Acute ischemic stroke due to endocarditis from Brucella infection

Brucellosis is a zoonotic disease which could be transmitted from animals to humans, mainly in Mediterranean basin countries, often after the ingestion of meals containing not perfectly sterilized dairy products. High fever, myalgia, and arthralgia of the large joints are the principal symptoms. Neurological complications are quite serious and occur in about 10% of cases. The most common presentations are acute or chronic meningoencephalitis, peripheral or cranial neuropathies, or cerebellar dysfunction. Endocarditis is seen in < 2% of cases. Stroke occurs in about 35% of cases of infective endocarditis, mostly based on septic brain embolization. We report a patient with stroke due to endocarditis from Brucella infection. Early diagnosis and treatment is top-flight for Brucella endocarditis. Antimicrobial drugs combined with heparin (once or twice daily) and acetylsalicylic acid, in our experience, proved a positive outcome and led us to a better prognosis for the patient.