Abstract：
BACKGROUND: Brucellosis is a public health concern that affects multiple organs. However, cardiovascular problems arise infrequently, affecting fewer than 2% of cases, typically presenting as endocarditis.
METHODS: A 50-year male was admitted with low-grade fever, night sweats, weight loss (13 kg), malaise, and generalized weakness for the past 6 months. On clinical examination, he was febrile with 39.0°C, an average heart rate of 54 bpm, and 100/40 mmHg blood pressure. On cardiovascular examination, S1 and S2 were soft with pan systolic murmur present in the mitral area, and the early diastolic murmur was present in the left third intercostal space. Electrocardiography was suggestive of third-degree heart block with AV dissociation. Transthoracic echocardiography showed mobile vegetations attached to multiple valves- an aortic valve (18.2x11.9mm) and a mitral valve (2.9x7.5mm) with perivalvular abscess. He was given oral doxycycline (100mg B.D.) and rifampicin (600mg/day); the patient responded, but the AV block did not resolve.
CONCLUSIONS: This report has drawn attention to multivalvular involvement and cardiac rhythm abnormalities in Brucellosis (in this case, A.V. dissociation was present) because early diagnosis and treatment can cause a significant decrease in morbidity as well as mortality by appropriate treatment.
METHODS: A 50-year male was admitted with low-grade fever, night sweats, weight loss (13 kg), malaise, and generalized weakness for the past 6 months. On clinical examination, he was febrile with 39.0°C, an average heart rate of 54 bpm, and 100/40 mmHg blood pressure. On cardiovascular examination, S1 and S2 were soft with pan systolic murmur present in the mitral area, and the early diastolic murmur was present in the left third intercostal space. Electrocardiography was suggestive of third-degree heart block with AV dissociation. Transthoracic echocardiography showed mobile vegetations attached to multiple valves- an aortic valve (18.2x11.9mm) and a mitral valve (2.9x7.5mm) with perivalvular abscess. He was given oral doxycycline (100mg B.D.) and rifampicin (600mg/day); the patient responded, but the AV block did not resolve.
CONCLUSIONS: This report has drawn attention to multivalvular involvement and cardiac rhythm abnormalities in Brucellosis (in this case, A.V. dissociation was present) because early diagnosis and treatment can cause a significant decrease in morbidity as well as mortality by appropriate treatment.
摘要：
背景：布鲁氏菌病是一种影响多个器官的公共卫生问题。然而,心血管问题很少出现，影响不到2%的病例，通常表现为心内膜炎。
方法：一名50岁男性因低烧入院，盗汗,体重减轻（13公斤），萎靡不振,以及过去6个月的普遍疲软。在临床检查中，他发烧了39.0°C，平均心率为54bpm,和100/40mmHg的血压。在心血管检查中，S1和S2较软，二尖瓣区域出现全收缩期杂音，左第三肋间存在舒张早期杂音。心电图提示三度心脏传导阻滞伴房室分离。经胸超声心动图显示，多个瓣膜-主动脉瓣（18.2x11.9mm）和二尖瓣（2.9x7.5mm）上附着有瓣膜周围脓肿的移动植被。患者口服多西环素（100mgB.D.）和利福平（600mg/天）；患者有反应，但AV块没有解决。
结论：本报告提请注意布鲁氏菌病的多瓣膜受累和心律异常（在这种情况下，存在A.V.解离），因为早期诊断和治疗可以通过适当的治疗显着降低发病率和死亡率。
方法：一名50岁男性因低烧入院，盗汗,体重减轻（13公斤），萎靡不振,以及过去6个月的普遍疲软。在临床检查中，他发烧了39.0°C，平均心率为54bpm,和100/40mmHg的血压。在心血管检查中，S1和S2较软，二尖瓣区域出现全收缩期杂音，左第三肋间存在舒张早期杂音。心电图提示三度心脏传导阻滞伴房室分离。经胸超声心动图显示，多个瓣膜-主动脉瓣（18.2x11.9mm）和二尖瓣（2.9x7.5mm）上附着有瓣膜周围脓肿的移动植被。患者口服多西环素（100mgB.D.）和利福平（600mg/天）；患者有反应，但AV块没有解决。
结论：本报告提请注意布鲁氏菌病的多瓣膜受累和心律异常（在这种情况下，存在A.V.解离），因为早期诊断和治疗可以通过适当的治疗显着降低发病率和死亡率。
