title: Infective endocarditis and acute purulent pericarditis in a patient with hyperglycemia.
abstract: A diabetic patient was admitted to our hospital for infective endocarditis with acute purulent pericarditis and diabetic ketoacidosis. Echocardiography revealed attachment of vegetation to the chordae tendineae in the left ventricle and pericaridial effusion. The vegetation was enlarged and pendulated for a few days despite maximal antimicrobial therapy. Surgical resection was desirable to decrease the risk of embolic complications and cardiovascular collapse. We could not open the heart because of accumulation of purulent pericardial fluid, and right renal infarction was complicated. We believe that the immunocompromised and hypercoagulable state due to diabetes caused these conditions.
authors: Department of Internal Medicine, National Hospital Organization Higashihiroshima Medical Center, Jike, Saijo.
authors: Kenji
authors: K
authors: Oki
authors: Wataru
authors: W
authors: Matsuura
authors: Yasuhiro
authors: Y
authors: Saito
authors: Yujiro
authors: Y
authors: Ono
authors: Kaoru
authors: K
authors: Yanagihara
authors: Masafumi
authors: M
authors: Sueshiro
authors: Satoru
authors: S
authors: Morita
authors: Junko
authors: J
authors: Koide
authors: Akihiro
authors: A
authors: Maeda
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D004452:Echocardiography; D004562:Electrocardiography; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications* / Q000276:immunology; D008297:Male; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology; D010494:Pericarditis, Constrictive / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013290:Streptococcal Infections / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology; D013291:Streptococcus / Q000302:isolation & purification; D013492:Suppuration
chemical_list: D001786:Blood Glucose