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Infection

, Volume 46, Issue 2, pp 245–251 | Cite as

Endocarditis associated with vertebral osteomyelitis and septic arthritis of the axial skeleton

  • Oscar Murillo
  • Imma Grau
  • Joan Gomez-Junyent
  • Celina Cabrera
  • Alba Ribera
  • Fe Tubau
  • Carmen Peña
  • Javier Ariza
  • Roman Pallares
Original Paper

Abstract

Purpose

The relationship between infective endocarditis (IE) and osteoarticular infections (OAIs) are not well known. We aimed to study the characteristics of patients with IE and OAIs, and the interactions between these two infections.

Methods

An observational study (1993–2014) which includes two cohorts: (1) patients with IE (n = 607) and (2) patients with bacteremic OAIs (n = 458; septic arthritis of peripheral and axial skeleton, and vertebral and peripheral osteomyelitis). These two cohorts were prospectively collected, and we retrospectively reviewed the clinical and microbiological variables.

Results

There were 70 cases of IE with concomitant OAIs, representing 11.5% of IE cases and 15% of bacteremic OAI cases. Among cases with IE, the associated OAIs mainly involved the axial skeleton (n = 54, 77%): 43 were vertebral osteomyelitis (61%), mainly caused by “less virulent” bacteria (viridans and bovis streptococci, enterococci, and coagulase-negative staphylococci), and 15 were septic arthritis of the axial skeleton (21%), which were mainly caused by Staphylococcus aureus. OAIs with involvement of the axial skeleton were associated with IE (adjusted OR = 2.2; 95% CI 1.1–4.3) independently of age, sex, and microorganisms.

Conclusions

Among patients with IE, the associated OAIs mainly involve the axial skeleton. Transesophageal echocardiography should be carefully considered in patients presenting with these bacteremic OAIs.

Keywords

Endocarditis Osteoarticular infections Bacteremia Septic arthritis Axial skeleton Vertebral osteomyelitis 

Notes

Acknowledgements

We thank Michael Maudsley for helping with the English in this manuscript.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The institutional review board approved this study and publication of the results. The need for informed consent was waived as the study analysed data retrospectively and the data were anonymized.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Oscar Murillo
    • 1
  • Imma Grau
    • 1
  • Joan Gomez-Junyent
    • 1
  • Celina Cabrera
    • 1
  • Alba Ribera
    • 1
  • Fe Tubau
    • 2
    • 3
  • Carmen Peña
    • 1
  • Javier Ariza
    • 1
  • Roman Pallares
    • 1
  1. 1.Infectious Diseases Department, IDIBELL-Hospital Universitari de BellvitgeUniversity of BarcelonaBarcelonaSpain
  2. 2.Microbiology DepartmentIDIBELL-Hospital Universitari de BellvitgeBarcelonaSpain
  3. 3.Spain Ciber de Enfermedades Respiratorias ISCIIIMadridSpain

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