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Pneumococcal infective endocarditis in Brazil: a multicenter study on a severe condition Brazil
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Mamani, Roxana Flores

; Siciliano, Rinaldo Focaccia

; Fortes, Claudio Querido

; Damasco, Paulo Vieria

; Lamas, Cristiane da Cruz

Brazilian Journal of Infectious Diseases

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2024, Volume 28 N. 4 elocation 103837

Abstract: En | Text: En | PDF: En

Abstract Background Streptococcus pneumoniae bacteremia may result in Infective Endocarditis (IE). In the pre-antibiotic era, it caused 10 %‒15 % of IE, decreasing to < 3 % after penicillin availability. Although infrequent, it causes aggressive disease. Methods Retrospective analysis of endocarditis databases, prospectively implemented in 4 Brazilian institutions, 2005‒2023. Results From the prospective cohorts comprising 2321 adult patients with IE, we identified 11 (0.47%) with pneumococcal IE. Males represented 7/11 and mean age was 54 years (22‒77). All had native valve involvement; perivalvular abscess was present in 6/11. Only one patient had concurrent meningitis. Beta-lactams were the antibiotics used in 10/11. All had surgical indication, but only 6 had it, as the others were seriously ill. Overall, in hospital mortality was 6/11, but only 1/6 of those who underwent surgery died, compared to 5/5 of those who had an indication for surgery and did not have it. Conclusions The high mortality rates and need for surgical intervention emphasize the need to promptly identify and manage pneumococcal endocarditis. Physicians ought to recommend vaccination to all patients at risk for severe pneumococcal disease. IE . (IE) preantibiotic pre antibiotic era 1 15 %‒1 availability infrequent disease databases institutions 20052023 2005 2023 2005‒2023 232 0.47% 047 0 47 (0.47% 711 7 7/1 5 22‒77. 2277 22‒77 22 77 (22‒77) involvement 611 6/11 meningitis Betalactams Beta lactams 1011 10/11 ill Overall 16 1/ died 55 5/ (IE %‒ 2005202 200 202 2005‒202 23 0.47 04 (0.47 71 7/ 227 22‒7 2 (22‒77 61 6/1 101 10/1 200520 20 2005‒20 0.4 (0.4 22‒ (22‒7 6/ 10/ 20052 2005‒2 0. (0. (22‒ 2005‒ (0 (22 ( (2

https://doi.org/10.1016/j.bjid.2024.103837

Diretriz de Avaliação Cardiovascular Perioperatória da Sociedade Brasileira de Cardiologia – 2024 202 20 2
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Gualandro, Danielle Menosi

; Fornari, Luciana Savoy

; Caramelli, Bruno

; Abizaid, Alexandre Antonio Cunha

; Gomes, Brenno Rizerio

; Tavares, Caio de Assis Moura

; Fernandes, Caio Julio Cesar dos Santos

; Polanczyk, Carisi Anne

; Jardim, Carlos

; Vieira, Carolina Leticia Zilli

; Pinho, Claudio

; Calderaro, Daniela

; Schreen, Dirk

; Marcondes-Braga, Fabiana Goulart

; Souza, Fábio de

; Cardozo, Francisco Akira Malta

; Tarasoutchi, Flavio

; Carmo, Gabriel Assis Lopes

; Kanhouche, Gabriel

; Lima, José Jayme Galvão de

; Bichuette, Luciana Dornfeld

; Sacilotto, Luciana

; Drager, Luciano Ferreira

; Vacanti, Luciano Janussi

; Gowdak, Luis Henrique Wolff

; Vieira, Marcelo Luiz Campos

; Martins, Marcelo Luiz Floriano Melo

; Lima, Márcio Silva Miguel

; Lottenberg, Marcos Pita

; Aliberti, Márlon Juliano Romero

; Marchi, Mauricio Felippi de Sá

; Paixão, Milena Ribeiro

; Oliveira Junior, Mucio Tavares de

; Yu, Pai Ching

; Cury, Patricia Ramos

; Farsky, Pedro Silvio

; Pessoa, Ranna Santos

; Siciliano, Rinaldo Focaccia

; Accorsi, Tarso Augusto Duenhas

; Correia, Vinícius Machado

; Mathias Junior, Wilson

Arquivos Brasileiros de Cardiologia

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2024, Volume 121 N. 9 elocation e20240590

