Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA.
Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, Bethesda, MD, USA.
Lancet Infect Dis. 2014 Jun;14(6):520-6. doi: 10.1016/S1473-3099(13)70270-6. Epub 2014 Jan 28.
Brucellosis is the most common bacterial zoonosis, and causes a considerable burden of disease in endemic countries. Cardiovascular involvement is the main cause of mortality due to infection with Brucella spp, and most commonly manifests as endocarditis, peripheral and cerebrovascular aneurysms, or arterial and venous thromboses. We report a case of brucellosis presenting as bacteraemia and aortic endarteritis 18 years after the last known exposure to risk factors for brucella infection. The patient was treated with doxycycline, rifampicin, and gentamicin, and underwent surgical repair of a penetrating aortic ulcer, with a good clinical recovery. We review the signs and symptoms, diagnostic approach, prognosis, and treatment of brucella arteritis. We draw attention to the absence of consensus about the optimum therapy for vascular brucellosis, and the urgent need for additional studies and renewed scientific interest in this major pathogen.
布鲁氏菌病是最常见的细菌性人畜共患病，在流行国家造成相当大的疾病负担。心血管受累是布鲁氏菌属感染导致死亡的主要原因，最常见的表现为心内膜炎、周围和脑血管动脉瘤，或动脉和静脉血栓形成。我们报告了一例布鲁氏菌病病例，该病例在最后一次已知接触布鲁氏菌感染危险因素 18 年后表现为菌血症和主动脉内膜炎。该患者接受了多西环素、利福平、庆大霉素治疗，并接受了穿透性主动脉溃疡的手术修复，临床恢复良好。我们回顾了布鲁氏菌性动脉炎的体征、症状、诊断方法、预后和治疗。我们注意到，对于血管性布鲁氏菌病的最佳治疗方法尚未达成共识，迫切需要更多的研究和对这种主要病原体的重新科学关注。
