Management of Brucella Endocarditis with Aortic Root Abscess

Kasab, Saad Al; Fagih, Mohamed Al; Rasheed, Abdur; Khan, Behram; Bitar, Issam Al; Shahed, Mona Al; Sawyer, W. A.

doi:10.1378/chest.98.6.1532

Cited by 24 publications

(21 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(4) The aortic valve is the most commonly affected cardiac valve, reported in 75% of cases, and a particularly feared complication is the formation of aortic root abscesses. (7,8) The involvement rate of prosthetic valves was found to be 8%. (7) Myocarditis is another rare complication of adult brucellosis, which is initially associated with a prolonged PR interval and T segment changes.…”

Section: Discussionmentioning

confidence: 99%

“…The accepted treatment for BE is a combination of medical and surgical interventions. (6,8,11,12) Although conservative antibiotic treatment alone is considered ineffective, and has not been recommended by most authors for this reason, a complete cure has been reported in a few cases of BE (13,14) using this method. Patients who may be suitable for this kind of treatment are those with congestive heart failure, relatively mild extravalvular involvement and a short symptomatic period before antibiotic therapy begins.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Brucella Endocarditis: A Case Study

Kušljugić¹,

Kovačević²

2015

Scientific Symposium Acquired Heart Diseases. World Heart Day 2014. Proceedings

View full text Add to dashboard Cite

Endocarditis is a rare and serious complication of brucellosis and is the main cause of death in this pathology. Diagnosis requires a high level of attention, and is based on the association of epidemiological, clinical and serological elements. Echocardiography plays a crucial role in early diagnosis, as well as in identifying a predisposition to heart disease and local complications typical of this pathology. This case study follows a case of Brucella endocarditis involving the aortic valve, in a 39-year-old male, diagnosed in October 2010. Despite being given complete pharmaceutical treatment, in this instance emergency heart surgery was necessary, due to an inability to control the infection and subsequent changes in the patient's condition, which were leading to congestive heart failure. Aggressive treatment, with surgery performed during a period of active infection, produced good results in the eradication of infection, and in preventing fatal complications. The patient is now fully recovered, and was given triple therapy for brucellosis according to existing recommendations.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Brucella Endocarditis: A Case Study

Kušljugić¹,

Kovačević²

2015

Scientific Symposium Acquired Heart Diseases. World Heart Day 2014. Proceedings

View full text Add to dashboard Cite

show abstract

“…Of these, 39 were reviewed and published by Jacobs et ul.? and the rest were traced on our own review of the literature.4%8, 10,[22][23][24] Table I1 compares the surgically and conservatively treated groups with respect to a number of important clinical and bacteriological data. The salient features of the surgical group were prosthetic valves and congestive heart failure, the latter being highly significant on statistical analysis (p> 0.002).…”

Section: Discussionmentioning

confidence: 99%

“…', Valve replacement and antibiotics are iiccepted as the treatment of choice.2-'0 Antibiotic treatment alone is not recommended, as it is considered ineffective for eradicating Brucella from the infected valves.'.". 10 Some authors even state that antibiotic treatment alone implies an unacceptable risk of death.2, lo Nevertheless, reviewing the English literature, we were able to find I2 cases of successful conservative treatment for BE.' '-I9 We present an additional case and discuss the issue of conservative versus surgical treatment.…”

Section: Introductionmentioning

confidence: 91%

Conservative treatment for brucella endocarditis

Cohen¹,

Golik²,

Alon³

et al. 1997

Clinical Cardiology

View full text Add to dashboard Cite

Summary:Endocarditis is the most devastating complication of brucellosis. The accepted treatment for Brucella endocarditi\ (BE) is a combination of valve replacement and antibiotics. Concervative antibiotic treatment alone is not recommended by most authors, as it is considered ineffective, risking fatality. We describe a patient with BE, in whom antibiotic treatment alone resulted in complete recovery. On reviewing the literature, we found 12 additional such cases. We compared this group of I3 patients with data from 49 published cases treated with a combination of surgery and antibiotics, with afavorable outcome. Absence of congestive heart failure or a prosthetic valve, relatively mild extravalvular cardiac involvement, and a somewhat shorter disease history until initiation of treatment were characteristic of the group treated conservatively in comparison with patients who underwent surgery. In selected patients with BE, conservative antibiotic treatment may be a valid alternative to surgery.

show abstract

“…BE is a destructive process of the native or bioprosthesis valve that commonly leads to heart failure occurring within 3 to 11 months after the onset of symptoms. The aortic valve is the most commonly affected cardiac valve and a fearful complication is the formation of aortic root abscess [4]. The diagnosis of brucellosis is based on epidemiological evidence and positive culture or serology.…”

mentioning

confidence: 99%