The Role of Antibiotic Treatment Alone for the Management of Brucella Endocarditis in Adults: A Case Report and Literature Review

Ali Mert, MD,1 Funda Kocak, MD,1 Resat Ozaras, MD,1 Fehmi Tabak, MD,1 Muammer Bilir, MD,2 Serdar Kucukuglu, MD,3 Recep Ozturk, MD,1 and Yildirim Aktuglu, MD1

Endocarditis is a rare complication of brucellosis but it is the main cause of the mortality in this disease. The accepted treatment for Brucella endocarditis (BE) is a combination of valve replacement and antibiotics. Conservative antibiotic treatment alone is not recommended by most of the authors as it is considered ineffective and increase the risk of fatality. In our literature search, we found 14 adult patients with BE treated only with antibiotics with a favorable outcome. In this report, we described a patient treated with antibiotics alone and reviewed the literature. Depending on the data from the growing literature and our patient we suggest that in selected patients with BE who do not have congestive heart failure, valvular destruction, abscess formation, or a prosthetic valve, conservative antibiotic treatment may be a valid alternative to surgery. (Ann Thorac Cardiovasc Surg 2002; 8: 381-381)

Key words: brucellosis, endocarditis

From 1Infectious Diseases and Clinical microbiology and 2Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, and 3Cardiology Institute, Istanbul, Turkey

Received June 20, 2002; accepted for publication September 6, 2002
Address reprint requests to Ali Mert, MD: Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, 34303 Aksaray, Istanbul, Turkey.