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Related Experiment Videos

Apyrexic Brucella melitensis aortic valve endocarditis.

D S al-Mudallal1, A R Mousa, A A Marafie

  • 1Medical Department, Al-Adan Hospital, Ministry of Public Health, Kuwait.

Tropical and Geographical Medicine
|October 1, 1989
PubMed
Summary
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Severe brucellosis, caused by Brucella melitensis, can occur without fever. This case highlights successful treatment of aortic valve endocarditis with multiple organ complications using antibiotics and supportive care.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Internal Medicine

Background:

  • Brucellosis is a zoonotic disease caused by Brucella species, often presenting with fever and flu-like symptoms.
  • Aortic valve endocarditis is a serious complication of bacterial infections, requiring prompt diagnosis and treatment.
  • Brucella melitensis is a particularly virulent species, commonly associated with severe human infections.

Observation:

  • A young shepherd presented with aortic valve endocarditis due to Brucella melitensis.
  • The patient's illness was characterized by an afebrile course, complicating initial diagnosis.
  • Additional complications included disseminated intravascular coagulation (DIC), nephritis, hepatitis, and peritonitis.

Findings:

  • The patient's severe brucellosis, including endocarditis and multi-organ involvement, responded well to treatment.

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  • Treatment involved a combination of antibiotics: tetracycline, trimethoprim-sulphamethoxazole, and amikacin sulphate.
  • Supportive measures were crucial in managing the disseminated intravascular coagulation, nephritis, hepatitis, and peritonitis.

    • Implications:

    • This case underscores that severe brucellosis, including endocarditis, can manifest without fever, challenging typical diagnostic approaches.
    • The successful management demonstrates the efficacy of a multi-drug antibiotic regimen and supportive care in complex brucellosis cases.
    • Clinicians should maintain a high index of suspicion for brucellosis in patients with endocarditis and multi-organ dysfunction, even in the absence of fever.