Brucella endocarditis: epidemiology and clinical features of 23 cases from 2007 to 2018

Abstract Background : The data of Brucella endocarditis is relatively little. This study was to summarize the characteristics of epidemiology and clinical features of brucella endocarditis. Methods: 23 patients with brucella endocarditis collected in our hospital from July 2007 to August 2018 were analyzed. Results: Among the patients, 91.3% was male, the age was 42.6±12.4 years old. 69.6% patients had contacted with cattle and sheep. The most common symptom in these patients was chest tightness (60.8%), shortness of breath (60.8%), fever (43.5%) and anemia (43.5%). In the patients with anemia, 50% also had a lower platelet (including one patient had lower leucocyte level). Blood culture before taking antibiotics is easy to find Brucella sp . The aortic valve (91.3%) is most commonly involved, followed by mitral valve (17.4%) and tricuspid valve (8.7%). 87.0% of patients followed with complications, including cardiac failure (73.9%), pulmonary infection (43.5%), hydropericardium (34.8%), renal insufficiency (21.7%), multiple organ disfunction (4.3%), bacterial aneurysm rupture (4.3%), paravertebral abscess (4.3%), cerebral infarction (4.3%), pericardial stenosis and adhesion (4.3%). 47.8% of patients exhibited hyperglobulinemia and 80% of patients with renal insufficiency had hyperglobulinemia. 22 patients had suffered antibiotics and surgery treatment and one patient gave up treatment. 2 patients (8.7%) died because of ventricular fibrillation and refractory heart failure. Conclusion: Brucella endocarditis was a complex disease and could lead to multiple organ disfunction. Cardiac failure was the main reason for death and the mortality was 8.7%.