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Clinical implications of cardiac involvement in Q fever: Findings from a Spanish cohort

Ester Mínguez de la Guía1, Macarena López Vázquez1, Jose Javier Blanch Sancho2

  • 1General Hospital University of Albacete, Cardiology Department, Spain.

Medicina Clinica
|January 14, 2026
PubMed
Abstract

Insights

Q fever, a Coxiella burnetii infection, frequently causes cardiac complications like endocarditis, myocarditis, and pericarditis, particularly in its chronic form. These manifestations are often underdiagnosed and linked to significant mortality, necessitating clinical vigilance.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Public Health

Background:

  • Q fever is a zoonotic disease caused by Coxiella burnetii, with Spain having the highest European incidence.
  • The chronic form of Q fever can manifest as infective endocarditis and other cardiac issues.

Purpose of the Study:

  • To analyze the clinical presentation of Q fever patients, focusing on cardiac involvement.
  • To determine the frequency and outcomes of cardiac complications in Q fever.

Main Methods:

  • Retrospective study of microbiologically confirmed Q fever cases from 2000-2023.
  • Analysis of clinical data, with specific attention to patients exhibiting cardiac involvement.

Main Results:

  • 12 out of 42 patients (28.5%) had cardiac involvement, including infective endocarditis (7), myocarditis (3), and pericarditis (2).
  • Cardiac involvement was more common in chronic Q fever and associated with a 25% mortality rate.
  • Myocarditis cases sometimes progressed to dilated cardiomyopathy.

Conclusions:

  • Cardiac manifestations of Q fever are potentially underdiagnosed.
  • Frequent cardiac involvement and high mortality underscore the severity of Q fever.
  • Clinicians should suspect Q fever, especially in chronic cases or fever of unknown origin, to improve diagnosis and outcomes.
Keywords:
Cardiac manifestationsCoxiella burnetiiEndocarditis infecciosaFever QFiebre QInfective endocarditisManifestaciones cardiacasMiocarditisMyocarditis

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