title: [Brucella canis endocarditis: first documented case in Argentina].
abstract: We herein present the case of an adult male patient who consulted for lower extremity edema, a 2- month history of fever and oppressive chest pain radiating to the left arm. He referred neither contact with breeding animals nor consumption of unpasteurized dairy products. A diagnosis of endocarditis was confirmed by cardiac studies. Since the empirical treatment with cephalotin, ampicillin and gentamicin failed, the patient underwent aortic valve replacement. A total of four blood cultures were positive with a gram-negative rod. Bacterial identification was performed using the API 20 NE technique (bioMèrieux), the Phoenix automated method (BD) and conventional biochemical tests which were unable to classify the isolate as to genus and species. The strain was sent to the INEI-ANLIS "Dr. Carlos G. Malbrán" where it was identified as Brucella canis. The antimicrobial treatment was switched to doxycycline, rifampicin and trimethoprim-sulfamethoxazole with good evolution of the patient. The clinical significance of this case report lies in the possible failure of the empiric antibiotic therapy administered for endocarditis, since B. canis did not respond to the conventional antimicrobial treatment for this pathology.
authors.affiliation: Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Argentina. valeriamanias@yahoo.com.ar
authors.forename: Valeria
authors.initials: V
authors.lastname: Manias
authors.forename: Alicia
authors.initials: A
authors.lastname: Nagel
authors.forename: Analía
authors.initials: A
authors.lastname: Mollerach
authors.forename: María A
authors.initials: MA
authors.lastname: Mendosa
authors.forename: Hugo
authors.initials: H
authors.lastname: Freyre
authors.forename: Abel
authors.initials: A
authors.lastname: Gómez
authors.forename: Elisa
authors.initials: E
authors.lastname: Ferrara
authors.forename: Carlos
authors.initials: C
authors.lastname: Vay
authors.forename: Emilce
authors.initials: E
authors.lastname: de Los A Méndez
mesh_terms: D000328:Adult; D001021:Aortic Valve / Q000382:microbiology / Q000601:surgery; D001118:Argentina / Q000453:epidemiology; D016470:Bacteremia / Q000382:microbiology; D015373:Bacterial Typing Techniques; D041002:Brucella canis / Q000187:drug effects / Q000302:isolation & purification*; D002006:Brucellosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000601:surgery; D002637:Chest Pain / Q000209:etiology; D003131:Combined Modality Therapy; D004318:Doxycycline / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D004487:Edema / Q000209:etiology; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000601:surgery; D005334:Fever / Q000209:etiology; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D012293:Rifampin / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D004318:Doxycycline; D012293:Rifampin