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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Brucella endocarditis, although a rare complication of brucellosis, is the main cause of death attributable to this disease. Mycotic aneurysm is an important extracardiac complication of infective endocarditis. Mycotic aneurysm of the superior mesenteric artery is extremely rare. In the present case, we report a patient with Brucella melitensis endocarditis complicated with a superior mesenteric artery aneurysm. To our knowledge, this is the first such reported case.
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PMID:Brucella endocarditis complicated with a mycotic aneurysm of the superior mesenteric artery: a case report. 1497 71

Brucellosis is a multisystemic disease. The most common cause of death from the disease is endocarditis. The aortic valve is most commonly affected. The disease rarely involves the mitral valve. A 30 year-old woman presented with complaints of chills and fever up to 38 degrees C at night, fatigue, palpitations, and dyspnea for the previous 3 weeks. Cardiac auscultation revealed a diastolic murmur in the mitral area. Her temperature was 38.3 degrees C. On echocardiographic examination, the mitral valve area was 0.62 cm (2) and an isoechoic mass thought to be a vegetation was detected on the anterior mitral leaflet. A diagnosis of infective endocarditis was made and vancomycin administration was commenced. Brucella melitensis was isolated in all three blood samples, however, the patient remained seronegative with Brucella agglutination titers of up to 1/160. The antibiotic therapy was then shifted to doxycycline (200 mg/day), rifampicin (600 mg/day), and ciprofloxacin (1000 mg/day). After 30 days of treatment, surgery was performed for the severely stenotic mitral valve and to remove the vegetation. The operation was successful. The postoperative period was uneventful. On the follow-up she had no complaints. In cases with Brucella endocarditis, after diagnosis, antibiotic therapy must be started immediately and when the clinical condition improves, surgical intervention should be performed when indicated.
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PMID:A case of mitral stenosis complicated with seronegative Brucella endocarditis. 1509 Jul 14

The epidemiological features and clinical manifestations of adult cases of brucellosis admitted to the Department of Infectious Diseases, Babol Medical University, Iran from 1997 to 2002 were investigated. Of 469 cases, 267 (56.9%) were males. The mean age of cases was 36.9 +/- 15 years. Most (60.8%) were from rural areas. Two thirds of cases (306, 66.3%) presented during spring or summer. Fresh cheese (22.4%), animal husbandry (11.3%), laboratory worker (8.1%) and veterinary profession (1.5%) were the main risk factors. Forty-five families (9.6%) had two cases. Sweating, fever, and arthralgia were the most frequent clinical symptoms. Complications were documented in 105 males (39.5%) and 41 females (20.3%, P=0.0001). Peripheral arthritis was seen in 24 (9%) males and 19 (9.4%) females, with knees and hips being the most common sites of infection. Sacroiliitis and spondylitis were seen in 28 (6%) and 32 (6.8%) cases respectively with spondylitis more common in males (P=0.023). Epididymo-orchitis was seen in 29 (10.9%) males. There were three cases each of endocarditis (0.6%) and neurological complications (0.6%). Most patients with brucellosis did not have any of the known risk factors for brucellosis. Thus consumption of unsafe dairy products could be the main route of infection. The disease manifested with a diversity of clinical manifestations and complications. Complications were more frequent in males than females.
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PMID:Epidemiological features and clinical manifestations in 469 adult patients with brucellosis in Babol, Northern Iran. 1563 68

Brucella endocarditis, although a rare complication of brucellosis, is a life threatening and often under-diagnosed complication. Despite its high mortality rate with combined medical and surgical treatment, has a low occurrence rate in cases of brucellosis. Here we describe a patient who underwent mitral valve replacement for 3 times due to underdiagnosis of Brucella endocarditis. If a valve replacement fails because of an unknown reason, the doubt of a Brucella infection should be kept in mind for accurate treatment of such patients.
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PMID:Brucella endocarditis with repeated mitral valve replacement. 1572 49

Brucella endocarditis is a rare but fatal complication of Brucellosis, it causes destructive valvular lesions. The aortic valve is the most common affected site. We present a case of Brucella endocarditis with aortic root abscess, the patient received a prolonged combination of antibiotic therapy, and underwent aortic valve replacement. After one and a half years of follow up, the patient is still without signs of recurrence. The high mortality in Brucella endocarditis can be overcome by early diagnosis and aggressive therapy.
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PMID:Successful treatment of Brucella endocarditis with aortic root abscess. 1580 23

Human brucellosis has become a rare disease in Germany since the eradication of bovine and ovine/caprine brucellosis in this country. Therefore, most physicians are unfamiliar with the illnesses clinical presentation, diagnostic tools, and therapeutic strategies. This retrospective study was carried out to evaluate the epidemiological, clinical, and laboratory features of human brucellosis in Germany in the years 2002 and 2003. Thirty-one bacterial isolates from 30 patients sent to the German national reference laboratory were characterized using the genus-specific bcsp31 real-time PCR, the species-specific AMOS-PCR, and standard microbiological methods for the detection and identification of Brucella spp. The medical records of all patients with bacteriologically confirmed brucellosis were evaluated. All 31 isolates proved to be Brucella (30 Brucella melitensis and 1 Brucella suis). Most of the brucellosis patients were infected in endemic countries while visiting friends and relatives during their summer holidays. One case of laboratory-acquired infection was identified. Brucellosis was transmitted mainly by the consumption of contaminated unpasteurized milk or cheese from goats and sheep. The patients presented primarily with flu-like symptoms, i.e. fever, chills, sweating, headaches, arthralgia, and myalgia. In most cases, however, symptoms and signs of focal complications, e.g. spondylitis, endocarditis, and meningoencephalitis, predominated. The rate of complications was much higher than that in endemic countries, presumably as a result of diagnostic delay due to a low index of suspicion. In summary, physicians in nonendemic countries such as Germany must be aware of brucellosis being a possible cause of fever of unknown origin in immigrants and tourists travelling from endemic countries.
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PMID:Human brucellosis in a nonendemic country: a report from Germany, 2002 and 2003. 1595 15

