culture positive brucella endocarditis in a case of baloon mitral valvotomy

Brucella endocarditis is a rare condition which occurs as a focal complication in chronic brucellosis cases. We report a rare brucella endocarditis case in a RVHD patient. A 26 years old male was admitted with fever on off for almost one year. The blood culture yielded growth of Brucella melitensis after ten days of incubation. Isolated colonies were reconfirmed as Brucella species by PCR study. Patient’s serum tested positive for brucella slide agglutination test and STAT titer was 640IU. Echocardiography showed vegetation on mitral valve. Patient was treated with both medical and surgical intervention. After chemotherapy, patient’s blood culture was sterile, slide agglutination & STAT (40IU) were negative. Repeat echocardiography showed no fresh vegetation. Considering high mortality rate (80%) in Brucella endocarditis, it is very important for clinicians to suspect it. Prompt antibiotic therapy and surgical intervention is life saving in fatal cases.