The role of antibiotic treatment alone for the management of Brucella endocarditis in adults: a case report and literature review

Abstract

Endocarditis is a rare complication of brucellosis but it is the main cause of the mortality in this disease. The accepted treatment for Brucella endocarditis (BE) is a combination of valve replacement and antibiotics. Conservative antibiotic treatment alone is not recommended by most of the authors as it is considered ineffective and increase the risk of fatality. In our literature search, we found 14 adult patients with BE treated only with antibiotics with a favorable outcome. In this report, we described a patient treated with antibiotics alone and reviewed the literature. Depending on the data from the growing literature and our patient we suggest that in selected patients with BE who do not have congestive heart failure, valvular destruction, abscess formation, or a prosthetic valve, conservative antibiotic treatment may be a valid alternative to surgery.