Brucella Infection Associated with Complete Atrioventricular Block

Brucella Infection Associated with Complete Atrioventricular Block

Background: The clinical spectrum of Brucella infection is quite diverse and characterized by multi-system involve-ment. Patients present with myocarditis, endocarditis, or pericarditis. Infective endocarditis is the most common cardiovascular complication in patients with brucellosis. Although conduction abnormalities are seen in cases with endocarditis, they are reported very rarely in the setting of cardiac Brucella infection.Case Report: An eight and a half-year-old male patient was referred to our clinic due to inadequate response to cotrimaxazole plus streptomycin treatment at the 15th day of admission. Although local hospital records on the patient showed a heart rate of 80 bpm, we determined a heart rate of 46 bpm. The electrocardiogram showed com-plete atrioventricular (AV) block. The average heart rate was determined as 48 bpm with 24-hour Holter electro-cardiogram (ECG) monitoring. The echocardiographic examination showed normal-sized heart chambers and the absence of valvular involvement. An agglutination test for brucellosis was found to be positive with a titer of 1/320. High fever, arthralgia, and splenomegaly regressed fol-lowing doxycycline plus rifampicin therapy, but there was no improvement in the AV block. A permanent pacemaker was implanted because of the detection of an average heart rate of 48 bpm.Conclusion: Because cardiac failure and rhythm abnor-malities are reported in the course of Brucella infection and may be associated with significant outcomes, cases with brucellosis should be evaluated carefully in terms of cardiac involvement. This report aims to draw attention to complete AV block as an extremely rare complication of Brucella infection

___

  • Abid L, Frikha Z, Kallel S, Chokri Z, Ismahen B, Amin B, et al. Brucella Myocarditis: A rare and life-threatening cardiac com- plication of Brucellosis. Intern Med 2012;51:901-4. [CrossRef]
  • Shah FS, Fennelly G, Weingarten-Arams J, Yang L, Glickstein J. Endocardial abscesses in children: case report and review of the literature. Clin Infect Dis 1999;29:1478-82. [CrossRef]
  • D'Agrosa MC, Lusson JR, Beytout J, Bailly P, Peycelon B, de Riberolles C, et al. Brucella endocarditis caused by reinfection of an aortic Starr valve. Apropos of a case with a favorable de- velopment after valvular replacement. Arch Mal Coeur Vaiss 1988;11:1403-7.
  • Kaya O, Avşar K, Akçam FZ. Unusual manifestations of brucel- losis. Arch Med Sci 2011;7:173-5. [CrossRef]
  • Bukharie HA. Clinical features, complications and treatment outcome of Brucella infection: ten years' experience in an en- demic area. Trop J Pharm Res 2009;8:303-10. [CrossRef]
  • Colmenero JD, Reguera JM, Martos F, Sánchez-De-Mora D, Delgado M, Causse M. et al. Complications associated with Brucella mellitensis infection: a study of 530 cases. Medicine (Baltimore) 1996;75:195-210. [CrossRef]
  • Lulu AR, Araj GF, Khateeb MI, Mustafa MY, Yusuf AR, Fenech FF. Human Brucellosis in Kuwait: a prospective study of 400 cases. Q J Med 1988;66:39-54.
  • Sharifkazemi MB, Moarref AR, Rezaian S, Rezaian GR. Brucel- la endocarditis of pseudoaneurysm of an aortic composite graft. J Cardiovasc Ultrasound 2013;21:183-5. [CrossRef]
  • Yazıcı HU, Mert KU, Senol U, Ulus T. A case with tricuspid valve brucella endocarditis presenting with acute right heart fail- ure Arch. Turk Kariyol Dern Ars 2012;40:364-7. [CrossRef]
Balkan Medical Journal-Cover
  • ISSN: 2146-3123
  • Başlangıç: 2015
  • Yayıncı: Erkan Mor
Sayıdaki Diğer Makaleler

Canal of Nuck Hernia in a Female Infant Containing Uterus, Bilateral Adnexa and Bowel

Suat FİTOZ, Meltem Bingöl KOLOĞLU, Betül Emine DERİNKUYU, Mohammad Reza AFFRANCHEH, Didem SÖNMEZ

Langerhans Cell Histiocytosis with Atypical Intervertebral Disc and Sacroiliac Joint Involvement Mimicking Osteoarticular Tuberculosis in an Adult

Zeynep Maraş ÖZDEMİR, Ayşegül SAĞIR KAHRAMAN, Cemile AYŞE GÖRMELİ, Reşit SEVİMLİ, Nusret AKPOLAT

Evaluation of Serum S100A8/S100A9 Levels in Patients with Autoimmune Thyroid Diseases

Ersin AKARSU, Hakan KORKMAZ, Nurten AKSOY, Mesut ÖZKAYA, Suzan TABUR, Şefika Nur AKSOY, Esen SAVAŞ

Assessment of the Speech Intelligibility Performance of Post Lingual Cochlear Implant Users at Different Signal-to-Noise Ratios Using the Turkish Matrix Test

Ahmet ATAŞ, Erdoğan BULUT, Zahra POLAT

Anti-inflammatory and Anti-apoptotic Effect of Valproic Acid and Doxycycline Independent from MMP Inhibition in Early Radiation Damage

Ferda HOSGORLER, Oğuz ÇETİNAYAK, Ülker CANKURT, Didem KELEŞ, Gülgün OKTAY, Zekiye AYDOĞDU, Mustafa AKHISAROGLU, Sevil GÖNENÇ ARDA, Serpil TANRIVERDI AKHISAROGLU, Seniz İNANC, Ahmet Deniz UÇAR

Neutrophil-to-Lymphocyte Ratio and Non-arteritic Anterior Ischemic Optic Neuropathy

Akın ÇAKIR, Murat AFYON

Autosomal Dominant Polycystic Disease is Associated with Depressed Levels of Soluble Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand

Atıl BİSGİN, Funda SARI, Saadet GÜMÜŞLÜ, Ramazan ÇETİNKAYA, Gizem Esra GENÇ, Metin SARIKAYA, Arzu Didem YALÇIN

Brucella Infection Associated with Complete Atrioventricular Block

Volkan TUZCU, Fikri DEMİR, Fatma BOZKURT, Murat Muhtar YILMAZER

Does Short Message Service Increase Adherence to Smoking Cessation Clinic Appointments and Quitting Smoking?

Mehmet Atilla UYSAL, Sibel YURT, Ayşe BAHADIR, Sinem İLİAZ, Didem GÖRGÜN HATTATOĞLU, Mediha GÖNENÇ ORTAKÖYLÜ, Belma Akbaba BAĞCI, Efsun Gonca UĞUR CHOUSEİN, Seda Tural ÖNÜR

Oleander Poisoning as an Example of Self-Medication Attempt

Işıl BAVUNOĞLU, Zeynep TURKMEN, Musa MALTA