Q fever endocarditis in Iran: A case report.

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• Q fever endocarditis is a rare but serious complication of Coxiella burnetii infection.
• Chronic Q fever endocarditis typically presents in patients with a history of valvular heart disease or surgery.
• Early diagnosis and treatment are crucial for favorable outcomes.

Observation:

• A 72-year-old woman in Iran presented with symptoms suggestive of endocarditis.
• The patient had a history of radiation-associated heart disease and multiple cardiac surgeries, including valve replacements.
• Blood cultures were negative, complicating the initial diagnosis.

Findings:

• Diagnosis of Q fever endocarditis was confirmed by high serologic titers (IgG phase I 1:32,768).
• This represents the first reported chronic case of Q fever endocarditis in Iran.
• The patient's complex cardiac history likely contributed to the development of endocarditis.

Implications:

• Highlights the importance of considering Q fever in patients with suspected endocarditis, especially those with cardiac surgery history.
• Emphasizes the utility of serologic testing for Coxiella burnetii when blood cultures are negative.
• Suggests the need for increased awareness and diagnostic preparedness for Q fever endocarditis in the region.