Hüseyin OKUTAN, Ali K. ADİLOĞLU, Mehmet ÖZAYDIN, Oktay PEKER

Combination of medical and surgical therapy in the management of Brucella endocarditis

SüleymanDemirel Üniversitesi TIP FAKÜLTESİ DERGİSİ: 2005 Aralık; 12(4) Combination of medical and surgical therapy in the management of Brucella endocarditis Hüseyin Okutan, Ali K. Adiloğlu , Mehmet Özaydin, Oktay Peker, Özet Brucella endokardit tedavisinde medikal ve cerrahi tedavi kombinasyonu Bu yazıda, nativ aort kalp kapağını tutan bir Brucella endokarditi olgusu sunulmuştur. Kırkdört yaşında erkek hasta nativ aort kapağı tutan Brucella endokardit tanısını almış olarak hastanemize başvurdu. Hastanemizde Brucella tanısı klinik özelliklerle ve pozitif kan kültürü ve seroloji tetkikleri ile kondu. Medikal tedavi (doksisiklin ve rifampisin) yetersizdi ve ekokardiyografide vejetasyon kitlesi ve dördüncü derece aort yetmezliği bulguları izlendi. Acil olarak aort kapak replasmanı yapıldı ve kan ve kapak kültürlerinde B. melitensis üredi. Hasta ameliyat sonrası 8. gün taburcu edildi ve aynı antibiyotik tedavisine 3 ay devam edildi. Hasta ameliyat sonrası 30. aya kadar düzenli olarak kontrol edildi ve hastada klinik olarak tam iyileşme gözlendi. Anahtar kelimeler: Endokardit, kapak replasmanı, aort kapağı, Brucella melitensis Abstract Here, we present a case of Brucella endocarditis of the native aortic valve. A 44-years-old man was admitted to our hospital with a pre-diagnosis of Brucella endocarditis of the aortic valve. In our hospital, the diagnosis of brucellosis was established by clinical features, positive blood culture and positive serology. Medical treatment (doxycycline and rifampicin) was insufficient and echocardiography showed a mass of vegetation and fourth degree aortic insufficiency. Replacement of the aortic valve was carried out as emergency procedure. Blood and valve cultures were positive for Brucela melitensis. The patient was discharged on 8th postoperative day and received the same antibiotic therapy for 3 months. The patient was regularly controlled throughout postoperative 30 months, and the clinical status has been found excellent. Key words: Endocarditis; valve replacement; aortic valve; Brucella melitensis

Anahtar Kelimeler:

Endokardit, kapak replasmaný, aort kapaðý, Brucella melitensis

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