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 invo...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 2003-11, Vol.22 (11), p.647-650
Main Authors: REGUERA, J. M, ALARCON, A, MIRALLES, F, PACHON, J, JUAREZ, C, COLMENERO, J. D
Format: Article
Language:English
Subjects:
Adult
Aged
Anti-Bacterial Agents - therapeutic use
Biological and medical sciences
Biopsy, Needle
Blood Chemical Analysis
Brucella - isolation & purification
Brucellosis - diagnosis
Brucellosis - epidemiology
Brucellosis - therapy
Cardiology. Vascular system
Combined Modality Therapy
Echocardiography, Transesophageal - methods
Endocardial and cardiac valvular diseases
Endocarditis, Bacterial - diagnostic imaging
Endocarditis, Bacterial - mortality
Endocarditis, Bacterial - therapy
Female
Follow-Up Studies
Heart
Heart Valve Diseases - diagnostic imaging
Heart Valve Diseases - mortality
Heart Valve Diseases - surgery
Heart Valve Prosthesis
Humans
Male
Medical sciences
Middle Aged
Postoperative period
Prospective Studies
Risk Assessment
Sampling Studies
Severity of Illness Index
Spain
Survival Rate
Treatment Outcome
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Summary: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.
ISSN:0934-9723
1435-4373
DOI:10.1007/s10096-003-1026-z