Journal of Patient Safety & Quality Improvement

Journal of Patient Safety & Quality Improvement

Molecular Imaging and Diagnostic Advances in Brucella Endocarditis: A Narrative Review

Document Type : Review Article

Authors
Leili Avesta 1
Samira Akbarieh 2
Ayda Vakili-Ardabili 3
Shahnaz Fooladi Sarabi 4
1 1. Cancer Immunology and Immunotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran. 2. School of Medicine, Imam Khomeini Hospital, Ardabil University of Medical Sciences, Ardebil, Iran
2 Department of Infectious Disease, Ardabil University of Medical Sciences, Ardebil, Iran.
3 Department of Anesthesiology and intensive care, school of medical, Ardabil university of medical sciences, Ardabil Iran.
4 Cancer Immunology and Immunotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
10.22038/psj.2026.96138.1534
Abstract
Background:
Brucella endocarditis is a rare but fatal manifestation of brucellosis. Delayed diagnosis often leads to serious complications such as extensive valvular destruction. Traditional diagnostic methods have limited accuracy; therefore, the use of advanced diagnostic techniques is recommended.

Methods:
This review evaluates traditional, molecular, and advanced diagnostic techniques for the diagnosis of Brucella endocarditis, including blood culture, tissue and valve cultures, serology, Shell Vial assay, FDG PET/CT, cardiac CT, and MRI. While traditional tools like blood culture and echocardiography offer limited sensitivity for early diagnosis of Brucella endocarditis, advanced modalities—including PCR, NGS, FDG PET/CT, cardiac CT, and MRI—provide high accuracy in detecting occult lesions, paravalvular involvement, and culture-negative infections, especially in difficult cases.

Results:
The review includes studies related to blood culture, tissue and valve cultures, serology, Shell Vial assay, FDG PET/CT, cardiac CT, and MRI. The combination of advanced techniques with traditional approaches can help form a more complete diagnostic pathway and improve clinical outcomes.
Conclusion:
In conclusion, early and accurate diagnosis is important for clinical interventions, prevention of complications and decrease mortality. Wider access to modern molecular and imaging tools in endemic regions and high-quality studies on advanced diagnosis are needed for improvement of Brucella endocarditis survival outcomes. A structured, multimodality diagnostic strategy can have a key role in reducing mortality and improving long-term outcomes in patients with Brucella endocarditis.
Keywords
Brucella endocarditis
Molecular diagnostic techniques
FDG PET/CT
Serology
Culture-negative endocarditis
Next-generation sequencing (NGS)
Subjects
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Journal of Patient Safety & Quality Improvement
Volume 14, Issue 4
Autumn 2026
Pages 201-219