title: Streptococcus bovis endocarditis and its association with chronic liver disease: an underestimated risk factor.
abstract: Clinical and epidemiological characteristics of Streptococcus bovis endocarditis were prospectively studied among 199 patients with definite endocarditis. Thirty patients (15.1%) had S. bovis endocarditis. Compared with patients with non-S. bovis endocarditis, these 30 patients were older (mean age, 58.6+/-12.4 years vs. 46.0+/-17.0 years; P<.001) and had higher rates of bivalvular involvement (43.3% vs. 7.7%; P<.001), embolism (73.3% vs. 40.2%; P=.002), and diskitis (23.3% vs. 0.6% P<.001). In patients with S. bovis biotype I (S. bovis I) endocarditis, advanced liver disease was present in 56.7%, compared with 15.3% of patients with non-S. bovis endocarditis (P<.001), and colonic adenoma was present in 46.7%. The in-hospital mortality rate (16.7%) was correlated with delayed diagnosis and advanced liver diseases. In our city, S. bovis I endocarditis is frequently correlated with liver diseases; diskitis may be the first sign of the disease.
authors.affiliation: Department of Internal Medicine, Second University of Naples, I-80135 Naples, Italy. Mariefranc.tripodi@unina2.it
authors.forename: M F
authors.initials: MF
authors.lastname: Tripodi
authors.forename: L E
authors.initials: LE
authors.lastname: Adinolfi
authors.forename: E
authors.initials: E
authors.lastname: Ragone
authors.forename: E
authors.initials: E
authors.lastname: Durante Mangoni
authors.forename: R
authors.initials: R
authors.lastname: Fortunato
authors.forename: D
authors.initials: D
authors.lastname: Iarussi
authors.forename: G
authors.initials: G
authors.lastname: Ruggiero
authors.forename: R
authors.initials: R
authors.lastname: Utili
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002908:Chronic Disease; D003110:Colonic Neoplasms; D015299:Discitis / Q000209:etiology*; D004617:Embolism / Q000209:etiology; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000401:mortality; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000453:epidemiology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013290:Streptococcal Infections / Q000150:complications* / Q000401:mortality; D016985:Streptococcus bovis / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents