Bacterial endocarditis presenting as acute vertebral osteomyelitis: 14 cases.

Area of Science:

• Infectious Diseases
• Cardiology
• Orthopedic Surgery

Background:

• The association between bacterial endocarditis (BE) and vertebral osteomyelitis (VO) is infrequently documented.
• Understanding this co-occurrence is vital for comprehensive patient management.

Purpose of the Study:

• To analyze the characteristics and outcomes of patients with concurrent BE and VO.
• To compare the clinical and microbiological profiles of BE with VO to BE without VO.

Main Methods:

• Retrospective analysis of 280 BE cases and 150 VO cases.
• Identification of 14 cases with coexisting BE and VO.
• Review of patient demographics, clinical presentation, microbiological data, imaging, and treatment outcomes.

Main Results:

• The 14 patients (12 males, 2 females; mean age 56.6) presented with fever and back pain preceding VO diagnosis.
• Common pathogens included Streptococcus viridans, Str. faecalis, and staphylococcus.
• Valvular insufficiencies (mitral and aortic) were noted, with vegetations seen on echocardiogram in 6/9 cases.
• Ten patients were cured with antibiotics alone; four required valve replacement.

Conclusions:

• BE and VO share similar epidemiological, clinical, and microbiological features with BE alone.
• Early diagnosis and prolonged antibiotic therapy are key to successful treatment and preventing severe complications.
• Survival rates are comparable when prompt recognition and treatment are implemented.