brucella mellitensis endocarditis: diagnosis and treatment in six adult patients.

brucella endocarditis is an uncommon but not rare manifestation of brucellosis in our country. we report six adult patients aged 20 to 45 years. two of our patients were female, and this is the first time that brucella endocarditis was reported in adult females. in five cases, aortic valve replacement was performed in addition to combined antibiotic therapy. one of them died due to immediate complication of cardiac surgery, but the others had an excellent recovery. our study shows that medical treatment is not sufficient for brucella mellitensis endocarditis, and urgent cardiac valve replacement must be considered. the prognosis will not be poor with combined medical and surgical therapy.