Q Fever Endocarditis in Iran.

Area of Science:

• Cardiovascular Medicine
• Infectious Diseases
• Microbiology

Background:

• Q fever endocarditis, caused by Coxiella burnetii, is a serious complication in patients with valvular heart disease.
• Evidence suggests Coxiella burnetii infection exists in Iran, necessitating investigation into Q fever endocarditis prevalence.
• Culture-negative infective endocarditis (IE) poses diagnostic challenges, potentially masking Q fever.

Purpose of the Study:

• To determine the prevalence of Q fever endocarditis in patients with culture-negative infective endocarditis in Iran.
• To evaluate the utility of Coxiella burnetii testing in this patient population.
• To highlight the importance of diagnosing Q fever in specific IE cases.

Main Methods:

• Prospective enrollment of 126 hospitalized IE patients (August 2016-September 2018) at Rajaie Cardiovascular Medical and Research Center.
• Focus on 52 culture-negative IE patients, assessed using Raoult criteria for Q fever endocarditis diagnosis.
• Serological and Polymerase Chain Reaction (PCR) testing for Coxiella burnetii on blood and tissue samples.

Main Results:

• 16 out of 52 culture-negative IE patients (30.77%) were diagnosed with Q fever endocarditis.
• The affected patients underwent medical treatment.
• The mean age of Q fever IE patients was 46.6 years, with 75% being male.

Conclusions:

• Q fever endocarditis is highly prevalent in culture-negative IE patients in Iran.
• Testing for Coxiella burnetii is crucial for diagnosing Q fever endocarditis in patients with culture-negative IE.
• Early diagnosis and treatment of Q fever endocarditis can improve patient outcomes.