Yazıcı Hüseyin Uğur, Mert Kadir Uğur, Senol Utku, Ulus Taner
Department of Cardiology, Eskişehir Osmangazi University Faculty of Medicine, Turkey.
Turk Kardiyol Dern Ars. 2012 Jun;40(4):364-7. doi: 10.5543/tkda.2012.32067.
Although the presence of brucella endocarditis is encountered rarely, it is the most fetal complication of brucellosis, which is shown to affect the aortic valve primarily and the mitral valve secondarily. Involvement of the tricuspid valve is extremely rare. A 62-year-old female was admitted with complaints of fever, fatigue, difficulty in breathing, and swellings in her legs. A transthoracic echocardiogram was performed since acute right heart failure was considered due to her symptoms. The echocardiogram showed enlarged right heart chambers, serious tricuspid valve insufficiency, and a mass on the tricuspid valve compatible with a vegetation moving in and out of the right ventricle. Although no growths were observed in the blood culture, antibody titration for brucellosis was found to be 1/640 (+) in the serological examination. The patient was diagnosed with brucella endocarditis and placed on doxycycline, rifampicin, and ceftriaxone treatment for eight weeks. At the end of the eight-week treatment, the symptoms of right heart failure receded and the patient recovered from the endocarditis. Tricuspid valve brucella endocarditis should be considered in patients suffering from acute right heart failure accompanied by systemic infection findings since brucellosis is presently endemic in Turkey.
尽管布鲁氏菌性心内膜炎很少见,但它是布鲁氏菌病最致命的并发症,该病主要影响主动脉瓣,其次是二尖瓣。三尖瓣受累极为罕见。一名62岁女性因发热、疲劳、呼吸困难和腿部肿胀入院。由于考虑到她的症状可能是急性右心衰竭,因此进行了经胸超声心动图检查。超声心动图显示右心腔扩大、严重的三尖瓣关闭不全,以及三尖瓣上有一个与赘生物相符的肿块,该赘生物在右心室内外移动。尽管血培养未发现生长物,但血清学检查发现布鲁氏菌病抗体滴度为1/640(+)。该患者被诊断为布鲁氏菌性心内膜炎,并接受了为期八周的强力霉素、利福平及头孢曲松治疗。在八周治疗结束时,右心衰竭症状消退,患者的心内膜炎得以康复。由于布鲁氏菌病目前在土耳其呈地方性流行,对于伴有全身感染症状的急性右心衰竭患者,应考虑三尖瓣布鲁氏菌性心内膜炎。