Early prosthetic valve endocarditis

Early prosthetic valve endocarditis (PVE), with an onset within 60 days of valve replacement, accounts for approximately one-third of all cases, while the remaining two-thirds, occur more than two months postoperatively (late prosthetic valve endocarditis) Objectives: Prosthetic valve endocarditis (PVE) is an uncommon yet dreadful complication in patients with prosthetic valves that requires a distinct analysis from native valve endocarditis. The present study aims to investigate independent risk factors for early surgical outcomes in patients with PVE. Methods: A retrospective cohort study was conducted in 8 Italian Cardiac Surgery Units from. Early prosthetic valve endocarditis after transcatheter aortic valve implantation using St Jude Medical Portico valve. Ibrahim A(1), Ahmed A(2), Kiernan T(2), Arnous S(2)

Prosthetic valve endocarditis: an overvie

• Prosthetic valve endocarditis (PVE) is one type of infectious endocarditis (IE). It accounts for 20% of all cases of endocarditis. It is important to achieve an early diagnosis and initiate the treatment as early as possible. This activity provides a review of this disease's etiology, the clinical presentation, and the appropriate management
• The risk for early PVE is higher (approximately 5%) in patients with replacement surgery during active infective endocarditis, especially if the causal organism is unknown or the antibiotic treatment is insufficient. The incidence of late PVE is lower for mechanical prostheses than for bioprostheses
• To discard an early prosthetic endocarditis, a transesophageal echocardiography was carried out showing signs of endocarditis in the mechanical mitral prosthetic valve with extensive infiltration of the native ring; small vegetation on the prosthetic ring was also observed, along with 2 large dehiscence and severe regurgitation
• Early onset PVE refers to disease developing within 60 days of valve placement. When infection arises prior to discharge from the hospital after surgery the typical, often subtle, manifestations of endocarditis may be obscured by findings related to surgery itself or complications thereof. Typically, patients with early onset PVE have
• g of the infection after surgical valve replacement reflects different pathogenic mechanisms that, in turn, influence the clinical presentation
• As compared with conventional treatment, early surgery in patients with infective endocarditis and large vegetations significantly reduced the composite end point of death from any cause and..

Prosthetic valve endocarditis: predictors of early outcome

A 56-year-old woman was admitted to our department for a suspicion of early onset prosthetic valve endocarditis after an aortic valve replacement. An early clinical and biological improvement, features on a chest computed tomography scan, as well as a surgical correlation were able to rectify the diagnosis Most cases in both groups occurred between 31 days and one year. Most important finding was that prosthetic valve endocarditis was associated with a more than four fold risk of death. In this study, early prosthetic valve endocarditis was defined as before 30 days, 31 days to one year as intermediate and beyond 1 year as late The diagnosis of early mechanical prosthetic endocarditis due to F magna was established, and therapy was changed to penicillin G sodic (4 g intravenously for 4 hours) plus gentamicin (240 mg/d) was started. The patient was surgically treated urgently with mitral valve replacement using mechanical prosthesis. The excised valve Prosthetic Valve Endocarditis Prosthetic valve endocarditis accounts for 10% to 20% of most series, with an overall incidence of 0.1% to 2.3% per patient-year. 6,79 Cases may be classified as early or late depending on whether infection arises within 1 year of surgery or later

Early prosthetic valve endocarditis after transcatheter

1. Prosthetic valve endocarditis is a disease of low incidence but great importance. The incidence of prosthetic valve endocarditis is highest within 12 months of valve replacement surgery (early onset prosthetic valve endocarditis [EO-PVE]) and ranges between 1.4% and 3.1% 1, 2, 3, 4
2. Prosthetic valve endocarditis (PVE) is a rare but serious complication of relative to valve replacement surgery [1,12,13]. Early-onset PVE is defined as that occurring within 60 days of surgery and it is usually a manifestation of healthcare-acquired infections. Staphylococca
3. Patients with bioprosthetic valves had a higher risk of infective endocarditis compared with patients receiving mechanical valves (OR 1.59, 95% CI 1.35 to 1.88, p<0.001) with an absolute risk reduction of 9 per 1000 (95% CI 6 to 14). Heterogeneity within the included studies was low (I 2 =0%)
4. GUIDELINES FOR TREATMENT OF PROSTHETIC VALVE INFECTIVE ENDOCARDITIS IN ADULTS (Infectious Diseases consultation is recommended) Empiric Therapy§ Pathogens Subsequent Therapy (Renal Dose Adjustments May Be Necessary) Duration of Therapy Comments Early (≤1 year since valve replacement): Vancomycin IV4 + Cefepime 2 g IV q8h1 + Rifampin 300 mg PO/I
5. In-hospital and 1-year mortality in patients undergoing early surgery for prosthetic valve endocarditis. JAMA Intern Med 2013; 173:1495. Chirouze C, Alla F, Fowler VG Jr, et al. Impact of early valve surgery on outcome of Staphylococcus aureus prosthetic valve infective endocarditis: analysis in the International Collaboration of Endocarditis.
6. Prosthetic valve endocarditis (PVE) occurs in approximately 3% to 6% of patients within 5 years of valve implantation and is associated with significant morbidity and mortality. 1-4 Surgical intervention with debridement and valve replacement is recommended by consensus guidelines 5,6 for patients with complications such as valve dysfunction.
7. † Early endocarditis was defined as prosthetic valve endocarditis within 1 year of aortic valve replacement. ‡ Late endocarditis was defined as prosthetic valve endocarditis >1 year after aortic valve replacement. In this nationwide, population-based cohort study, the incidence of PVE after AVR was 0.57% per person-year

Early PVE, which presents shortly after surgery, has a different bacteriology and prognosis than late PVE, which presents in a subacute fashion similar to NVE. Infection associated with aortic.. Objective: To compare the early and late outcome of medical and surgical treatment in patients with prosthetic valve endocarditis within a single unit. Design: All patients with proven prosthetic valve endocarditis treated in one institution between 1989 and 1999 were studied. Results: There were 66 patients (24 female, 42 male), mean (SD) age 57 (14) years valve replacement. This was thought to be due the potential attachment of bacteria to the exposed prosthetic valve material as endothelialisation takes around 12 months to complete.21 Prosthetic valve endocarditis (PVE) post-transcatheter aortic Early PVE carries a higher risk of mortality and tends to have Prosthetic valve endocarditis can be early (< 60 days of valvular surgery), intermediate (60 days to 1 year) or late (> 1 year following valvular surgery). [citation needed] Early prosthetic valve endocarditis is usually due to intraoperative contamination or postoperative bacterial contamination which is usually nosocomial in nature An 87-year-old woman presented to the emergency department with a 2-week history of progressively worsening shortness of breath, fever and generalised myalgia. She underwent a transcatheter Portico aortic valve implantation for severe symptomatic aortic stenosis 3 months prior to this presentation. Examination revealed a temperature of 40°C and a systolic murmur in the aortic area

Prosthetic Valve Endocarditis - StatPearls - NCBI Bookshel

FDG PET/CT scanning identifying lead endocarditis, prosthetic aortic valve infection, and polyps localized in the sigmoid. Transaxial CT views (A, B, and C), FDG PET views (D, E, and F), and fused PET/CT views (G, H, and I) at the level of the pacing lead, the mechanical prosthetic aortic valve, and the sigmoid colon.There is increased FDG uptake in the intra-cardiac portion of the lead at the. Inpatient mortality was 23% (50% in early prosthetic valve endocarditis). After a mean follow-up of 56 months there were 5 cases of recurrence, four patients required late surgery and 5 patients died Early>onset prosthetic valve endocarditis THOMAS F. KEYS, MD BACKGROUND Endocarditis following cardiac valve implan-tation is a rare but serious complication. OBJECTIVE To determine the risk and outcom early-onsee of t prosthetic valve endocarditis (EO-PVE) in adult patients at The Cleveland Clinic

Context Early prosthetic valve endocarditis is a deadly disease and blood cultures remain negative in 14-30% of cases. Objectives To analyse the clinical and microbiological profile of patients with blood culture-negative (BCN) early prosthetic valve endocarditis (PVE) in order to define the most appropriate empiric treatment. Design, Setting and Participants From June 2001 to February 2009. The diagnosis of early mechanical prosthetic endocarditis due to F magna was established, and therapy was changed to penicillin G sodic (4 g intravenously for 4 hours) plus gentamicin (240 mg/d) was started. The patient was surgically treated urgently with mitral valve replacement using mechanical prosthesis Prosthetic valve endocarditis (PVE) is usually defined as early or late. Many currently favor a cut-off of 12 months post surgery. Many currently favor a cut-off of 12 months post surgery. Infections presenting in the first 2 months after surgery are usually the result of infection during surgery, whilst those occurring up to 12 months may be. Patients were also excluded if they had infective endocarditis involving a prosthetic valve, right-sided vegetations, or small vegetations (diameter, ≤10 mm) or had been referred from another.

