Septic Necrosis of the Odontoid Apophysis and Cervical Spondylodiscitis from <i>Enterococcus faecalis</i> Endocarditis: A First Report

Authors

  • Victor Mosquera
  • Vicente Campos
  • Jose Vicente Valle
  • Alberto Juffé

DOI:

https://doi.org/10.1532/HSF98.20071151

Abstract

We describe a 75-year-old male patient who developed a general syndrome, with a fever of 39°C, weight loss, and cervical pain, during the month following a urological procedure. The presence of positive blood cultures for Enterococcus faecalis, aortic vegetations, and severe aortic regurgitation observed with echocardiogram confirmed the diagnosis of infective endocarditis (IE). Magnetic resonance imaging of the spinal cord showed significant erosion and irregularities of the odontoid apophysis, with hyperintensity of bone marrow in T2-weighted images because of edema and inflammation. These findings suggested an infective necrosis of the odontoid apophysis. Despite the common occurrence of rheumatologic manifestations in IE, with prevalence rates of 25% to 44%, spondylodiscitis is rarely observed (5%-13%). The lumbar region is the most commonly involved. We found only one other reported case of cervical spondylodiscitis. The case we describe is the first report of septic necrosis of the odontoid apophysis associated with IE.

References

Azevedo J, Ribeiro C, Loureiro O, Cordeiro A. 1984. Rheumatic symptoms and signs in subacute infective endocarditis. Eur Heart J 5(Suppl C):71-5.nChurchill MA, Jr, Geraci JE, Hunder GG. 1977. Musculoskeletal manifestations of bacterial endocarditis. Ann Intern Med 87:754-9.nLe Moal G, Roblot F, Paccalin M, et al. 2002. Clinical and laboratory characteristics of infective endocarditis when associated with spondy-lodiscitis. Eur J Clin Microbiol Infect Dis 21:671-5.nMorelli S, Carmenini E, Caporossi AP, Aguglia G, Bernardo ML, Gurgo AM. 2001. Spondylodiscitis and infective endocarditis: case studies and review of the literature. Spine 26:499-500.nMund DJ. 1980. Pyogenic vertebral osteomyelitis; manifestation of bacterial endocarditis. N Y State J Med 1980; 80:980-2.n

Published

2008-04-22

How to Cite

Mosquera, V., Campos, V., Valle, J. V., & Juffé, A. (2008). Septic Necrosis of the Odontoid Apophysis and Cervical Spondylodiscitis from <i>Enterococcus faecalis</i> Endocarditis: A First Report. The Heart Surgery Forum, 11(2), E108-E109. https://doi.org/10.1532/HSF98.20071151

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Section

Articles