A clinical analysis of six patients with Brucella endocarditis and literature review

Abstract

Objective: To analyze the epidemiology and clinical characteristics of patients with Brucella endocarditis in order to improve the understanding and treatment of Brucella endocarditis. Methods: The clinical data including demographic characteristics, clinical features, laboratory data, echocardiography, treatment and clinical outcome of 6 patients with Brucella endocarditis were collected and analyzed. Results: In our database consisting of 211 brucellosis patients with positive blood culture, 6 patients (2.8%) with Brucella endocarditis were selected from May 2007 to December 2016 in Peking Union Medical College Hospital.The age range was 25-55 years, among whom 5 patients were men.The majority were farmers and all patients reported the history of closely contact with livestock.All of them had fever and 3 of them had arthralgia.Four patients had aortic involvement (4/6) and 2 of them presented with symptoms of left ventricular failure at admission.Blood culture of Brucella and serum agglutination test of Brucella were positive in all of them.Combined antibiotics treatments were given to all patients.Valve replacement surgery was performed in four patients, among them, three patients well recovered, one lost. Among all the patients, four were followed up continually and other two were lost. Conclusions:Brucella endocarditis has a predominance of aortic involvement and is prone to left ventricular failure.Early antibiotic treatment combined with valve-replacement surgery is effective to improve the prognosis.