Prosthetic valve IE. Prosthetic valve endocarditis is the most serious form of IE, and more difficult to treat using antibiotics alone. In general, current guidelines support consideration of a surgical strategy for high-risk subgroups with prosthetic valve IE, including patients with heart failure, abscess, or persistent fever Prosthetic valve endocarditis accounts for 10% to 20% of most series, with an overall incidence of 0.1% to 2.3% per patient-year. 6,79 Cases may be classified as early or late depending on whether infection arises within 1 year of surgery or later. The aortic valve is most frequently affected, and metallic prostheses and bioprostheses are. Of note, however, prosthetic valve endocarditis after the first year of valve replacement tends to be community acquired, as reflected by increased incidence of Streptococcus spp and Enterococcus infections.38 Antibiotic prophylaxis for staphylococci prior to implantation of a CIED is a class 1 recommendation by the AHA and was shown to be.

BACKGROUND Endocarditis following cardiac valve implantation is a rare but serious complication. OBJECTIVE To determine the risk and outcome of early-onset prosthetic valve endocarditis (EO-PVE) in adult patients at The Cleveland Clinic. METHODS Retrospective review of a 5-year case series of patients who acquired bloodstream infections within 60 days of surgery identified through a. study 55 percent of the patients were older than 60 years.(4) The majority of native valve endocarditis is caused by Streptococcus viridans (50 percent) and Staphylococcus aureus (20 percent).(5) In early prosthetic valve endocarditis Staphylococcus epidermis is the most frequent organism. Late‐onse We reviewed all cases of early onset prosthetic valve endocarditis (EO-PVE) occurring less than 12 months after valve operation among 7,043 patients undergoing heart valve replacements or repairs. Infective endocarditis is the most serious complications of valve replacement and has been reported to occur in 1-6% of patients with valve prostheses. 1 Despite improvements in medical treatment and surgery, prosthetic valve endocarditis (PVE) carries a high mortality risk ranging from 20-80% of affected patients. 1 This unacceptably high mortality explains why several studies have tried. Prosthetic valve endocarditis was defined as infection occurring on any type of tissue or mechanical valve device. 'Early' prosthetic valve endocarditis was present if recurrent or residual endocarditis occurred within 60 days after surgery, while prosthetic valve endocarditis occurring after 60 days was labeled 'late'

Endocarditis occurs most often in older adults over age 60. Artificial heart valves. Germs are more likely to attach to an artificial (prosthetic) heart valve than to a normal heart valve. Damaged heart valves Atypical Early Aspergillus Endocarditis Post Prosthetic Mitral Valve Repair: A Case Report Ahmed AbdulAziz Abuzaid 1, Mahmood Zaki 2, Habib Tarif 3 1 Department of Cardiovascular Surgery, Mohammed bin Khalifa Cardiac Centre, Bahrain Defence Force Hospital, Al-Riffa, Bahrai 2 Department of Intensivest of cardiac anesthesia, Mohammed bin Khalifa Cardiac Centre, Bahrain Defence Force Hospital, Al. A 66-year old man from Australia underwent uneventful elective replacement of a heavily calcified severely stenotic aortic valve (AVR) with a 22 mm Medtronic-Hall valve. Six weeks later, the patient was readmitted because of progressively worsenin P rosthetic valve endocarditis (PVE), although uncommon, is one of the most serious complications after heart valve surgery. 1,2 The prognosis of PVE is attributable not only to morbidity and mortality during the active phase but also to late complications that may develop once the infection has been resolved Surgical treatment of active prosthetic valve endocarditis is associated with substantial early and late mortality.8-10 The current elderly man had an extensive annular abscess, severe aortic insufficiency, and New York Heart Association class III to IV heart failure when he initially presented with prosthetic valve endocarditis

