Brucella endocarditis a Rare Case Having Multivalvular Involvement

A rare case of Brucella endocarditis affecting two valves. A case report and review of literature. We present a very rare case of 45yr old male who came in contact with brucellosis while employed as a farm worker in the Middle East. He has continuous fever for 9 months and was treated medically. Subsequently, he developed sever aortic regurgitation and mitral regurgitation and presented with cardiac shock NYHA class 4. He had oliguria and hypotension. X-rays shows pulmonary oedema. 2D echo and Doppler study revealed mobile vegetation involving the aortic valve with sever aortic regurgitation, moderate mitral regurgitation and tricuspid regurgitation. The patient was taken up for emergency surgery at 11pm. His aortic valve was perforated and the aortic mitral continuity was disrupted thus explaining the moderate mitral regurgitation. The right ventricle was dilated resulting in moderate tricuspid regurgitation.