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

https://doi.org/10.36660/abc.20240590

Fatores de Risco para Infecção da Ferida Operatória em Pacientes Submetidos à Cirurgia Cardíaca Pediátrica
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Ribeiro, Anna Christina de Lima

; Siciliano, Rinaldo Focaccia

; Lopes, Antonio Augusto

; Strabelli, Tania Mara Varejão

Arquivos Brasileiros de Cardiologia

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dec 2023, Volume 120 N. 12 elocation e20220592

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamento A infecção do sítio cirúrgico (ISC) é uma importante complicação no pós-operatório de cirurgia cardíaca pediátrica associada ao aumento da morbimortalidade. Objetivos Identificar fatores de risco para a ISC após cirurgias cardíacas para correção de malformações congênitas. Métodos Este estudo caso-controle incluiu 189 pacientes com um ano completo e 19 anos e 11 meses, submetidos à cirurgia cardíaca em hospital universitário terciário de cardiologia de janeiro de 2011 a dezembro de 2018. Foi realizado registro e análise de dados pré, intra e pós-operatórios. Para cada caso foram selecionados dois controles, conforme o diagnóstico da cardiopatia e cirurgia realizada em um intervalo de até 30 dias para minimizar diferenças pré e/ou intraoperatórias. Para a análise dos fatores de risco foi utilizado o modelo de regressão binária logística. Significância estatística definida como valor de p<0,05. Resultados O estudo incluiu 66 casos e 123 controles. A incidência de ISC variou de 2% a 3,8%. Fatores de risco identificados: faixa etária de lactentes (OR 3,19, IC 95% 1,26 – 8,66, p=0,014), síndrome genética (OR 6,20, IC 95% 1,70 – 21,65, p=0,004), RACHS-1 categorias 3 e 4 (OR 8,40, IC 95% 3,30 – 21,34, p<0,001), o valor da proteína C reativa (PCR) de 48 horas pós-operatórias foi demonstrado como fator protetor para esta infecção (OR 0,85, IC 95% 0,73 – 0,98, p=0,023). Conclusão Os fatores de risco identificados não são variáveis modificáveis. Vigilância e medidas preventivas contínuas são fundamentais para reduzir a infecção. O papel do PCR elevado no pós-operatório foi fator protetor e precisa ser melhor estudado. (ISC pósoperatório pós operatório morbimortalidade congênitas casocontrole controle 18 1 meses 201 2018 pósoperatórios. pósoperatórios operatórios. operatórios pós-operatórios controles eou ou intraoperatórias logística p005 p 0 05 p<0,05 6 12 2 38 8 3,8% OR 319 3,19 95 126 26 1,2 866 8,66 p=0,014, p0014 p=0,014 , 014 p=0,014) 620 20 6,20 170 70 1,7 2165 21 65 21,65 p=0,004, p0004 p=0,004 004 p=0,004) RACHS1 RACHS RACHS- 840 40 8,40 330 3,3 2134 34 21,34 p<0,001, p0001 p<0,001 001 p<0,001) (PCR pósoperatórias operatórias 085 85 0,85 073 73 0,7 098 98 0,98 p=0,023. p0023 p=0,023 . 023 p=0,023) modificáveis estudado p00 p<0,0 3,8 31 3,1 9 1, 86 8,6 p001 p=0,01 01 62 6,2 17 7 216 21,6 p000 p=0,00 00 84 8,4 33 3, 213 21,3 p<0,00 08 0,8 07 0, 09 0,9 p002 p=0,02 02 p0 p<0, 8, p=0,0 6, 21, p<0 p=0, p< p=0 p=

Abstract Background Surgical site infection is an important complication after pediatric cardiac surgery, associated with increased morbidity and mortality. Objectives We sought to identify risk factors for surgical site infection after pediatric cardiac surgeries. Methods A case-control study included patients aged between 1 year and 19 years and 11 months of age, submitted to cardiac surgery performed at a tertiary cardiac center from January 1 st , 2011, through December 31, 2018. Charts were reviewed for pre-, intra, and postoperative variables. We identified two randomly selected control patients with the same pathophysiological diagnosis and underwent surgery within thirty days of each index case. Univariate and multivariate logistic regression analyses were performed to identify risk factors. Statistical significance was defined as p<0.05. Results Sixty-six cases and 123 controls were included. Surgical site infection incidence ranged from 2% to 3.8%. The following risk factors were identified: Infant age (OR 3.19, 95% CI 1.26 to 8.66, p=0.014), presence of genetic syndrome (OR 6.20, CI 95% 1.70 to 21.65, p=0.004), categories 3 and 4 of RACHS-1 (OR 8.40, CI 95% 3.30 to 21.34, p<0.001), 48 h C-reactive protein level range was detected as a protective factor for this infection (OR 0.85, 95% CI 0.73 to 0.98, p=0.023). Conclusions The risk factors defined in this study could not be modified. Therefore, additional surveillance and new preventive strategies need to be implemented to reduce the incidence of surgical site infection. The increased CRP in the postoperative period was a protective factor that needs further understanding. mortality surgeries casecontrol case 2011 31 2018 pre, pre pre- intra variables p005 p 0 05 p<0.05 Sixtysix Sixty six 12 2 38 8 3.8% OR 319 3.19 95 126 26 1.2 866 66 8.66 p=0.014, p0014 p=0.014 014 p=0.014) 620 6 20 6.20 170 70 1.7 2165 21 65 21.65 p=0.004, p0004 p=0.004 004 p=0.004) RACHS1 RACHS RACHS- 840 40 8.40 330 30 3.3 2134 34 21.34 p<0.001, p0001 p<0.001 001 p<0.001) Creactive C reactive 085 85 0.85 073 73 0.7 098 98 0.98 p=0.023. p0023 p=0.023 . 023 p=0.023) modified Therefore understanding 201 p00 p<0.0 3.8 3.1 9 1. 86 8.6 p001 p=0.01 01 62 6.2 17 7 216 21.6 p000 p=0.00 00 84 8.4 33 3. 213 21.3 p<0.00 08 0.8 07 0. 09 0.9 p002 p=0.02 02 p0 p<0. 8. p=0.0 6. 21. p<0 p=0. p< p=0 p=

https://doi.org/10.36660/abc.20220592

Early Diagnosis and Treatment in Infective Endocarditis: Challenges for a Better Prognosis
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Sobreiro, Daniely Iadocico

; Sampaio, Roney Orismar

; Siciliano, Rinaldo Focaccia

; Brazil, Calila Vieira Andrade

; Branco, Carlos Eduardo de Barros

; Lopes, Antônio Sergio de Santis Andrade

; Tarasoutchi, Flávio

; Strabelli, Tânia Mara Varejão

Arquivos Brasileiros de Cardiologia

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feb 2019, Volume 112 N. 2 Pages 201 - 203

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.5935/abc.20180270 4663 downloads

Bacteroides fragilis endocarditis: a case report and review of literature
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Rodrigues, Cristhieni

; Siciliano, Rinaldo Focaccia

; Zeigler, Rogerio

; Strabelli, Tania Mara Varejão

Brazilian Journal of Infectious Diseases

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feb 2012, Volume 16 N. 1 Pages 100 - 104

Abstract: En | Text: En | PDF: En

Endocarditis due to Bacteroides fragilis is a rare disorder. This article describes a case of Bacteroides fragilis endocarditis associated with portal and superior mesenteric venous thrombosis in a patient without preexisting valvular heart disease and review the cases of endocarditis due to this anaerobic bacterium in medical literature since 1980.

