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[Brucella pancarditis with fatal outcome]

P Chevalier1, E Bonnefoy, G Kirkorian

  • 1Hôpital cardiovasculaire et pneumologique, Lyon.

Presse Medicale (Paris, France : 1983)
|April 13, 1996
PubMed
Summary

Brucella melitensis can cause rapid, destructive aortic valve endocarditis, especially in farm workers. Prompt surgical intervention is crucial for survival, as medical treatment alone may be insufficient.

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pathology

Background:

  • Brucellosis is a zoonotic infection that can affect multiple organ systems.
  • Endocarditis is a serious complication of brucellosis, particularly affecting the aortic valve.

Observation:

  • A 21-year-old farm worker presented with acute pulmonary edema due to Brucella melitensis endocarditis.
  • Echocardiography revealed aortic valve lesions, and blood cultures confirmed Brucella melitensis.
  • Despite antibiotic treatment (doxycycline and rifampicin), the patient experienced rapid left ventricular failure and died.

Findings:

  • Autopsy revealed occlusive vegetations on the aortic valve, abscess formation in the Valsalva sinus, and fibrino-hemorrhagic pericarditis.
  • Gram-negative organisms were identified within the abscess.
  • The patient's condition rapidly deteriorated, leading to cardiac arrest before surgery.

Implications:

  • This case highlights the aggressive and destructive potential of Brucella melitensis endocarditis.
  • Early surgical intervention is critical for managing aortic valve Brucellosis.
  • Delayed surgery significantly increases mortality risk in patients with Brucella endocarditis.

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