Unusual Cardiovascular Complications of Brucellosis
Unusual Cardiovascular Complications of Brucellosis
Introduction: Brucellosis is a zoonosis with worldwide distribution, which is particularly endemic in many countries of the Mediterranean basin. Cardiovascular complications of this disease, such as endocarditis, myocarditis and pericarditis, are very rare, with even fewer cases of myocarditis or asymptomatic pericardial effusion in the absence of concomitant endocarditis being reported.
Case presentation: We report two cases of brucellosis in two Caucasian men, aged 17 and 34 years old, with myocarditis and asymptomatic pericardial effusion, respectively. Of note, neither patient had concomitant endocarditis. The disease was confirmed serologically and by blood cultures. Both patients recovered completely after receiving appropriate antibiotic treatment without any sign of relapse during a follow-up of 12 months.
Conclusion: These two cases emphasize that in endemic areas Brucella can be considered as a potentially causative agent of idiopathic pericardial effusion or myocarditis, even in the absence of concomitant endocarditis. This possibility could be taken into account particularly in cases where contraction of brucellosis is possible, such as occupational exposure or consumption of unpasteurized dairy products.
Brucellosis is a worldwide zoonosis, with the Mediterranean basin, the Middle East, India, Mexico, and Central and South America being the most affected areas. The disease has generalized and systemic symptoms, and almost every organ of the human body can be affected by Brucella. Despite this, the incidence of cardiovascular complications in brucellosis, such as endocarditis, myocarditis or pericarditis, is reported to be as low of 1% of cases, with even fewer cases of myocarditis or pericarditis in the absence of concomitant endocarditis being reported. Indeed, myocarditis, pericarditis or asymptomatic pericardial effusion in brucellosis is thought to develop almost exclusively in the presence of endocarditis. We report two cases of patients, one with asymptomatic pericardial effusion and the other myocarditis caused by brucellosis in the absence of concomitant endocarditis. These unusual features of brucellosis may be underestimated components of the disease.
Abstract and Introduction
Abstract
Introduction: Brucellosis is a zoonosis with worldwide distribution, which is particularly endemic in many countries of the Mediterranean basin. Cardiovascular complications of this disease, such as endocarditis, myocarditis and pericarditis, are very rare, with even fewer cases of myocarditis or asymptomatic pericardial effusion in the absence of concomitant endocarditis being reported.
Case presentation: We report two cases of brucellosis in two Caucasian men, aged 17 and 34 years old, with myocarditis and asymptomatic pericardial effusion, respectively. Of note, neither patient had concomitant endocarditis. The disease was confirmed serologically and by blood cultures. Both patients recovered completely after receiving appropriate antibiotic treatment without any sign of relapse during a follow-up of 12 months.
Conclusion: These two cases emphasize that in endemic areas Brucella can be considered as a potentially causative agent of idiopathic pericardial effusion or myocarditis, even in the absence of concomitant endocarditis. This possibility could be taken into account particularly in cases where contraction of brucellosis is possible, such as occupational exposure or consumption of unpasteurized dairy products.
Introduction
Brucellosis is a worldwide zoonosis, with the Mediterranean basin, the Middle East, India, Mexico, and Central and South America being the most affected areas. The disease has generalized and systemic symptoms, and almost every organ of the human body can be affected by Brucella. Despite this, the incidence of cardiovascular complications in brucellosis, such as endocarditis, myocarditis or pericarditis, is reported to be as low of 1% of cases, with even fewer cases of myocarditis or pericarditis in the absence of concomitant endocarditis being reported. Indeed, myocarditis, pericarditis or asymptomatic pericardial effusion in brucellosis is thought to develop almost exclusively in the presence of endocarditis. We report two cases of patients, one with asymptomatic pericardial effusion and the other myocarditis caused by brucellosis in the absence of concomitant endocarditis. These unusual features of brucellosis may be underestimated components of the disease.
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