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The Development of Lyophilized Loop-mediated Isothermal Amplification Reagents for the Detection of Coxiella burnetii
Published on: April 18, 2016
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Asymptomatic bilateral acute multifocal retinitis in Q fever endocarditis
Carl Eiselen1, Enzo Binotto2, Stephen O'Hagan3,4
1Ophthalmology, Cairns Base Hospital, Cairns, Queensland, Australia cgeiselen@gmail.com.
BMJ Case Reports
|July 16, 2025
Summary
Early detection of silent eye inflammation in Q fever endocarditis is crucial. Routine funduscopy in patients with Coxiella burnetii infection can prevent vision loss.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Cardiology
Background:
- Acute Coxiella burnetii endocarditis can present with systemic symptoms like fever, encephalopathy, and hepatitis.
- Ocular manifestations of Q fever endocarditis are not widely recognized, potentially leading to delayed diagnosis and treatment.
- Silent ocular involvement can occur, necessitating specific diagnostic tools for early detection.
Purpose of the Study:
- To report a case of unexpected bilateral acute multifocal retinitis in a patient with Q fever endocarditis.
- To highlight the utility of dilated funduscopy and spectral-domain optical coherence tomography (SD-OCT) in diagnosing subclinical ocular involvement.
- To emphasize the importance of early detection and treatment to prevent visual sequelae.
Main Methods:
- A case study of a cattle farmer with Q fever endocarditis.
- Clinical examination including dilated funduscopy.
- Spectral-domain optical coherence tomography (SD-OCT) for detailed retinal imaging.
- Systemic treatment with doxycycline and hydroxychloroquine.
Main Results:
- The patient presented with fever, encephalopathy, and hepatitis due to Coxiella burnetii endocarditis.
- Dilated funduscopy revealed clinically silent bilateral acute multifocal retinitis.
- SD-OCT showed inner-retinal hyper-reflectivity, indicating retinal involvement.
- Treatment resulted in complete anatomical and functional recovery of vision by 10 months.
Conclusions:
- Routine funduscopy should be an integral part of the systemic evaluation for Q fever endocarditis.
- Early detection of ocular manifestations, even when clinically silent, is vital.
- Prompt and appropriate treatment can prevent permanent visual impairment in Q fever patients.
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