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Erschienen in: Infection 5/2019

23.05.2019 | Original Paper

Clinical features of patients with septic arthritis and echocardiographic findings of infective endocarditis

verfasst von: Sarah B. Lieber, Ori Tishler, Kunwal Nasrullah, Mary Louise Fowler, Robert H. Shmerling, Ziv Paz

Erschienen in: Infection | Ausgabe 5/2019

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Abstract

Purpose

Patients with septic arthritis (SA) often undergo echocardiographic evaluation to identify concomitant infective endocarditis (IE). The purpose of this study is to identify distinguishing features of patients with SA and IE by comparing them to patients with SA alone.

Methods

We conducted a retrospective study of all patients 18 and older admitted to a single tertiary hospital between 1998 and 2015 with culture-positive SA. Patients were stratified by echocardiogram status and the presence of vegetations: those who had echocardiographic evaluation with no evidence of infective endocarditis (ECHO + IE−) or with a vegetation present (ECHO + IE+) and those who had no echocardiographic evaluation (ECHO−). Demographic data, clinical characteristics, microbiology data, treatment strategies, and patient outcomes were recorded and compared.

Results

We identified 513 patients with SA. Transthoracic echocardiogram and/or transesophageal echocardiogram were performed in 263 patients (51.2%) and demonstrated evidence for IE in 19 patients (3.7%). While most demographic features, comorbidities, and clinical characteristics did not differ significantly between those with and without IE, those with IE had higher rates of sepsis and septic shock. In addition, patients with SA and IE had higher rates of positive blood cultures and Methicillin-sensitive staphylococcus aureus (MSSA) infection when compared to those with SA without IE. Patients with IE had higher rates of intensive care unit admission and increased 30-day mortality.

Conclusions

IE is uncommon among patients with SA. Echocardiography may be overutilized and may be more useful among patients presenting with sepsis, shock, or positive blood cultures, especially when MSSA is isolated.
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Metadaten
Titel
Clinical features of patients with septic arthritis and echocardiographic findings of infective endocarditis
verfasst von
Sarah B. Lieber
Ori Tishler
Kunwal Nasrullah
Mary Louise Fowler
Robert H. Shmerling
Ziv Paz
Publikationsdatum
23.05.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Infection / Ausgabe 5/2019
Print ISSN: 0300-8126
Elektronische ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-019-01302-9

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