PMID- 31449594
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200929
IS  - 2514-2119 (Electronic)
IS  - 2514-2119 (Linking)
VI  - 3
IP  - 2
DP  - 2019 Jun 1
TI  - A tale of four valves: outcome of Brucella endocarditis: a case series.
LID - 10.1093/ehjcr/ytz035 [doi]
LID - ytz035
AB  - BACKGROUND: Brucellosis is a zoonotic infection. Humans contract brucellosis 
      through inhalation of aerosolized infected particles, or when they come in direct 
      contact with infected animal parts, or on consuming unpasteurised dairy products. 
      It can affect multiple organs and systems. Endocarditis is diagnosed late in the 
      course of the disease with mostly aortic valve involvement with serious morbidity 
      and mortality. CASE SUMMARY: We report a case series of four patients with 
      Brucella endocarditis. The first patient presented with fever, malaise, and 
      exertional breathlessness. He underwent aortic valve replacement for refractory 
      heart failure and bulky vegetations after failed medical therapy. The second 
      patient presented with fever, breathlessness New York Heart Association (NYHA) 
      III, with arthralgia, myalgia, anorexia, and weight loss. In view of aortic 
      abscess with impending rupture and compression of left main coronary artery, 
      aortic valve replacement was performed on the 4th day of antibiotic treatment. 
      The third patient presented with fever, fatigue, NYHA II, and developed 
      peripheral embolization but responded to medical treatment alone. The fourth 
      patient presented with intermittent fever for 7 months. During hospitalization, 
      he suffered acute limb ischaemia and stroke with absence of left dorsalis pedis 
      and posterior tibial pulsation. Brucella IgG ELISA was positive. Mitral valve 
      replacement was done subsequently with unremarkable hospital course. DISCUSSION: 
      Brucellosis is a challenging diagnosis to make. The diagnosis and treatment is 
      often delayed as it presents with non-specific symptoms and signs. Cardiac 
      involvement occurs in only 2% of the cases, but accounts for 80% of the mortality 
      due to brucellosis. Brucella endocarditis should be suspected in cases of 
      endocarditis with negative blood cultures and a risk of exposure. The most 
      accepted treatment for Brucella endocarditis is a combination of antimicrobial 
      therapy with surgery.
CI  - (c) The Author(s) 2019. Published by Oxford University Press on behalf of the 
      European Society of Cardiology.
FAU - Kulkarni, Suraj Kumar
AU  - Kulkarni SK
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Bannerghetta Road, Jayanagar 9th block, Bangalore, India.
FAU - Bhairappa, Shivakumar
AU  - Bhairappa S
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Bannerghetta Road, Jayanagar 9th block, Bangalore, India.
FAU - Rangan, Kapil
AU  - Rangan K
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Bannerghetta Road, Jayanagar 9th block, Bangalore, India.
FAU - P, Beeresh
AU  - P B
AD  - Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and 
      Research, Bannerghetta Road, Jayanagar 9th block, Bangalore, India.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur Heart J Case Rep
JT  - European heart journal. Case reports
JID - 101730741
PMC - PMC6601232
OTO - NOTNLM
OT  - Brucella melitensis
OT  - Aortic abscess
OT  - Case series
OT  - Embolic phenomenon
OT  - Infective endocarditis
EDAT- 2019/08/27 06:00
MHDA- 2019/08/27 06:01
PMCR- 2019/04/10
CRDT- 2019/08/27 06:00
PHST- 2018/07/28 00:00 [received]
PHST- 2019/03/28 00:00 [accepted]
PHST- 2019/08/27 06:00 [entrez]
PHST- 2019/08/27 06:00 [pubmed]
PHST- 2019/08/27 06:01 [medline]
PHST- 2019/04/10 00:00 [pmc-release]
AID - 5445406 [pii]
AID - ytz035 [pii]
AID - 10.1093/ehjcr/ytz035 [doi]
PST - ppublish
SO  - Eur Heart J Case Rep. 2019 Jun 1;3(2):ytz035. doi: 10.1093/ehjcr/ytz035.