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Cardiac device-related endocarditis complicated by spinal abscess

Yasser Rodriguez1, Arnold J Greenspon, Muhammad R Sohail

  • 1Department of Cardiothoracic Surgery, University of Miami, Miami, FL, USA.

Pacing and Clinical Electrophysiology : PACE
|December 14, 2011
PubMed

Insights

Cardiac device infections can lead to spinal abscesses. Prompt diagnosis and treatment, including device removal, are crucial for managing device-related endocarditis and preventing severe outcomes.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Infective endocarditis is a severe cardiac device infection with potential for metastatic spread.
  • The link between device-related endocarditis and spinal abscesses is not well-established.

Purpose of the Study:

  • To investigate the association between cardiac device-related endocarditis and spinal abscess formation.
  • To describe the clinical characteristics, management, and outcomes of patients with this complication.

Main Methods:

  • Retrospective review of hospital records from three centers (2005-2010).
  • Inclusion criteria: confirmed device-related endocarditis (positive blood cultures, echocardiogram findings).
  • Identification of six patients with co-existing spinal abscesses.

Main Results:

  • Six of 384 (1.5%) patients with device-related endocarditis developed spinal abscesses.
  • Common symptoms included fever, malaise, and neurological signs.
  • Causative pathogens included Staphylococcus aureus and coagulase-negative Staphylococci.
  • Outcomes varied: two deaths, two with permanent neurological deficits, two recovered fully.

Conclusions:

  • Spinal abscesses in patients with bacteremia should prompt consideration of device-related endocarditis.
  • Early diagnosis via imaging, antimicrobial therapy, and device removal are critical.
  • Timely intervention can reduce mortality and neurological sequelae.
Abstract

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