Prosthetic valve endocarditis Hear

In-Hospital and 1-Year Mortality in Patients Undergoing Early Surgery for Prosthetic Valve Endocarditis. JAMA Internal Medicine, 2013. G. Corey. Margaret Hannan. Paolo Grossi. Vance Fowler. Vivian Chu. Daniel Sexton. G. Corey Prosthetic valve endocarditis (PVE) is a microbial infection of the endovascular that occurs on parts of a prosthetic valve or on the reconstructed native valve of the heart. [1] PVE accounts for 20% of infective endocarditis. It is the most severe form of infective endocarditis and is associated with high morbidity and mortality Summary. Infective endocarditis (IE) is an infection of the endocardium that typically affects one or more heart valves.The condition is usually a result of bacteremia, which is most commonly caused by dental procedures, surgery, distant primary infections, and nonsterile injections. IE may be acute (developing over hours or days) or subacute (progressive over weeks to months) Context Early prosthetic valve endocarditis is a deadly disease and blood cultures remain negative in 14-30% of cases. Objectives To analyse the clinical and microbiological profile of patients.

Prosthetic valve endocarditis (PVE) is associated with high mortality and reoperation rates despite diagnostic and therapeutic improvements. We retrospectively analyzed the data of 35 patients who had undergone reoperative cardiac surgery for PVE in our hospital between January 1, 2005 and December 31, 2014 In particular, early prosthetic valve endocarditis (PVE) is a dangerous complication of cardiac surgery, with mortality rates approaching 35% (1,2). The risk of early A prospective series of 78 cases of prosthetic valve endocarditis (PVE) was studied (35 cases of early PVE and 43 cases of late PVE). The in-hospital mortality rate was significantly higher in patients with early PVE (31% vs 9%, p <0.01) because the onset of heart failure was more common in these patients (55% vs 37%, p <0.05). However, event-free survival at 4 years in survivors to the active. Prosthetic valve endocarditis (PVE) is the most severe form of infective endocarditis and accounts for 20% of all cases of infective endocarditis. 1,2 However, studies reporting the incidence of PVE after surgical aortic valve replacement (AVR) are scarce and based mainly on noncontemporary patient cohorts. Whether PVE affects biological and mechanical aortic valves to the same extent remains.

Early Prosthetic Valve Endocarditis Due to Finegoldia

1. Early Surgery for Prosthetic Valve Endocarditis? Larry M. Baddour, MD , reviewing Lalani T et al. JAMA Intern Med 2013 Jul 15 Bolger AF. JAMA Intern Med 2013 Jul 1
2. CONCLUSIONS AND RELEVANCE: Prosthetic valve endocarditis remains associated with a high 1-year mortality rate. After adjustment for differences in clinical characteristics and survival bias, early valve replacement was not associated with lower mortality compared with medical therapy in the overall cohort
3. Since the 1960s, valve replacement and valve repair have become common procedures for management of selected cases of infective endocarditis (IE). A review foun It seems to us that you have your JavaScript disabled on your browser
4. Prosthetic valve endocarditis. In: Kaye D, ed., unique in several ways: (i) it is a multicentre study; (ii) Infective endocarditis. 2nd edn. New York: Raven Press; 1992. p375-396. our patients were consecutively and prospectively included; 2. Chastre J, Trouillet JL. Early infective endocarditis on prosthetic valves
5. We report a case of prosthetic aortic valve S. warneri endocarditis, in which the patient lacked typical infectious signs and symptoms, instead presenting with congestive heart failure due to.
6. 4.2. Mitral prosthetic valve endocarditis. Endocarditis is rare after mitral valve repair. The rate of freedom from endocarditis at 10 years following mitral valve repair is estimated at 95-99% . Although native valve endocarditis can often be managed medically, PVE typically requires early operation

Prosthetic Valve Endocarditis - Infectious Disease Adviso

1. Early prosthetic valve replacement during the active phase of the disease (the active phase was considered to be the period when the patient was still receiving antibiotics) was considered in the following situations: staphylococcal or fungal endocarditis, moderate to severe cardiac failure due to prosthetic dysfunction, repetitive emboli, and.
2. Prosthetic valve endocarditis (PVE) is a complication with an even higher rate of mortality and morbidity than endocarditis in the absence of prosthetic material. In the literature, it is described as a relatively uncommon clinical entity. In-hospital and 1-year mortality in patients undergoing early surgery for prosthetic valve endocarditis
3. Prosthetic valve endocarditis (PVE) is a low incidence microbial infection complicating surgical valve replacements with a very high rate of early mortality. We present a series of 5 patients who required redo surgical interventions due to PVE as a complication within the first 3 postoperative months
4. The benefit of early surgery was investigated in the early surgery versus conventional treatment for infective endocarditis trial, which is the first randomized trial in endocarditis [2]. In this study, 76 patients with left-sided native valve infective endocarditis, vegetations >10 mm, and severe valve dysfunction were randomly assigned to.
5. Prosthetic valve endocarditis. Like other CNS, S. lugdunensis also causes prosthetic valve endocarditis (2,37,53,60, 96, 164,183). Thirteen percent of 69 cases of S. lugdunensis endocarditis cases.
6. Infectious endocarditis is the inflammation of the endocardium, the inner lining of the heart, as well as the valves that separate each of the four chambers within the heart. It is primarily a disease caused by bacteria and has a wide array of manifestations and sequelae. Without early identification and treatment, a myriad of intracardiac and.

