Akademik Veri Yönetim Sistemi
Clinical Cardiology, cilt.33, sa.2, 2010 (SCI-Expanded)
Objective: Brucellosis is frequently seen in Mediterranean and Middle East countries, including Turkey. We report themedical and surgical management of 31 cases of native endocarditis. Material and Method: Thirty-one patients were admitted to our clinic with suspected Brucella Endocarditis. The diagnosiswas establishedby either isolation of Brucella species, or the presence of antibodies. Following preoperative antibiotic therapy patients underwent valve replacement with excessive tissue debridment. Patients were followed up with Brucella titers, blood cultures, and echocardiography. Results: On admission all patients were febrile and mostly dyspneic (NYHA Class 3 or 4). The blood tests were normal except for elevated ESR, CRP and serological tests. The aortic valve was involved in 19 patients, mitral valve in 7 patients, and both valves in 5. After serological confirmation of BE, antibiotic therapy was maintained. Twenty-five of the patients received rifampicine, doxycycline, and cotrimaxozole; 2 of them received a combination of rifampicine, streptomycin, and doxycycline; and 4 of them received rifampicine, tetracycline, andcotrimaxozole. Tissue loss inmost of the affectedleaflets and vegetationswere presentingall patients. Valve replacements were performed with mechanical and biologic prostheses. All the patients were afebrile at discharge but receivedthe antibioticsfor 101, 2 ± 16, 9 days. The follow-up was 37, 1 ± 9, 2 months. Discussion: In our retrospective study, combination of adequate medical and surgical therapy resulted in declined morbidity and mortality rate. The valve replacement with aggressive debridement is the most important part of the treatment, which should be supported with efficient preoperative and long term postoperativemedical treatment. © 2010 Wiley Periodicals, Inc.