Chronic Q fever: A missed prosthetic valve endocarditis possibly for years. (2016)

• Record Type: Journal Article
• Authors: Ferraz, Rita Veiga; Andrade, Marta; Silva, Filipa; Andrade, Paulo; Carvalho, Cláudia; Torres, José Pinheiro; Almeida, Jorge; Sarmento, António; Santos, Lurdes
• Is Part Of: IDCases. Volume 6(2016)
• Page Start: 55
• Page End: 57
• Publication Date: 2016
• Subjects: Chronic Q fever -- Coxiella burnetii -- Endocarditis -- Prosthetic valve; Communicable diseases -- Periodicals; Communicable Diseases -- Case Reports; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; 616.9
• DOI: 10.1016/j.idcr.2016.09.005
• Languages: English
• ISSNs: 2214-2509

Abstract

Abstract: Chronic Coxiella burnetii endocarditis usually develops in people with underlying heart disease and accounts for 60–70% of chronic Q fever. Onset is generally insidious and manifestations are atypical. The authors report a case of Coxiella burnetii prosthetic valve endocarditis in a 53 years- old patient with recurrent mechanical valve dehiscence on mitral position. He lived in a rural area with sheep and goats on the surroundings. During a 9 year- period, he was submitted to three cardiac mitral valve surgeries two of which with no Q fever diagnosis suspicion. Diagnosis was based on a positive serology test (Indirect imunofluorescence). Treatment consisted in a combination of prolonged course of hydroxychloroquine plus doxycycline and surgical replacement of the mitral valve, with a favorable outcome. With this case report, the authors pretend to highlight the not always expected diagnosis of Q fever endocarditis. If not considered, Coxiella burnetii endocarditis may lead to multiple cardiac surgeries, greater morbidity and potentially death.