Treatment of Brucella endocarditis: 15 years of clinical and surgical experience.

Abstract

Brucella endocarditis is a life-threatening complication of human brucellosis. In this study, our aim was to evaluate the effects of combined medical and surgical treatment in the midterm to long term. We retrospectively analyzed 13 patients (mean age 44 +/- 18 years; 8 males) who were operated on from January 1993 to June 2009. Duke criteria were used for the diagnosis of endocarditis. The primary endpoint was defined as the overall mortality and readmission to the hospital during early and late follow-up periods. The other collected data included baseline and follow-up clinical findings, along with echocardiographic and laboratory measurements. No patients died in the early period (up to 1 month) and 2 patients (15.3%) died during the late follow-up period. Aortic valve disease was observed in 11 of 13 patients (85%). The most commonly performed procedure was aortic valve replacement (10 of 13 patients; 77%) during a mean follow-up period of 95 +/- 60 months (range, 10 to 184; median, 74). For Brucella endocarditis, perioperative antibiotic therapy combined with surgical treatment (prosthetic valve replacement) has satisfactory results and increases the quality of life in the long-term follow-up.