Vertebral Osteomyelitis and Infective Endocarditis Co-Infection

Area of Science:

• Infectious Diseases
• Cardiology
• Orthopedic Surgery

Background:

• Vertebral osteomyelitis (VO) and infective endocarditis (IE) co-infection is increasingly recognized.
• The precise incidence and clinical impact of IE in VO patients remain incompletely understood.
• Early diagnosis and treatment are vital for managing co-existing VO and IE.

Purpose of the Study:

• To determine the incidence of infective endocarditis (IE) in patients diagnosed with vertebral osteomyelitis (VO).
• To analyze the clinical characteristics, diagnostic findings, and outcomes of patients with concurrent VO and IE.
• To emphasize the importance of suspecting IE in VO patients.

Main Methods:

• A retrospective study involving 59 patients diagnosed with VO across five medical university hospitals.
• Exclusion of patients with a history of spinal surgery.
• Routine echocardiography for all VO patients; IE diagnosis based on modified Duke criteria.

Main Results:

• Infective endocarditis (IE) was diagnosed in 7 out of 59 (12%) patients with vertebral osteomyelitis (VO).
• No significant differences were observed in clinical features, causative microorganisms, or radiographic findings between VO-IE co-infection and VO-only groups.
• Routine echocardiography identified IE in 12% of the VO cohort.

Conclusions:

• Routine echocardiography in vertebral osteomyelitis (VO) patients reveals a 12% prevalence of infective endocarditis (IE).
• The absence of specific clinical and laboratory markers can hinder IE diagnosis in VO patients.
• Clinicians must maintain a high index of suspicion for IE in all patients presenting with VO.