Human Brucellosis presenting as endocarditis

摘要

Brucellosis is a bacterial disease of acute or insidious beginning, characterized by constant, intermittent or irregular fever, cefalagia, weakness, diaforesis, arthralgia, mialgias, and general discomfort (1), caused in animals and men by Brucella abortus , biotipo 1,6,9, melitensis biotipos 1,3, suis biotipos 1,5 and canis. (2.) OBJECTIVE : to present an individual case of brucellosis in a male patient. CLINICAL CASE: 46-year-old male patient from Mapiricure Cantaura, state Anzoátegui, worker of a slaughter house for 3 years, used to consuming raw milk and aborted cattle fetuses, his current disease started 1 month before consulting, when presented intermittent fever, mialgias, arthralgias, profuse perspiration, hiporexia, weakness and weight loss of approximately 16 kg in 1 month, At the time of consultation presented: Hf 86b/m, Rf 16rpm, BP 120/80 mmhg, febrile, diaforetic, eupneic without positive findings in the physical examination. Laboratory test: Hb 8,7g/dl, Hcto 25 % plt 112.000/mm leukocytes 3300mm, 47 segmented %, 53 % lymphocytes, vsg 80mm/1h, br 0,50mg/dl, bi 0,30mg/dl, bd 0,15mg/dl, alkaline phophatase 138 or, blood sugar 112g/dl, urea 32mg/dl, creatinine 0,7mg/dl uric acid 3, 6 mg/dl, negative hiv, vdrl i do not reactivate. Transthoracic ecocardiogram showed a round mobile image of 3,5 x 5 cm in the mitral, suggestive of vegetacion, producing severe mitral insufficiency. Blood samples gave positive tests for Brucella sp. The patient was subjected to a mitral valve replacement, with a satisfactory evolution. DISCUSSION: Brucellosis is a predominantly occupational zoonosis in workers of slaughter houses, veterinarians, farmers; whose period of incubation is variable from 5 to 60 days, more frequent from one to 2 months, and is acquired by direct contact with fabrics, urines, secretions, ingestion of lacteal products from infected animals .la recovery is the rule, but the disability is in the habit of being intense; without treatment the letalidad ranges in 2%.