A rare complication of brucellosis: mitral valve endocarditis

Early diagnosis of brucella endocarditis is of paramount importance because of its fatal consequences. The most commonly affected localization is the aortic valve, while mitral valve involvement is rare. A 44-year-old male patient with a history of rheumatic heart disease presented with fever, fatigue, and back pain. Three consecutive blood cultures revealed growth of Brucella melitensis. On transthoracic echocardiography, mitral valve area was 1.5 cm2 and there was mild mitral regurgitation. Transesophageal echocardiography showed multiple vegetations on the anterior and posterior mitral valve leaflets. Combination of medical and surgical treatment was planned for the patient with the diagnosis of brucella endocarditis.