Infectious endocarditis: A rare etiology

Abstract

male sex. Its incidence has increased associated with bacteriemias related to the use of intravenous devices and substances and increasing age of the population. The purpose of this work is to present 4 cases of spondylodiscitis at different locations with different pathogenic mechanisms. Methods: Retrospective analysis of 4 clinical files of patients admitted to the service of Internal Medicine. Results: Clinical case 1: A 63-year-old male patient presenting with cervicalgias with 1 month of evolution and progressive worsening that emerged after ophthalmic surgery. Cervical spondylodiscitis(C6–C7) was diagnosed, with blood cultures positive for Staphylococcus epidermidis. Clinical Case 2: A 66-year-old male patient with a history of type 2 diabetes mellitus, previous acute myocardial infarction and previous admissions for septicemia of unknown origin and pneumonia caused by Staphylococcus hominis. History of pain in the dorso-lumbar region with 2 months of evolution associated with weight loss of 10 kg in the same period. Dorsal spondylodiscitis (D9–D10) was diagnosed with blood cultures positive for S. hominis. Clinical case 3: A 62-year-old male patient with a history of type 2 diabetes mellitus, hypertension and Buerger disease. Previous hospitalization for urosepsis. Complaints of chills, diaphoresis and malaise. Lumbar pain that worsened in the previous 2 months. Spondylodiscitis was confirmed by magnetic resonance imaging (L5-S1). Blood cultures were positive for Staphylococcus aureus. Clinical case 4: A 58-year-old male patient with neurogenic bladder, carrier of a urethral catheter and recurrent urinary tract infections. Complaints of astenia, anorexia, weight loss, fever and lumbar pain. He was diagnosed with spondylodiscitis (L3-S1) associated with a subacute endocarditis mitral and aortic. Blood cultures were positive for Streptococcus sanguis. Conclusions: Although pain complaints associated with the spine are common, they are usually of mechanical/degenerative etiology. Nevertheless, it is important to exclude infectious diseases in order to avoid more serious complications as vertebral collapse and neurological disorders. The best way to reduce morbidity and mortality associated with this disease is to reduce the time between the beginning of symptoms and the institution of appropriate treatment. All patients listed in this abstract had a favorable evolution.