The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

A case of brucella endocarditis with spondylitis in a patient with multiple myeloma

다발성 골수종 환자에서 척추염을 동반한 브루셀라 심내막염

Kang, Yung-Un;Jung, Young-Sun;Park, Kyung-Hwa;Jung, Sook-In;Shin, Jong-Hee;Anh, Byung-Hee;Ko, Kwan-Soo
강용운;정영선;박경화;정숙인;신종희;안병희;고관수

  • Published : 20080000
⟨ Previous Next ⟩

Abstract

Brucella endocarditis is a rare complication, but it is responsible for the majority of deaths related to this illness. A 67 year-old man presented with complaints of fever and lower back pain that he had experienced during the previous four weeks. The laboratory finding showed pancytopenia and an inverted total protein/globulin ratio. Multiple myeloma was diagnosed by bone marrow biopsy and serum electrophorosis. The spine MRI scan demonstrated spondylitis with epidural abscess (L5-S1). On the echocardiographic examination, there was vegetation on the right coronary cusp of the aortic valve and perivalvular abscess. The blood isolate was confirmed as Brucella abortus by using DNA sequencing of the 16S rRNA and the omp2a and omp2b genes. The clinical manifestations improved after appropriate antibiotics and aortic valve replacement. We describe here the first Korean case of human brucella endocarditis that was treated by valve replacement. (Korean J Med 74:561-565, 2008)

저자들은 다발성골수종 환자에서 요천추 척추염과 경막외 농양을 동반한 브루셀라 심내막염을 진단하고 적절한 항생제 치료와 대동맥 판막 치환술을 시행하여 호전을 보인 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 352:2325-2336, 2005 https://doi.org/10.1056/NEJMra050570
  2. 질병관리본부. 국내 브루셀라증 발생 현황: 2002-2004. 감염병발생정보 16:128, 2005
  3. Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL. Harrison's prinsples of internal medicine. 16th ed. p. 914-917, New York, MeGraww-Hill, 2005
  4. Yavuz T, Ozaydin M, Ulusan V, Ocal A, Ibrisim E, Kutsal A. A case of mitral stenosis complicated with seronegative Brucella endocarditis. Jpn Heart J 45:353-358, 2004 https://doi.org/10.1536/jhj.45.353
  5. Mert A, Kocak F, Ozaras R, Tabak F, Bilir M, Kucukuglu S, Ozturk R, Aktuglu Y. The role of antibiotic treatment alone for the management of Brucella endocarditis in adults: a case report and literature review. Ann Thorac Cardiovasc Surg 8:381-385, 2002
  6. Yilmaz MB, Kisacik HL, Korkmaz S. Persisting fever in a patient with brucella endocarditis: occult splenic abscess. Heart 89:e20, 2003
  7. WHO. Joint FAO/WHO Expert Committee on Brucellosis. World Health Organ Tech Rep Se 740:1-132, 1986
  8. 정성주, 김성범, 박대원, 정혜원, 기세윤, 권정아, 박만석, 박미연, 정희진, 김우주. 감염된 가축과의 직접 접촉 없이 발생한 브루셀라증 환자 1례와 축산 부산물 시장에서의 역학조사. 감염과화학요법 36:170-174, 2004
  9. 이유지, 고관수, 박미연, 오원섭, 권기태, 류성열, 허상택, 백경란, 이남용, 송재훈. 주외막단백 유전자 분석을 이용한 Brucella abortus의 동정. 대한내과학회지 71:10-16, 2006
  10. Goldman L, Ausiello D, Arend WP, Armitage JO, Drazen JM, Gill GN, Griggs RC, Powell DW, Scheld WM. Ceil textbook of medicine. 22th ed. p. 1889-1890, Philadelphia, Elsevier, 2004
  11. Staszkiewicz J, Lewis CM, Colville J, Zervos M, Band J. Outbreak of Brucella melitensis among microbiology laboratory workers in a community hospital. J Clin Microbiol 29:287-290, 1991
  12. Fiori PL, Mastrandrea S, Rappelli P, Cappuccinelli P. Brucella abortus infection acquired in microbiology laboratories. J Clin Microbiol 38:2005-2006, 2000
  13. Navarro E, Segura JC, Castano MJ, Solera J. Use of real-time quantitative polymerase chain reactin to monitor the evolution of Brucella melitensis DNA load during therapy and post- therapy follow-up in patients with brucellosis. Clin Infect Dis 42:1266-1273, 2006 https://doi.org/10.1086/503035
  14. Nimri LF. Diagnosis of recent and relapsed cases of human brucellosis by PCR assay. BMC infect Dis 3:5, 2003 https://doi.org/10.1186/1471-2334-3-5
  15. Drancourt M, Bollet C, Carlioz A, Martelin R, Gayral JP, Raoult D. 16S ribosomeal DNA sequence analysis of a large collection of environmental and clinical unidentifiable bacterial isolates. J Clin Microbiol 38:3623-3630, 2000
  16. Solera J, Rodriquez-Zapata M, Geijo P, Largo J, Paulino J, Saez L, Martinez-Alfaro E, Sanchez L, Sequlveda MA, Ruiz- Ribo MD. Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis. Antimicrob Agents Chemother 39:2061-2067, 1995 https://doi.org/10.1128/AAC.39.9.2061