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. 2009 Dec 30;33(2):E20–E26. doi: 10.1002/clc.20606

Native Valve Brucella Endocarditis

Mustafa Bahadir Inan 1,✉, Zeynep Bastuzel Eyileten 1, Evren Ozcinar 1, Levent Yazicioglu 1, Mustafa Sirlak 1, Sadik Eryilmaz 1, Ruchan Akar 1, Adnan Uysalel 1, Refik Tasoz 1, Neyyir Tuncay Eren 1, Atilla Aral 1, Bulent Kaya 1, Kemalettin Ucanok 1, Tumer Corapcioglu 1, Umit Ozyurda 1
PMCID: PMC6653561  PMID: 20043343

Abstract

Objective

Brucellosis is frequently seen in Mediterranean and Middle East countries, including Turkey. We report the medical and surgical management of 31 cases of native endocarditis.

Material and Method

Thirty‐one patients were admitted to our clinic with suspected Brucella Endocarditis. The diagnosis was established by either isolation of Brucella species, or the presence of antibodies. Following preoperative antibiotic therapy patients underwent valve replacement with excessive tissue debridment. Patients were followed up with Brucella titers, blood cultures, and echocardiography.

Results

On admission all patients were febrile and mostly dyspneic (NYHA Class 3 or 4). The blood tests were normal except for elevated ESR, CRP and serological tests. The aortic valve was involved in 19 patients, mitral valve in 7 patients, and both valves in 5. After serological confirmation of BE, antibiotic therapy was maintained. Twenty‐five of the patients received rifampicine, doxycycline, and cotrimaxozole; 2 of them received a combination of rifampicine, streptomycin, and doxycycline; and 4 of them received rifampicine, tetracycline, and cotrimaxozole. Tissue loss in most of the affected leaflets and vegetations were presenting all patients. Valve replacements were performed with mechanical and biologic prostheses. All the patients were afebrile at discharge but received the antibiotics for 101, 2±16, 9 days. The follow‐up was 37, 1±9, 2 months.

Discussion

In our retrospective study, combination of adequate medical and surgical therapy resulted in declined morbidity and mortality rate. The valve replacement with aggressive debridement is the most important part of the treatment, which should be supported with efficient preoperative and long term postoperative medical treatment. Copyright © 2010 Wiley Periodicals, Inc.

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