[Brucella endocarditis caused by reinfection of an aortic Starr valve. Apropos of a case with a favorable development after valvular replacement].
We report the case of a 36-year old male patient who was admitted for subacute endocarditis on an aortic prosthetic valve implanted 14 years previously for endocarditic valve regurgitation; no pathogen had been isolated at that time. Nine blood cultures were positive for Brucella abortus. The conventional antibiotic therapy did not prevent the formation of an abscess below the aortic annulus. A third antibiotic combination (quinolone and rifampicin) resulted in pyrexia prior to surgery. An atrioventricular block initially noted raised the problem of an associated myocarditis. The risk of Brucella infection existed before the first operation, and five serological tests were positive for that organism between the two episodes, which makes reinfection highly probable. This is the third case of Brucella endocarditis on a prosthetic valve. Its originality lies in its mechanism.
D'Agrosa
M C
MC
Service de cardiologie (8e étage), hôpital Saint-Jacques, Clermont-Ferrand.
Lusson
J R
JR
Beytout
J
J
Bailly
P
P
Peycelon
B
B
de Riberolles
C
C
Jourde
M
M
Cassagnes
J
J
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001021:Aortic Valve; D002003:Brucella abortus; D002006:Brucellosis / Q000188:drug therapy; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000209:etiology*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D012086:Reoperation
D000900:Anti-Bacterial Agents
Endocardite brucellienne par réinfestation sur valve de Starr aortique. A propos d'un cas d'évolution favorable après remplacement valvulaire.