Q fever endocarditis: is it always subacute or chronic?

Area of Science:

• Infectious Diseases
• Cardiology
• Microbiology

Background:

• Q fever is a zoonotic disease caused by Coxiella burnetii, an obligate intracellular bacterium.
• Coxiella burnetii is a significant cause of blood culture-negative infective endocarditis globally.
• The incidence and clinical presentation of Q fever endocarditis in Turkey remain underexplored.

Observation:

• Q fever endocarditis typically follows a subacute or chronic course, often with subtle symptoms and no visible vegetations on echocardiography.
• This report details an unusual case of Q fever endocarditis with an acute clinical presentation.
• The patient, a young man, rapidly developed New York Heart Association class IV heart failure within one month.

Findings:

• A large, 3-cm vegetation was identified on echocardiography in the patient with acute Q fever endocarditis.
• The case demonstrates the potential for Coxiella burnetii to cause rapid cardiac valve destruction and severe heart failure.
• Successful treatment outcomes are reported for this acute presentation of Q fever endocarditis.

Implications:

• This case underscores the importance of considering Q fever in the differential diagnosis of infective endocarditis, even with acute presentations.
• Further research is needed to define the incidence of Q fever endocarditis in Turkey.
• Early diagnosis and treatment are crucial for managing Q fever endocarditis and preventing severe cardiac complications.