A Case of<i>Brucella</i>Endocarditis in Association with Subclavian Artery Thrombosis

Colomba, Claudia; Siracusa, Lucia; Rubino, Raffaella; Trizzino, Marcello; Scarlata, Francesco; Imburgia, Claudia; Titone, Lucina

doi:10.1155/2012/581489

Cited by 13 publications

(16 citation statements)

References 12 publications

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“…Although this test was rarely done in previous published studies, it seems to have adequate sensitivity (80%). 27,44,45,51,55 The potential diagnostic usefulness of PCR is exemplified by one case with negative blood cultures in which the diagnosis of brucellosis was made from a positive PCR on resected tissue. 27 Despite the fact that brucella is traditionally thought to be a fastidious organism on culture, blood and tissue cultures are sensitive and useful tests for diagnosis of brucella in these cases.…”

Section: Case Presentationmentioning

confidence: 99%

“…The mortality rate in published cases is 21%, and many patients’ infection progressed despite adequate therapy. 32,41,50,52,55 A review of published cases suggested that several factors seem to be associated with increased likelihood of mortality with brucella arteritis. Survival seems to be lower in those infected with B suis than in those infected with other strains.…”

Section: Case Presentationmentioning

confidence: 99%

“…21 Some cases of concurrent endocarditis and endarteritis have been treated with cardiac surgery alone, and without surgical management of the infected vessel. 55 …”

Section: Case Presentationmentioning

confidence: 99%

“…25–32, 35–45,47,49,50,52,53,55,56,57,58 Sulfa drugs include co-trimoxazole, terfonyl, and sulfanilamide.…”

Section: Figurementioning

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%

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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“…Brusella endokarditinde literatürde en sık aortik kapak tutulumu olduğu görülmektedir ve %82'ye varan oranda aortik kapak tutulumu gösterilmiştir ve bizim çalışmamızda bu oran %62,5'tir (19,20). Brusella endokarditinde aortik kapak tutulumu çok sayıda sistemik embolik komplikasyona yol açmaktadır: Süperiyor mezenterik arter anevrizması, miyokardit, splenik apse ve subklavyan arter trombozu gibi pek çok komplikasyon bildirilmiştir (21)(22)(23)(24). Takip ettiğimiz tüm hastalar kapakta vejetasyon ile gelmiş olup, sadece bir hastada periannüler aortik apse de mevcuttu.…”

Section: Discussionunclassified

One of every three cases of infective endocarditis followed in our center is Brucella endocarditis

