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Mycobacterial endocarditis: a comprehensive review.

Yuan SM - Rev Bras Cir Cardiovasc (2015 Jan-Mar)

Bottom Line: This condition has changed significantly in terms of epidemiology since the 21st century, with more broad patient age range, longer latency, prevailed mitral valve infections and better prognosis.Amikacin, ciprofloxacin and clarithromycin are the most frequently used targeted antimicrobial agents but often show poor responses.With periodic multidrug therapy guided by drug susceptibility testing, and surgical managements, patients may achieve good therapeutic results.

View Article: PubMed Central - PubMed

Affiliation: Teaching Hospital, Fujian Medical University, Putian, People's Republic of China.

ABSTRACT

Objective: A systematic analysis was made in view of the epidemiology, clinical features, diagnosis, treatment and main outcomes of mycobacterial endocarditis.

Methods: The data source of the present study was based on a comprehensive literature search in MEDLINE, Highwire Press and Google search engine for publications on mycobacterial endocarditis published between 2000 and 2013.

Results: The rapidly growing mycobacteria become the predominant pathogens with Mycobacterium chelonae being the most common. This condition has changed significantly in terms of epidemiology since the 21st century, with more broad patient age range, longer latency, prevailed mitral valve infections and better prognosis.

Conclusion: Mycobacterial endocarditis is rare and the causative pathogens are predominantly the rapidly growing mycobacteria. Amikacin, ciprofloxacin and clarithromycin are the most frequently used targeted antimicrobial agents but often show poor responses. Patients with deep infections may warrant a surgical operation or line withdrawal. With periodic multidrug therapy guided by drug susceptibility testing, and surgical managements, patients may achieve good therapeutic results.

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Eventual mycobacterial strains
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f03: Eventual mycobacterial strains

Mentions: By preliminary blood cultures, histological staining, molecular analyses andchromatographic techniques, the eventual mycobacterial strains were identifiedin all but one patient (Figure 3).Distributions of the mycobacteria responding to the four predisposing riskfactors showed cardiac operation was associated with more, prevailed rapidlygrowing mycobacteria (M. chelonae, M. fortuitum and M. chimaera) endocarditis,foreign material implant was associated with M. fortuitum, and intravenous druguse and miscellaneity were prone to be of tuberculous endocarditis (Figure 4, Table 5).


Mycobacterial endocarditis: a comprehensive review.

Yuan SM - Rev Bras Cir Cardiovasc (2015 Jan-Mar)

Eventual mycobacterial strains
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4389517&req=5

f03: Eventual mycobacterial strains
Mentions: By preliminary blood cultures, histological staining, molecular analyses andchromatographic techniques, the eventual mycobacterial strains were identifiedin all but one patient (Figure 3).Distributions of the mycobacteria responding to the four predisposing riskfactors showed cardiac operation was associated with more, prevailed rapidlygrowing mycobacteria (M. chelonae, M. fortuitum and M. chimaera) endocarditis,foreign material implant was associated with M. fortuitum, and intravenous druguse and miscellaneity were prone to be of tuberculous endocarditis (Figure 4, Table 5).

Bottom Line: This condition has changed significantly in terms of epidemiology since the 21st century, with more broad patient age range, longer latency, prevailed mitral valve infections and better prognosis.Amikacin, ciprofloxacin and clarithromycin are the most frequently used targeted antimicrobial agents but often show poor responses.With periodic multidrug therapy guided by drug susceptibility testing, and surgical managements, patients may achieve good therapeutic results.

View Article: PubMed Central - PubMed

Affiliation: Teaching Hospital, Fujian Medical University, Putian, People's Republic of China.

ABSTRACT

Objective: A systematic analysis was made in view of the epidemiology, clinical features, diagnosis, treatment and main outcomes of mycobacterial endocarditis.

Methods: The data source of the present study was based on a comprehensive literature search in MEDLINE, Highwire Press and Google search engine for publications on mycobacterial endocarditis published between 2000 and 2013.

Results: The rapidly growing mycobacteria become the predominant pathogens with Mycobacterium chelonae being the most common. This condition has changed significantly in terms of epidemiology since the 21st century, with more broad patient age range, longer latency, prevailed mitral valve infections and better prognosis.

Conclusion: Mycobacterial endocarditis is rare and the causative pathogens are predominantly the rapidly growing mycobacteria. Amikacin, ciprofloxacin and clarithromycin are the most frequently used targeted antimicrobial agents but often show poor responses. Patients with deep infections may warrant a surgical operation or line withdrawal. With periodic multidrug therapy guided by drug susceptibility testing, and surgical managements, patients may achieve good therapeutic results.

Show MeSH
Related in: MedlinePlus