[A case of brucella endocarditis in Tunisia].

Medecine tropicale et sante internationale Pub Date : 2025-03-04 eCollection Date: 2025-06-30 DOI:10.48327/mtsi.v5i2.2025.668
Oussema Haddar, Rania Ammar, Mabrouk Bahloul, Chokri Ben Hamida
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引用次数: 0

Abstract

Introduction: Brucella 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.

Observation: 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 B. melitensis 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.

Conclusion: 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.

Abstract Image

[突尼斯布鲁氏菌心内膜炎1例]。
布鲁氏菌心内膜炎(BE)是一种罕见但严重的布鲁氏菌病并发症,是这种感染导致死亡的主要原因。由于其非特异性症状和低患病率,通常难以诊断。观察:本临床病例涉及一位59岁男性机械主动脉假体患者,其表现为心力衰竭,假体脱落,主动脉环脓肿,血培养阴性。手术标本的血清学检测和培养证实了这一诊断,结果显示与食用未经巴氏消毒的原料奶有关的猪利氏芽孢杆菌感染。治疗需要手术更换假体并排出脓肿,并延长抗生素治疗时间,包括强力霉素、复方新诺明和利福平。尽管有术后并发症,但血流动力学和感染结果良好。结论:该病例强调了多学科方法的重要性,包括靶向血清学检测和心脏成像,以早期诊断。同时强调了外科治疗结合适当的抗生素治疗以改善BE患者预后的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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