title: Brucella endocarditis: clinical, diagnostic, and therapeutic approach.
abstract: Brucella endocarditis is an uncommon focal complication of brucellosis. Presented here are 11 cases of Brucella endocarditis, all managed uniformly. The median duration of symptoms prior to diagnosis was 3 months. Five patients (45%) had underlying valvular damage, and in six (55%) endocarditis involved a normal valve. There was a predominance of aortic involvement (82%) and a high incidence of left ventricular failure (91%). Diagnostic suspicion was essential in order to test blood cultures correctly, which in this series were positive in 63% of the patients. Surgical treatment was undertaken in eight patients (72%), all with aortic involvement and left ventricular failure impossible to control with medication. One patient died during the immediate postoperative period. All the other patients received antibiotic therapy for 3 months, with no signs of relapse of the infection or malfunction of the prosthesis during a minimum follow-up period of 24 months.
authors.affiliation: Infectious Diseases INIT, Internal Medicine Department, Carlos Haya University Hospital, Avenida Carlos Haya, 29010 Malaga, Spain. jmreguera99@yahoo.com
authors.forename: J M
authors.initials: JM
authors.lastname: Reguera
authors.forename: A
authors.initials: A
authors.lastname: Alarcón
authors.forename: F
authors.initials: F
authors.lastname: Miralles
authors.forename: J
authors.initials: J
authors.lastname: Pachón
authors.forename: C
authors.initials: C
authors.lastname: Juárez
authors.forename: J D
authors.initials: JD
authors.lastname: Colmenero
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D001774:Blood Chemical Analysis; D002002:Brucella / Q000302:isolation & purification; D002006:Brucellosis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D003131:Combined Modality Therapy; D017548:Echocardiography, Transesophageal / Q000379:methods; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D013030:Spain; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents