-treated bacteria did not reduce the survival rate of the silkworms. These results suggest that amoxicillin-killed Cnm-positive S. mutans strains maintain collagen-binding properties and pathogenicity in the silkworm model, and are possibly associated with pathogenicity in cardiovascular diseases.
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Affiliation(s)
- Yuto Suehiro
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan.
| | - Saaya Matayoshi
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Masatoshi Otsugu
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Naoki Iwashita
- Laboratory of Veterinary Pharmacology, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara, Kanagawa, 252-5201, Japan
| | - Kazuhiko Nakano
- Department of Pediatric Dentistry, Osaka University Graduate School of Dentistry, 1-8 Yamada-oka, Suita, Osaka, 565-0871, Japan
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Abstract
The management of infective endocarditis is complex and inherently requires multidisciplinary cooperation. About half of all patients diagnosed with infective endocarditis will meet the criteria to undergo cardiac surgery, which regularly takes place in urgent or emergency settings. The pathophysiology and clinical presentation of infective endocarditis make it a unique disorder within cardiac surgery that warrants a thorough understanding of specific characteristics in the perioperative period. This includes, among others, echocardiography, coagulation, bleeding management, or treatment of organ dysfunction. In this narrative review article, the authors summarize the current knowledge on infective endocarditis relevant for the clinical anesthesiologist in perioperative management of respective patients. Furthermore, the authors advocate for the anesthesiologist to become a structural member of the endocarditis team.
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40
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Blood culture-negative prosthetic valve endocarditis and daptomycin-associated eosinophilic pneumonia: A case report. J Cardiol Cases 2022; 25:354-358. [DOI: 10.1016/j.jccase.2021.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/08/2021] [Accepted: 12/15/2021] [Indexed: 11/17/2022] Open
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41
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Imai S, Kadomura S, Miyai T, Kashiwagi H, Sato Y, Sugawara M, Takekuma Y. Using Japanese big data to investigate novel factors and their high-risk combinations that affect vancomycin-induced nephrotoxicity. Br J Clin Pharmacol 2022; 88:3241-3255. [PMID: 35106797 DOI: 10.1111/bcp.15252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 11/28/2022] Open
Abstract
AIMS Several factors related to vancomycin-induced nephrotoxicity (VIN) have not yet been clarified. In the present study, we used Japanese big data to investigate novel factors and their high-risk combinations that influence VIN. METHODS We employed a large Japanese electronic medical record database and included patients who had been administered intravenous vancomycin between June 2000 and December 2020. VIN was defined as an increase in serum creatinine ≥0.5 mg/dL or 1.5-fold higher than the baseline. The outcomes were: (1) factors affecting VIN that were identified using multiple logistic regression analysis, and (2) combinations of factors that affect the risk of VIN according to a decision tree analysis, which is a typical machine learning method. RESULTS Of the 7,306 patients that were enrolled, VIN occurred in 14.2% of them (1,035). A multivariate analysis extracted 22 variables as independent factors. Concomitant ramelteon use (odds ratio; 0.701, 95% confidence interval; 0.512-0.959), ward pharmacy service (0.741, 0.638-0.861), duration of VCM <7 days (0.748, 0.623-0.899) and trough concentrations 10-15 mg/L (0.668, 0.556-0.802) reduce the risk of VIN. Meanwhile, concomitant piperacillin-tazobactam use (2.056, 1.754-2.409) and piperacillin use (2.868, 1.298-6.338) increase the risk. The decision tree analysis showed that a combination of vancomycin trough concentrations ≥20 mg/L and concomitant piperacillin-tazobactam use was associated with the highest risk. CONCLUSIONS We revealed that the concomitant ramelteon use and ward pharmacy service may decrease the risk of VIN, while the concomitant use of not only piperacillin-tazobactam but also piperacillin may increase the risk.
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Affiliation(s)
- Shungo Imai
- Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Shota Kadomura
- Department of Pharmacy, Japan Community Healthcare Organization Sapporo Hokushin Hospital, Sapporo, Japan
| | - Takayuki Miyai
- Graduate School of Life Science, Hokkaido University, Sapporo, Japan
| | - Hitoshi Kashiwagi
- Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Yuki Sato
- Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Mitsuru Sugawara
- Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan.,Department of Pharmacy, Hokkaido University Hospital, Sapporo, Japan.,Global Station for Biosurfaces and Drug Discovery, Hokkaido University, Sapporo, Japan
| | - Yoh Takekuma
- Department of Pharmacy, Hokkaido University Hospital, Sapporo, Japan
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Minagawa T, Ohara T, Oizumi T, Takeda M, Hiranuma W, Matsuoka T, Shimizu T, Kawamoto S. Infective Endocarditis with a Left Ventricular Pseudoaneurysm Caused by Proteus mirabilis: A Case Report. J Cardiol Cases 2022; 25:79-82. [PMID: 35079303 DOI: 10.1016/j.jccase.2021.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 11/19/2022] Open
Abstract
Infective endocarditis (IE) due to Proteus mirabilis is rare. Given that cases of IE complicated with a left ventricular pseudoaneurysm (LVP) caused by P. mirabilis have not been reported thus far, here we report a case of IE complicated with an LVP caused by P. mirabilis. An 83-year-old woman was admitted to our hospital for urinary tract infection, and P. mirabilis was detected in blood cultures. Transesophageal echocardiography and electrocardiogram-gated computed tomography revealed mitral regurgitation and a mass protruding from the mitral annulus on the dorsal side. We made a diagnosis of an LVP due to IE and performed mitral valve replacement and patch plasty of the mitral annulus. Thus, P. mirabilis can cause bloodstream infections and lead to IE, which may result in LVPs. <Learning objective: Proteus mirabilis commonly causes urinary tract infection in older adults and is also likely to cause bloodstream infections; however, it is rarely known to be the causative agent of infective endocarditis and left ventricular pseudoaneurysms. However, in clinical settings, clinicians should be aware that P. mirabilis can also cause IE with annular extension.>.
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Affiliation(s)
- Tadanori Minagawa
- Division of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Takahiro Ohara
- Division of Community Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Tomoya Oizumi
- Division of Emergency and Disaster Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Miki Takeda
- Division of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Wakiko Hiranuma
- Division of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Takayuki Matsuoka
- Division of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Takuya Shimizu
- Division of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Shunsuke Kawamoto
- Division of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
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Sato M, Yamana H, Ono S, Ishimaru M, Matsui H, Yasunaga H. Trends in prophylactic antibiotic use for tooth extraction from 2015 to 2018 in Japan: An analysis using a health insurance claims database. J Infect Chemother 2021; 28:504-509. [PMID: 34973876 DOI: 10.1016/j.jiac.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/30/2021] [Accepted: 12/15/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION To describe patterns in antibiotic prophylaxis for tooth extraction following the 2016 Japanese National Action Plan on Antimicrobial Resistance. METHODS Using a health insurance claims database, we retrospectively identified tooth extraction visits by patients aged ≥18 years from September 2015 to August 2018 and classified patients as undergoing extraction of a fully impacted or horizontally impacted mandibular wisdom tooth, being at risk of infective endocarditis or surgical site infection, or being at low risk. Antibiotic use and type of antibiotics prescribed on the day of tooth extraction were evaluated across the study period, with stratification by tooth extraction category and facility type (hospital or dental clinic). RESULTS We identified 662,435 patients with tooth extraction. The mean age was 42.7 years, and 57% were male. Twelve percent underwent wisdom tooth extraction, 32% were high risk, and 10% visited hospitals. The proportion of antibiotic use was 83% overall and 82% among low-risk patients. This proportion remained similar throughout the study period. A shift from third-generation cephalosporins to amoxicillin was observed from 2015 to 2018: the proportion prescribed third-generation cephalosporins decreased from 58% to 34% in hospitals and from 57% to 56% in clinics, and the proportion prescribed amoxicillin increased from 16% to 37% in hospitals and from 6% to 10% in clinics. CONCLUSIONS The pattern of prophylactic antibiotic use for tooth extraction gradually changed after the initiation of the National Action Plan. Further efforts are required to reduce potentially inappropriate prescriptions for low-risk patients, especially in dental clinics.
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Affiliation(s)
- Misuzu Sato
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Hayato Yamana
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Sachiko Ono
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Miho Ishimaru
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
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Nashi M, Yamamoto S, Maeda K, Taniike N, Takenobu T. A Case of Infective Endocarditis Due to Oral Streptococci After Perioperative Oral Function Management. Cureus 2021; 13:e20446. [PMID: 35047283 PMCID: PMC8759947 DOI: 10.7759/cureus.20446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 12/02/2022] Open
Abstract
Infective endocarditis is an extremely serious disease that can present with a variety of clinical manifestations, including infection of valves and endocardium, in patients with cardiac disease, and is associated with risk factors such as invasive dental procedures, caries, and periodontal disease. On the other hand, it has been shown that perioperative oral function management before various surgeries, such as those for malignant tumors, cardiovascular disease, and transplantation, may prevent or reduce postoperative complications. Close coordination between the dentist and cardiac surgeon is especially necessary before heart valve surgery because of the risk of severe complications. The number of perioperative oral management procedures being performed in community dental clinics is increasing. In the absence of clear guidelines, the physician-in-charge usually determines how to best perform oral management while considering the patient’s needs. We report a case of infective endocarditis occurring after perioperative oral management in a young patient with good oral hygiene. This case shows that standardization of the techniques and widespread dissemination of the guidelines are required. Patients should be counseled regarding the importance of maintaining oral hygiene from a young age. This case report should act as a cautionary tale not only for hospital clinicians but also for community medical and dental practitioners, as the number of such patients is expected to increase in the future.
