ArticleEuropean heart journal. Case reports2026
Chronic brucellosis presenting as cardiac implantable electronic device-related endocarditis: diagnostic challenges and management-a case report.
Article in European heart journal. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Brucellosis is a zoonotic infection that may rarely involve the cardiovascular system, causing infective endocarditis. Diagnosis of Brucella-associated cardiac implantable electronic device (CIED) endocarditis is challenging because of its indolent course and frequently negative blood cultures. Case summary: A 42-year-old shepherd with an implantable cardioverter-defibrillator had experienced fever, myalgia, arthralgia, and weight loss for approximately 18 months. During this period, investigations for malignancy and rheumatologic diseases were unrevealing. He was subsequently diagnosed with brucellosis at another institution based on a Brucella serum agglutination test positive at a titre of 1:1280, and antibiotic therapy was initiated. Three weeks later, he was referred to our centre because of generator pocket erosion and purulent drainage. Tissue cultures from the pocket and repeat blood cultures showed no growth. Transoesophageal echocardiography demonstrated a 14 × 8 mm mobile mass attached to the right ventricular lead, suspicious for vegetation. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ( Discussion: Brucella infection should be considered in patients from endemic regions or high-risk occupational groups presenting with culture-negative CIED infection. In such cases, serological testing combined with transoesophageal echocardiography and
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