Open AccessLeft-Sided Endocarditis due to Pseudomonas aeruginosa
Author(s) -
Mark L. Wieland,
Michael M. Lederman,
Christine Kline-King,
Thomas F. Keys,
Phillip I. Lerner,
Steven Bass,
Richard Chemilewski,
Virginia Banks,
Jerrold J. Ellner
Publication year - 1986
Publication title -
medicine
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/00005792-198605000-00006
Subject(s) - medicine , bass (fish) , endocarditis , pseudomonas aeruginosa , ecology , bacteria , genetics , biology
Ten confirmed cases of left-sided endocarditis due to Pseudomonas aeruginosa were reported in detail and the English literature was reviewed. In recent years, venous access (usually illicit) has been the major predisposing factor to this infection and abuse of pentazocine and tripelennamine has been particularly associated with endocarditis due to this organism. This infection involves previously damaged as well as normal valves. The development of congestive heart failure did not adversely affect the prognosis of this infection. However, the development of azotemia was associated with a greater likelihood of a fatal outcome. In the current series, deaths were due to uncontrolled infection. This often occurred despite inhibitory and bactericidal activity in serum generally considered adequate for treatment of endocarditis. Medical treatment alone rarely produced cure of infection. Our experience with a high frequency of major vessel embolization (4/10) and the improved survival after medical/surgical treatment suggests that prompt valve replacement combined with high doses of an aminoglycoside plus carbenicillin or ticarcillin provide the best opportunity for successful outcome in patients with left-sided endocarditis due to P. aeruginosa.