Haddar Oussema, Ammar Rania, Bahloul Mabrouk, Ben Hamida Chokri
Service de cardiologie, Centre hospitalier universitaire Hédi Chaker de Sfax, Tunisie.
Université de Sfax, Tunisie.
Med Trop Sante Int. 2025 Mar 4;5(2). doi: 10.48327/mtsi.v5i2.2025.668. eCollection 2025 Jun 30.
endocarditis (BE) is a rare but serious complication of brucellosis and is the leading cause of death from this infection. It is often difficult to diagnose due to its non-specific symptoms and low prevalence.
This clinical case concerns a 59-year-old man with a mechanical aortic prosthesis who presented with heart failure with prosthetic disconnection, aortic annulus abscess, and negative blood cultures. The diagnosis was confirmed by serologic testing and culture of the surgical specimen, which revealed infection with associated with consumption of unpasteurized raw milk. Treatment required surgery to replace the prosthesis and drain the abscess, and prolonged antibiotic therapy with doxycycline, cotrimoxazole, and rifampicin. Despite postoperative complications, hemodynamic and infectious outcomes were favorable.
This case highlights the importance of a multidisciplinary approach, including targeted serologic testing and cardiac imaging, for early diagnosis. It also emphasizes the need for surgical management combined with appropriate antibiotic therapy to improve the prognosis of patients with BE.
布鲁氏菌性心内膜炎(BE)是布鲁氏菌病一种罕见但严重的并发症,是该感染导致死亡的主要原因。由于其症状不具特异性且发病率低,往往难以诊断。
本临床病例涉及一名59岁男性,他植入了机械主动脉瓣膜假体,出现了伴有假体脱节、主动脉瓣环脓肿且血培养阴性的心力衰竭。血清学检测和手术标本培养确诊了该疾病,结果显示感染与饮用未巴氏杀菌的生牛奶有关。治疗需要通过手术更换假体并引流脓肿,以及使用强力霉素、复方新诺明和利福平进行长期抗生素治疗。尽管术后出现了并发症,但血流动力学和感染方面的结果良好。
本病例突出了多学科方法(包括针对性血清学检测和心脏成像)对于早期诊断的重要性。它还强调了手术管理与适当抗生素治疗相结合以改善布鲁氏菌性心内膜炎患者预后的必要性。