INFECTIVE ENDOCARDITIS AND OCCULT SPLENIC ABSCESS CAUSED BY BRUCELLA-MELITENSIS INFECTION - A CASE-REPORT AND REVIEW OF THE LITERATURE

This report describes a patient with prosthetic aortic valve endocardi tis caused by Brucella melitensis infection with an initial relapse af ter apparent recovery due to associated occult splenic abscess. In spi te of a prolonged period of recovery (6 months) achieved with splenect omy and antibrucella antimicrobial therapy, a second relapse occurred and cure was achieved after replacement of the infected prosthetic val ve and prolonged courses of antibrucella antimicrobial therapy. There is controversy on the optimal therapy of such cases, but this report s uggests that successful management requires a combination of medical a nd early surgical therapy.