"Grey Zone" Patterns of Unexplained Endocarditis: Still a Challenge for Clinical Decision Making

Antonio Grimaldi, Maurizio Taramasso, Francesco Maisano, Giovanni La Canna, Maria Grazia Pala, Stefano Benussi, Giorgio Viganò, Ottavio Alfieri

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The authors report two cases of unexplained active inflammatory endocarditis with totally different clinical presentations. The patients had undergone previous mitral repair surgery and were referred for multiple soft mobile masses on the mitral ring without clinical or laboratory signs of endocarditis. Serologic screening and blood culture results were negative, including those for specific fastidious bacteria, as well as immunologic tests to rule out "nonbacterial thrombotic endocarditis." Before new surgery, both patients were treated with long-term antibiotic and anticoagulant therapy, with no significant changes in clinical setting and echocardiographic patterns. In neither case was it possible to characterize a specific microorganism: the intraoperative findings were highly evocative of active endocarditis with a macroscopic infiltration of the mitral ring, and culture results from surgical material and valvular tissue were negative.

Original languageEnglish
JournalJournal of the American Society of Echocardiography
Volume23
Issue number2
DOIs
Publication statusPublished - Feb 2010

Fingerprint

Endocarditis
Immunologic Tests
Anticoagulants
Anti-Bacterial Agents
Bacteria
Clinical Decision-Making
Therapeutics

Keywords

  • Acute endocarditis
  • Mitral valve repair
  • Three-dimensional echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

"Grey Zone" Patterns of Unexplained Endocarditis : Still a Challenge for Clinical Decision Making. / Grimaldi, Antonio; Taramasso, Maurizio; Maisano, Francesco; La Canna, Giovanni; Pala, Maria Grazia; Benussi, Stefano; Viganò, Giorgio; Alfieri, Ottavio.

In: Journal of the American Society of Echocardiography, Vol. 23, No. 2, 02.2010.

Research output: Contribution to journalArticle

Grimaldi, Antonio ; Taramasso, Maurizio ; Maisano, Francesco ; La Canna, Giovanni ; Pala, Maria Grazia ; Benussi, Stefano ; Viganò, Giorgio ; Alfieri, Ottavio. / "Grey Zone" Patterns of Unexplained Endocarditis : Still a Challenge for Clinical Decision Making. In: Journal of the American Society of Echocardiography. 2010 ; Vol. 23, No. 2.
@article{aa4b2061797340098714a4445cc46d1e,
title = "{"}Grey Zone{"} Patterns of Unexplained Endocarditis: Still a Challenge for Clinical Decision Making",
abstract = "The authors report two cases of unexplained active inflammatory endocarditis with totally different clinical presentations. The patients had undergone previous mitral repair surgery and were referred for multiple soft mobile masses on the mitral ring without clinical or laboratory signs of endocarditis. Serologic screening and blood culture results were negative, including those for specific fastidious bacteria, as well as immunologic tests to rule out {"}nonbacterial thrombotic endocarditis.{"} Before new surgery, both patients were treated with long-term antibiotic and anticoagulant therapy, with no significant changes in clinical setting and echocardiographic patterns. In neither case was it possible to characterize a specific microorganism: the intraoperative findings were highly evocative of active endocarditis with a macroscopic infiltration of the mitral ring, and culture results from surgical material and valvular tissue were negative.",
keywords = "Acute endocarditis, Mitral valve repair, Three-dimensional echocardiography",
author = "Antonio Grimaldi and Maurizio Taramasso and Francesco Maisano and {La Canna}, Giovanni and Pala, {Maria Grazia} and Stefano Benussi and Giorgio Vigan{\`o} and Ottavio Alfieri",
year = "2010",
month = "2",
doi = "10.1016/j.echo.2009.08.010",
language = "English",
volume = "23",
journal = "Journal of the American Society of Echocardiography",
issn = "0894-7317",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - "Grey Zone" Patterns of Unexplained Endocarditis

T2 - Still a Challenge for Clinical Decision Making

AU - Grimaldi, Antonio

AU - Taramasso, Maurizio

AU - Maisano, Francesco

AU - La Canna, Giovanni

AU - Pala, Maria Grazia

AU - Benussi, Stefano

AU - Viganò, Giorgio

AU - Alfieri, Ottavio

PY - 2010/2

Y1 - 2010/2

N2 - The authors report two cases of unexplained active inflammatory endocarditis with totally different clinical presentations. The patients had undergone previous mitral repair surgery and were referred for multiple soft mobile masses on the mitral ring without clinical or laboratory signs of endocarditis. Serologic screening and blood culture results were negative, including those for specific fastidious bacteria, as well as immunologic tests to rule out "nonbacterial thrombotic endocarditis." Before new surgery, both patients were treated with long-term antibiotic and anticoagulant therapy, with no significant changes in clinical setting and echocardiographic patterns. In neither case was it possible to characterize a specific microorganism: the intraoperative findings were highly evocative of active endocarditis with a macroscopic infiltration of the mitral ring, and culture results from surgical material and valvular tissue were negative.

AB - The authors report two cases of unexplained active inflammatory endocarditis with totally different clinical presentations. The patients had undergone previous mitral repair surgery and were referred for multiple soft mobile masses on the mitral ring without clinical or laboratory signs of endocarditis. Serologic screening and blood culture results were negative, including those for specific fastidious bacteria, as well as immunologic tests to rule out "nonbacterial thrombotic endocarditis." Before new surgery, both patients were treated with long-term antibiotic and anticoagulant therapy, with no significant changes in clinical setting and echocardiographic patterns. In neither case was it possible to characterize a specific microorganism: the intraoperative findings were highly evocative of active endocarditis with a macroscopic infiltration of the mitral ring, and culture results from surgical material and valvular tissue were negative.

KW - Acute endocarditis

KW - Mitral valve repair

KW - Three-dimensional echocardiography

UR - http://www.scopus.com/inward/record.url?scp=75949104435&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=75949104435&partnerID=8YFLogxK

U2 - 10.1016/j.echo.2009.08.010

DO - 10.1016/j.echo.2009.08.010

M3 - Article

C2 - 19815381

AN - SCOPUS:75949104435

VL - 23

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

SN - 0894-7317

IS - 2

ER -