title: Streptococcal and enterococcal spondylodiscitis (vertebral osteomyelitis). High incidence of infective endocarditis in 50 cases.
abstract: OBJECTIVE
  To characterize the clinical, biological, and imaging features and outcomes of patients with streptococcal and enterococcal spondylodiscitis (SESD).
  
  
  METHODS
  This retrospective study of patients with SESD was carried out in 2 departments of rheumatology from 1990 through 2002. Comparison was made with cases of staphylococcal spondylodiscitis (SSD) seen during the same period, excluding postoperative cases.
  
  
  RESULTS
  Fifty cases of SESD were reviewed and compared with 86 cases of SSD. The main finding was a higher frequency of concomitant infective endocarditis in patients with SESD (11/42 vs 1/37; p = 0.009). Evidence of inflammation, imaging features, and neurological impairment at admission appeared to be less severe in SESD, but the difference did not reach statistical significance. Duration of treatment was shorter in SESD than in SSD (105 +/- 26 days vs 130 +/- 49 days; p = 0.003).
  
  
  CONCLUSIONS
  Our study confirms the high incidence of infective endocarditis (26%) during SESD. Clinicians must look for predisposing factors and clinical abnormalities in patients with spondylodiscitis whenever a streptococcal or enterococcal agent is identified. Echocardiography should be performed as routine in such situations.
authors.affiliation: Department of Rheumatology, University Hospital of Lille, Lille, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Mulleman
authors.forename: Peggy
authors.initials: P
authors.lastname: Philippe
authors.forename: Eric
authors.initials: E
authors.lastname: Senneville
authors.forename: Chantal
authors.initials: C
authors.lastname: Costes
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Fages
authors.forename: Xavier
authors.initials: X
authors.lastname: Deprez
authors.forename: René-Marc
authors.initials: RM
authors.lastname: Flipo
authors.forename: Bernard
authors.initials: B
authors.lastname: Duquesnoy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015299:Discitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D013904:Thoracic Vertebrae