Management of Brucella endocarditis on native mitral valve in a patient with prosthetic aortic valve: A case report

Katırcıbaşı, Mahmut Tuna; Kocum, Halil Tolga; Çölkesen, A. Yücel; Tekin, Abdullah; Sezgin, Alpay Turan

doi:10.1016/j.ijcard.2007.06.058

Cited by 3 publications

(6 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Blood culture is the only specific test, but its sensitivity ranges from 17% to 85% depending on culture conditions, antibiotic therapy and the interval between the onset of symptoms and diagnosis. 4 None of the blood cultures revealed any growth in the present case, which may have been because she was given antibiotic medications before admission. For this reason, agglutination titers, as well as clinical evaluation, should be used for the diagnosis.…”

Section: Discussionmentioning

confidence: 61%

Atrial Septal Defect Presenting With Brucella Endocarditis

Tuncer

Ekim

Güneş

et al. 2008

Circ J

View full text Add to dashboard Cite

rucellosis is a zoonosis and the organism most commonly implicated is Brucella mellitensis which is found in the Mediterranean, the Arabian Gulf, Latin America, Asia, parts of Mexico, the Indian subcontinent 1 and the Middle East. It continues to be endemic to the eastern part of Turkey.In humans, brucellosis behaves as a systemic infection with various clinical signs and symptoms. The disease usually presents as a fever with no apparent focus, although in 20-40% of cases there are focal forms that have been described in almost all organs and systems, with the osteoarticular forms being more common and those affecting the heart and central nervous system being more severe. 1 Brucella endocarditis, although a rare complication of Brucella infection, is nevertheless responsible for the majority of deaths related to this illness. The diagnosis and treatment of endocarditis following brucellosis is difficult because of its stealthy progress and difficulties in isolating the causative organism. 2 In this report, a case of Brucella endocarditis associated with an atrial septal defect (ASD) was successfully treated with a combination of medical and surgical therapy. To our knowledge, a fossa ovalis type of ASD presenting with Brucella endocarditis in an adult patient has not previously been described. Case ReportA 45-year-old woman was admitted with complaints of intermittent fever associated with chills and rigors, shortness of breath and weight loss for 3 weeks. She had been given several antibiotics at primary care centers. At presentation, her body temperature was 39°C, blood pressure was 85/66 mmHg, and pulse rate was 118 beats/min. Auscultation revealed a systolic ejection murmur over the left sternal edge and fixed splitting of the second heart sound.The hemoglobin level was 12.0 g/dl, the white blood cell count was 14.200/mm 3 , the platelet count was 400.000/mm 3 , and the erythrocyte sedimentation rate was 65.0 mm/h. Chest radiography showed a marked widening of the pulmonary arteries, and electrocardiogram revealed atrial fibrillation and an incomplete right bundle branch block. Three blood culture specimens were obtained on separate occasions, but no microorganism was isolated in the cultures. Serologic analysis was positive for Brucella agglutinin (1/320). Echocardiography showed an ostium secundum ASD (fossa ovalis type) that was 2 cm in diameter with left-to-right shunting through the defect. There was a mobile vegetation measuring 0.5×0.8 cm arising from the border of the defect (Fig 1). The patient was offered opera- J 2008; 72: 2096 -2097 (Received November 29, 2007 revised manuscript received January 18, 2008; accepted February 28, 2008; released online October 14, 2008 Brucellosis is a zoonosis that behaves as a systemic infection with various clinical signs and symptoms. Brucella endocarditis, although a rare complication of Brucella infection, is nevertheless responsible for the majority of deaths related to this illness. Brucella endocarditis was associated with an atrial septal defect (ASD) ...

show abstract

Section: Discussionmentioning

confidence: 61%

Atrial Septal Defect Presenting With Brucella Endocarditis

Tuncer

Ekim

Güneş

et al. 2008

Circ J

View full text Add to dashboard Cite

show abstract

“…This is generally a result of heart failure resulting from aortic and/or mitral regurgitations. A combination of medical and surgical therapy is necessary for successful treatment of Brucella endocarditis [1,4].…”

Section: Discussionmentioning

confidence: 99%

“…Blood culture is a specific test; however, its sensitivity ranges between 17% and 85% [1,8]. Diagnosis could be delayed because symptoms are nonspecific and serological confirmation could made after beginning antibiotic treatment [2][3][4].…”

Section: Discussionmentioning

confidence: 99%

“…Human beings could be infected by contaminated milk and milk products or by direct contact with the animal itself, visceral organs of animals or secretions [1]. This disease is more common in rural areas.…”

Section: Introductionmentioning

confidence: 99%

“…It occurs in less than 2% of Brucella cases [1,5]. Even though adequate medical therapy is available, Brucella endocarditis usually requires cardiac surgery.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical approach to the management of Brucella endocarditis

Taşdemir¹,

Kaya²,

Mavili³

et al. 2010

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

show abstract

Medical Versus Medical and Surgical Treatment for Brucella Endocarditis

Keshtkar-Jahromi

Razavi

Gholamin

et al. 2012

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

This review was undertaken to determine the role of surgery in the treatment of brucella endocarditis. All English and French articles reporting brucella endocarditis (1966–2011) in Pubmed, Google and Scopus were reviewed. 308 cases were identified and Linear and Logistic regression was performed. Surgery improved outcomes by decreasing mortality from 32.7% in the medical treatment only group to 6.7% in the combined surgical and medical treatment group (p<.001). This association was still significant while controlling for other contributing factors. In the absence of a controlled trial, we recommend the utmost vigilance and consideration of surgical management in treating such patients.

show abstract

Management of Brucella endocarditis on native mitral valve in a patient with prosthetic aortic valve: A case report

Cited by 3 publications

References 6 publications

Atrial Septal Defect Presenting With Brucella Endocarditis

Atrial Septal Defect Presenting With Brucella Endocarditis

Surgical approach to the management of Brucella endocarditis

Medical Versus Medical and Surgical Treatment for Brucella Endocarditis

Contact Info

Product

Resources

About