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Review
. 2021 Aug 9;33(3):198-212.
doi: 10.37616/2212-5043.1257. eCollection 2021.

Brucella Prosthetic Valve Endocarditis: A Systematic Review

Karima Taamallah  1 , Fatma Hammami  2 , Hédi Gharsallah  3 , Makram Koubaa  2 , Mounir Ben Jemaa  2 , Wafa Fehri  1
Affiliations
Review

Brucella Prosthetic Valve Endocarditis: A Systematic Review

Karima Taamallah et al. J Saudi Heart Assoc. .

Abstract

Objective: Brucella prosthetic valve endocarditis is a rare but a life-threatening complication of brucellosis. It remains a diagnostic challenge. Optimal treatment of Brucella prosthetic valve endocarditis is debated. Available data is limited to case reports or small case series. The purpose of this study was to systematically review all published cases of Brucella prosthetic valve endocarditis in the literature.

Method: A systematic review of PubMed database, Google, Google Scholar, and Scopus (From January 1974 to the present) for studies providing epidemiological, clinical and microbiological data as well as data on treatment and outcomes of Brucella prosthetic valve endocarditis was performed.

Results: A total of 51 reported cases were reviewed. Brucella melitensis (45%) and Brucella abortus (11.7%) were the most frequently isolated species. Most common type of prosthesis valve was mechanical prothesis (84.3%) and ten patients had double valve prosthesis (19.6%). Fever and dyspnea were present in 100% and 37.2% of the cases, respectively. The diagnosis was set with echocardiographic finding in 30 cases (93.7%), which revealed vegetation in 27 cases (84.3%). Most used antibiotics were rifampicin, doxycycline and aminoglycoside or cotrimoxazole. No deaths were noted in patients treated by combined medical and surgical treatment, but mortality was noted in 27.7% of the cases treated by antibiotics alone (p = 0.006).

Conclusion: This systematic review highlights diagnostic challenges and demonstrates that surgery improved outcome by reducing mortality in patients treated with the combined surgical and medical treatment option. Brucellosis should be considered in the differential diagnosis of prosthetic valve endocarditis in patients residing in or traveling to areas of endemicity.

Keywords: Antibiotics; Brucella; Endocarditis; Prosthetic valve; Surgery.

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Conflict of interest statement

Conflict of interest None declared.

Figures

Fig. 1
Fig. 1
Flow diagram of study inclusion.
Fig. 2
Fig. 2
Early mortality among treatment group and medical treatment alone group (Surgery + : Combined medical and surgical therapy, Surgery -: Medical treatment alone).
See this image and copyright information in PMC

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