Unusual cardiovascular complications of brucellosis presenting in two men: two case reports and a review of the literature.
BACKGROUND
Brucellosis is a zoonosis with worldwide distribution, which is particularly endemic in many countries of the Mediterranean basin. Cardiovascular complications of this disease, such as endocarditis, myocarditis and pericarditis, are very rare, with even fewer cases of myocarditis or asymptomatic pericardial effusion in the absence of concomitant endocarditis being reported.


METHODS
We report two cases of brucellosis in two Caucasian men, aged 17 and 34 years old, with myocarditis and asymptomatic pericardial effusion, respectively. Of note, neither patient had concomitant endocarditis. The disease was confirmed serologically and by blood cultures. Both patients recovered completely after receiving appropriate antibiotic treatment without any sign of relapse during a follow-up of 12 months.


CONCLUSIONS
These two cases emphasize that in endemic areas Brucella can be considered as a potentially causative agent of idiopathic pericardial effusion or myocarditis, even in the absence of concomitant endocarditis. This possibility could be taken into account particularly in cases where contraction of brucellosis is possible, such as occupational exposure or consumption of unpasteurized dairy products.
Department of Medicine, Medical School, University of Thessaly, Larissa, Greece. dalekos@med.uth.gr.
Nikolaos K
NK
Gatselis
Konstantinos P
KP
Makaritsis
Ioannis
I
Gabranis
Aggelos
A
Stefos
Konstantinos
K
Karanikas
George N
GN
Dalekos
Infection. 1988 Jul-Aug;16(4):254
3182095
Int J Infect Dis. 2009 Sep;13(5):564-9
19071050
Arch Dis Child. 1986 Jun;61(6):569-72
3729526
Postgrad Med J. 1984 Aug;60(706):544-5
6473235
N Engl J Med. 2005 Jun 2;352(22):2325-36
15930423
Medicina (B Aires). 1995;55(2):145-6
7565052
Int J Infect Dis. 2003 Sep;7(3):236
14563232
Trop Doct. 2003 Jul;33(3):151-3
12875250
Int J Infect Dis. 2010 Apr;14(4):e358-60
19665411
Chest. 1990 Apr;97(4):1008-9
2323233
Am Heart J. 1985 May;109(5 Pt 1):1108
3993521
Scand J Infect Dis. 2004;36(9):694-7
15370660
Occup Med (Lond). 2008 Jun;58(4):305-7
18397911
Rev Esp Cardiol. 2004 Jul;57(7):709
15274859
J Heart Valve Dis. 2001 Jul;10(4):486-8
11499595
Emerg Infect Dis. 1997 Apr-Jun;3(2):213-21
9204307
An Med Interna. 1991 Feb;8(2):100-1
1892994
Intern Med. 2009;48(19):1773-4
19797836
Med Clin (Barc). 1986 Jan 18;86(2):43-8
3959633
Vet Microbiol. 2002 Dec 20;90(1-4):81-110
12414137
J Med Case Rep. 2007 Jul 21;1:53
17659088
Lancet. 1997 Apr 5;349(9057):994
9100627
Vet Microbiol. 2002 Dec 20;90(1-4):111-34
12414138
Q J Med. 1988 Jan;66(249):39-54
3051080
Scand J Infect Dis. 2003;35(3):204-5
12751720
J Infect Dis. 1986 Sep;154(3):544
3734497
Medicine (Baltimore). 1996 Jul;75(4):195-211
8699960