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布鲁氏菌性心内膜炎的临床特征与转归:病例系列研究

Clinical Characteristics and Outcome of Brucella Endocarditis: A Case Series.

作者信息

Alfakeeh Sara, Alghanem Reema Fahad, Bin Obaid Shahad, Alsuwayhib Alya, Al Kawabah Ghaida, Abanamy Reem, Bosaeed Mohammad

机构信息

College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

出版信息

Infect Drug Resist. 2024 Oct 29;17:4733-4740. doi: 10.2147/IDR.S485537. eCollection 2024.

Abstract

PURPOSE

Brucella endocarditis is a rare complication with a high mortality risk. This research aims to evaluate patients diagnosed with Brucella Endocarditis and review clinical characteristics, diagnosis, and treatment strategies to serve as a foundation for future research in managing Brucella endocarditis and improving patient care and outcomes.

PATIENTS AND METHODS

This retrospective study reviewed the medical records of patients diagnosed with Brucella endocarditis from 2011 to 2022. The study included patients of all ages and genders who were diagnosed based on positive serum serology or blood culture in conjunction with clinical presentation. Diagnostic criteria for endocarditis were based on evidence of endocardial involvement, as confirmed by echocardiographic findings consistent with infective endocarditis. Descriptive statistics were used for data analysis.

RESULTS

Nine patients were included in this study. The most common presenting symptom was shortness of breath. Treatment regimens included Doxycycline and Rifampicin, always in combination with other antibiotics. Surgical intervention was necessary for two-thirds of the patients. Complications, such as septic shock, stroke, and heart failure, were observed in most cases. Six patients achieved clinical and microbiological cures, while one-third of the patients died. The deaths were primarily attributed to patients being deemed unsuitable for surgery due to a high surgical risk, based on their comorbidities and clinical assessments.

CONCLUSION

This study highlights the importance of initiating an appropriate antibiotic regimen in a timely manner. Particularly in patients with pre-existing heart diseases, surgical intervention can significantly improve patient outcomes and reduce complications associated with Brucella endocarditis.

摘要

目的

布鲁氏菌性心内膜炎是一种罕见的并发症,具有较高的死亡风险。本研究旨在评估被诊断为布鲁氏菌性心内膜炎的患者,并回顾其临床特征、诊断和治疗策略,为未来布鲁氏菌性心内膜炎的管理研究以及改善患者护理和预后奠定基础。

患者与方法

本回顾性研究回顾了2011年至2022年期间被诊断为布鲁氏菌性心内膜炎患者的病历。该研究纳入了所有年龄和性别的患者,这些患者根据血清学阳性或血培养结果结合临床表现进行诊断。心内膜炎的诊断标准基于心内膜受累的证据,经超声心动图检查结果证实符合感染性心内膜炎。采用描述性统计进行数据分析。

结果

本研究纳入了9名患者。最常见的症状是呼吸急促。治疗方案包括强力霉素和利福平,且总是与其他抗生素联合使用。三分之二的患者需要手术干预。大多数病例观察到并发症,如感染性休克、中风和心力衰竭。6名患者实现了临床和微生物学治愈,而三分之一的患者死亡。死亡主要归因于根据患者的合并症和临床评估,因其手术风险高而被认为不适合手术。

结论

本研究强调了及时启动适当抗生素治疗方案的重要性。特别是对于已有心脏病的患者,手术干预可显著改善患者预后并减少与布鲁氏菌性心内膜炎相关的并发症。

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