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[Q fever endocarditis: a case report].
Imen Fradi1, Mohamed Akram Drissa, Mehdi Cheour
1Service de Cardiologie Adultes Hôpital La Rabra, Tunis, Tunisie.
La Tunisie Medicale
|December 30, 2006
Summary
This case study highlights infective endocarditis caused by Coxiella Burnetii in a 42-year-old patient. Prompt diagnosis and combined antibiotic therapy followed by valve replacement led to successful patient recovery.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Case Study
Background:
- Mitro-aortic valvulopathy presents a significant risk factor for infective endocarditis.
- Infective endocarditis requires timely diagnosis and appropriate antimicrobial therapy to prevent severe complications.
Observation:
- A 42-year-old patient presented with dyspnea, fever, malaise, and splenomegaly, indicative of a serious underlying condition.
- Chest X-ray revealed a pulmonary parenchymal focus, while echocardiography showed mitral stenosis and aortic valve disease with a mitro-aortic trigone abscess.
- Negative blood cultures contrasted with positive Rickettsia serology, suggesting an atypical pathogen.
Findings:
- The patient was diagnosed with infective endocarditis due to Coxiella Burnetii.
- Initial treatment involved a combination of Doxycycline, Hydroxychloroquine, and Ofloxacin.
- Surgical intervention, including aortic and mitral valve replacement, was performed after 20 days of antibiotic therapy.
Implications:
- This case underscores the importance of considering Coxiella Burnetii in infective endocarditis, especially with negative blood cultures.
- Multidrug antibiotic regimens combined with surgical management can be effective in treating complex cases of infective endocarditis.
- Successful valve replacement offers a favorable long-term prognosis for patients with severe valvular heart disease secondary to infection.
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