INTRODUCTION Brucella endocarditis is a disease that is hard to treat medically and has a high mortality. Immediate surgery after medical treatment is very important because delaying surgery may lead to that are difficult to repair. METHODS Five patients who were admitted to our institution with a diagnosis of Brucella endocarditis were medically treated with doxycycline (200 mg/d), rifampin (600 mg/d), and ceftriaxone (2 g/d). Preoperative mean medical treatment time was 5.2 weeks (range, 4-6 weeks). The patients were taken for operation when their general status improved. We report in this study the results of these patients. RESULTS Three patients had aortic valve replacement whereas 2 had both aortic and mitral valve replacements. No mortality or morbidity was encountered in the patients. Mean postoperative hospitalization time was 15 days (range, 12-19 days). The patients were discharged with doxycycline (200 mg/d) and rifampin (600 mg/d) but without antipyretic medication. Postoperative antibiotherapy was continued up to a mean of 3.6 months (range, 2-6 months). Mean postoperative follow-up time was 15.8 months. None of the patients needed hospitalization in their follow-up time. CONCLUSION Adequate preoperative antibiotherapy, immediate surgery, and continuation of postoperative antibiotherapy according to clinical progress seem to be a convenient treatment strategy for Brucella endocarditis.

中文翻译：

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布鲁氏菌性心内膜炎：药物治疗后手术时机的重要性（5例）。

引言布鲁氏菌性心内膜炎是一种医学上难以治疗且死亡率高的疾病。药物治疗后立即进行手术非常重要，因为延迟手术可能会导致难以修复。方法入院的5例确诊为布鲁氏菌性心内膜炎的患者接受了强力霉素（200 mg / d），利福平（600 mg / d）和头孢曲松钠（2 g / d）的药物治疗。术前平均医疗时间为5.2周（4-6周）。患者的一般状况改善后，他们被送去手术。我们在这项研究中报告了这些患者的结果。结果3例患者进行了主动脉瓣置换术，而2例同时进行了主动脉瓣和二尖瓣置换术。患者未见死亡或发病。术后平均住院时间为15天（范围12-19天）。患者出院时服用了强力霉素（200 mg / d）和利福平（600 mg / d），但未使用退热药。术后平均持续进行抗生素治疗长达3.6个月（2-6个月）。术后平均随访时间为15.8个月。没有患者在随访期间需要住院。结论根据临床进展，适当的术前抗生物治疗，立即手术以及继续术后抗生物治疗似乎是布鲁氏菌性心内膜炎的便捷治疗策略。术后平均随访时间为15.8个月。没有患者在随访期间需要住院。结论根据临床进展，充分的术前抗生物治疗，立即手术以及继续术后抗生物治疗似乎是布鲁氏菌性心内膜炎的一种简便治疗策略。术后平均随访时间为15.8个月。没有患者在随访期间需要住院。结论根据临床进展，充分的术前抗生物治疗，立即手术以及继续术后抗生物治疗似乎是布鲁氏菌性心内膜炎的一种简便治疗策略。