Osteomyelitis and Endocarditis Due to Brucellosis

Abstract

Introduction: Brucellosis is a multi-systemic infectious disease characterized by fever, sweating, generalized malaise, weight loss, and arthralgia. Brucella Endocarditis (BE) is a serious complication of Brucellosis and occurs in 1% of all types of Brucella infections. Also, Brucella is one of the main causes of vertebral osteomyelitis. To the authors’ best knowledge, to date there has been no report regarding the concurrence of endocarditis and osteomyelitis in Brucellosis. Case Presentation: The current case was a 70-year-old female presented with fever and low back pain. The spinal Magnetic Resonance Imaging (MRI) was performed and signal changing in T9, T10 with probability of metastasis was reported. Before neurosurgical management, 2ME and Wright were checked and the titers were positive. Changing heart murmur, transthoracic, and transesophageal, and aortic-valve vegetation were detected in physical examinations and echocardiography. The patient was treated for six months and the low back pain improved and no vegetation was detected in echocardiography at the end of this period. Conclusions: Physicians should consider Brucellosis in all patients with low back pain in the Brucella endemic regions, and in those with spondylitis or culture-negative IE in the Brucella endemic regions.