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Endocarditis with spondylodiscitis: clinical characteristics and prognosis
Stefano Del Pace1,2, Valentina Scheggi3,4, Giacomo Virgili2,5
1Division of General Cardiology, University of Florence, Florence, Italy.
BMC Cardiovascular Disorders
|April 16, 2021
Summary
Infective endocarditis (IE) associated with spondylodiscitis (SD) occurs in 8% of patients. While SD does not worsen overall prognosis, it is linked to higher rates of IE relapses, particularly in patients with a history of drug abuse.
Area of Science:
- Infectious Diseases
- Cardiology
- Orthopedics
Background:
- The co-occurrence of infective endocarditis (IE) and spondylodiscitis (SD) is infrequently documented.
- Limited data exist on the clinical characteristics and prognosis of patients with concurrent IE and SD.
Purpose of the Study:
- To determine the prevalence of SD in patients diagnosed with IE.
- To investigate the clinical features associated with IE-SD co-infection.
- To assess the prognostic impact of SD on IE outcomes.
Main Methods:
- Retrospective analysis of 363 patients with non-device-related IE.
- Radiological confirmation of SD in 29 patients (8%).
- Long-term follow-up including telephone interviews and echocardiography.
Main Results:
- SD in IE patients was associated with male gender, diabetes, drug abuse, and specific bacterial infections (Streptococcus Viridans, Enterococcus).
- Mortality rates were similar between patients with and without SD.
- SD was associated with increased IE relapses at 3 years, but only drug abuse independently predicted relapse.
Conclusions:
- The association of IE with SD is not rare and warrants screening for vertebral metastatic infection in IE patients with risk factors.
- SD does not appear to negatively impact in-hospital or long-term prognosis for IE patients.
- Drug abuse is a significant independent predictor of IE relapse in patients with or without SD.
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