Native Valve Brucella Endocarditis
| Autor: | Ümit Özyurda, Mustafa Şirlak, Kemalettin Uçanok, Tümer Çorapçıoğlu, Zeynep Eyileten, Refik Taşöz, Atilla Aral, Rüçhan Akar, Mustafa Inan, Bülent Kaya, Adnan Uysalel, Levent Yazicioglu, Sadık Eryilmaz, Neyyir Tuncay Eren, Evren Ozcinar |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Aortic valve medicine.medical_specialty Time Factors Turkey medicine.medical_treatment Clinical Investigations Heart Valve Diseases Brucella Prosthesis Design Severity of Illness Index Brucellosis Young Adult Pharmacotherapy Valve replacement Mitral valve medicine Humans Endocarditis Aged Retrospective Studies Bioprosthesis Heart Valve Prosthesis Implantation Doxycycline biology business.industry Endocarditis Bacterial General Medicine Middle Aged medicine.disease biology.organism_classification Combined Modality Therapy Anti-Bacterial Agents Surgery Treatment Outcome medicine.anatomical_structure Debridement Aortic Valve Heart Valve Prosthesis Mitral Valve Drug Therapy Combination Female Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal medicine.drug |
| Zdroj: | Clinical Cardiology. 33:E20-E26 |
| ISSN: | 0160-9289 |
| DOI: | 10.1002/clc.20606 |
| Popis: | OBJECTIVE: Brucellosis is frequently seen in Mediterranean and Middle East countries, including Turkey. We report the medical 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 diagnosis was established by 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, and cotrimaxozole. Tissue loss in most of the affected leaflets and vegetations were presenting all patients. Valve replacements were performed with mechanical and biologic prostheses. All the patients were afebrile at discharge but received the antibiotics for 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 postoperative medical treatment. Copyright © 2010 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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