Kaya¹,

Yıldız²,

Yeşilay³

et al. 2013

Gaziantep Med J

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ÖzetBu çalışma ile hastanemizde takip edilen enfektif endokardit (EE) olgularının epidemiyolojik, klinik, laboratuar özellikleri ile Brusella endokarditinin merkezimizdeki sıklığının ve özelliklerinin belirlenmesi amaçlanmıştır. Çalışmaya, 2008-2012 yılları arasında, kliniğimizde takip edilen ve modifiye Duke kriterlerine göre EE tanısı konulan 24 hasta (12 kadın,12 erkek; ortalama yaş; 41,3 yıl, yaş aralığı; 12-85 yıl) alındı. Hastaların demografik, klinik, ekokardiyografik, laboratuar, tedavi ve takip verileri değerlendirildi. Hastaların 20'sinde (%83,3) doğal kapak, 3'ünde (%12,5) mekanik protez kapak, 1'inde (%4,2) kalıcı kalp pili ile ilişkili EE saptandı. Doğal kapak tutulumunda en sık mitral etkilenmişti (Mitral %45; aortik kapak %35; triküspit kapak %10). Protez kapaklarda da en sık etkilenen kapak mitral kapak (%100) idi. En sık görülen semptomlar arasında ateş (% 66,7), titreme ve terleme (%37,5), halsizlik (%12,5) mevcuttu. Transtorasik ve/veya transözofageal ekokardiyografide en sık bulgu vejetasyondu (%66,6). Kültürlerde en sık Brusella (%33), stafilokok (%21) ve streptokok (%17) üredi; 5 (%20,8) olguda ise üreme olmadı. Toplamda 9 hastaya (%37,4) cerrahi tedavi uygulandı. Brusella tanısı konulanların % 50'si nativ aortik kapak, % 12,5 protez aortik kapak, %25 protez mitral kapak ve % 12,5 nativ mitral kapak idi. Brusella endokarditinin kliniği EE kliniği ile benzerdi. Brusella endokarditinde cerrahi+medikal tedavi en sık uygulanan tedaviydi. Genç yaş (ortalama yaş;38,9 yıl), aortik tutulum (%62,5), nativ kapak tutulum (%62,5), uzun süren inkübasyon periyodu (ortalama 10 gün) Brusella endokarditinin özellikleri arasında idi. EE özellikleri literatürdeki sonuçlar ile benzerlik göstermekteydi. Merkezimizdeki EE hastalarının 1/3'i gibi yüksek oranlarda Brusella endokarditi görülmekteydi. Genç yaş, aortik tutulum, nativ kapak, uzun inkübasyon periyodu gibi özellikleri taşıyan endokarditlerde Brusella endokarditi mutlaka düşünülmelidir. Anahtar kelimeler: Brusella endokarditi; enfektif endokardit. AbstractThe purpose of this study is to determine the epidemiological, clinical and laboratory characteristics and prevalence of Brucella endocarditis followed in our hospital was. The study were included 24 infective endocarditis (EE) patients (12 female, 12 male, mean age, 41.3 years, range, 12-85 years) followed in our clinic between 2008-2012 and diagnosed with modified Duke criteria. The demographic, clinical, echocardiographic, laboratory variables, treatment and follow-up data were evaluated. EE was associated with in 20 patients (83.3%), natural valve, 4 (12.2%), mechanical prosthetic valve and 1 patient (4.2%) a permanent pacemaker. Among natural valves, mitral valve was the most frequently involvement (45% of mitral, aortic 35%, tricuspid valve 10%). Mitral valve was most commonly affected prosthetic valves (100%). The most common symptoms included fever (66.7%), chills and sweating (37.5%), fatigue (12.5%). Vegetation was the most common lesion (66.6%) in transthoracic and/or transesophageal echocard...

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Comparative proteomics analysis of host cells infected with Brucella abortusA19

Jin

Pan

et al. 2014

Electrophoresis

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We carried out a proteomic analysis of THP-1-derived macrophages with and without Brucella abortus A19 (B. abortus A19) infection in order to study the cellular responses to B. abortus A19. The proteins were analyzed at different time points after infection with 2DE followed by MALDI-TOF/TOF identification. Comparative analysis of multiple 2DE gels revealed that the majority of changes in protein abundance appeared between 48 and 96 h after infection. MS identified 44 altered proteins, including 20 proteins increased in abundance and 24 proteins decreased in abundance, which were found to be involved in cytoskeleton, signal transduction, energy metabolism, host macromolecular biosynthesis, and stress response. Moreover, 22 genes corresponding to the altered proteins were quantified by real-time RT-PCR to examine the transcriptional profiles between infected and uninfected THP-1-derived macrophages. Finally, we mapped the altered pathways and networks using ingenuity pathway analysis, which suggested that the altered protein species were heavily favored germ cell-Sertoli cell junction signaling as the primary pathway. Furthermore, mechanisms of viral exit from host cell and macrophage stimulating protein-recepteur d'origine nantais signaling appeared to be major pathways modulated in infected cells. This study effectively provides useful dynamic protein-related information concerning B. abortus infection in macrophages.

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A Case ofBrucellaEndocarditis in Association with Subclavian Artery Thrombosis

Cited by 13 publications

References 12 publications

Brucella arteritis: clinical manifestations, treatment, and prognosis

Brucella arteritis: clinical manifestations, treatment, and prognosis

One of every three cases of infective endocarditis followed in our center is Brucella endocarditis

Comparative proteomics analysis of host cells infected with Brucella abortusA19

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