Brucella arteritis: clinical manifestations, treatment, and prognosis

被引:67
作者
Herrick, Jesica A. [1 ]
Lederman, Robert J. [4 ]
Sullivan, Brigit [5 ]
Powers, John H. [3 ,6 ]
Palmore, Tara N. [2 ]
机构
[1] NIAID, Parasit Dis Lab, Bethesda, MD 20892 USA
[2] NIAID, Lab Clin Infect Dis, Bethesda, MD 20892 USA
[3] NIAID, Sci Applicat Int Corp Support Collaborat Clin Res, Bethesda, MD 20892 USA
[4] NHLBI, Cardiovasc & Pulm Branch, Bethesda, MD 20892 USA
[5] NIH, Off Res Serv, Bethesda, MD 20892 USA
[6] George Washington Univ, Sch Med, Washington, DC USA
基金
美国国家卫生研究院;
关键词
ABDOMINAL AORTIC-ANEURYSM; MYCOTIC-ANEURYSM; ENDOCARDITIS; PSEUDOANEURYSM; DOXYCYCLINE; METAANALYSIS; MANAGEMENT; INFECTION; SECONDARY;
D O I
10.1016/S1473-3099(13)70270-6
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Brucellosis is the most common bacterial zoonosis, and causes a considerable burden of disease in endemic countries. Cardiovascular involvement is the main cause of mortality due to infection with Brucella spp, and most commonly manifests as endocarditis, peripheral and cerebrovascular aneurysms, or arterial and venous thromboses. We report a case of brucellosis presenting as bacteraemia and aortic endarteritis 18 years after the last known exposure to risk factors for brucella infection. The patient was treated with doxycycline, rifampicin, and gentamicin, and underwent surgical repair of a penetrating aortic ulcer, with a good clinical recovery. We review the signs and symptoms, diagnostic approach, prognosis, and treatment of brucella arteritis. We draw attention to the absence of consensus about the optimum therapy for vascular brucellosis, and the urgent need for additional studies and renewed scientific interest in this major pathogen.
引用
收藏
页码:520 / 526
页数:7
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