Can brucella endocarditis be treated successfully with medical therapy alone?

Human brucellosis is caused by one of the three species of Brucella: Brucella mellitensis, B. abortus, and B. suis. Worldwide, the incidence of human brucellosis ranges from <0.01 to >200 per 100,000 population. Cardiovascular complications occur in <2%, but accounts for most of the mortality. Brucella endocarditis usually involves normal native aortic valves in 75% of cases. A combination of antibiotics and valve replacement is the most acceptable treatment. So far only 15 adult cases have been reported as having been cured with medical therapy alone. We report another case treated successfully with antibiotics alone.