Staphylococcus Aureus – ABC CARDIOL

ABC

Image

Tricky Diagnosis: An Aberrant Mitral Valve Chord

Marina Santos et al. Mariana Paiva Joana Ferreira Sara Guerreiro

Case

We present the case of a 52-year-old man with hepatitis C and a history of intravenous drug abuse, admitted to the infectology department with spondylodiscitis and psoas muscle abscess. Staphylococcus aureus was isolated from blood, urine, and spinal fluid cultures, and the transthoracic echocardiogram was negative for vegetation, abscess, or fistula. The transesophageal echocardiogram (TEE) showed a filamentous and mobile structure attached to the atrial surface of the mitral valve (MV), and a diagnosis of infective endocarditis was presumed. Seven days later, the patient was referred to our tertiary institution for a detailed TEE. In 2D images, we found a thin, well-delineated strand connecting the interatrial septum (IAS) to the tip of the anterior mitral leaflet without significant regurgitation ( , supplementary video 1). 3D imaging confirmed the presence of an anomalous chord connecting the A2 scallop of MV to the middle of the interatrial septum ( , supplementary video 2). There was no evidence of infective endocarditis, and this strand was found to be compatible with an anomalous left atrial MV chord.

[…]

Read Full Article

IJCS

Editorial

Diabetes Mellitus, Insulin Use, and Infective Endocarditis

Rubens Antunes Cruz Filho

The prevalence of diabetes mellitus (DM) is very high in Brazil and worldwide. It is estimated that there are now more than 12 million diabetics in Brazil, not counting those who already have the disease but have not yet been diagnosed. Since the introduction of insulin, the treatment of DM has been constantly changing, according to treatment guidelines proposed by diabetes societies, from the diagnosis to more advanced stages of the disease. More stable insulins, as well as incretin-based therapy for subcutaneous use, have been proposed in the treatment of type 2 DM patients. These therapies have not only contributed to the better treatment of the most prevalent type of diabetes, but also introduced the use of a parenteral medication other than insulin.

Infective endocarditis (IE) is a relatively rare, serious cardiovascular disease with a hospital mortality rate of 17-25%, despite all therapeutic advances. In an observational study by Bezerra et al., published in this issue of the IJCS, the association between the use of insulin and IE is discussed. In this retrospective study involving 211 patients, 17 with DM (nine insulin users), there was a higher proportion of S. aureus infection in diabetics using insulin. However, mortality rate was not higher among diabetics when compared to non-diabetics. There is a lack of studies on IE in DM and regarding the use of insulin and IE, data are even more scarce. So, the study by Bezerra et al., assumes an importance in this area of knowledge, since we are talking about a highly prevalent disease (DM) and a serious comorbidity (IE) with a still high risk of mortality.

[…]

Read Full Article

Tricky Diagnosis: An Aberrant Mitral Valve Chord

Case

Diabetes Mellitus, Insulin Use, and Infective Endocarditis

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)