BACTERIAL-ENDOCARDITIS REVEALED BY INFECTIOUS DISCITIS

A study of 30 patients admitted for infectious discitis identified fou r cases with concomitant bacterial endocarditis, All four patients wer e male and had concomitant streptococcal septicemia, Two patients had known aortic valve disease, The vertebral infection was located to the thoracic or lumbar spine, Ultrasonography disclosed aortic lesions in all four patients and mitral lesions in two, Management consisted of intravenous antimicrobial therapy for four weeks followed by a three-m onth course of oral antimicrobial therapy, The outcome of the discitis was favorable within the usual period of time, However, the endocardi al lesions continued to progress, and three patients rapidly required valve replacement, Analysis of available data in the 30 patients with discitis showed that half the patients with streptococcal discitis als o had bacterial endocarditis and that the latter condition developed i n all the patients with streptococcal discitis and a history of valve disease, A number of risk factors were identified, An echocardiogram s hould be done routinely in patients with infectious discitis and risk factors for bacterial endocarditis.