Culture-negative endocarditis with features consistent with Brucella can rapidly destroy a normal aortic valve in young adults. 2023 Duke-ISCVID criteria (clinical/imaging findings plus histopathology), supported by serology and occupational exposure enabled urgent combined antimicrobial-surgical management without culture confirmation, highlighting the need for high suspicion and early intervention in endemic regions.
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Nassar et al. (2026) studied this question.
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