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1. Prosthetic valve endocarditis (PVE) is an important, albeit rare mechanism of valve failure after TAVR that has not been well-defined in the literature. Additionally, although surgical aortic valve replacement (SAVR)-PVE is better characterized in historical literature, it has been derived from single-center retrospective experiences, and data.
2. 2),3) Meanwhile, as a consequence of growing number of patients undergoing prosthetic heart valve replacement, the incidence of prosthetic valve endocarditis (PVE) has increased in recent years. PVE is typically known as a more deadly complication compared with native valve endocarditis (NVE) due to its challenging nature to handle severe.
3. Background: Early onset prosthetic valve endocarditis (EO-PVE) is an serious complication associated with heart valve replacement surgery. Objectives: To describe the epidemiologic, clinical, and laboratory profile of patients with EO-PVE in a cardiac surgical hospital. Patients and Methods: A retrospective analysis of an endocarditis database, implemented prospectively, with a post hoc study.

In 38 cases of prosthetic valve endocarditis, 19 were early cases (onset ≦ 60 days after insertion of prosthesis) and 19, late cases (onset ≧ 60 days). Nine late cases had onsets 12 to 53 months after surgery. The sources or predisposing factors in late cases included dental disease or manipulation; genitourinary tract procedures; and skin, urinary, or wound infections Acinetobacter is a highly resistant microorganism, commonly isolated in intensive and post-operative care units. Although rarely reported, it may constitute 1 of the several causes of early prosthetic valve endocarditis We classify prosthetic valve endocarditis based on time from surgery: -Early (<60d) associated with hospital-acquired microbes like staph aureus. -Intermediate (60-365d) most commonly coag negative staph. -Late (>365d) microbes typically resemble those of native valve endocarditis. -then TEE if not TTE not diagnostic, intracardiac device leads. Staphylococcus lugdunensis is a coagulase-negative Staphylococcus that causes skin and soft tissue infections and occasionally life threatening endocarditis of native valves. Prosthetic valve infection due to this pathogen is very rare and has not been described in HIV infected individuals. We report on the first case of early prosthetic valve endocarditis in an HIV-1 positive individual

Early Surgery versus Conventional Treatment for Infective

1. istered. Treatment of bacterial infections
2. Prosthetic valve endocarditis (PVE) is classified as early or late, depending on when infection is diagnosed: early PVE (within 12 mo nths after surgery) and late PVE (12 months or more after surgery). Nosocomial IE is defined as an infection occu rring > 72 h after admission to the hospital o
3. For example, in a recent multicenter, prospective, observational investigation involving >1000 consecutive patients with definite IE from >20 countries, S aureus was the most common cause of prosthetic valve IE (25.8% of 214 cases), whereas 64 (8%) cases of native valve endocarditis resulted from CoNS. 73 Thus, it is important to consider both.

Early onset prosthetic valve endocarditis: the Cleveland Clinic experience 1992-1997. Gordon SM, Serkey JM, Longworth DL, Lytle BW, Cosgrove DM 3rd. Ann Thorac Surg. 2000 May;69(5):1388-92. Aortic allograft valve reoperation: surgical challenges and patient risks. Nowicki ER, Pettersson GB, Smedira NG, Roselli EE, Blackstone EH, Lytle BW Objective: Prosthetic valve endocarditis remains a challenging complication after heart valve replacement. To identify predictive risk factors, we have reviewed 30 patients who underwent surgery for prosthetic valve endocarditis between March 1986 and May 1999.Methods: There were 15 men and 15 women (mean age 51 years). Prosthetic valve endocarditis was classified as early (≦ 1 year after. Prosthetic Valves (Early) Early prosthetic valve endocarditis defined as < 12 months post surgery. Vancomycin 30mg/kg/day IV in 2 doses PLUS; Gentamicin 3mg/kg/day IV in 2 or 3 doses PLUS; Rifampin 1200 mg/day PO in 2 doses; IV Drug User without Prosthetic Valve. Vancomycin 15-20 mg/kg IV BID daily; Daptomycin 6mg/kg IV once daily; Prosthetic.

