Management of Brucella endocarditis: results of the Gulhane study

Koruk, Süda Tekin; Erdem, Hakan; Koruk, İbrahim; Erbay, Ayşe; Tezer-Tekçe, Yasemin; Erbay, Ali Rıza; Dayan, Saim; Deveci, Özcan; İnan, Asuman; Engin, Derya Öztürk; Güner, Rahmet; Dikici, Nebahat; Doyuk-Kartal, Elif; Kurtaran, Behice; Pehlivanoğlu, Filiz; Sıpahi, Oğuz Reşat; Yalçı, Aysun; Yemişen, Mücahit; Alp-Çavuş, Sema; Gençer, Serap; Guzel, Gokhan; Öncül, Oral; Parlak, Mehmet; Kazak, Esra; Tülek, Necla; Ülçay, Asım; Savasci, Umit

doi:10.1016/j.ijantimicag.2012.04.009

Cited by 43 publications

(30 citation statements)

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“…The incidence of endocarditis disease is about 2%, however, it accounts for 80% of brucellosis related death [5]. The combination of antibiotics is the main regimen for brucellosis [7]. Long-term of taking drugs is required for cure treatment and reducing relapsed cases [8].…”

Section: Introductionmentioning

confidence: 99%

The clinical features of 590 patients with brucellosis in Xinjiang, China with the emphasis on the treatment of complications

et al. 2017

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BackgroundThis study aims to analyze the clinical characteristics and treatment outcomes of 590 patients with brucellosis in Xinjiang, China.Methodology and principal findingsThe clinical characteristics, laboratory findings, complications and prognosis of 590 patients infected with brucellosis were retrospectively analyzed. These patients had a mean age of 44.24 ± 15.83 years with 60.5% having a history of close contacting with cattle and sheep. Of them, 53.6% (316 /590) were in acute phase and 21.5% were in chronic phase. Agglutination test showed 98.5% positive with 34% blood culture positive of Brucella. The major symptoms were fatigue (91%), hyperhidrosis(88.1%), fever(86.9%), and joint pain(81%) with 29.8% having enlarged liver, 26.1% having enlarged spleen and 23.2% having osteoarticular complications. Combination of doxycycline plus rifampicin for 12 weeks was an effective regimen for patients without complications. The 3-drug regimen (doxycycline+rifampicin+levofloxacin) for 12 weeks was recommended for these with complications. There were 6 patients died (1.02%) with overall relapse rate of 5.98%.ConclusionsBrucellosis is mostly associated with contacting with domestic animal production in Xinjiang, China. Clinical symptoms include fever, fatigue, hyperhidrosis, and joint pain with common complication of osteoarticular involvement. Three-drug-regimen of doxycycline+rifampicin+levofloxacin for 12 weeks was effective for these patients with complications.

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Section: Introductionmentioning

confidence: 99%

The clinical features of 590 patients with brucellosis in Xinjiang, China with the emphasis on the treatment of complications

et al. 2017

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“…The triple-antibiotic regimen should be preferred. Doxycycline, rifampicin, streptomycin, co-trimoxazole, and ceftriaxone are good options (26).…”

Section: Endocarditismentioning

confidence: 99%

An old foe still with us: Troubling issues with brucellosis

Buzğan¹,

Hasanoğlu²

2017

Med J Islamic World Acad Sci

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Clinical featuresBrucellosis can be subclinical, acute, subacute, and chronic. It can present itself with nonspecific symptoms such as fever, night sweats, loss of appetite, weight loss, weakness, headache, and polyarthritis (2,5-7). Brucellosis should be considered as a differential diagnosis for fevers of unknown origin. Debilitating conditions such as arthralgia, myalgia, and back pain affects around half of the patients. The incubation period is 2-3 weeks. Physical findings may vary depending on the duration of the disease. Systemic brucellosis sometimes can be complicated with meningitis, endocarditis, septic arthritis, and osteomyelitis. These complications are not extremely rare. A large meta-analysis reported the prevalence of endocarditis and neurobrucellosis as 1% and 4%, respectively (6). Osteoarticular complications are the most common complications of brucellosis (2,6,8).Relapse can occur 2-3 months after the treatment and can be detected with serologic tests and blood culture positivity. Relapse rate is common in cases treated with a single antibiotic regimen and short-term treatment. SUMMARYAlthough brucellosis is an old disease, it is still challenging for physicians. In this review, we discussed common pitfalls of brucellosis.

