Surgical treatment of brucella endocarditis

Background. Brucella endocarditis (BE) is a lethal complication of human br ucellosis, which is rarely seen and hardly described. Methods. In the present report, six successfully treated cases of BE involv ing three native aortic valves, two native mitral-aortic valves, and a mitr al bioprosthesis are described. The diagnosis of BE was based on clinical f eatures, high brucella serologic titers, and positive blood cultures. Altho ugh the blood cultures were positive in all patients, all the resected valv e materials and tissue cultures were negative. The patients received rifamp icin, streptomycin, and doxycycline tin 3 patients), rifampicin, tetracycli ne, and cotrimoxazole (in 2 patients), and rifampicin, doxycycline, and cot rimoxazole tin 1 patient). Infected native valves and bioprosthesis were re placed by mechanical valves. Results. There was no early or late mortality. No recurrent infection devel oped after management with a combination of antibiotherapy lasting 6 months postoperatively during a mean follow-up of 47 months (range 20 to 84 month s). Conclusions. This report suggests that the combination of valve replacement and antibiotic therapy produces successful results in the treatment of BE. (C) 2001 by The Society of Thoracic Surgeons.