Brucella Endocarditis: Seven Cases Treated Surgically

Brucella endocarditis is a lifethreatening, often under-diagnosed complication of brucellosis. Seven cases of brucella endocarditis treated surgically in the last 25 years are described. The infection was localized on the aortic valve in 5 cases and on a prosthetic mitral valve in 2. All patients had a positive history of risk factors for brucella infection and all were in cardiac failure (5 in New York Heart Association functional class III and 2 in class IV). All underwent valve replacement followed by antibiotic therapy. Follow-up ranged from 1 and 206 months. One patient died following prosthetic valve replacement to treat a periprosthetic leak unrelated to the brucella infection. Brucella antibody tests and careful clinical history are mandatory in all patients with negative blood cultures in order to identify brucella earlier during the course of the infection before embolization or annular involvement occur.