Surgical treatment of Brucella endocarditis.
BACKGROUND
Brucella endocarditis (BE) is a lethal complication of human brucellosis, which is rarely seen and hardly described.


METHODS
In the present report, six successfully treated cases of BE involving three native aortic valves, two native mitral-aortic valves, and a mitral bioprosthesis are described. The diagnosis of BE was based on clinical features, high brucella serologic titers, and positive blood cultures. Although the blood cultures were positive in all patients, all the resected valve materials and tissue cultures were negative. The patients received rifampicin, streptomycin, and doxycycline (in 3 patients), rifampicin, tetracycline, and cotrimoxazole (in 2 patients), and rifampicin, doxycycline, and cotrimoxazole (in 1 patient). Infected native valves and bioprosthesis were replaced by mechanical valves.


RESULTS
There was no early or late mortality. No recurrent infection developed after management with a combination of antibiotherapy lasting 6 months postoperatively during a mean follow-up of 47 months (range 20 to 84 months).


CONCLUSIONS
This report suggests that the combination of valve replacement and antibiotic therapy produces successful results in the treatment of BE.
Keleş
C
C
Koşuyolu Heart and Research Hospital, Istanbul, Turkey.
Bozbuğa
N
N
Sişmanoğlu
M
M
Güler
M
M
Erdoğan
H B
HB
Akinci
E
E
Yakut
C
C
D000328:Adult; D000900:Anti-Bacterial Agents; D019072:Antibiotic Prophylaxis; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D002006:Brucellosis / Q000150:complications* / Q000175:diagnosis; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents