Endocarditis caused by Brucella melitensis.

OBJECTIVE

To describe the management of an uncommon but serious infection in Australia.

CLINICAL FEATURES

A 25-year-old woman developed endocarditis after residence in Turkey and consumption of goat dairy products. Brucella melitensis was isolated from blood cultures.

INTERVENTION AND OUTCOME

The valve remained infected after prolonged intravenous administration of trimethoprim-sulfamethoxazole, gentamicin and rifampicin. Uncontrolled sepsis and worsening haemodynamic function necessitated valve replacement. To date the patient remains well while taking trimethoprim-sulfamethoxazole and rifampicin.

CONCLUSION

Endocarditis due to Brucella spp. is uncommon in Australia. This infection is difficult to cure with antimicrobial therapy alone and early surgical intervention is advisable.