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“…Endokardit, brusellozun nadir görülen ve en yüksek mortaliteye sahip olan komplikasyonudur. Literatürde yer alan çalışmalarda Brucella'ya bağlı endokardit sıklığının %2'nin altında olduğu bildirilmiştir (2,(16)(17)(18)(19). En sık aort (%75), daha sonra mitral kapak tutulumu gözlenmektedir.…”

Section: İrdelemeunclassified

Infective Endocarditis Due to Brucella canis: A Case Report

Karaşahin¹,

Yılmaz²,

Aslan³

et al. 2016

Klimik Dergisi

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GirişBrucella türlerinden B. abortus, B. melitensis, B. suis ve nadiren de B. canis insanlarda hastalığa neden olur. B. canis insanlarda diğer türlere göre daha hafif veya asemptomatik infeksiyonlara neden olmaktadır. (1,2). Brucella endokarditi tanısı için kan kültürü, serolojik testler ve ekokardiyografi yapılması gerekmektedir (3,4). Kan kültürünün duyarlılığının düşük olması nedeniyle Brucella serolojik testlerinin önemi fazladır. Ancak, B. canis, rutinde kullanılan serolojik testlerle saptanamamaktadır. Bu nedenle, bruselloz belirtileri olan hastalarda rutinde uygulanan serolojik incelemelerde kullanılan S ("smooth") tipi Brucella antijenlerinin yanı sıra R ("rough") tipi antijenlerle hazırlanmış mikroaglütinasyon testi (MAT) gibi serolojik testlerin de yapılması öneril-mektedir (5,6).Bu bildiride, tanısı pozitif kan kültürüyle ve ekokardiyografik olarak desteklenen ve rutin serolojik yön-temlerin negatif sonuçlandığı ancak MAT pozitif olarak bulunan Brucella canis'e bağlı bir infektif endokardit olgusu sunularak tanı güçlüklerine dikkat çekilmek istenmiştir. AbstractIn this report, a case of infective endocarditis due to Brucella canis treated with antibiotics successfully in a 33-year-old man, having a history of rheumatic heart disease and raising animals, admitted with complaints of fever with chills, generalized myalgias, sweating and weakness was presented. Standard tube agglutination (STA) test was negative despite further dilutions to exclude prozone phenomenon. STA test repeated remained negative. Blood culture yielded Brucella spp. B. canis microagglutination test was detected to be positive in 1/160 dilution. A vegetation with dimensions of 0.5x0.7 cm detected on aortic valve echocardiographically became smaller after one month of doxycycline, rifampin, and streptomycin treatment, and was undetectable in second month. Repeat echocardiographic examination in the third month revealed no vegetation again, and treatment continued with doxycycline, rifampin and trimethoprim-sulfamethoxazole during outpatient period, and total duration of treatment was planned to be at least one year. Klimik Dergisi 2016; 29(3): 138-41.Key Words: Brucella canis, endocarditis. ÖzetBu bildiride, yüksek ateş, üşüme, titreme, yaygın vücut ağrısı, terleme ve halsizlik yakınmalarıyla başvuran, romatizmal kalp hastalığı öyküsü olan ve hayvancılık yapan 33 yaşında bir erkek hastadaki antibiyotiklerle başarıyla tedavi edilen Brucella canis'e bağlı bir infektif endokardit olgusu sunuldu. Hastanın Brucella standard tüp aglütinasyon testi (STA) prozon olayını dışlamak için dilüsyonların artırılmasına karşın negatifti. Olası blokan antikorlara yönelik olarak Coombs antiserumuyla yinelenen STA testi de negatif sonuçlandı. Hastanın kan kültürün-de Brucella spp. üredi. B. canis mikroaglütinasyon testi 1/160 titrede pozitif olarak saptandı. Aort kapağında ekokardiyografik olarak gözlenen 0.5x0.7 cm boyutlarındaki vejetasyon, doksisiklin, rifampisin ve streptomisin tedavisinin birinci ayında kü-çülmeye başladı ve ikinci ayda saptanmadı....

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Management of Brucella endocarditis: results of the Gulhane study

Cited by 43 publications

References 19 publications

The clinical features of 590 patients with brucellosis in Xinjiang, China with the emphasis on the treatment of complications

The clinical features of 590 patients with brucellosis in Xinjiang, China with the emphasis on the treatment of complications

An old foe still with us: Troubling issues with brucellosis

Infective Endocarditis Due to Brucella canis: A Case Report

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