Brucellar Endocarditis of the Tricuspid Valve: A Case Report and Review of the Literature

TL;DR

A 72-year-old woman with brucellar tricuspid endocarditis was successfully treated with antibiotics alone, avoiding surgery.

Contribution

The case suggests that non-surgical antibiotic treatment may be effective for mild brucellar tricuspid endocarditis.

Findings

The patient responded well to antibiotic therapy without needing surgery.

Right-sided brucellar endocarditis may have a better prognosis than left-sided cases.

Prolonged antibiotic treatment with intracellular activity can be effective for tricuspid valve involvement.

Abstract

Brucellar endocarditis is a rare entity commonly described as a severe disease associated with high mortality and generally requiring valve surgery for cure. Right-sided endocarditis, a very uncommon presentation of brucellosis, may be associated with a better prognosis. We describe the case of a 72-year-old woman admitted to our institution with a persistent fever and multiple pulmonary infiltrates. Transthoracic echocardiography and serologic tests led to the diagnosis of brucellar tricuspid endocarditis. The patient responded favorably to antibiotic treatment alone and did not need surgery. Prolonged antibiotic therapy with a combination of drugs active on intracellular microorganisms in the absence of surgical treatment could be effective in brucellar tricuspid endocarditis when the valve is not severely damaged.