title: Comparison of clinical and echocardiographic characteristics of Streptococcus bovis endocarditis with that caused by other pathogens.
abstract: The aim of our study was to compare the clinical, echographic, and prognostic features of Streptococcus bovis (S. bovis) endocarditis with those caused by other streptococci and pathogens in a large sample of patients with definite endocarditis by Duke criteria, using transesophageal echocardiography. Two hundred six patients (149 men, mean age 57 +/- 15 years) with a diagnosis of infective endocarditis formed the study population. All patients underwent multiplane transesophageal echocardiography and blood cultures. Cerebral, thoracoabdominal computed tomographic scan was performed in almost all patients (95%). All patients with S. bovis endocarditis underwent colonoscopy. Incidence of S. bovis endocarditis in our sample was 19%. Patients with S. bovis endocarditis were older than other groups. Multiple valve involvement, native valves, and large vegetations (>10 mm) were more frequent in patients with S. bovis. There was a significantly higher occurrence of embolism in the S. bovis group. Splenic embolism and multiple embolisms were significantly more frequent in patients with S. bovis. Gastrointestinal lesions, anemia, and spondylitis were observed more frequently with S. bovis endocarditis. In addition to the requirement for gastrointestinal examination for S. bovis endocarditis, our study underlines the need for systematic screening for vertebral and splenic localizations, and suggests the use of early surgery to prevent the high risk of embolism in these patients.
authors.affiliation: Department of Cardiology, La Timone Hospital, Marseille, France.
authors.forename: V
authors.initials: V
authors.lastname: Pergola
authors.forename: G
authors.initials: G
authors.lastname: Di Salvo
authors.forename: G
authors.initials: G
authors.lastname: Habib
authors.forename: J F
authors.initials: JF
authors.lastname: Avierinos
authors.forename: E
authors.initials: E
authors.lastname: Philip
authors.forename: J M
authors.initials: JM
authors.lastname: Vailloud
authors.forename: F
authors.initials: F
authors.lastname: Thuny
authors.forename: J P
authors.initials: JP
authors.lastname: Casalta
authors.forename: P
authors.initials: P
authors.lastname: Ambrosi
authors.forename: M
authors.initials: M
authors.lastname: Lambert
authors.forename: A
authors.initials: A
authors.lastname: Riberi
authors.forename: A
authors.initials: A
authors.lastname: Ferracci
authors.forename: T
authors.initials: T
authors.lastname: Mesana
authors.forename: D
authors.initials: D
authors.lastname: Metras
authors.forename: J R
authors.initials: JR
authors.lastname: Harle
authors.forename: P J
authors.initials: PJ
authors.lastname: Weiller
authors.forename: D
authors.initials: D
authors.lastname: Raoult
authors.forename: R
authors.initials: R
authors.lastname: Luccioni
mesh_terms: D000368:Aged; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000382:microbiology / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality; D016985:Streptococcus bovis