Brucella endocarditis.

Jeroudi, Majed; Halim, Magid A.; Harder, Edward J.; Al-Sibai, M. Badawi; Ziady, Galal M.; Mercer, Edward N.

doi:10.1136/hrt.58.3.279

Cited by 50 publications

(35 citation statements)

References 23 publications

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“…In most reports, a combination of antimicrobial agents and early valve replacement or extensive surgical debridement are recommended for successful treatment of Brucella endocarditis (5,11,12,16,(21)(22)(23)(24)32,33). The authors of these studies claim that a medical and surgical approach is mandatory, especially in patients suffering from progressive heart failure secondary to severe aortic regurgitation due to valvular destruction.…”

Section: Discussionmentioning

confidence: 99%

“…The aortic valve is predominantly affected (75%), and mitral valve, both mitral and aortic valves, and prosthetic valves are equally affected (8.3%) (10,11,22). The infection of a previously healthy valve most often involves the aortic valve, whereas secondary infections of predamaged valves preferably occur on mitral valves (20).…”

Section: Discussionmentioning

confidence: 99%

“…Some examples of these are myocardial abscesses and aneurysms (5,11); cusp perforation (25); ruptured chordae tendineae and detached leaflets (22); left ventricular failure; disseminated intravascular coagulation (28,29); and embolic phenomena (ie, mycotic aneurysms [15], transient ischemic attacks, myocardial and other organ infarctions [10,20,22,30]). Septic emboli dislodged from valve vegetations may cause infected infarcts of any organ, leading to relapse (21).…”

Section: Discussionmentioning

confidence: 99%

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Brucella endocarditis in prosthetic valves

Dahouk

Schneider

Jansen

et al. 2006

Canadian Journal of Cardiology

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Brucellosis is a common zoonosis in Mediterranean countries, transmitted to humans by direct contact with infected animals or by the consumption of contaminated food (eg, unpasteurized milk or dairy products, and raw meat) (1). Four of the six named species of the genus Brucella are human pathogens: Brucella melitensis, Brucella abortus, Brucella suis and Brucella canis. Human brucellosis is a severe systemic disease that may affect any organ and is characterized by focal complications, chronic courses, therapeutic failures and relapses. The case fatality rate is low (less than 1%). However, 80% of the fatal cases are caused by endocarditis (2). In endemic areas, Brucella endocarditis has been reported in 8.5% to 14.6% of all patients treated for endocarditis (3)(4)(5). A case of Brucella endocarditis on two valvular prostheses successfully treated in Charité -Campus Benjamin Franklin (Berlin, Germany) by a combined medical and surgical approach is described. Because Brucella endocarditis is a rare complication, general treatment recommendations do not exist for this potentially fatal complication. Therapeutic strategies in Brucella endocarditis are discussed. CASE PRESENTATIONA 55-year-old Turkish woman was hospitalized primarily because of remittent fever up to 39.5°C, accompanied by night sweats and abnormal fatigue; she also suffered from left thoracic pain. Her medical history revealed an episode of rheumatic fever during childhood, followed by rheumatic disease of the heart valves. Because of combined mitral regurgitation and stenosis, a St Jude Medical prosthesis (St Jude Medical, USA) was implanted when the patient was 37 years of age. The aortic valve was also replaced due to insufficiency by the same type of prosthesis two years before admission to the hospital. Transesophageal echocardiography (TEE) did not show any vegetation on the two valves. However, Enterobacteriaceae were found in urine cultures. Urinary tract infection was suspected and the patient was treated with co-trimoxazole. Body temperature decreased to normal values, and her health improved markedly. Four weeks later, blood cultures taken before antibiotic treatment yielded B melitensis bv 2. The isolates were identified by the German Reference Laboratory for brucellosis located at the Federal Institute for Risk Assessment (Berlin, Germany) following the standard laboratory procedures described by Alton et al (6). Rifampin and doxycycline were recommended for six weeks, but were only taken for two weeks because of noncompliance. A re-evaluation of the medical history did not reveal the probable source of infection, but the consumption of unpasteurized goat's milk and cheese during a family stay in Turkey seemed to be highly probable. 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 debi...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Brucella endocarditis in prosthetic valves

Dahouk

Schneider

Jansen

et al. 2006

Canadian Journal of Cardiology

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“…This species accounts for mild disease with very few severe complications. Brucella melitensis in eastern societies is responsible for severe suppurative and disabling complications (10). There are several reasons for low incidence of positive blood culture in Brucella endocarditis such as intracellular location and fastidious nature of organism, previous treatment with antibiotics, and long duration between beginnings of symptoms and the diagnosis (10).…”

Section: Discussionmentioning

confidence: 99%

Brucella Endocarditis

Roodpeyma

2013

Arch Pediatr Infect Dis

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Brucella endocarditis is a rare, and life threatening complication of human brucellosis. Children are usually infected by consumption of contaminated dairy product. Clinical presentation is similar to rheumatic fever. Aortic valve is most commonly involved. Clinical manifestations of fever, arthritis/arthralgia, aortic insufficiency, echocardiographic evidence of vegetation, and negative findings of blood culture, in a case with suspicious contact should suggest the diagnosis. Perioperative antibiotics combined with surgical treatment are an effective management. In pediatric age group, surgical techniques using biologic valves and preservation of native valves are preferred.Keywords: Aortic Valve Insufficiency; Brucellosis; Endocarditis; Therapeutics; General Surgery Implication for health policy/practice/research/medical education: Brucellosis is a common infection in Iran, and brucella endocarditis is a fatal cardiac involvement. Recognizing this life threatening complication is useful for pediatricians.

