Clinical Characteristics of a Zoonotic Occupational Disease—Brucella endocarditis with Review of Literature

Background Brucellosis is a zoonotic bacterial infection caused by a gram-negative aerobic coccobacillus. It can have varied presentation. Most severe complications include neurological and cardiovascular involvement (most commonly in the form of infective endocarditis). Aortic valve is most commonly involved (75%). Blood culture is highly specific, while serologic tests are more sensitive for diagnosing brucellosis. Transthoracic and transesophageal echocardiography plays a major role in diagnosing infective endocarditis. Treatment of Brucella endocarditis includes combination of antibiotic therapy and surgical valve replacement. We are presenting here a case series of seven cases of B. endocarditis with different presentations and varied underlying cardiac conditions. Materials and Methods Total seven cases of B. endocarditis were reported. The age group ranges from 22 to 45 years. Majority of them were from agriculture and dairy industry. All have presented with fever and three patients had severe breathlessness. Three cases were rheumatic valve diseases, one was bicuspid aortic valve, and one was congenital heart disease with prosthetic valve. Six patients had native valve endocarditis (four had predisposing cardiac condition with diseased valves, two had normal valves), whereas one had prosthetic valve endocarditis. Four had aortic valve involvement and three had mitral involvement. All cases were diagnosed using blood culture, serology, and echocardiography. Conclusion All were treated initially with antibiotics and valve replacement was done in five cases. Mortality was the outcome in two cases on conservative treatment and before surgery. Other five patients recovered after surgery.