Ferreira Pedro, Gama Pedro, Correia Jorge, Nunes Luís, Pipa João, Nascimento Celeste, Alexandre João Carlos, Henriques Pedro, Santos Jorge Oliveira
Serviço de Cardiologia do Hospital São Teotónio, Viseu, Portugal.
Rev Port Cardiol. 2008 Oct;27(10):1309-15.
Endocarditis is a rare and serious complication of brucellosis and is the main cause of death in this pathology. Diagnosis requires a high level of suspicion and is based on the association of epidemiological, clinical and serological elements. Echocardiography plays a crucial role in early diagnosis, as well as in identifying predisposing heart disease and local complications typical of this pathology. Treatment is not consensual; most authors recommend an early surgical approach, due to the degree of tissue destruction caused by Brucella and the high rate of recurrence. Nevertheless, other authors stress the need for prognostic stratification of each case and support conservative treatment in low-risk cases. This article describes the case of a patient with brucella endocarditis that was treated medically and reviews the relevant literature.
心内膜炎是布鲁氏菌病一种罕见且严重的并发症,是该疾病致死的主要原因。诊断需要高度怀疑,且基于流行病学、临床和血清学因素的综合判断。超声心动图在早期诊断以及识别易患心脏病和该疾病典型的局部并发症方面起着关键作用。治疗尚无共识;大多数作者建议早期手术治疗,因为布鲁氏菌造成的组织破坏程度以及复发率较高。然而,其他作者强调需要对每个病例进行预后分层,并支持低风险病例采用保守治疗。本文描述了一名接受药物治疗的布鲁氏菌性心内膜炎患者的病例,并对相关文献进行了综述。