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Management of Brucella endocarditis: results of the Gulhane study

Date
2012
Author
GUNER, Rahmet
Koruk, Suda Tekin
Koruk, Ibrahim
Erbay, Ayse
TEZER-TEKCE, Yasemin
Erbay, Ali Riza
Dayan, Saim
Deveci, Ozcan
INAN, Asuman
ENGIN, Derya Ozturk
Dikici, Nebahat
Doyuk-Kartal, Elif
Kurtaran, Behice
Pehlivanoğlu, Filiz
Sipahi, Oguz Resat
Yalci, Aysun
Alp-Cavus, Sema
GENCER, Serap
Guzel, Gokhan
Parlak, Mehmet
Kazak, Esra
TULEK, Necla
ULCAY, Asim
SAVASCI, Umit
ONCUL, Oral
Yemisen, Mücahit
ERDEM, Hakan
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Abstract
Brucella endocarditis (BE) is a rare but life-threatening complication of human brucellosis. The aim of this study was to investigate the course of BE along with the therapeutic interrelations. A total of 53 patients with BE hospitalised in 19 health institutions between 2006 and 2011 were included in the Gulhane study. Diagnosis of brucellosis was established by either isolation of Brucella sp. or the presence of antibodies, and the definition of endocarditis was made according to Duke's criteria. There were four treatment groups: ceftriaxone combined with oral antibiotics (Group 1); aminoglycosides combined with oral antibiotics (Group 2); oral antibiotic combinations (Group 3); and aminoglycoside plus ceftriaxone combined with an oral antibiotic (Group 4). Involvement rates of the aortic, mitral and tricuspid valves were 49.1%, 43.4% and 5.7%, respectively. Thirty-two patients (60.4%) had an underlying cardiac valvular problem, including previous prosthetic valve replacement (n = 18). Medical treatment was provided to 32 patients (60.4%), whilst concordant medical and surgical approaches were provided to 21 patients (39.6%). Mortality in Group 1 was 15% (3/20), whilst in Group 2 it was 5.3% (1/19). In Group 3, 25.0% (3/12) of the cases died, whereas none of the cases in Group 4 died. In conclusion, mortality increased 47-fold with pericardial effusion and 25-fold due to congestive heart failure that developed after BE. Although mortality was lower in the aminoglycoside-containing arm (Groups 2 and 4), statistical analysis could not be performed owing to the small number of patients. (C) 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
URI
http://hdl.handle.net/20.500.12627/83097
https://doi.org/10.1016/j.ijantimicag.2012.04.009
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Creative Commons Lisansı

İstanbul Üniversitesi Akademik Arşiv Sistemi (ilgili içerikte aksi belirtilmediği sürece) Creative Commons Alıntı-GayriTicari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.

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