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Masada K, Ueda H, Ozawa M, Mitsui N, Utsunomiya H, Takahashi S. A vegetation in a unique location without exposure to regurgitation or a shunt jet: A case report. J Cardiol Cases 2021; 25:343-347. [DOI: 10.1016/j.jccase.2021.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/10/2021] [Accepted: 12/08/2021] [Indexed: 01/02/2023] Open
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Aggressive early surgical strategy in patients with intracranial hemorrhage: a new cardiopulmonary bypass option. Gen Thorac Cardiovasc Surg 2021; 70:602-610. [PMID: 34813003 DOI: 10.1007/s11748-021-01743-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/09/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE We present a novel strategy in cardiac surgery with a cardiopulmonary bypass with low-dose heparin and Nafamostat mesylate as an anticoagulant (NM-CPB), which reduces postoperative neurological complications. METHOD AND RESULTS 19 patients with a mean age of 63.6 ± 20.2 years (range 24-91) and an indication of early cardiac surgery with intracranial complication (ICC) underwent surgery with NM-CPB. The preoperative diagnoses included seven cases of infective endocarditis and six of left atrial appendage thrombosis. ICC were noticed in seven cases with hemorrhages (hemorrhagic infarction: n = 4, subarachnoid hemorrhage: n = 3) and 12 without hemorrhage (large infarction: n = 10, small-multiple infarction at the risk for hemorrhagic transformation: n = 2). The mean interval between a diagnosis and cardiac surgery was 1.1 ± 1.5 days in the ICH cases and 1.4 ± 1.4 days otherwise. In-hospital mortality was 5.3%. The mean CPB time was 146.7 ± 66.03 min, the mean dose of NM, heparin were 2.23 ± 1.59 mg/kg/hr and 56.8 ± 20.3 IU/kg, respectively. The mean activated clotting time (ACT) was 426.8 ± 112.4 s. No further intracranial bleeding and no new hemorrhages were observed after surgery. CONCLUSIONS In early cardiac surgery with ICC, especially with hemorrhage, NM-CPB reduced postoperative neurological complications. We plan to use NM-CPB to expand the indications and to establish an early aggressive treatment.
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Antibiotika im Rahmen der Endokarditisprophylaxe – Risiko und Nutzen. WISSEN KOMPAKT 2021; 15:113-122. [PMID: 34426751 PMCID: PMC8374404 DOI: 10.1007/s11838-021-00134-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Für die Effektivität und Effizienz einer antibiotischen Prophylaxe vor zahnmedizinischen Eingriffen zum Schutz vor einer infektiösen Endokarditis liegt nur eine geringe Evidenz vor, die keine Rechtfertigung zur generalisierten Therapie von Patienten mit einem erhöhten Endokarditisrisiko darstellt. Aktuelle Leitlinien empfehlen daher, Antibiotika im Rahmen der Endokarditisprophylaxe auf Patienten zu beschränken, die zum einen ein hohes Risiko für die Entstehung einer infektiösen Endokarditis aufweisen und die sich zum anderen zahnärztlichen Eingriffen mit höchstem Endokarditisrisiko unterziehen. Einen hohen Stellwert besitzen allerdings auch Mund- und Hauthygienemaßnahmen, die nicht nur auf Risikopatienten, sondern auch auf die Allgemeinbevölkerung angewendet werden sollten, da die Inzidenz der infektiösen Endokarditis bei Patienten ohne anamnestisch bekannte Herzerkrankung zunehmend ansteigt.
