Cardiac manifestations in brucellosis

Cardiac involvement in childhood brucellosis is rare and when present mimics findings usually noted in acute rheumatic fever with carditis. We report five children aged 6 to 11 years. Echocardiography showed mitral valve vegetations in one, functional mitral valve incompetence in two, and sluggish myocardial function in one. All the patients presented with fever, arthralgia, and malaise, four of them had leucopenia, and all five showed relative lymphocytosis. Blood cultures grew Brucella melitensis, biotype 1 in four cases and type 2 in one. Treatment with oral tetracyclines over three weeks together with streptomycin over the first two weeks was successful in all the patients, including one in whom oral trimethoprim/sulphamethoxazole was first tried but was unsuccessful as the patient developed a relapse after two months.