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“…Özellikle küçük vejetasyonların saptanmasında TEE'nin, TTE'ye göre daha başarılı olduğu vurgulanmaktadır. Ayrıca TEE, kapak hasarının derecesi, myokardiyal veya aortik kök apselerinin ve anevrizma oluşumu hakkında daha fazla bilgi sağlamaktadır (3,4). Kan kültüründe Brucella izolasyonunun, özgüllüğü yüksek olmasına rağmen duyarlılığı oldukça düşüktür (%15-20).…”

Section: İrdelemeunclassified

Infective Endocarditis Due to Brucella canis: A Case Report

Karaşahin¹,

Yılmaz²,

Aslan³

et al. 2016

Klimik Dergisi

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GirişBrucella türlerinden B. abortus, B. melitensis, B. suis ve nadiren de B. canis insanlarda hastalığa neden olur. B. canis insanlarda diğer türlere göre daha hafif veya asemptomatik infeksiyonlara neden olmaktadır. (1,2). Brucella endokarditi tanısı için kan kültürü, serolojik testler ve ekokardiyografi yapılması gerekmektedir (3,4). Kan kültürünün duyarlılığının düşük olması nedeniyle Brucella serolojik testlerinin önemi fazladır. Ancak, B. canis, rutinde kullanılan serolojik testlerle saptanamamaktadır. Bu nedenle, bruselloz belirtileri olan hastalarda rutinde uygulanan serolojik incelemelerde kullanılan S ("smooth") tipi Brucella antijenlerinin yanı sıra R ("rough") tipi antijenlerle hazırlanmış mikroaglütinasyon testi (MAT) gibi serolojik testlerin de yapılması öneril-mektedir (5,6).Bu bildiride, tanısı pozitif kan kültürüyle ve ekokardiyografik olarak desteklenen ve rutin serolojik yön-temlerin negatif sonuçlandığı ancak MAT pozitif olarak bulunan Brucella canis'e bağlı bir infektif endokardit olgusu sunularak tanı güçlüklerine dikkat çekilmek istenmiştir. AbstractIn this report, a case of infective endocarditis due to Brucella canis treated with antibiotics successfully in a 33-year-old man, having a history of rheumatic heart disease and raising animals, admitted with complaints of fever with chills, generalized myalgias, sweating and weakness was presented. Standard tube agglutination (STA) test was negative despite further dilutions to exclude prozone phenomenon. STA test repeated remained negative. Blood culture yielded Brucella spp. B. canis microagglutination test was detected to be positive in 1/160 dilution. A vegetation with dimensions of 0.5x0.7 cm detected on aortic valve echocardiographically became smaller after one month of doxycycline, rifampin, and streptomycin treatment, and was undetectable in second month. Repeat echocardiographic examination in the third month revealed no vegetation again, and treatment continued with doxycycline, rifampin and trimethoprim-sulfamethoxazole during outpatient period, and total duration of treatment was planned to be at least one year. Klimik Dergisi 2016; 29(3): 138-41.Key Words: Brucella canis, endocarditis. ÖzetBu bildiride, yüksek ateş, üşüme, titreme, yaygın vücut ağrısı, terleme ve halsizlik yakınmalarıyla başvuran, romatizmal kalp hastalığı öyküsü olan ve hayvancılık yapan 33 yaşında bir erkek hastadaki antibiyotiklerle başarıyla tedavi edilen Brucella canis'e bağlı bir infektif endokardit olgusu sunuldu. Hastanın Brucella standard tüp aglütinasyon testi (STA) prozon olayını dışlamak için dilüsyonların artırılmasına karşın negatifti. Olası blokan antikorlara yönelik olarak Coombs antiserumuyla yinelenen STA testi de negatif sonuçlandı. Hastanın kan kültürün-de Brucella spp. üredi. B. canis mikroaglütinasyon testi 1/160 titrede pozitif olarak saptandı. Aort kapağında ekokardiyografik olarak gözlenen 0.5x0.7 cm boyutlarındaki vejetasyon, doksisiklin, rifampisin ve streptomisin tedavisinin birinci ayında kü-çülmeye başladı ve ikinci ayda saptanmadı....

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Brucella endocarditis.

Cited by 50 publications

References 23 publications

Brucella endocarditis in prosthetic valves

Brucella endocarditis in prosthetic valves

Brucella Endocarditis

Infective Endocarditis Due to Brucella canis: A Case Report

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