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Egi M, Ogura H, Yatabe T, Atagi K, Inoue S, Iba T, Kakihana Y, Kawasaki T, Kushimoto S, Kuroda Y, Kotani J, Shime N, Taniguchi T, Tsuruta R, Doi K, Doi M, Nakada TA, Nakane M, Fujishima S, Hosokawa N, Masuda Y, Matsushima A, Matsuda N, Yamakawa K, Hara Y, Sakuraya M, Ohshimo S, Aoki Y, Inada M, Umemura Y, Kawai Y, Kondo Y, Saito H, Taito S, Takeda C, Terayama T, Tohira H, Hashimoto H, Hayashida K, Hifumi T, Hirose T, Fukuda T, Fujii T, Miura S, Yasuda H, Abe T, Andoh K, Iida Y, Ishihara T, Ide K, Ito K, Ito Y, Inata Y, Utsunomiya A, Unoki T, Endo K, Ouchi A, Ozaki M, Ono S, Katsura M, Kawaguchi A, Kawamura Y, Kudo D, Kubo K, Kurahashi K, Sakuramoto H, Shimoyama A, Suzuki T, Sekine S, Sekino M, Takahashi N, Takahashi S, Takahashi H, Tagami T, Tajima G, Tatsumi H, Tani M, Tsuchiya A, Tsutsumi Y, Naito T, Nagae M, Nagasawa I, Nakamura K, Nishimura T, Nunomiya S, Norisue Y, Hashimoto S, Hasegawa D, Hatakeyama J, Hara N, Higashibeppu N, Furushima N, Furusono H, Matsuishi Y, Matsuyama T, Minematsu Y, Miyashita R, Miyatake Y, Moriyasu M, Yamada T, Yamada H, Yamamoto R, Yoshida T, Yoshida Y, Yoshimura J, Yotsumoto R, Yonekura H, Wada T, Watanabe E, Aoki M, Asai H, Abe T, Igarashi Y, Iguchi N, Ishikawa M, Ishimaru G, Isokawa S, Itakura R, Imahase H, Imura H, Irinoda T, Uehara K, Ushio N, Umegaki T, Egawa Y, Enomoto Y, Ota K, Ohchi Y, Ohno T, Ohbe H, Oka K, Okada N, Okada Y, Okano H, Okamoto J, Okuda H, Ogura T, Onodera Y, Oyama Y, Kainuma M, Kako E, Kashiura M, Kato H, Kanaya A, Kaneko T, Kanehata K, Kano KI, Kawano H, Kikutani K, Kikuchi H, Kido T, Kimura S, Koami H, Kobashi D, Saiki I, Sakai M, Sakamoto A, Sato T, Shiga Y, Shimoto M, Shimoyama S, Shoko T, Sugawara Y, Sugita A, Suzuki S, Suzuki Y, Suhara T, Sonota K, Takauji S, Takashima K, Takahashi S, Takahashi Y, Takeshita J, Tanaka Y, Tampo A, Tsunoyama T, Tetsuhara K, Tokunaga K, Tomioka Y, Tomita K, Tominaga N, Toyosaki M, Toyoda Y, Naito H, Nagata I, Nagato T, Nakamura Y, Nakamori Y, Nahara I, Naraba H, Narita C, Nishioka N, Nishimura T, Nishiyama K, Nomura T, Haga T, Hagiwara Y, Hashimoto K, Hatachi T, Hamasaki T, Hayashi T, Hayashi M, Hayamizu A, Haraguchi G, Hirano Y, Fujii R, Fujita M, Fujimura N, Funakoshi H, Horiguchi M, Maki J, Masunaga N, Matsumura Y, Mayumi T, Minami K, Miyazaki Y, Miyamoto K, Murata T, Yanai M, Yano T, Yamada K, Yamada N, Yamamoto T, Yoshihiro S, Tanaka H, Nishida O. The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020). J Intensive Care 2021; 9:53. [PMID: 34433491 PMCID: PMC8384927 DOI: 10.1186/s40560-021-00555-7] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/10/2021] [Indexed: 02/08/2023] Open
Abstract
The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS], and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members.As a result, 79 GRADE-based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J-SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.
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Affiliation(s)
- Moritoki Egi
- Department of Surgery Related, Division of Anesthesiology, Kobe University Graduate School of Medicine, Kusunoki-cho 7-5-2, Chuo-ku, Kobe, Hyogo, Japan.
| | - Hiroshi Ogura
- Department of Traumatology and Acute Critical Medicine, Osaka University Medical School, Yamadaoka 2-15, Suita, Osaka, Japan.
| | - Tomoaki Yatabe
- Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kazuaki Atagi
- Department of Intensive Care Unit, Nara Prefectural General Medical Center, Nara, Japan
| | - Shigeaki Inoue
- Department of Disaster and Emergency Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshiaki Iba
- Department of Emergency and Disaster Medicine, Juntendo University, Tokyo, Japan
| | - Yasuyuki Kakihana
- Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tatsuya Kawasaki
- Department of Pediatric Critical Care, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Shigeki Kushimoto
- Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiro Kuroda
- Department of Emergency, Disaster, and Critical Care Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Joji Kotani
- Department of Surgery Related, Division of Disaster and Emergency Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nobuaki Shime
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takumi Taniguchi
- Department of Anesthesiology and Intensive Care Medicine, Kanazawa University, Kanazawa, Japan
| | - Ryosuke Tsuruta
- Acute and General Medicine, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Kent Doi
- Department of Acute Medicine, The University of Tokyo, Tokyo, Japan
| | - Matsuyuki Doi
- Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Taka-Aki Nakada
- Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masaki Nakane
- Department of Emergency and Critical Care Medicine, Yamagata University Hospital, Yamagata, Japan
| | - Seitaro Fujishima
- Center for General Medicine Education, Keio University School of Medicine, Tokyo, Japan
| | - Naoto Hosokawa
- Department of Infectious Diseases, Kameda Medical Center, Kamogawa, Japan
| | - Yoshiki Masuda
- Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Asako Matsushima
- Department of Advancing Acute Medicine, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Naoyuki Matsuda
- Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuma Yamakawa
- Department of Emergency Medicine, Osaka Medical College, Osaka, Japan
| | - Yoshitaka Hara
- Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - Masaaki Sakuraya
- Department of Emergency and Intensive Care Medicine, JA Hiroshima General Hospital, Hatsukaichi, Japan
| | - Shinichiro Ohshimo
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshitaka Aoki
- Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Mai Inada
- Member of Japanese Association for Acute Medicine, Tokyo, Japan
| | - Yutaka Umemura
- Division of Trauma and Surgical Critical Care, Osaka General Medical Center, Osaka, Japan
| | - Yusuke Kawai
- Department of Nursing, Fujita Health University Hospital, Toyoake, Japan
| | - Yutaka Kondo
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Hiroki Saito
- Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | - Shunsuke Taito
- Division of Rehabilitation, Department of Clinical Support and Practice, Hiroshima University Hospital, Hiroshima, Japan
| | - Chikashi Takeda
- Department of Anesthesia, Kyoto University Hospital, Kyoto, Japan
| | - Takero Terayama
- Department of Psychiatry, School of Medicine, National Defense Medical College, Tokorozawa, Japan
| | | | - Hideki Hashimoto
- Department of Emergency and Critical Care Medicine/Infectious Disease, Hitachi General Hospital, Hitachi, Japan
| | - Kei Hayashida
- The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Toru Hifumi
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Tomoya Hirose
- Emergency and Critical Care Medical Center, Osaka Police Hospital, Osaka, Japan
| | - Tatsuma Fukuda
- Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Tomoko Fujii
- Intensive Care Unit, Jikei University Hospital, Tokyo, Japan
| | - Shinya Miura
- The Royal Children's Hospital Melbourne, Melbourne, Australia
| | - Hideto Yasuda
- Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Toshikazu Abe
- Department of Emergency and Critical Care Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan
| | - Kohkichi Andoh
- Division of Anesthesiology, Division of Intensive Care, Division of Emergency and Critical Care, Sendai City Hospital, Sendai, Japan
| | - Yuki Iida
- Department of Physical Therapy, School of Health Sciences, Toyohashi Sozo University, Toyohashi, Japan
| | - Tadashi Ishihara
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Kentaro Ide
- Critical Care Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Kenta Ito
- Department of General Pediatrics, Aichi Children's Health and Medical Center, Obu, Japan
| | - Yusuke Ito
- Department of Infectious Disease, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Yu Inata
- Department of Intensive Care Medicine, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Akemi Utsunomiya
- Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Unoki
- Department of Acute and Critical Care Nursing, School of Nursing, Sapporo City University, Sapporo, Japan
| | - Koji Endo
- Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan
| | - Akira Ouchi
- College of Nursing, Ibaraki Christian University, Hitachi, Japan
| | - Masayuki Ozaki
- Department of Emergency and Critical Care Medicine, Komaki City Hospital, Komaki, Japan
| | - Satoshi Ono
- Gastroenterological Center, Shinkuki General Hospital, Kuki, Japan
| | | | | | - Yusuke Kawamura
- Department of Rehabilitation, Showa General Hospital, Tokyo, Japan
| | - Daisuke Kudo
- Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kenji Kubo
- Department of Emergency Medicine and Department of Infectious Diseases, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Kiyoyasu Kurahashi
- Department of Anesthesiology and Intensive Care Medicine, International University of Health and Welfare School of Medicine, Narita, Japan
| | | | - Akira Shimoyama
- Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Takeshi Suzuki
- Department of Anesthesiology, Tokai University School of Medicine, Isehara, Japan
| | - Shusuke Sekine
- Department of Anesthesiology, Tokyo Medical University, Tokyo, Japan
| | - Motohiro Sekino
- Division of Intensive Care, Nagasaki University Hospital, Nagasaki, Japan
| | - Nozomi Takahashi
- Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Sei Takahashi
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan
| | - Hiroshi Takahashi
- Department of Cardiology, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Takashi Tagami
- Department of Emergency and Critical Care Medicine, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Japan
| | - Goro Tajima
- Nagasaki University Hospital Acute and Critical Care Center, Nagasaki, Japan
| | - Hiroomi Tatsumi
- Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masanori Tani
- Division of Critical Care Medicine, Saitama Children's Medical Center, Saitama, Japan
| | - Asuka Tsuchiya
- Department of Emergency and Critical Care Medicine, National Hospital Organization Mito Medical Center, Ibaraki, Japan
| | - Yusuke Tsutsumi
- Department of Emergency and Critical Care Medicine, National Hospital Organization Mito Medical Center, Ibaraki, Japan
| | - Takaki Naito
- Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masaharu Nagae
- Department of Intensive Care Medicine, Kobe University Hospital, Kobe, Japan
| | | | - Kensuke Nakamura
- Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Hitachi, Japan
| | - Tetsuro Nishimura
- Department of Traumatology and Critical Care Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shin Nunomiya
- Department of Anesthesiology and Intensive Care Medicine, Division of Intensive Care, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Yasuhiro Norisue
- Department of Emergency and Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Satoru Hashimoto
- Department of Anesthesiology and Intensive Care Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Daisuke Hasegawa
- Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - Junji Hatakeyama
- Department of Emergency and Critical Care Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Naoki Hara
- Department of Pharmacy, Yokohama Rosai Hospital, Yokohama, Japan
| | - Naoki Higashibeppu
- Department of Anesthesiology and Nutrition Support Team, Kobe City Medical Center General Hospital, Kobe City Hospital Organization, Kobe, Japan
| | - Nana Furushima
- Department of Anesthesiology, Kobe University Hospital, Kobe, Japan
| | - Hirotaka Furusono
- Department of Rehabilitation, University of Tsukuba Hospital/Exult Co., Ltd., Tsukuba, Japan
| | - Yujiro Matsuishi
- Doctoral program in Clinical Sciences. Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tasuku Matsuyama
- Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yusuke Minematsu
- Department of Clinical Engineering, Osaka University Hospital, Suita, Japan
| | - Ryoichi Miyashita
- Department of Intensive Care Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yuji Miyatake
- Department of Clinical Engineering, Kakogawa Central City Hospital, Kakogawa, Japan
| | - Megumi Moriyasu
- Division of Respiratory Care and Rapid Response System, Intensive Care Center, Kitasato University Hospital, Sagamihara, Japan
| | - Toru Yamada
- Department of Nursing, Toho University Omori Medical Center, Tokyo, Japan
| | - Hiroyuki Yamada
- Department of Primary Care and Emergency Medicine, Kyoto University Hospital, Kyoto, Japan
| | - Ryo Yamamoto
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takeshi Yoshida
- Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yuhei Yoshida
- Nursing Department, Osaka General Medical Center, Osaka, Japan
| | - Jumpei Yoshimura
- Division of Trauma and Surgical Critical Care, Osaka General Medical Center, Osaka, Japan
| | | | - Hiroshi Yonekura
- Department of Clinical Anesthesiology, Mie University Hospital, Tsu, Japan
| | - Takeshi Wada
- Department of Anesthesiology and Critical Care Medicine, Division of Acute and Critical Care Medicine, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Eizo Watanabe
- Department of Emergency and Critical Care Medicine, Eastern Chiba Medical Center, Togane, Japan
| | - Makoto Aoki
- Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hideki Asai
- Department of Emergency and Critical Care Medicine, Nara Medical University, Kashihara, Japan
| | - Takakuni Abe
- Department of Anesthesiology and Intensive Care, Oita University Hospital, Yufu, Japan
| | - Yutaka Igarashi
- Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital, Tokyo, Japan
| | - Naoya Iguchi
- Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Masami Ishikawa
- Department of Anesthesiology, Emergency and Critical Care Medicine, Kure Kyosai Hospital, Kure, Japan
| | - Go Ishimaru
- Department of General Internal Medicine, Soka Municipal Hospital, Soka, Japan
| | - Shutaro Isokawa
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Ryuta Itakura
- Department of Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Hisashi Imahase
- Department of Biomedical Ethics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Haruki Imura
- Department of Infectious Diseases, Rakuwakai Otowa Hospital, Kyoto, Japan
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | | | - Kenji Uehara
- Department of Anesthesiology, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan
| | - Noritaka Ushio
- Advanced Medical Emergency Department and Critical Care Center, Japan Red Cross Maebashi Hospital, Maebashi, Japan
| | - Takeshi Umegaki
- Department of Anesthesiology, Kansai Medical University, Hirakata, Japan
| | - Yuko Egawa
- Advanced Emergency and Critical Care Center, Saitama Red Cross Hospital, Saitama, Japan
