Brucella-mediated prosthetic valve endocarditis with brachial artery mycotic aneurysm

dc.contributor.authorCakalagaoglu C.
dc.contributor.authorKeser N.
dc.contributor.authorAlhan C.
dc.date.accessioned2024-07-12T21:50:45Z
dc.date.available2024-07-12T21:50:45Z
dc.date.issued1999en_US
dc.departmentMaltepe Üniversitesien_US
dc.description.abstractA 39-year-old female with a Hall-Kaster mitral prosthesis developed fever, general malaise and arthralgia 15 years after valve replacement for rheumatic mitral valve disease. Prosthetic valve endocarditis was identified after serial laboratory, clinical and echocardiographic examinations. Penicillin G (40 x 106 units/day, i.v.) + gentamicin (240 mg/day, i.v.) was started as initial therapy. The patient showed no signs of recovery, and penicillin G was replaced with vancomycin (1,000 mg/day, i.v.). There was a gradual reduction in spiking fever, and prominent reductions in erythrocyte sedimentation rate and white cell count. Meanwhile, a tender and pulsatile mass developed in the anterior surface of the left arm; peripheral angiography yielded a diagnosis of brachial artery aneurysm. A successful aneurysmectomy with saphenous vein interposition was performed. Histopathology of the lesion revealed mycotic aneurysm. An initial control SAT for Brucella of 1/80(+) was found to increase. A detailed history showed the patient to have consumed unpasteurized dairy products. Doxycyline (200 mg/day, oral) + co-trimoxazole (2,700 mg/day, oral) + rifampicin (600 mg/day, oral) was administered to treat brucellosis. Later, doxycyline caused intolerable gastrointestinal side effects and was replaced by ciprofloxacin (1,000 mg/day, oral). Subsequently, the patient made an uneventful recovery within one week. Antibiotic treatment was continued for 12 months, with complete resolution of vegetation and paravalvular leakage. During a four- year follow up, the patient showed no signs of relapse.en_US
dc.identifier.endpage590en_US
dc.identifier.issn0966-8519
dc.identifier.issue5en_US
dc.identifier.pmid10517403en_US
dc.identifier.scopus2-s2.0-0032826083en_US
dc.identifier.scopusqualityQ4en_US
dc.identifier.startpage586en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12415/8199
dc.identifier.volume8en_US
dc.identifier.wosWOS:000082782200027en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.relation.ispartofJournal of Heart Valve Diseaseen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmzKY01911
dc.titleBrucella-mediated prosthetic valve endocarditis with brachial artery mycotic aneurysmen_US
dc.typeArticle
dspace.entity.typePublication

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