Every effort should be made to identify this organism in the laboratory. When clinically indicated, early presumptive antibiotic therapy with TMP-SMX should be started. The Journal of Heart Valve Disease 2005;14:271-274. Fatal Burkholderia cepacia Early Prosthetic Valve Endocarditis: A Very Rare Case and a Review of the Literatur microbial infection occurring on parts of the valve prosthesis Background: Prosthetic valve endocarditis (PVE) is an important cause of morbidity and mortality associated with heart valve replacement surgery. The aim of the present study was to describe the early outcome of treatment in patients with PVE in a single center Prosthetic valve endocarditis - Indications for surgery. Prosthetic valve endocarditis is a life threatening situation and often can be refractory to medical therapy, requiring surgical intervention. Indications for surgery in prosthetic valve endocarditis (PVE) include: Persistent bacteremia after 7-10 days. Heart failure What are the in-hospital and 1-year survival statistics among patients who undergo early surgery versus medical therapy for prosthetic valve endocarditis (PVE)? Methods: Participants were enrolled between June 2000 and December 2006, in the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), a prospective.

Surgicel mimicking early onset prosthetic valve

There were 8 cases of early prosthetic valve endocarditis (defined as occurring less than 60 days after initial surgical intervention) and 48 cases of late prosthetic valve endocarditis (occurring after 60 days). The overall mortality rate of the 56 patients was 32% (18 patients). Of the 8 patients with early prosthetic valve endocarditis, 6. OBJECTIVES: Prosthetic valve endocarditis (PVE) is an uncommon yet dreadful complication in patients with prosthetic valves that requires a distinct analysis from native valve endocarditis. The present study aims to investigate independent risk factors fo r early surgical outcomes in patients with PVE

Prosthetic valve endocarditis: Predictors of early outcome of surgical therapy. A multicentric stud 3 PubMed TI In-hospital and 1-year mortality in patients undergoing early surgery for prosthetic valve endocarditis. AU Lalani T, Chu VH, Park LP, Cecchi E, Corey GR, Durante-Mangoni E, Fowler VG Jr, Gordon D, Grossi P, Hannan M, Hoen B, Muñoz P, Rizk H, Kanj SS, Selton-Suty C, Sexton DJ, Spelman D, Ravasio V, Tripodi MF, Wang A, International Collaboration on Endocarditis-Prospective.

Prosthetic valve endocarditis - Early and late (beyond a year

The early mortality after isolated valve replacement in complicated prosthetic valve endocarditis with conventional prostheses is reported to be as high as 9.7% with a 5- and 10-year survival of 87% and 75%, respectively Prosthetic Valve Endocarditis Highest risk is during the 1st three months after surgery, then risk falls gradually. Risk is likely equal between AVR and MVR. The risk is equal for mechanical vs bioprosthetic valves during the 1st year, but afterwards, bioprosthetic valves are at higher risk (due to the leaflets experiencing age-related.

Prosthetic Valve Endocarditis. Prosthetic valve endocarditis (PVE) accounts for 10-20% of most series with an overall incidence of 0.1-2.3% per patient-year. Most cases of early prosthetic. We report a case of B. quintana endocarditis affecting a prosthetic valve in a person with no known risk factors. Case Report A 46-year-old Indian woman, who had lived in the United Kingdom for 10 years, was admitted to our hospital in June 2000 with a 3-month history of fever, sweats, and rigors associated with anorexia and 5-kg weight loss CiteSeerX - Document Details (Isaac Councill, Lee Giles, Pradeep Teregowda): Objective: To compare the early and late outcome of medical and surgical treatment in patients with prosthetic valve endocarditis within a single unit. Design: All patients with proven prosthetic valve endocarditis treated in one institution between 1989 and 1999 were studied As AE is a late consequence of redo prosthetic valve replacement, extended follow-up, early diagnosis, repeating valve-replacement surgeries, and timely selective antifungal treatments are warranted. Keywords: fungal endocarditis, Aspergillus, antifungal, prosthetic valve replacemen

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