Human brucellosis is usually caused by one of three species of the genus Brucella: melitensis, abortus, and suis; it is rarely caused by Brucella canis.3 Brucellae are small, non-motile, gram negative capnophilic coccobacilli with optimum growth at temperature of 37°C and a pH of 6-6-6-8. Brucellosis is found primarily in animals and is spread to man by direct contact with infected tissue or by ingestion of infected animal products, most commonly milk or milk products. In Westem countries, brucellosis is an occupational disease found mainly in farmers, people working in meat packing plants, veterinary surgeons, and livestock producers. In other areas of the world the disease is more widespread and is found in the general population.

Thirty-five adult patients with an established diagnosis of infective endocarditis were treated at the King Faisal Specialist Hospital between 1976 and 1985. There were 26 males and 9 females with a mean age of 32 years. Endocarditis was found on a native valve in 14 patients, on a prosthetic valve in 14, on a congenital lesion in 6, and 1 patient had dilated cardiomyopathy. Positive blood cultures were obtained in 25 patients (71%). The commonest infective organism of native valves was Streptococcus viridans and of prosthetic valves was Staphylococcus epidermidis. Brucella accounted for 3 cases. Echocardiogram was available in 27 patients and vegetation could be demonstrated in 14 (52%). Pericardial effusion was seen in 6 patients and was associated with a high complication rate. Twelve patients needed early surgery with 3 deaths (25%) resulting. The indications for early surgery in the active stage were hemodynamic deterioration in 7, persistent infection in 4 and fear of embolism in one. Five patients had elective surgery with no mortality. All Brucella endocarditis patients needed early surgery. In the whole group there were seven early deaths, and two late deaths in a mean follow-up period of 35 months.

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