Combined Brucella melitensis and Staphylococcus aureus endocarditis in a patient with a prosthetic aortic valve with fatal outcome

Brucella prosthetic valve endocarditis: a systematic review

“…The mean duration of the symptoms before diagnosis was 3 ± 3 months (with extremes ranging from one week to 15 months). This duration was between two months and one year in ten patients [ 8 , 19 , 31 , 37 , 38 , 41 – 43 ], less or equal to two months in 24 patients [ 5 , 8 , 9 , 11 , 13 , 17 – 20 , 22 – 28 , 30 , 31 , 33 , 39 , 40 ] and above one year in four patients [ 6 , 15 , 35 , 36 ]. It was not specified for the rest of the patients.…”

“…Results of serologic tests were not mentioned in six patients [ 12 , 28 , 35 , 36 , 38 , 40 ]. PCR test was performed in only three patients [ 22 , 35 , 43 ]. It was positive in two patients among them [ 22 , 35 ].…”

“…PCR test was performed in only three patients [ 22 , 35 , 43 ]. It was positive in two patients among them [ 22 , 35 ]. It allowed the diagnosis of brucellosis in one patient with negative blood culture and negative serologic tests [ 21 ].…”

“…We identified 29 patients (56.8%) who had combination of medical and surgical treatment (group 1) [ 4 – 6 , 8 – 10 , 12 – 16 , 18 – 20 , 23 – 25 , 27 , 28 , 31 – 33 ] and 18 patients (35.2%) who had medical treatment alone (group 2) [ 7 , 11 , 17 , 21 , 26 , 29 , 30 , 32 , 34 , 36 – 39 , 41 – 43 ]. Three patients (5.8%) have died before treatment [ 22 , 31 , 35 ] ( Table 3 ).…”

“…There was no information about treatment in one patient. Five patients were treated with antibiotics alone, and three patients with PVE died before the diagnosis of brucella PVE [ 22 , 31 , 35 ]. No deaths were noted in patients treated by combined medical and surgical treatment, but mortality was noted in 27.7% of the cases treated by antibiotics alone (5/18).…”