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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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High incidence of infective endocarditis in patients with pyogenic spondylodiscitis: The diagnostic value of routine transesophageal echocardiography

Meeting Abstract

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  • Bedjan Behmanesh - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
  • Florian Geßler - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
  • Katrin Schnoes - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
  • Daniel Dubinski - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
  • Sae-Yeon Won - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
  • Volker Seifert - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
  • Lutz Weise - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
  • Matthias Setzer - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV301

doi: 10.3205/18dgnc321, urn:nbn:de:0183-18dgnc3213

Veröffentlicht: 18. Juni 2018

© 2018 Behmanesh et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: The increasing number of patients with pyogenic spinal infection and the subsequent adequate therapy still remain challenging. Beside treatment of the spinal infection early diagnosis and therapy of coexisting infections, especially of infective endocarditis is an important issue. Aim of this study is to evaluate the value of routine transesophageal echocardiography in the management of these patients.

Methods: Retrospective, single center review of all cases admitted with a spondylodiscitis between 2008– 2017. Patients' data, medical charts, surgical, radiological and microbiological data were analyzed. The efficacy of routinely performed transesophageal echocardiography was investigated for detection of infective endocarditis.

Results: During the abovementioned period 95 (40.8%) of 233 patients with newly diagnosed pyogenic spondylodiscitis were evaluated with transesophageal echocardiography. Infective endocarditis was diagnosed in 28 (29.5 %). Twelve of 28 patients (42.9%) revealed severe valve destruction and cardiac failure and subsequently underwent cardiac surgery. Six patients (21.4 %) died before performing surgery due to severe cardiac failure. The risk of infective endocarditis in patients with spondylodiscitis was highly associated with bacteremia as diagnosed by positive blood cultures, p = 0.003. Of the comorbidities analyzed, terminal renal failure with need of dialysis was associated with the development of infective endocarditis (p = 0.02) in patients with spondylodiscitis. Three transesophageal echocardiography were necessary to detect one patient with infectious endocarditis.

Conclusion: Transesophageal echocardiography should be performed routinely in all patients with spondylodiscitis. Even in 32 % of patients with negative blood culture infectious endocarditis could be detected as well.