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June 1987

Prosthetic Valve Endocarditis Caused by Brucella melitensisA Report of Four Cases Successfully Treated With Tetracycline, Streptomycin, and Sulfamethoxazole and Trimethoprim Plus Valve Replacement

Author Affiliations

From the Division of Infectious Diseases, Department of Internal Medicine (Drs Fernández-Guerrero, Aguado, and Ponte) and the Department of Cardiovascular Surgery (Drs Martinell, Fraile, and de Rábago), Fundación Jiménez Díaz, Universidad Autónoma de Madrid.

Arch Intern Med. 1987;147(6):1141-1143. doi:10.1001/archinte.1987.00370060137022

• Optimal treatment of prosthetic valve endocarditis due to Brucella melitensis is unknown. The presence of ring abscess makes extensive surgical débridement and valve replacement essential steps of management. Antimicrobial therapy with tetracycline hydrochloride plus streptomycin sulfate or sulfamethoxazole and trimethoprim can achieve the sterilization of infected cardiac tissue. Late bland periprosthetic leaks occur frequently. Reoperation can be safely performed after a period of antimicrobial therapy. Prolonged treatment with doxycycline hyclate seems advisable.

(Arch Intern Med 1987;147:1141-1143)