title: Surgical approach to the management of Brucella endocarditis.
abstract: OBJECTIVE
  Brucella endocarditis is a rare complication of Brucella infection; however, it is the major cause of deaths in those infected with this disease. In this study, we aim to discuss the results of seven cases who underwent surgery for Brucella endocarditis in our clinic using the knowledge gathered through the literature.
  
  
  METHODS
  We reviewed seven patients with Brucella endocarditis, who underwent surgery in our department between October 1990 and April 2007. Brucella endocarditis was diagnosed by physical examination, laboratory findings, serological tests, blood culture, transthoracic and trans-oesophageal echocardiography. All cases underwent surgery after 4-6 weeks of medical therapy. Antimicrobial treatment was maintained for an average of 6 months after surgery. The mean follow-up was 27.4 months.
  
  
  RESULTS
  The mean age was 30 years (range, 5-47 years). Four of the patients were male. Of the cases, aortic valve replacement (AVR) was performed in three, mitral valve replacement (MVR) was performed in three and combined aortic and mitral valve replacement (AVR+MVR) was performed in one patient. Pericardial tube drainage was done in one patient because of pericardial effusion and cardiac tamponade that developed 13 days after surgery. One (14.3%) of our patients died 15 days after surgery. The others were discharged.
  
  
  CONCLUSIONS
  We concluded that medical and surgical treatment had to be performed simultaneously for the successful management of Brucella endocarditis, a fatal complication of Brucella infection.
authors.affiliation: Department of Cardiovascular Surgery, Erciyes University School of Medicine, 38039 Kayseri, Turkey.
authors.forename: Kutay
authors.initials: K
authors.lastname: Tasdemir
authors.forename: Mehmet Gungor
authors.initials: MG
authors.lastname: Kaya
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Mavili
authors.forename: Ozgur
authors.initials: O
authors.lastname: Gunebakmaz
authors.forename: Ali
authors.initials: A
authors.lastname: Ozbek
authors.forename: Bahadir
authors.initials: B
authors.lastname: Sarli
authors.forename: Mikail
authors.initials: M
authors.lastname: Yarlioglues
authors.forename: Naci
authors.initials: N
authors.lastname: Emirogullari
mesh_terms: D000293:Adolescent; D000328:Adult; D001021:Aortic Valve / Q000601:surgery; D002006:Brucellosis / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult