Espondilodiscite como manifestação clínica de endocardite infecciosa

Calderaro, Daniela; Galvão, Tatiana; Bagnatori, Renato Scotti; Caramelli, Bruno

doi:10.1590/s0066-782x2003001300009

Cited by 2 publications

(1 citation statement)

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“…In 1965, Sèze et al described a first case associating spondylodiscitis and endocarditis [1]. Since then many case reports outlined this combination but it is controversial and prospective studies still lacking [2][3][4][5][6][7][8][9][10][11]. The frequency of this association is ranging from 0.6%-2.2%, when patients with established spondylodiscitis were screened for endocarditis [2,3].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Endocarditis with Spondylodiscitis: A lucky Finding

Tabbah¹

2020

BJSTR

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Spondylodiscitis and endocarditis is a rare association especially when involving a pulmonary endocarditis. We describe a case of a 61 year old male patient presented to his primary physician for back pain for more than 3 months. His history revealed an episode of community acquired pneumonia 4 months before his presentation to the clinic. Patient still complaining about a nonproductive cough since his treatment. His physical examination revealed a murmur on the left lateral sternal border. Patient report pain on percussion over the spinal segment. Laboratory tests revealed normal blood count with normal white blood cells and normal inflammatory parameters. Blood cultures were negative. MRI of the spine showed erosions of the vertebral plates in L4 and L5 and an edematous regional infiltration of the psoas muscle are common signs of spondylodiscitis with an anterior epidural abscess. Cardiac ultrasound revealed a moderate pulmonary regurgitation grade II with a hyperechogenic image on the pulmonary valve measuring(14x20mm) suspicious of a vegetation. TEE showed signs of a pulmonary vegetation with a moderate pulmonary regurgitation and no signs of abscess. Treatment with antibiotics for 6 weeks was initiated. Cardiac ultrasound after regimen revealed stable vegetation more hyperechogenic and calcified as a sign of chronic endocarditis. His last MRI revealed complete regression of the epidural collection with residual signs of spondylodiscitis. This case highlights the diagnostic challenge of characterizing pulmonary valve endocarditis and regurgitation. It also emphasizes on the management challenges of these rare cases that need to be adjusted. Close monitoring is mandatory and regular cardiac ultrasound is the key for diagnosis and follow up.

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Section: Introductionmentioning

confidence: 99%

Pulmonary Endocarditis with Spondylodiscitis: A lucky Finding

Tabbah¹

2020

BJSTR

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Spondylodiscitis and infectious endocarditis: a round-trip to be considered

Calderaro¹,

Gualandro²,

Yu³

et al. 2008

Braz J Infect Dis

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The association between spondylodiscitis and endocarditis was first reported in 1965 by de Sèze et al. The most common clinical picture of this association is musculoskeletal symptoms preceding endocarditis diagnosis, but we report here a case of spondylodiscitis complicating endocarditis in its late course. A 70-year-old man, with an established diagnosis of mitral valve endocarditis caused by Streptococcus intermedius, early submitted to surgical treatment because of heart failure, who had an uneventful recovery up to the 12th day of antibiotic therapy when he presented intensive backache, with tenderness in the two lower lumbar vertebras. Spondylodiscitis was confirmed by a magnetic resonance imaging and the treatment was non-esteroidal anti-inflamatory and analgetics drug, with good results, and prolongation of antibiotic treatment up to 3 months. Appropriate diagnosis of this association has important consequences, as the need of a longer antibiotic therapy course, which can range from 6 weeks to 3 months.

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Espondilodiscite como manifestação clínica de endocardite infecciosa

Abstract: Calderaro e cols Espondilodiscite como manifestação clínica de endocardite infecciosa

Cited by 2 publications

References 4 publications

Pulmonary Endocarditis with Spondylodiscitis: A lucky Finding

Pulmonary Endocarditis with Spondylodiscitis: A lucky Finding

Spondylodiscitis and infectious endocarditis: a round-trip to be considered

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