Bone and Joint Infections in Patients with Infective Endocarditis: Review of a 4-Year Experience

Abstract

Musculoskeletal complaints have been reported to occur in as many as 44% of patients with infective endocarditis (IE). A 4-year retrospective review of 104 cases of IE in which new diagnostic criteria were used showed that 24 episodes (23%) began with musculoskeletal complaints. Sixteen of the 24 episodes (66%) involved osteoarticular infection (OAI) documented during the period of hospitalization. Thus, in 15% of the 104 cases of IE, OAI was documented. The 16 episodes occurred in 15 patients, all of whom were intravenous drug abusers (IVDAs). In contrast, OAI was documented in none of the 38 cases in the IE population that did not involve IVDAs. Only three episodes were associated with single rather than multiple bone or joint involvement. There were no deaths, and the patients' conditions seemed to respond well to appropriate therapy. OAIs appear to be uncommon in patients with IE who are not IVDAs. Musculoskeletal complaints in the IVDA population with IE, however, should prompt a careful search for OAI.

Clinical Characteristics and Follow-Up Data in a Series of Twenty Infective Endocarditis Complicated of Rheumatic Manifestations

“…It mainly affects the shoulders, knees, hips, ankles. There is mono-or oligo-arthritis in half of the cases [5] [6].…”

“…Musculoskeletal manifestations of IE associated arthralgia including low back pain, and inflammatory or septic arthritis, spondylodiscitis, sacroiliitis, osteitis, myalgia, tenosynovitis and bursitis [5] [6].…”

“…Peripheral arthritis is seen in 20% -50% of patients with rheumatologic events corresponding to a mono or oligo-arthritis interesting shoulder, knee or ankle [5] [6].…”

“…The diagnosis was based on the presence of two major criteria of Duke, modified by Li et al [5]. All patients were treated with antibiotics.…”

Pyogenic Arthritis of the Shoulder in Patient with Infective Endocarditis -A Case Report-

“…감염성 심 내막염을 가진 환자에서 혈행성 전염을 통한 골관절 감 염이 0.5~9%로 보고 되고 있으며 척추 부위의 이환이 가장 많고, 고관절, 슬관절, 족근관절, 견관절 순위로 견관절의 이환률은 상대적으로 낮게 나타났다 . 상대적으로 견관절에 화농성 관절염이 동반되는 경우는 매우 드문 것으로 보고 되고 있으나 감염성 심내막염에 동반하는 일반적인 근골격계 증상으로 간과한다면 심각한 합병증 으로 발생할 수 있음으로 주의 깊게 판단하여야 한다고 생각한다 5,8,10) .…”