Dourakis Spyros, Sambatakou Helen, Tsiachris Dimitris, Kittou Naso, Alexopoulou Alexandra, Archimandritis Athanasios
Int J Cardiol. 2008 Jun 6;126(3):e47-9. doi: 10.1016/j.ijcard.2007.01.018. Epub 2007 Mar 29.
Brucella endocarditis is a rare and life threatening complication of brucellosis. It usually involves the aortic valve and successful management requires a combination of medical treatment and valve replacement. We describe a case of tricuspid valve and defibrillator lead brucella endocarditis induced by the implantation of the defibrillator itself. Our patient was admitted to hospital with a 2-week history of fever, back pain and night sweats. One month prior to admission, due to episodes of syncope, he was hospitalized at the Cardiology Department and because of a low grade fever he underwent complete investigation with no result. His original symptoms relapsed 2 days after dischargement. Although serological tests were not indicative, blood cultures grew Brucella melitensis and transesophageal echocardiography showed a vegetation on tricuspid valve, which was mildly regurgitant. Fever subsided 2 days following start of triple antibiotic therapy and 2 weeks later the defibrillator and the pacemaker were surgically explanted.
布鲁氏菌性心内膜炎是布鲁氏菌病一种罕见且危及生命的并发症。它通常累及主动脉瓣,成功的治疗需要药物治疗与瓣膜置换相结合。我们描述了一例因植入除颤器本身而引发的三尖瓣及除颤器导线布鲁氏菌性心内膜炎病例。我们的患者因发热、背痛和盗汗2周入院。入院前1个月,因晕厥发作,他入住心内科,因低热接受了全面检查但未得出结果。出院2天后,他原来的症状复发。尽管血清学检查无指示性,但血培养长出了羊种布鲁氏菌,经食管超声心动图显示三尖瓣有赘生物,有轻度反流。三联抗生素治疗开始2天后发热消退,2周后手术取出除颤器和起搏器。