Brucella endocarditis: clinical, diagnostic, and therapeutic approach.
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.
Reguera
J M
JM
Infectious Diseases INIT, Internal Medicine Department, Carlos Haya University Hospital, Avenida Carlos Haya, 29010 Malaga, Spain. jmreguera99@yahoo.com
Alarcón
A
A
Miralles
F
F
Pachón
J
J
Juárez
C
C
Colmenero
J D
JD
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
D000900:Anti-Bacterial Agents