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Brucella melitensis Endocarditis Combined With Candida albicans in a Patient With Prosthetic Valves

Tekçe, Yasemin Tezer MD*; Erbay, Ayşe MD*; Erbay, Ali Rza MD†ı; Çabadak, Hatice MD*; Şen, Süha MD*

Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0b013e3181e9b6a3
Case Reports
Abstract

Brucella and Candida species are rare causes of infective endocarditis. A 27-year-old male patient with a mechanical aortic and mitral valve prostheses developed brucella endocarditis. Transthoracic echocardiography demonstrated vegetations on the aortic valve. At the 30th day of medical treatment (rifampicin, doxycycline, and trimethoprim-sulfamethoxazole) for brucellosis, fever and leukocytosis developed, and from the repeated blood cultures, Candida albicans were yielded. Caspofungin was added to the treatment regimen. At the 43rd day of hospitalization, he underwent aortic valve replacement because of unresponsiveness to medical treatment, aortic valve dysfunction, and left ventricular failure. Cultures of the excised aortic valve yielded C. albicans. The patient recovered fully without sequelae with the combination of medical and surgical intervention. During the treatment of brucella endocarditis, C. albicans may become an additional causative agent of endocarditis because of extensive use of antibiotics and presence of deterioration, and a relapsing fever should alert the clinicians about this possibility. Successful treatment of candida endocarditis could be achievable by use of caspofungin therapy.

Author Information

From the Departments of *Infectious Diseases and Clinical Microbiology and †Cardiology, Türkiye Yüksek İhtisas Education and Research Hospital, Ankara, Turkey.

Correspondence to: Ayşe Erbay, MD, Belkis sokak No. 9/9, Kucukesat, Ankara 06660, Turkey. E-mail: aerbay@ttmail.com; ayseerbay@gmail.com.

The authors have no funding or conflicts of interest to disclose.

© 2010 Lippincott Williams & Wilkins, Inc.