Brucella endocarditis in prosthetic valves.
Human brucellosis is a multiple organ disease that presents with fever and is most often transmitted via contaminated, unpasteurized goat milk and cheese. In chronic cases, focal complications (eg, spondylitis, neurobrucellosis and endocarditis) are frequently seen. Although the disease may be severely debilitating, the mortality rate is low. Fatal cases are often due to endocarditis. Because Brucella endocarditis is a rare complication (2% to 5%), therapeutic considerations are based on single-case experiences only. Therapy includes long-term antibiotic treatment using combinations of various antimicrobial drugs and surgical valve replacement when required. A case of Brucella endocarditis complicated by the infection of two valvular prostheses implanted after involvement of the mitral and aortic valve due to rheumatic fever is described. The patient was successfully treated by a medical and surgical approach. Therapeutic strategies in Brucella endocarditis are discussed in light of the current literature.
Al Dahouk
Sascha
S
Department of Bacteriology, Bundeswehr Institute of Microbiology, Munich, Germany. SaschaAlDahouk@bundeswehr.org
Schneider
Thomas
T
Jansen
Andreas
A
Nöckler
Karsten
K
Tomaso
Herbert
H
Hagen
Ralf M
RM
Scholz
Holger C
HC
Rudwaleit
Martin
M
Neubauer
Heinrich
H
Morguet
Andreas J
AJ
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000601:surgery; D002002:Brucella; D002006:Brucellosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D012214:Rheumatic Heart Disease / Q000150:complications / Q000601:surgery
D000900:Anti-Bacterial Agents