Successful Conservative Management of Complicated Brucella Endocarditis - PubMed
5 hours ago
- #Prosthetic valve
- #Conservative management
- #Brucella endocarditis
- Brucella endocarditis (BE) is a rare but life-threatening complication of brucellosis and a major cause of disease-related mortality.
- Prosthetic-valve involvement in BE is uncommon and typically requires combined medical and surgical therapy due to high risks of abscess formation and embolic complications.
- A 51-year-old man with a bioprosthetic aortic valve presented with recurrent fever, weight loss, and acute neurological deficits after treated brucellosis from unpasteurized goat milk.
- Diagnostic findings included embolic ischemic stroke, prosthetic-valve vegetation with paravalvular aortic-root abscess, rising Brucella melitensis titers, and brucellar spondylitis.
- Despite recommendation for urgent surgery, the patient opted for conservative management with prolonged combination antimicrobial therapy.
- The outcome was favorable, with full recovery, neurological improvement, normalized inflammatory markers, and resolution of vegetation and abscess on echocardiography.
- This case highlights the potential for individualized conservative management in selected complicated BE cases.