NA. Laryngoscope, 127:E100-E106, 2017.

Vertebral osteomyelitis is an uncommon complication of infective endocarditis with the organism Streptococcus viridans being a rare cause of the condition. This case highlights an unusual presentation of Streptococcus viridans associated with infective endocarditis and pyogenic osteomyelitis in a patient following a dental procedure.

These modified techniques, performed with endoscopic assistance under hypotensive anaesthesia, without embolisation, offer a superior option over other open procedures with regard to morbidity and recurrences.

The study highlighted (a) areas within the guidelines that require further clarification and research and (b) that in the group studied half did not have access to the guidelines.

As 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors ('statins') are being increasingly prescribed for the prevention of cardiovascular disease, this case report describes adverse effects of statin therapy which can sometimes be fatal. It highlights the need for physicians to be aware of individual patient risk factors predisposing to statin induced myopathy. It also highlights the need for further research into cholesterol lowering drugs which do not have such side effects. When prescribing statins for patients, we must also explain potential side effects following initiation of therapy and with dose titrations.