Al Dahouk Sascha, Schneider Thomas, Jansen Andreas, Nöckler Karsten, Tomaso Herbert, Hagen Ralf M, Scholz Holger C, Rudwaleit Martin, Neubauer Heinrich, Morguet Andreas J
Department of Bacteriology, Bundeswehr Institute of Microbiology, Munich, Germany.
Can J Cardiol. 2006 Sep;22(11):971-4. doi: 10.1016/s0828-282x(06)70316-6.
Human brucellosis is a multiple organ disease that presents with fever and is most often transmitted via contaminated, unpasteurized goat milk and cheese. In chronic cases, focal complications (eg, spondylitis, neurobrucellosis and endocarditis) are frequently seen. Although the disease may be severely debilitating, the mortality rate is low. Fatal cases are often due to endocarditis. Because Brucella endocarditis is a rare complication (2% to 5%), therapeutic considerations are based on single-case experiences only. Therapy includes long-term antibiotic treatment using combinations of various antimicrobial drugs and surgical valve replacement when required. A case of Brucella endocarditis complicated by the infection of two valvular prostheses implanted after involvement of the mitral and aortic valve due to rheumatic fever is described. The patient was successfully treated by a medical and surgical approach. Therapeutic strategies in Brucella endocarditis are discussed in light of the current literature.
人类布鲁氏菌病是一种多器官疾病，表现为发热，最常通过受污染的、未经过巴氏消毒的山羊奶和奶酪传播。在慢性病例中，常可见局灶性并发症（如脊柱炎、神经布鲁氏菌病和心内膜炎）。尽管该病可能使人严重虚弱，但死亡率较低。死亡病例通常是由心内膜炎所致。由于布鲁氏菌性心内膜炎是一种罕见的并发症（2%至5%），治疗考虑仅基于个案经验。治疗包括长期使用多种抗菌药物联合进行抗生素治疗，并在必要时进行外科瓣膜置换。本文描述了一例布鲁氏菌性心内膜炎病例，该病例因风湿热导致二尖瓣和主动脉瓣受累后植入的两个人工瓣膜发生感染。该患者通过药物和手术方法成功治愈。结合当前文献对布鲁氏菌性心内膜炎的治疗策略进行了讨论。
