Endocarditis due to nutritionally deficient streptococci: therapeutic dilemma.

D. S. Stein, Kenrad Edwin Nelson

Research output: Contribution to journalArticle

Abstract

Three cases of endocarditis due to nutritionally deficient (variant) streptococci are presented and the literature is reviewed. In all of the cases reviewed, the patient presented with an indolent subacute course. Prior heart disease was present in 90% of the patients, embolization occurred in 27%, relapse after therapy in 17%, and death in 17%. Bacteriologic failure occurred in 41% of cases, despite sensitivity of the organisms to the antibiotics used in two-thirds of these cases. Combination therapy with penicillin and an aminoglycoside has been recommended previously; however, in 38% of the cases reviewed, bacteriologic failures occurred and the patients required surgery. The results of in vitro antibiotic-sensitivity testing are difficult to interpret and to apply to the expected response to therapy. Further studies on these organisms are needed to reduce the high rates of failure, relapse, and fatality.

Original languageEnglish (US)
Pages (from-to)908-916
Number of pages9
JournalReviews of Infectious Diseases
Volume9
Issue number5
StatePublished - Sep 1987
Externally publishedYes

Fingerprint

Endocarditis
Streptococcus
Anti-Bacterial Agents
Recurrence
Aminoglycosides
Penicillins
Heart Diseases
Therapeutics

ASJC Scopus subject areas

  • Microbiology (medical)

Cite this

Endocarditis due to nutritionally deficient streptococci : therapeutic dilemma. / Stein, D. S.; Nelson, Kenrad Edwin.

In: Reviews of Infectious Diseases, Vol. 9, No. 5, 09.1987, p. 908-916.

Research output: Contribution to journalArticle

@article{c758326be0be461c81301c5df779cc8e,
title = "Endocarditis due to nutritionally deficient streptococci: therapeutic dilemma.",
abstract = "Three cases of endocarditis due to nutritionally deficient (variant) streptococci are presented and the literature is reviewed. In all of the cases reviewed, the patient presented with an indolent subacute course. Prior heart disease was present in 90{\%} of the patients, embolization occurred in 27{\%}, relapse after therapy in 17{\%}, and death in 17{\%}. Bacteriologic failure occurred in 41{\%} of cases, despite sensitivity of the organisms to the antibiotics used in two-thirds of these cases. Combination therapy with penicillin and an aminoglycoside has been recommended previously; however, in 38{\%} of the cases reviewed, bacteriologic failures occurred and the patients required surgery. The results of in vitro antibiotic-sensitivity testing are difficult to interpret and to apply to the expected response to therapy. Further studies on these organisms are needed to reduce the high rates of failure, relapse, and fatality.",
author = "Stein, {D. S.} and Nelson, {Kenrad Edwin}",
year = "1987",
month = "9",
language = "English (US)",
volume = "9",
pages = "908--916",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "5",

}

TY - JOUR

T1 - Endocarditis due to nutritionally deficient streptococci

T2 - therapeutic dilemma.

AU - Stein, D. S.

AU - Nelson, Kenrad Edwin

PY - 1987/9

Y1 - 1987/9

N2 - Three cases of endocarditis due to nutritionally deficient (variant) streptococci are presented and the literature is reviewed. In all of the cases reviewed, the patient presented with an indolent subacute course. Prior heart disease was present in 90% of the patients, embolization occurred in 27%, relapse after therapy in 17%, and death in 17%. Bacteriologic failure occurred in 41% of cases, despite sensitivity of the organisms to the antibiotics used in two-thirds of these cases. Combination therapy with penicillin and an aminoglycoside has been recommended previously; however, in 38% of the cases reviewed, bacteriologic failures occurred and the patients required surgery. The results of in vitro antibiotic-sensitivity testing are difficult to interpret and to apply to the expected response to therapy. Further studies on these organisms are needed to reduce the high rates of failure, relapse, and fatality.

AB - Three cases of endocarditis due to nutritionally deficient (variant) streptococci are presented and the literature is reviewed. In all of the cases reviewed, the patient presented with an indolent subacute course. Prior heart disease was present in 90% of the patients, embolization occurred in 27%, relapse after therapy in 17%, and death in 17%. Bacteriologic failure occurred in 41% of cases, despite sensitivity of the organisms to the antibiotics used in two-thirds of these cases. Combination therapy with penicillin and an aminoglycoside has been recommended previously; however, in 38% of the cases reviewed, bacteriologic failures occurred and the patients required surgery. The results of in vitro antibiotic-sensitivity testing are difficult to interpret and to apply to the expected response to therapy. Further studies on these organisms are needed to reduce the high rates of failure, relapse, and fatality.

UR - http://www.scopus.com/inward/record.url?scp=0023402550&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023402550&partnerID=8YFLogxK

M3 - Article

C2 - 3317735

AN - SCOPUS:0023402550

VL - 9

SP - 908

EP - 916

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 5

ER -