Management of brucella endocarditis of a prosthetic valve

Arslan, Hande; Korkmaz, Mehmet Emin; Kart, Hamide; Gül, Cengiz

doi:10.1016/s0163-4453(98)90819-2

Cited by 19 publications

(25 citation statements)

References 10 publications

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“…Any organism can induce infection of a prosthesis by the hematogenous route, although Staphylococcus epidermidis, Staphylococcus aureus, aerobic streptococci and gram-negative bacilli are generally the main causative agents. Brucella infection of prosthetic devices has been reported in the literature and includes prosthetic joints [10,11], prosthetic heart valves and one report of an infected pacemaker [12,13]. To our knowledge, the present case is the first one of Brucella infection in a breast implant.…”

Section: Discussionmentioning

confidence: 73%

Unusual Complication of Breast Implants: Brucella Infection

2001

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Brucellosis is hyperendemic in Saudi Arabia. We report infection in a breast implant as an unusual complication of laboratory-acquired brucellosis. A 48-year-old female developed fever, rigors, headache, arthralgia and weight loss. A blood culture for Brucella was positive. A 6-week course of antibiotics effected a clinical and bacteriological cure but the resolution was short-lived. Six weeks later a relapse of her febrile symptoms occurred together with the appearance of a breast abscess. Cultures of the abscess and blood yielded brucella. A second course of antibiotics together with surgical drainage and subsequent reconstruction resulted in a cure.

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Section: Discussionmentioning

confidence: 73%

Unusual Complication of Breast Implants: Brucella Infection

2001

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“…Brucellosis is still an endemic disease in Turkey and this is not the ® rst case of Brucella endocarditis detected in our country. Two other cases, both involving prosthetic valves, have been reported previously (4,5).…”

Section: Discussionmentioning

confidence: 88%

A Case of Prosthetic Mitral Valve Endocarditis Caused by Brucella abortus

Akıncı

Göl²,

Balbay³

2001

Scandinavian Journal of Infectious Diseases

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Endocarditis is a rare but serious complication of brucellosis. We report here a case of Brucella abortus endocarditis occurring on a prosthetic mitral valve. The diagnosis was established by positive serology, the presence of vegetation on the mitral prosthesis and isolation of B. abortus from the blood and valve cultures. The patient was successfully treated with combined medical and surgical therapy.

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“…Brucella prosthetic valve endocarditis on mechanical and bioprostheses has been described frequently (5,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). In endemic areas, such as Saudi Arabia, Brucella has established a high incidence (approximately 10%) among the causative agents of prosthetic valve endocarditis (12,15).…”

Section: Discussionmentioning

confidence: 99%

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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Management of brucella endocarditis of a prosthetic valve

Cited by 19 publications

References 10 publications

Unusual Complication of Breast Implants: Brucella Infection

Unusual Complication of Breast Implants: Brucella Infection

A Case of Prosthetic Mitral Valve Endocarditis Caused by Brucella abortus

Brucella endocarditis in prosthetic valves

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