Comparative study on clinical features of brucellosis infective endocarditis and non-brucellosis infective endocarditis

YE Jing-jing; WANG Fang; CAO Wei; HUANG Xuan; WANG Ting-ting; YANG Xue; ZHOU Li; NA Li-sha

doi:10.19538/j.nk2023120112

Abstract：Objective Compare and analyze the clinical characteristics of patients with Brucella and non-Brucella infective endocarditis.Methods A total of 11 patients with Brucella infective endocarditis in General Hospital of Ningxia Medical University from March 2011 to July 2021 were included as the case group,and 22 patients with non Brucella infective endocarditis at the same period were randomly selected as the control group.The clinical characteristics,blood indexes,echocardiographic performances,treatment methods and prognosis of the 2 groups were retrospectively analyzed.Results The male patients were more than female ones in the 2 groups,and the cases were mainly young adults.There was no significant difference in age and gender between the 2 groups.Fever was the most common symptom in both groups.The percentage of increased white blood cell count,anemia,decreased thrombocytopenia and decreased eosinophil granulocyte in blood routine,the percentage of hypoproteinemia,hyponatremia,hypocalcemia in blood biochemistry,the positive rate of Brucella agglutination test,and the percentage of complication with pulmonary infection,embolism,heart failure and allergic purpura in the case group were higher than those in the control group,while the percentage of prositive blood oulture was lower,and difference was statistically significant(P＜0.05).There was no significant difference in the proportion of liver and/or renal dysfunction,pleural or peritoneal effusion,Janeway lesion or Olser nodule,hepatosplenomegaly or spondylitis between the 2 groups(P＞0.05).Increased erythrocyte sedimentation rate was found in 100％of the.patients in both groups and increased c-reactive proteinmore was found in more than 90％of the patients in the 2 groups.There was no significant difference in the proportion between the 2 groups(P＞0.05).Cardiac vegetations or suspicious.vegetations in both groups were found by transthoracic or transesophageal echocardiography.Rheumatic heart disease,abnormal valvular morphology structure and congenital heart defect were the most common underlying cardiac diseases.The ratio of abnormal valvular morphology structure in the case group was higher than that in the control group,and the difference was statistically significant(P＜0.05).The vegetations in the case group were large,oscillating obviously with the cardiac cycle,varied in shape and different in echo intensity.Aortic valve involvement was more common in the 2 groups and there was no significant difference in the ratio of aortic valve involvement between the 2 groups(P＞0.05).The incidences of perforation,perivalvular abscess and moderate regurgitation and above was higher in the case group than in the control group.The incidence of chordae tendineae rupture was not significantly different(P＞0.05).There was no significant difference in the ratio of complication with valvular stenosis,cardiac dilatation and pericardial effusion between the 2 groups(P＞0.05).Conclusions The Brucella infective endocarditis patients are more serious than non-Brucella infective endocarditis,and the clinical manifestations are more complex and varied.The therapy of surgery combined with medicine is effective.