Abstract

Objective: Although patients with cirrhosis have an increased susceptibility for bacterial infections, endocarditis complicating cirrhosis has been reported only infrequently. In this study, our objective was to determine whether, bacterial endocarditis is, in fact, a complicating factor in cirrhosis. Methods: We retrospectively studied all cases of bacterial endocarditis that occurred over the last 15 yr in patients with known cirrhosis. Results: Ten patients (three males, seven females) were identified, whose mean age was 55 yr (range 29–65 yr). Bacterial organisms included Staphylococcus aureus, coagulase‐positive (eight patients), Peptostreptococcus (one patient), and Enterococcus (one patient). Underlying liver disease consisted of alcobolism (five patients), autoimmune chronic active hepatitis (two), cryptogenic cirrhosis (two), and primary biliary cirrhosis (one). Distribution of heart valves affected were mitral valve (six), aorta (two), and there were two involving both mitral and aortic valves. Echocardiograms revealed vegetation in 50% of the patients. Laboratory studies were markedly abnormal, with mean values of albumin 2.4 mg/dl, creatinine 2.5 mg/dl, BUN 76.5 mg/dl, and total bilirubin 8.2 mg/dl. Potential associated sources of infection were upper gastrointestinal bleeding (four), pneumonia (two), and one each of spontaneous bacterial peritonitis, hip replacement, heart catheterization, and abdominal abscess. the outcome was poor, with death in eight of 10 patients. Conclusions: Bacterial endocarditis may complicate cirrhosis, may be more frequent in females, typically involves the mitral valve, and probably is due to Staphy‐lococcus aureus.

Original languageEnglish (US)
Pages (from-to)924-927
Number of pages4
JournalThe American journal of gastroenterology
Volume89
Issue number6
DOIs
StatePublished - Jun 1994

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Bacterial Endocarditis
Liver Diseases
Chronic Disease
Fibrosis
Mitral Valve
Staphylococcus aureus
Peptostreptococcus
Abdominal Abscess
Autoimmune Hepatitis
Biliary Liver Cirrhosis
Blood Urea Nitrogen
Heart Valves
Enterococcus
Chronic Hepatitis
Cardiac Catheterization
Peritonitis
Aortic Valve
Bilirubin
Bacterial Infections
Aorta

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Bacterial Endocarditis in Patients with Chronic Liver Disease",
abstract = "Objective: Although patients with cirrhosis have an increased susceptibility for bacterial infections, endocarditis complicating cirrhosis has been reported only infrequently. In this study, our objective was to determine whether, bacterial endocarditis is, in fact, a complicating factor in cirrhosis. Methods: We retrospectively studied all cases of bacterial endocarditis that occurred over the last 15 yr in patients with known cirrhosis. Results: Ten patients (three males, seven females) were identified, whose mean age was 55 yr (range 29–65 yr). Bacterial organisms included Staphylococcus aureus, coagulase‐positive (eight patients), Peptostreptococcus (one patient), and Enterococcus (one patient). Underlying liver disease consisted of alcobolism (five patients), autoimmune chronic active hepatitis (two), cryptogenic cirrhosis (two), and primary biliary cirrhosis (one). Distribution of heart valves affected were mitral valve (six), aorta (two), and there were two involving both mitral and aortic valves. Echocardiograms revealed vegetation in 50{\%} of the patients. Laboratory studies were markedly abnormal, with mean values of albumin 2.4 mg/dl, creatinine 2.5 mg/dl, BUN 76.5 mg/dl, and total bilirubin 8.2 mg/dl. Potential associated sources of infection were upper gastrointestinal bleeding (four), pneumonia (two), and one each of spontaneous bacterial peritonitis, hip replacement, heart catheterization, and abdominal abscess. the outcome was poor, with death in eight of 10 patients. Conclusions: Bacterial endocarditis may complicate cirrhosis, may be more frequent in females, typically involves the mitral valve, and probably is due to Staphy‐lococcus aureus.",
author = "McCashland, {Timothy M} and Sorrell, {Michael Floyd} and Zetterman, {Rowen K}",
year = "1994",
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TY - JOUR

T1 - Bacterial Endocarditis in Patients with Chronic Liver Disease

AU - McCashland, Timothy M

AU - Sorrell, Michael Floyd

AU - Zetterman, Rowen K

PY - 1994/6

Y1 - 1994/6

N2 - Objective: Although patients with cirrhosis have an increased susceptibility for bacterial infections, endocarditis complicating cirrhosis has been reported only infrequently. In this study, our objective was to determine whether, bacterial endocarditis is, in fact, a complicating factor in cirrhosis. Methods: We retrospectively studied all cases of bacterial endocarditis that occurred over the last 15 yr in patients with known cirrhosis. Results: Ten patients (three males, seven females) were identified, whose mean age was 55 yr (range 29–65 yr). Bacterial organisms included Staphylococcus aureus, coagulase‐positive (eight patients), Peptostreptococcus (one patient), and Enterococcus (one patient). Underlying liver disease consisted of alcobolism (five patients), autoimmune chronic active hepatitis (two), cryptogenic cirrhosis (two), and primary biliary cirrhosis (one). Distribution of heart valves affected were mitral valve (six), aorta (two), and there were two involving both mitral and aortic valves. Echocardiograms revealed vegetation in 50% of the patients. Laboratory studies were markedly abnormal, with mean values of albumin 2.4 mg/dl, creatinine 2.5 mg/dl, BUN 76.5 mg/dl, and total bilirubin 8.2 mg/dl. Potential associated sources of infection were upper gastrointestinal bleeding (four), pneumonia (two), and one each of spontaneous bacterial peritonitis, hip replacement, heart catheterization, and abdominal abscess. the outcome was poor, with death in eight of 10 patients. Conclusions: Bacterial endocarditis may complicate cirrhosis, may be more frequent in females, typically involves the mitral valve, and probably is due to Staphy‐lococcus aureus.

AB - Objective: Although patients with cirrhosis have an increased susceptibility for bacterial infections, endocarditis complicating cirrhosis has been reported only infrequently. In this study, our objective was to determine whether, bacterial endocarditis is, in fact, a complicating factor in cirrhosis. Methods: We retrospectively studied all cases of bacterial endocarditis that occurred over the last 15 yr in patients with known cirrhosis. Results: Ten patients (three males, seven females) were identified, whose mean age was 55 yr (range 29–65 yr). Bacterial organisms included Staphylococcus aureus, coagulase‐positive (eight patients), Peptostreptococcus (one patient), and Enterococcus (one patient). Underlying liver disease consisted of alcobolism (five patients), autoimmune chronic active hepatitis (two), cryptogenic cirrhosis (two), and primary biliary cirrhosis (one). Distribution of heart valves affected were mitral valve (six), aorta (two), and there were two involving both mitral and aortic valves. Echocardiograms revealed vegetation in 50% of the patients. Laboratory studies were markedly abnormal, with mean values of albumin 2.4 mg/dl, creatinine 2.5 mg/dl, BUN 76.5 mg/dl, and total bilirubin 8.2 mg/dl. Potential associated sources of infection were upper gastrointestinal bleeding (four), pneumonia (two), and one each of spontaneous bacterial peritonitis, hip replacement, heart catheterization, and abdominal abscess. the outcome was poor, with death in eight of 10 patients. Conclusions: Bacterial endocarditis may complicate cirrhosis, may be more frequent in females, typically involves the mitral valve, and probably is due to Staphy‐lococcus aureus.

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