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[Q fever endocarditis and bicuspid aortic valve]

O Shovman¹, J George, Y Shoenfeld

¹Medial Dept. B, Chaim Sheba Medical Center, Tel Hashomer.

|January 7, 1998

Summary

Q fever endocarditis, caused by Coxiella burnetii, often presents with vague symptoms. Early consideration in "sterile" endocarditis cases improves diagnosis.

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Area of Science:

Infectious Diseases
Cardiology
Microbiology

Background:

Q fever is caused by Coxiella burnetii, an intracellular bacterium transmitted via inhalation of infected animal dust.
Chronic Q fever frequently manifests as endocarditis, with immunocompromised individuals and those with heart disease at higher risk.
Diagnosis of Q fever endocarditis is often delayed due to nonspecific symptoms.

Observation:

Chronic Q fever endocarditis is often diagnosed late due to nonspecific symptoms.
Risk factors include immunocompromised states and pre-existing heart disease.
A case of Q fever endocarditis in a 49-year-old man with a bicuspid aortic valve is presented.

Findings:

The patient presented with fever, weight loss, and a new heart murmur.
Diagnosis was confirmed by positive Q fever serology and echocardiographic findings of vegetations and valvular dysfunction.
New diagnostic criteria include positive blood cultures for Coxiella burnetii, serology, and echocardiography.

Implications:

Q fever endocarditis should be suspected in patients with culture-negative or "sterile" endocarditis.
Timely diagnosis and treatment are crucial for managing this serious condition.
This case highlights the importance of considering zoonotic infections in endocarditis evaluations.

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