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Poststernotomy aspergillosis: successful treatment with voriconazole, surgical debridement and vacuum-assisted closure therapy
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Siciliano, Rinaldo Focaccia

; Waisberg, Daniel Reis

; Samano, Marcos Naoyuki

; Leite, Paulo Ferreira

; Tuma Júnior, Paulo

; Barreiro, Guilherme Cardinali

; Strabelli, Tania Mara Varejão

Clinics

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2012, Volume 67 N. 3 Pages 297 - 299

Abstract: En | Text: En | PDF: En

https://doi.org/10.6061/clinics/2012(03)17 1420 downloads

Infectious endocarditis caused by Nocardia sp.: histological morphology as a guide for the specific diagnosis
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Castelli, Jussara Bianchi

; Siciliano, Rinaldo Focaccia

; Abdala, Edson

; Aiello, Vera Demarchi

Brazilian Journal of Infectious Diseases

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aug 2011, Volume 15 N. 4 Pages 384 - 386

Abstract: En | Text: En | PDF: En

Nocardia is a rare opportunistic agent, which may affect immunocompromised individuals causing lung infections and exceptionally infective endocarditis (IE). There are few reports of IE caused by Nocardia sp., usually involving biological prostheses but rarely in natural valves. Its accurate microbiological identification may be hampered by the similarity with Rhodococcus equi and Corynebacterium spp. Here we report a case of native mitral valve IE caused by this agent in which the clinical absence of response to vancomycin and the suggestion of Nocardia sp. by histology pointed to the misdiagnosis of Corynebacterium spp. in blood cultures. The histological morphology can advise on the need for expansion of cultivation time and use of extra microbiological procedures that lead to the differential diagnosis with Corynebacterium spp. and other agents, which is essential to establish timely specific treatment, especially in immunocompromised patients.

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Endocardite por Coxiella burnetii (febre Q): doença rara ou pouco diagnosticada? Relato de caso
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Siciliano, Rinaldo Focaccia

; Ribeiro, Henrique Barbosa

; Furtado, Remo Holanda de Mendonça

; Castelli, Jussara Bianchi

; Sampaio, Roney Orismar

; Santos, Fabiana Cristina Pereira dos

; Colombo, Silvia

; Grinberg, Max

; Strabelli, Tânia Mara Varejão

Revista da Sociedade Brasileira de Medicina Tropical

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aug 2008, Volume 41 N. 4 Pages 409 - 412

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A febre Q é uma zoonose de distribuição mundial causada por Coxiella burnetii, sendo raros os registros da doença no Brasil. Estudos soroepidemiológicos mostraram uma freqüência relativamente elevada de anticorpos contra Coxiella burnetii em populações com exposição ocupacional. Em humanos, pode se manifestar clinicamente como doença aguda ou crônica, sendo que a endocardite é a forma crônica mais freqüente da febre Q e de maior morbi-mortalidade. Relatamos um caso grave de endocardite por Coxiella burnetii adquirida no Brasil com desfecho fatal, apesar de antibioticoterapia adequada e tratamento cirúrgico valvar.

Q fever is a zoonosis of worldwide distribution that is caused by Coxiella burnetii. However, reports of this disease in Brazil are rare. Seroepidemiological studies have shown relatively high frequencies of antibodies against Coxiella burnetii in populations with occupational exposure. In humans, it can be manifested clinically as acute or chronic disease. Endocarditis is the most frequent chronic form of Q fever and the form with the greatest morbidity and mortality. We report a severe case of endocarditis due to Coxiella burnetii acquired in Brazil that had a fatal outcome, despite specific antibiotic therapy and valve surgery treatment.

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Antifibrotic therapy in chronic hepatitis C
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Siciliano, Rinaldo Focaccia

; Barone, Antonio Alci

Brazilian Journal of Infectious Diseases

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oct 2007, Volume 11 Suppl. 1 Pages 20 - 21

Abstract: En | Text: En | PDF: En

1188 downloads

10.

Rhodococcus equi bacteremia with lung abscess misdiagnosed as corynebacterium: a report of 2 cases
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Tuon, Felipe Francisco

; Siciliano, Rinaldo Focaccia

; Al-Musawi, Tarik

; Rossi, Flavia

; Capelozzi, Vera Luiza

; Gryschek, Ronaldo Cesar

; Medeiros, Eduardo Alexandrino Sérvolo

Clinics

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2007, Volume 62 N. 6 Pages 795 - 798

Abstract: En | Text: En | PDF: En

3163 downloads

11.

Hepatite C: tratamento revisitado
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Siciliano, Rinaldo Focaccia

; Boulos, Marcos

Arquivos de Gastroenterologia

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mar 2004, Volume 41 N. 1 Pages 1 - 2

Abstract: Pt | Text: Pt | PDF: Pt

4528 downloads

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