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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
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Native valve Brucella endocarditis

Mustafa Bahadir Inan1, Zeynep Bastuzel Eyileten, Evren Ozcinar

  • 1Department of Cardiovascular Surgery, Ankara University School of Medicine, Ankara, Turkey. mbahadirinan@gmail.com

Clinical Cardiology
|January 1, 2010
PubMed
Abstract

Insights

This study highlights that combining medical and surgical treatments for Brucella endocarditis (BE) significantly reduces patient morbidity and mortality. Aggressive valve replacement with debridement, alongside long-term antibiotic therapy, is crucial for effective management of this infection.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Surgical Management

Background:

  • Brucellosis is endemic in the Mediterranean and Middle East, including Turkey.
  • Native endocarditis caused by Brucella species (Brucella endocarditis, BE) presents a significant clinical challenge.

Purpose of the Study:

  • To report the medical and surgical management outcomes for 31 patients diagnosed with native Brucella endocarditis.
  • To evaluate the effectiveness of combined therapeutic strategies in reducing morbidity and mortality associated with BE.

Main Methods:

  • Retrospective analysis of 31 patients with suspected Brucella endocarditis.
  • Diagnosis confirmed by Brucella species isolation or serological antibody presence.
  • Patients received preoperative antibiotic therapy, followed by valve replacement with extensive tissue debridement, and long-term antibiotic treatment. Follow-up included serological titers, blood cultures, and echocardiography.

Main Results:

  • All patients presented with fever and dyspnea (NYHA Class 3 or 4).
  • Aortic valve was most commonly affected (19 patients), followed by the mitral valve (7 patients) and both valves (5 patients).
  • Valve replacement with mechanical or biologic prostheses was performed. Post-treatment, all patients were afebrile at discharge, with a mean antibiotic duration of 101.2 ± 16.9 days and a follow-up of 37.1 ± 9.2 months.

Conclusions:

  • A combination of adequate medical and surgical therapy significantly decreased morbidity and mortality rates in native Brucella endocarditis.
  • Aggressive valve replacement with debridement, supported by efficient preoperative and long-term postoperative medical treatment, is the cornerstone of successful management.

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