Medical Versus Medical and Surgical Treatment for Brucella Endocarditis

Keshtkar-Jahromi, Maryam; Razavi, Seyed Mostafa; Gholamin, Sharareh; Keshtkar-Jahromi, Marzieh; Hossain, Mian Bazle; Sajadi, Mohammad M.

doi:10.1016/j.athoracsur.2012.07.006

Cited by 35 publications

(40 citation statements)

References 66 publications

(14 reference statements)

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“…His positive blood culture drew attention to the infection; in a review, positive blood cultures were associated with survival in patients with brucella endocarditis because they led to earlier diagnosis. 61 Our review identified two additional cases with remarkably long intervals between exposure and diagnosis. 25,27 These cases of prolonged, low-grade infection are unsurprising in view of the pathophysiology of brucella.…”

Section: Case Presentationmentioning

confidence: 99%

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Brucella arteritis: clinical manifestations, treatment, and prognosis

Herrick

Lederman

Sullivan

et al. 2014

The Lancet Infectious Diseases

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Brucellosis is the most common bacterial zoonosis, and causes a considerable burden of disease in endemic countries. Cardiovascular involvement is the main cause of mortality due to infection with Brucella spp., and most commonly manifests as endocarditis, peripheral and cerebrovascular aneurysms, or arterial and venous thrombosis. We report a case of brucellosis presenting as bacteremia and aortic endarteritis 18 years after the last known exposure to risk factors for brucella infection. The patient was treated with doxycycline, rifampin, and gentamicin, and underwent surgical repair of a penetrating aortic ulcer, with a good clinical recovery. We review the signs and symptoms, diagnostic approach, prognosis, and treatment of brucella arteritis. We draw attention to the absence of consensus about the optimum therapy for vascular brucellosis, and the urgent need for additional studies and renewed scientific interest in this major pathogen.

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Section: Case Presentationmentioning

confidence: 99%

“…Results of a review of brucella endocarditis showed a dramatic survival advantage when patients underwent surgery and medical therapy. 61 Thus, whether any circumstances exist in which patients who have brucella arteritis could be treated with antibiotics alone is unclear.…”

Section: Case Presentationmentioning

confidence: 99%

Brucella arteritis: clinical manifestations, treatment, and prognosis

Herrick

Lederman

Sullivan

et al. 2014

The Lancet Infectious Diseases

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“…Aorta was the most commonly involved valve and usually needed emergency replacement with a mechanical valve. Surgery improved outcome by decreasing mortality from 32.7% in patients who received only medical therapy to 6.7% in those who received combination of medical and surgical treatment (P < 0.001) (5). Mitral valve is less frequently involved.…”

Section: Discussionmentioning

confidence: 92%

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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“…A review of the 308 cases reported in the literature showed that surgical intervention improved the clinical outcome in patients with Brucella endocarditis. It decreased the death rate from 32.7% in the medical treatment only group to 6.7% in the combined surgical and medical treatment group (p<0.001) 15. However, there is recently a growing trend to manage selected patients with antibiotics alone 16.…”

Section: Discussionmentioning

confidence: 99%

Brucella endocarditis: an occupational hazard!

et al. 2013

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SUMMARYA young man presented with a 2-month history of fever and malaise. Cardiac auscultation revealed the presence of a diastolic murmur. Subsequently, a cardiac echocardiogram was done, which showed a large vegetation adherent to an anterior mitral leaflet. The blood culture was positive for Brucella species. The patient was given antibiotic therapy for brucellosis and referred for surgery. Brucella endocarditis is one of the rarest, yet most notorious complications of this infection. This condition requires a high degree of clinical suspicion in order to facilitate prompt diagnosis and treatment. BACKGROUND

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Medical Versus Medical and Surgical Treatment for Brucella Endocarditis

Cited by 35 publications

References 66 publications

Brucella arteritis: clinical manifestations, treatment, and prognosis

Brucella arteritis: clinical manifestations, treatment, and prognosis

Brucella Endocarditis

Brucella endocarditis: an occupational hazard!

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