Ostium secundum atrial septal defect endocarditis caused by brucella infection

Abstract

The most common cardiovascular presentation of brucellosis (a zoonotic infection) in Iran is aortic valve endocarditis. Brucellosis is a systemic infection and may involve any congenital heart defect with various clinical signs and symptoms. We report brucella endocarditis in an atrial septal defect (ASD) in a 55-year-old man who presented with fever and hemiplegia. Echocardiography showed a secundum ASD with large vegetations of 0.5Χ1 cm arising from the rim of the ASD. Serological analysis was positive for Brucella agglutinin, thus confirming the diagnosis. The brain CT scan revealed a large ischaemic zone in the left hemisphere. At surgery, large vegetations were excised and the defect was closed with fresh pericardium. After surgery the patient was treated with a 4- week course of antibiotics. His recovery was uneventful except for the neurological deficit (hemiplegia); he was discharged on postoperative day 35.