Streptococcus bovis endocarditis: Clinical, Echocardiographic and prognostic features.

ABSTRACT

The aim of this study was to determine clinic and echocardiographic characteristics of Streptococcus bovis endocarditis [El] and its prognosis. We studied the clinic and echocardiographic characteristics of 54 patients with a Streptococcus bovis El among 350 cases of El. We included 44 men and 10 women, 64 +/- 15 years of age, with a native valvular disease in 31.5% of cases and a valvular prosthesis in 13%. 74% had a worsened general state; 48% presented with signs of cardiac insufficiency. 12 patients [22%] were followed for cancer including 7 digestive colic localizations [confirmed by coloscopy and histology]. Vegetation was identified in all patients. It was a left localization in 98.1%. Vegetation diameter was>10 mm in 37 patient s [68.5%] and>20 mm in 9 patients [16%]. During the follow-up, 59.3% developed an embolic accident, 17 cases of CVA and 7 cases of spondylodiscitis [7 out of 11 cases of spondylodiscitis described in the 350 cases of El]. Mortality reached 7%. The statistical analysis showed that Streptococcus Bouis was the major predictive factor for embolic complications, especially for spondylodiscitis. Streptococcus bovis El is more frequent in patients with digestive colic neoplasia. It is characterized by large vegetation which has a high embolic potential worsening the prognosis