[Q fever endocarditis - a rare condition with high mortality].

Area of Science:

• Infectious Diseases
• Cardiology
• Microbiology

Background:

• Coxiella burnetii causes Q fever, with chronic infection often manifesting as culture-negative endocarditis.
• This serious condition predominantly affects individuals with pre-existing valvulopathy, immunocompromised status, or pregnancy.
• Delayed diagnosis due to nonspecific symptoms leads to high mortality without appropriate antimicrobial therapy.

Purpose of the Study:

• To present a fatal case of Q fever endocarditis diagnosed post-mortem.
• To underscore the importance of considering Q fever endocarditis in specific patient populations and risk groups.
• To highlight the utility of PCR in diagnosing Q fever endocarditis in challenging cases.

Main Methods:

• Case report presentation.
• Autopsy examination of cardiac valves.
• Polymerase Chain Reaction (PCR) for Coxiella burnetii DNA detection.

Main Results:

• The patient, who died of unknown causes, was diagnosed with Q fever endocarditis post-mortem.
• PCR analysis of the cardiac valve confirmed the presence of Coxiella burnetii.

Conclusions:

• Q fever endocarditis should be suspected in patients with relevant risk factors and endocarditis symptoms, even with negative blood cultures.
• Post-mortem diagnosis using PCR can be crucial in identifying the cause of death in undiagnosed cases.
• Early recognition and treatment are vital for improving outcomes in Q fever endocarditis.