Fadul Abdalla, Fadul Mohamed H, Demir Gokhan, Safieh Mohamad, Lebbe Ahamed, Falamrz Fatema, Mohamed Abdelaziz, Hamad Nabiel, Akbar Raza A
Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
IDCases. 2024 Apr 2;36:e01937. doi: 10.1016/j.idcr.2024.e01937. eCollection 2024.
Brucellosis (undulant fever) is a zoonotic infection caused by Brucella species. It typically presents with fever, malaise, night sweats, and arthralgia. One of its rare complications is infective endocarditis, which occurs in approximately 1.3% of patients and can be further complicated by embolic stroke. This report describes a rare occurrence of Brucella endocarditis presenting as an embolic stroke. A 34-year-old male presented with sudden left-sided weakness and fever. He reported headaches, fever, and generalized weakness in the preceding week. The patient worked on a farm and hence had animal contact. A neurological exam showed left-sided facial weakness, and power of 0/5 and 1/5 in the left upper and lower extremities, respectively. CT scan of the head revealed a right middle cerebral artery (MCA) territory infarct with penumbra and a right MCA occlusion. He underwent a cerebral artery thrombectomy with successful recanalization. However, he continued to have fever and high inflammatory markers. Echocardiography showed aortic valve vegetation and blood cultures grew . A multidisciplinary meeting was held to determine the optimal management, which included a course of rifampicin and doxycycline.
布鲁氏菌病（波状热）是由布鲁氏菌属引起的一种人畜共患感染。其典型症状为发热、不适、盗汗和关节痛。其罕见并发症之一是感染性心内膜炎，约1.3%的患者会出现，还可能进一步并发栓塞性中风。本报告描述了一例罕见的以栓塞性中风为表现的布鲁氏菌性心内膜炎。一名34岁男性出现突发左侧肢体无力和发热。他自述前一周有头痛、发热和全身乏力症状。该患者在农场工作，因此有动物接触史。神经系统检查显示左侧面部无力，左侧上肢和下肢肌力分别为0/5级和1/5级。头部CT扫描显示右侧大脑中动脉（MCA）供血区梗死伴半暗带，右侧MCA闭塞。他接受了脑动脉取栓术，血管成功再通。然而，他仍持续发热，炎症指标居高不下。超声心动图显示主动脉瓣赘生物，血培养结果为……。为此召开了多学科会议以确定最佳治疗方案，包括使用利福平和强力霉素疗程。 （注：原文“blood cultures grew.”后面似乎缺失内容）
