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[Brucella endocarditis on Starr aortic valve prosthesis].

The authors report the case of a 22 year old patient with brucella endocarditis on a Starr-Edwards aortic valve prosthesis implanted 5 years previously. Six blood cultures were positive for Brucella melitensis biovar I. Antibiotic therapy associating Rifampicin and Tetracycline and then Rifampicin and Ofloxacine did not prevent abscess formation and valve dehiscence. The poor haemodynamic status and persistent infection led to replacement of the valve prosthesis. Culture of the infected prosthesis grew a colony of brucella melitensis resistant to fluoro-quinolones. Valve replacement and antibiotic therapy led to clinical improvement and constant apyrexia with a 12 month follow-up. Brucella endocarditis on a valve prosthesis is a very rare occurrence. The combination of valve replacement and antibiotic therapy is usually required.