| | - Yuki Enomoto
- Department of Emergency and Critical Care Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kohei Ota
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshifumi Ohchi
- Department of Anesthesiology and Intensive Care, Oita University Hospital, Yufu, Japan
| | - Takanori Ohno
- Department of Emergency and Critical Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Hiroyuki Ohbe
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | | | - Nobunaga Okada
- Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yohei Okada
- Department of Primary care and Emergency medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiromu Okano
- Department of Anesthesiology, Kyorin University School of Medicine, Tokyo, Japan
| | - Jun Okamoto
- Department of ER, Hashimoto Municipal Hospital, Hashimoto, Japan
| | - Hiroshi Okuda
- Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Takayuki Ogura
- Tochigi prefectural Emergency and Critical Care Center, Imperial Gift Foundation Saiseikai, Utsunomiya Hospital, Utsunomiya, Japan
| | - Yu Onodera
- Department of Anesthesiology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Yuhta Oyama
- Department of Internal Medicine, Dialysis Center, Kichijoji Asahi Hospital, Tokyo, Japan
| | - Motoshi Kainuma
- Anesthesiology, Emergency Medicine, and Intensive Care Division, Inazawa Municipal Hospital, Inazawa, Japan
| | - Eisuke Kako
- Department of Anesthesiology and Intensive Care Medicine, Nagoya-City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masahiro Kashiura
- Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Hiromi Kato
- Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Akihiro Kanaya
- Department of Anesthesiology, Sendai Medical Center, Sendai, Japan
| | - Tadashi Kaneko
- Emergency and Critical Care Center, Mie University Hospital, Tsu, Japan
| | - Keita Kanehata
- Advanced Medical Emergency Department and Critical Care Center, Japan Red Cross Maebashi Hospital, Maebashi, Japan
| | - Ken-Ichi Kano
- Department of Emergency Medicine, Fukui Prefectural Hospital, Fukui, Japan
| | - Hiroyuki Kawano
- Department of Gastroenterological Surgery, Onga Hospital, Fukuoka, Japan
| | - Kazuya Kikutani
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hitoshi Kikuchi
- Department of Emergency and Critical Care Medicine, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Takahiro Kido
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan
| | - Sho Kimura
- Division of Critical Care Medicine, Saitama Children's Medical Center, Saitama, Japan
| | - Hiroyuki Koami
- Center for Translational Injury Research, University of Texas Health Science Center at Houston, Houston, USA
| | - Daisuke Kobashi
- Advanced Medical Emergency Department and Critical Care Center, Japan Red Cross Maebashi Hospital, Maebashi, Japan
| | - Iwao Saiki
- Department of Anesthesiology, Tokyo Medical University, Tokyo, Japan
| | - Masahito Sakai
- Department of General Medicine Shintakeo Hospital, Takeo, Japan
| | - Ayaka Sakamoto
- Department of Emergency and Critical Care Medicine, University of Tsukuba Hospital, Tsukuba, Japan
| | - Tetsuya Sato
- Tohoku University Hospital Emergency Center, Sendai, Japan
| | - Yasuhiro Shiga
- Department of Orthopaedic Surgery, Center for Advanced Joint Function and Reconstructive Spine Surgery, Graduate school of Medicine, Chiba University, Chiba, Japan
| | - Manabu Shimoto
- Department of Primary care and Emergency medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shinya Shimoyama
- Department of Pediatric Cardiology and Intensive Care, Gunma Children's Medical Center, Shibukawa, Japan
| | - Tomohisa Shoko
- Department of Emergency and Critical Care Medicine, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Yoh Sugawara
- Department of Anesthesiology, Yokohama City University, Yokohama, Japan
| | - Atsunori Sugita
- Department of Acute Medicine, Division of Emergency and Critical Care Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Satoshi Suzuki
- Department of Intensive Care, Okayama University Hospital, Okayama, Japan
| | - Yuji Suzuki
- Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomohiro Suhara
- Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan
| | - Kenji Sonota
- Department of Intensive Care Medicine, Miyagi Children's Hospital, Sendai, Japan
| | - Shuhei Takauji
- Department of Emergency Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Kohei Takashima
- Critical Care Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Sho Takahashi
- Department of Cardiology, Fukuyama City Hospital, Fukuyama, Japan
| | - Yoko Takahashi
- Department of General Internal Medicine, Koga General Hospital, Koga, Japan
| | - Jun Takeshita
- Department of Anesthesiology, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Yuuki Tanaka
- Fukuoka Prefectural Psychiatric Center, Dazaifu Hospital, Dazaifu, Japan
| | - Akihito Tampo
- Department of Emergency Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Taichiro Tsunoyama
- Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Kenichi Tetsuhara
- Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan
| | - Kentaro Tokunaga
- Department of Intensive Care Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - Yoshihiro Tomioka
- Department of Anesthesiology and Intensive Care Unit, Todachuo General Hospital, Toda, Japan
| | - Kentaro Tomita
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Naoki Tominaga
- Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital, Tokyo, Japan
| | - Mitsunobu Toyosaki
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yukitoshi Toyoda
- Department of Emergency and Critical Care Medicine, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan
| | - Hiromichi Naito
- Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Isao Nagata
- Intensive Care Unit, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - Tadashi Nagato
- Department of Respiratory Medicine, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Yoshimi Nakamura
- Department of Emergency and Critical Care Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Yuki Nakamori
- Department of Clinical Anesthesiology, Mie University Hospital, Tsu, Japan
| | - Isao Nahara
- Department of Anesthesiology and Critical Care Medicine, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Hiromu Naraba
- Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Hitachi, Japan
| | - Chihiro Narita
- Department of Emergency Medicine and Intensive Care Medicine, Shizuoka General Hospital, Shizuoka, Japan
| | - Norihiro Nishioka
- Department of Preventive Services, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomoya Nishimura
- Advanced Medical Emergency Department and Critical Care Center, Japan Red Cross Maebashi Hospital, Maebashi, Japan
| | - Kei Nishiyama
- Division of Emergency and Critical Care Medicine Niigata University Graduate School of Medical and Dental Science, Niigata, Japan
| | - Tomohisa Nomura
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Taiki Haga
- Department of Pediatric Critical Care Medicine, Osaka City General Hospital, Osaka, Japan
| | - Yoshihiro Hagiwara
- Department of Emergency and Critical Care Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Katsuhiko Hashimoto
- Research Associate of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | - Takeshi Hatachi
- Department of Intensive Care Medicine, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Toshiaki Hamasaki
- Department of Emergency Medicine, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan
| | - Takuya Hayashi
- Division of Critical Care Medicine, Saitama Children's Medical Center, Saitama, Japan
| | - Minoru Hayashi
- Department of Emergency Medicine, Fukui Prefectural Hospital, Fukui, Japan
| | - Atsuki Hayamizu
- Department of Emergency Medicine, Saitama Saiseikai Kurihashi Hospital, Kuki, Japan
| | - Go Haraguchi
- Division of Intensive Care Unit, Sakakibara Heart Institute, Tokyo, Japan
| | - Yohei Hirano
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Ryo Fujii
- Department of Emergency Medicine and Critical Care Medicine, Tochigi Prefectural Emergency and Critical Care Center, Imperial Foundation Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Motoki Fujita
- Acute and General Medicine, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Naoyuki Fujimura
- Department of Anesthesiology, St. Mary's Hospital, Our Lady of the Snow Social Medical Corporation, Kurume, Japan
| | - Hiraku Funakoshi
- Department of Emergency and Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Masahito Horiguchi
- Department of Emergency and Critical Care Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Jun Maki
- Department of Critical Care Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Naohisa Masunaga
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yosuke Matsumura
- Department of Intensive Care, Chiba Emergency Medical Center, Chiba, Japan
| | - Takuya Mayumi
- Department of Internal Medicine, Kanazawa Municipal Hospital, Kanazawa, Japan
| | - Keisuke Minami
- Ishikawa Prefectual Central Hospital Emergency and Critical Care Center, Kanazawa, Japan
| | - Yuya Miyazaki
- Department of Emergency and General Internal Medicine, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
| | - Kazuyuki Miyamoto
- Department of Emergency and Disaster Medicine, Showa University, Tokyo, Japan
| | - Teppei Murata
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Machi Yanai
- Department of Emergency Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takao Yano
- Department of Critical Care and Emergency Medicine, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
| | - Kohei Yamada
- Department of Traumatology and Critical Care Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Naoki Yamada
- Department of Emergency Medicine, University of Fukui Hospital, Fukui, Japan
| | - Tomonori Yamamoto
- Department of Intensive Care Unit, Nara Prefectural General Medical Center, Nara, Japan
| | - Shodai Yoshihiro
- Pharmaceutical Department, JA Hiroshima General Hospital, Hatsukaichi, Japan
| | - Hiroshi Tanaka
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Osamu Nishida
- Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Japan
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Ohara T. Diagnostic Strategy for Infective Endocarditis in Patients With Adult Congenital Heart Disease. Circ J 2021; 85:1514-1516. [PMID: 33994410 DOI: 10.1253/circj.cj-21-0271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Takahiro Ohara
- Division of Community Medicine, Tohoku Medical and Pharmaceutical University
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Nogami A, Kurita T, Abe H, Ando K, Ishikawa T, Imai K, Usui A, Okishige K, Kusano K, Kumagai K, Goya M, Kobayashi Y, Shimizu A, Shimizu W, Shoda M, Sumitomo N, Seo Y, Takahashi A, Tada H, Naito S, Nakazato Y, Nishimura T, Nitta T, Niwano S, Hagiwara N, Murakawa Y, Yamane T, Aiba T, Inoue K, Iwasaki Y, Inden Y, Uno K, Ogano M, Kimura M, Sakamoto S, Sasaki S, Satomi K, Shiga T, Suzuki T, Sekiguchi Y, Soejima K, Takagi M, Chinushi M, Nishi N, Noda T, Hachiya H, Mitsuno M, Mitsuhashi T, Miyauchi Y, Miyazaki A, Morimoto T, Yamasaki H, Aizawa Y, Ohe T, Kimura T, Tanemoto K, Tsutsui H, Mitamura H. JCS/JHRS 2019 guideline on non-pharmacotherapy of cardiac arrhythmias. J Arrhythm 2021; 37:709-870. [PMID: 34386109 PMCID: PMC8339126 DOI: 10.1002/joa3.12491] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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