Infective endocarditis in patients with pyogenic spondylodiscitis: implications for diagnosis and therapy

被引：30

作者：

Behmanesh, Bedjan ^{[1
]}

Gessler, Florian ^{[1
]}

Schnoes, Katrin ^{[2
]}

Dubinski, Daniel ^{[1
]}

Won, Sae-Yeon ^{[1
]}

Konczalla, Juergen ^{[1
]}

Seifert, Volker ^{[1
]}

Weise, Lutz ^{[1
,3
]}

Setzer, Matthias ^{[1
]}

机构：

[1] Goethe Univ Hosp, Dept Neurosurg, Frankfurt, Germany

[2] Goethe Univ Hosp, Med Clin 3, Dept Cardiol, Frankfurt, Germany

[3] Dalhousie Univ, Div Neurosurg, QEII Hlth Sci Ctr, Halifax, NS, Canada

来源：

NEUROSURGICAL FOCUS | 2019年 / 46卷 / 01期

关键词：

infective endocarditis; spinal infection; surgery; transesophageal echocardiography; STAPHYLOCOCCUS-AUREUS BACTEREMIA; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; VERTEBRAL OSTEOMYELITIS; SURGERY;

D O I：

10.3171/2018.10.FOCUS18445

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

OBJECTIVE The incidence of patients with pyogenic spinal infection is increasing. In addition to treatment of the spinal infection, early diagnosis of and therapy for coexisting infections, especially infective endocarditis (IE), is an important issue. The aim of this study was to evaluate the proportion of coexisting IE and the value of routine transesophageal echocardiography (TEE) in the management of these patients. METHODS The medical history, laboratory data, radiographic findings, treatment modalities, and results of TEE of patients admitted between 2007 and 2017 were analyzed. RESULTS During the abovementioned period, 110 of 255 total patients underwent TEE for detection of IE. The detection rate of IE between those patients undergoing and not undergoing TEE was 33% and 3%, respectively (p < 0.0001). Thirty-six percent of patients with IE needed cardiac surgical intervention because of severe valve destruction. Chronic renal failure, heart failure, septic condition at admission, and preexisting heart condition were significantly associated with coexisting IE. The mortality rate in patients with IE was significantly higher than in patients without IE (22% vs 3%, p = 0.002). CONCLUSIONS TEE should be performed routinely in all patients with spondylodiscitis.

引用

页数：5