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Acute and Chronic Q Fever in a Child With Repaired Tetralogy of Fallot: A Case Report

Alaa Mohammed Al Juaid1, Faisal Almalki2, Reema E Aloteibi2

  • 1Pediatrics, King Abdullah Specialized Children Hospital, Ministry of National Guard - Health Affairs, Jeddah, SAU.

Cureus
|August 27, 2025
PubMed

Insights

Q fever can present as a serious illness in children, especially those with congenital heart disease. Early diagnosis and long-term antibiotic treatment are crucial for recovery.

Area of Science:

  • Pediatric Infectious Diseases
  • Cardiology
  • Medical Case Reports

Background:

  • Q fever (Coxiella burnetii infection) typically presents as acute febrile illness in children.
  • Congenital heart disease (CHD) can complicate presentations and management of infections.

Observation:

  • A 38-month-old girl with complex CHD (tetralogy of Fallot, pulmonary atresia, VSD) presented with fever, dyspnea, and vomiting.
  • Initial treatment for pneumonia was ineffective; patient developed heart failure, hepatosplenomegaly, and pancytopenia.

Findings:

  • Positive Q fever serology confirmed chronic Q fever.
  • 18-month treatment with doxycycline and hydroxychloroquine led to improved liver function and normalized echocardiography within four months.

Implications:

  • Highlights the importance of considering Q fever in pediatric patients with complex CHD.
  • Emphasizes the need for comprehensive diagnostic workup and prolonged antibiotic therapy for chronic Q fever.
  • Underscores the potential for Q fever to cause severe systemic illness in immunocompromised or complex cardiac pediatric patients.

Keywords:
acute q fevercase reportchronic q feverculture-negative endocarditispediatric q fever

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