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[Infectious endocarditis due to Q fever. A report of 4 new cases]
M Anguita1, M Ciudad, A Gallardo
1Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba.
Abstract:
Q fever (Coxiella burnetii) is an uncommon cause of culture-negative infective endocarditis. Four cases of Q fever endocarditis diagnosed at our hospital in the last 7 years are reported (8% of all infective endocarditis). Infection involved a prosthetic heart valve in 3 cases (15% of all prosthetic valve endocarditis), and one patient with single ventricle and pulmonary stenosis in the remaining case. Important complications developed in all cases, and 3 patients underwent cardiac surgery. Mortality was 50%. Some diagnostic and therapeutical aspects of this disease are discussed.
Insights
Q fever endocarditis, caused by Coxiella burnetii, is a rare but serious condition. This study reports four cases, highlighting significant complications and a 50% mortality rate, emphasizing diagnostic and therapeutic challenges.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Q fever endocarditis (QFE) is an uncommon manifestation of Coxiella burnetii infection.
- Culture-negative infective endocarditis (IE) poses diagnostic challenges.
- Prosthetic heart valves are a common site for IE.
Observation:
- Four cases of QFE were diagnosed over seven years, representing 8% of all IE cases.
- Three out of four QFE cases involved prosthetic heart valves.
- One case presented in a patient with complex congenital heart disease (single ventricle and pulmonary stenosis).
Findings:
- All reported QFE cases experienced significant complications.
- Cardiac surgery was required in three patients.
- The mortality rate for QFE in this series was 50%.
Implications:
- QFE should be considered in culture-negative endocarditis, especially with prosthetic valves or congenital heart disease.
- Early diagnosis and appropriate management, including potential surgery, are crucial for improving outcomes.
- Further research into diagnostic and therapeutic strategies for QFE is warranted.