Right ventricular outflow tract endocarditis caused by brucellosis

Right-ventricular outflow tract (RVOT) endocarditis is a very rare presentation of right-sided infective endocarditis (RSIE) by brucellosis. RSIE occurs most commonly in immune-suppressed cases and illicit drug abuser. The patients with RSIE and an incompetent immune system usually have a prosthetic foreign body in blood circulation such as catheter, pacemakers, or central venous lines and may be accompanied with tricuspid or pulmonary valve dysfunction. The most common site for RSIE is the tricuspid valve. We describe an exceedingly rare condition of RVOT endocarditis in a patient with brucellosis in which vegetation is attached to a muscle bundle of the RVOT. Despite appropriate antibiotic therapy, the general condition of the patient deteriorated and was finally scheduled for open-heart surgery. The mass was resected and the patient recovered uneventfully and was discharged on the 9th day of surgery with appropriate oral antibiotics. (C) 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Limited. All rights reserved.