Results obtained by standard tube agglutination (STA) test which is the most widely used serological method for brucellosis, are often evaluated together with the clinical and microbiological findings, and the titers of > or = 1/160 are generally accepted as an indicator of acute infection. However, cross reactions with some other bacteria may lead to false positive results in this test. In this study, the performance of STA test in the diagnosis of brucellosis has been evaluated by using serum samples obtained from 40 culture positive brucellosis patients, 54 patients with bacterial infections other than brucellosis and 40 healthy blood donors. The distribution of infections and number of patients were as follows; urinary infection (n: 16), salmonellosis (n: 15), bacterial meningitis (n: 5), tuberculosis (n: 4), pneumoniae (n: 3), osteomyelitis (n: 3), infective endocarditis (n: 2), peritonitis (n: 2), diabetic foot infection (n: 2), acute cholecystitis (n: 1), and catheter infection (n: 1). STA were positive in all of the brucellosis patients between the titers of 1/160-1/1280 (mean: 1/640), whereas STA were found negative in all of the healthy subjects. Nevertheless two patients whose stool cultures yielded Salmonella spp., one patient whose urine culture yielded E. coli, one patient whose diabetic foot lesion culture yielded group A beta-hemolytic streptococci, exhibited STA positivity at the titers of 1/160. There was no history of brucellosis or presence of co-infections in the patients with non-brucellosis infections and blood donors. In conclusion, cross reactions due to the presence of other bacterial infections should be considered for the evaluation of Brucella STA test results, together with the endemicity of the country of interest and seropositivity rate of the population.
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PMID:[Evaluation of Brucella tube agglutination test in patients with brucellosis, patients with bacterial infections other than brucellosis and healthy subjects]. 1612 33

The efficacy and tolerability of three different combination treatment regimens in human brucellosis were compared in 118 uncomplicated patients enrolled in a prospective study between May 1997 and December 2002. Brucellosis was diagnosed using standard clinical and microbiological findings. Patients with central nervous system involvement, spondylitis, endocarditis or children under 16 years of age were excluded from the study. Patients were randomly assigned to receive 400 mg of ofloxacin plus 600 mg of rifampicin (OR, n = 41), 200 mg of doxycycline plus 600 mg of rifampicin (DR, n = 45) or 1g intramuscularly streptomycin (administered for three weeks) plus 200 mg doxycycline (DS, n = 32) daily for 6 weeks. All patients were followed up at least 6 months after cessation of therapy. There was no statistical difference between the groups on relapse rates and clinical response to the treatment (P>0.05). Five patients in OR (12.8%), six patients in DR (14.3%) and three patients in DS groups (9.7%) suffered relapse. The side-effects were seen in eight (19.5%), 21 (46.7%) and eight (25.0%) patients of OR, DR and DS groups, respectively. The use of combination therapy of ofloxacin plus rifampicin for 6 weeks was found to be as effective as DR and DS. The side-effects of therapy in OR and DS groups was less severe than in the DR group.
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PMID:Comparison of three different combination therapies in the treatment of human brucellosis. 1635 69

This prospective study was carried out in two university hospitals between January 2000 and December 2002. The diagnosis of brucellosis was made with compatible clinical findings, positive Brucella agglutination > or =1/160 titres, and/or the isolation of Brucella species. The patients were followed up without intervention. One hundred and thirty-eight patients with active brucellosis were evaluated. Of the participants, 79 (57.2%) cases were acute, 23 (16.7%) sub-acute and 36 (26.1%) chronic. Brucella melitensis was isolated in the specimens of 24 (26.9%) out of 89 patients. The most frequent symptoms were fever (78.3%), arthralgia (77.5%) and sweating (72.5%). The most common physical findings were fever (40.6%), splenomegaly (36.2%), and hepatomegaly (26.8%). The osteoarticular involvement was found in 64 patients (46.4%). Ten (7.5%) patients had orchiepididymitis. Meningitis, pulmonary involvement, endocarditis, and hepatitis were found in five (3.6%), three (2.1%), two (1.5%) and one (0.7%) patient, respectively. Relative lymphomonocytosis was found in 80 cases (58.8%), anaemia in 46 (33.3%) and leucopoenia in 30 cases (21.7%). Clinical relapse was observed in 14 patients (10.1%).
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PMID:Clinical and laboratory features of brucellosis in two university hospitals in Southeast Turkey. 1648 39

We report a series of four cases presented with transient ischemic attacks (TIA) or ischemic stroke as the predominant manifestation of neurobrucellosis (NB). Three of the patients were 20-28 years of age, and one patient was 53 years old. They all used to consume unpasteurized milk or its products. Two patients had systemic brucellosis in the past and received antibiotic treatment. Other causes of TIA including cardiac embolism, hypercoagulability, vascular malformations, systemic vasculitis, and infective endocarditis were excluded. NB was diagnosed with serological tests or cultures for Brucella in the cerebrospinal fluid. None of the patients had any further TIA after the initiation of specific treatment. NB should always be sought in young patients with TIA or ischemic stroke, especially if they have no risk factors for stroke and live in an endemic area for brucellosis, even if they do not have other systemic signs of brucellosis.
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PMID:Neurobrucellosis as an exceptional cause of transient ischemic attacks. 1672 84


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