Brucella spp. is a recognised cause of blood culture-negative infective endocarditis (IE). Because conventional blood cultures frequently fail to isolate this organism, the diagnosis and management of this subgroup follow a specific pathway distinct from common bacterial endocarditis.
This protocol addresses patients with blood culture-negative infective endocarditis in whom Brucella spp. has been identified as the causative pathogen. Standard culture negativity in this setting reflects the organism's demanding growth requirements, making targeted serological and molecular investigation essential before treatment is initiated.
Management involves a combination of antibiotics administered over a prolonged course. Some approaches incorporate an additional agent during the initial period of treatment. The complete regimen — including drug selection, sequencing, and duration — is available in the full structured protocol.
Treatment success is defined by achieving an antibody titre below a specified threshold, with serological monitoring used to track the response throughout the course of therapy.
DOI: 10.1093/eurheartj/ehad193