Can brucella endocarditis be treated successfully with medical therapy alone?

Abstract

Human brucellosis is caused by one of the three species of Brucella: Brucella mellitensis, B. abortus, and B. suis. Worldwide, the incidence of human brucellosis ranges from <0.01 to >200 per 100,000 population. Cardiovascular complications occur in <2%, but accounts for most of the mortality. Brucella endocarditis usually involves normal native aortic valves in 75% of cases. A combination of antibiotics and valve replacement is the most acceptable treatment. So far only 15 adult cases have been reported as having been cured with medical therapy alone. We report another case treated successfully with antibiotics alone.

Brucella endocarditis, a report of 14 cases (1991–2009)

“…7 CRP plasma concentrations and PCT levels were retrospectively measured following the manufacturer's manual.…”

Presentation of Two Cases Diagnosed with Brucella Endocarditis

“…To our knowledge only 16 cases have been reported in the literature who have been cured with medical therapy alone (12). In the present second case, the patient was diagnosed even though there were no symptoms.…”

Brucella endocarditis: an occupational hazard!

“…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. The presence of endocarditis mandates a more prolonged course of antibiotics as dictated by the clinical condition 16 17.…”

“…However, there is recently a growing trend to manage selected patients with antibiotics alone 16. The presence of endocarditis mandates a more prolonged course of antibiotics as dictated by the clinical condition 16 17. In general, human brucellosis infection is conventionally treated with a combination of doxycycline plus aminoglycosides or rifampicin.…”