Brucella Prosthetic Valve Endocarditis: A Systematic Review.

Area of Science:

• Infectious Diseases
• Cardiology
• Medical Microbiology

Background:

• Brucella prosthetic valve endocarditis is a rare, life-threatening complication of brucellosis.
• Diagnosis and optimal treatment remain challenging, with limited data available.
• This study systematically reviews published cases to inform clinical practice.

Purpose of the Study:

• To systematically review all published cases of Brucella prosthetic valve endocarditis.
• To analyze epidemiological, clinical, microbiological, treatment, and outcome data.
• To identify factors influencing patient prognosis.

Main Methods:

• Systematic review of PubMed, Google, Google Scholar, and Scopus databases.
• Inclusion of studies from January 1974 to the present.
• Data extraction on patient demographics, clinical presentation, diagnostics, treatment, and outcomes.

Main Results:

• 51 cases reviewed; Brucella melitensis most common species.
• Mechanical prostheses were most frequent; fever and dyspnea were common symptoms.
• Diagnosis often utilized echocardiography; combined medical-surgical treatment showed no mortality versus 27.7% with antibiotics alone (p=0.006).

Conclusions:

• Brucella prosthetic valve endocarditis presents diagnostic challenges.
• Combined surgical and medical treatment significantly improves outcomes and reduces mortality.
• Brucellosis should be considered in prosthetic valve endocarditis differentials, especially in endemic areas.