International Journal of Cardiology 172 (2014) e509–e510

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Letter to the Editor

Brucella infective endocarditis M. Scarano a,⁎, F. Pezzuoli a, S. Patanè b a b

Cardiology Unit, Emergency Department, Hospital “Madonna del Soccorso”, San Benedetto del Tronto, Italy Cardiology Unit, Hospital “San Vincenzo” Taormina, ASP Messina, Italy

a r t i c l e

i n f o

Article history: Received 11 January 2014 Accepted 15 January 2014 Available online 28 January 2014 Keywords: Endocarditis Brucellosis Valvular heart disease Heart disease

Despite the progress in its knowledge and treatment, infective endocarditis [1–27] remains a therapeutic challenge [27]. Endocarditis is a rare and serious complication of brucellosis [28,29]. We present a case of an infective endocarditis in a 42-year-old Italian woman. The 42-year-old Italian woman reported a history of high blood pressure, diabetes (newly diagnosed), and fever a year ago and its remission after a month of therapy with a residual ingravescent dyspnea [30–37]. Echocardiographic evaluation revealed an advanced fibrocalcification of the mitral valve (Fig. 1A) with a severe mitral insufficiency (Fig. 1B) and an important fibrocalcific thickening aortic valve with a hyperechogenic mass adhesive on aortic cusps (Fig. 1A) and a severe aortic insufficiency (Fig. 1C). A fibrocalcification of the tricuspid valve with a severe tricuspid insufficiency was also shown (Fig. 1D). Elevated IgG-class brucella antibodies were found. Also, this case focuses attention on rare and serious brucella infective endocarditis. (See Fig. 1.) Acknowledgements The authors of this manuscript have certified that they adhere to the statement of ethical publishing as appears in the International Journal of Cardiology. Author contributions Michele Scarano conducted the clinical diagnosis and conceived the case study. Franco Pezzuoli performed the patient’s follow-up. Salvatore Patanè wrote the work. ⁎ Corresponding author at: Cardiology Unit, Emergency Department, Hospital “Madonna del Soccorso,” Via Silvio Pellico n.32, 63039, San Benedetto del Tronto, Ascoli Piceno, Italy. Tel.: +39 3931861283. E-mail address: [email protected] (M. Scarano). 0167-5273/$ – see front matter © 2014 Elsevier Ireland Ltd. All rights reserved.

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M. Scarano et al. / International Journal of Cardiology 172 (2014) e509–e510

Fig. 1. (A) An advanced fibrocalcification of the mitral valve, an important fibrocalcific thickening aortic valve with a hyperechogenic mass adhesive on aortic cusps. (B) Severe mitral insufficiency. (C) Severe aortic insufficiency. (D) Severe tricuspid insufficiency.

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