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Patient with endocarditis who has an embolic occlusion of a large artery
    Differential Diagnosis[Top] [Nav]
fungal endocarditis, nonbacterial thrombotic endocarditis, atrial myxoma
    Discussion -- not available online[Top] [Nav]
    Update Comments[Top] [Nav]
  • Says large vegetations are common in:
    • Endocarditis caused by HACEK organisms: Causes vegetations that "are thought to be characteristically large, but possibly the size reflects the result of delayed diagnosis." HACEK = selected species of Hemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella.
    • Brucella endocarditis: "bulky and ulcerative."
    • Fungal endocarditis: "The development of emboli in major arterial vessels... is considered a hallmark of the disease and is often the initial sign."
    • Chlamydia psittacosis endocarditis: "The vegetations are usualy large with fingerlike projections."
    [101]
  • Says (without references) that large vegetations and major embolic events are common in endocarditis caused by C. burnetti, fungi, and haemophilus species. [102]
  • A case of H. parainfluenzae endocarditis. Large-artery embolization is "common" in this disease. [103]
    Footnotes in Print Edition[Top] [Nav]
    (1) Pathoanatomic, pathophysiologic and clinical correlations in endocarditis (second of two parts).
  Weinstein L, Schlesinger JJ.   N Engl J Med 1974 Nov 21;291(21):1122-6.  Pubmed  Similars
    (2) Scientific American Medicine.
  Rubenstein E, Federman DD, et al. NY: Scientific American: Sept. 1988;7:XVIII:4-5 [chapter = Karchmer AW, Swartz MN. Infective Endocarditis].
    (3) Echocardiographic and clinical correlates in drug addicts with infective endocarditis. Implications of vegetation size.
  Manolis AS, Melita H.   Arch Intern Med 1988 Nov;148(11):2461-5.  Pubmed+Abstract  Similars
    (4) The significance of nonbacterial thrombotic endocarditis: an autopsy and clinical study of 78 cases.
  MacDonald RA, Robbins SL.   Ann Int Med. 1957;46:255-273.
    New References[Top] [Nav]
    101.Infective endocarditis due to unusual or fastidious microorganisms.
  Berbari EF, Cockerill FR 3rd, et al.   Mayo Clin Proc 1997 Jun;72(6):532-42.  Pubmed+Abstract  Similars
    102.Endocarditis with negative blood cultures [editorial].
  Tunkel AR, Kaye D.   N Engl J Med 1992 Apr 30;326(18):1215-7.  Pubmed  Similars
    103.Clinical problem-solving. Assembling a coherent story [see comments].
  Oren R, Matzner Y.   N Engl J Med 1994 Jan 6;330(1):48-50.  Pubmed  Similars
    104.Echocardiography in infective endocarditis: reassessment of prognostic implications of vegetation size determined by the transthoracic and the transesophageal approach.
  Mugge A, Daniel WG, et al.   J Am Coll Cardiol 1989 Sep;14(3):631-8.  Pubmed+Abstract  Similars
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    ©1986-2000 John Sotos, MD. All rights reserved.  Last updated 16:34 PDT on July 4, 2000.[Top]

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