A 29-year-old gentleman, employed in an animal farm, presented with a 6-month history of chronic fever, anorexia, and malaise. He had undergone aortic valve replacement with mechanical prosthesis for severe aortic stenosis due to bicuspid aortic valve at the age of 25. Clinical examination showed a normal jugular pulse, absence of cardiomegaly, normal prosthetic valve clicks, grade 3 ejection systolic murmur in the right second parasternal space, and non-tender hepatosplenomegaly. Labortory examination showed hemoglobin – 15.9 g/dl and a total count of 4900 cells/mm
3 with a differential count of 49% polymorphs and 48% lymphocytes. Electrocardiogram showed a normal sinus rhythm with a PR interval of 150 ms. Echocardiography, transthoracic (Fig.
1), transesophageal (Fig.
2), and 3D (Fig.
1c, d, Video
3), revealed multiloculated aortic root abscess encircling the prosthetic valve. Blood culture grew
Brucella melitensisin three consecutive samples and the same was...
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Compliance with ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Conflicts of interest
The authors declare that they have no conflict of interest.