Chronic Q Fever in a Renal Transplant Recipient: A Case Report

Godinho, Iolanda; Nogueira, Estela; Santos, Cláudia Simone Silveira dos; Paulo, SE; Fortes, Alice; Guerra, J.; Costa, António Gomes da

doi:10.1016/j.transproceed.2015.03.022

Cited by 16 publications

(8 citation statements)

References 27 publications

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“…In immunocompromised hosts, Q fever is more common in non‐transplant patients on anti‐tumor necrosis factor (TNF)‐alpha therapy, patients with human immunodeficiency virus and acute malignancies. Q fever in transplant patients is extremely rare with only three cases previously reported in kidney transplant recipients and another in a liver transplant recipient . While rituximab was given to our patient for presumed autoimmune GN, it likely did not play a role in progressive disease.…”

Section: Discussionmentioning

confidence: 69%

Unrecognized pre‐transplant disseminated Coxiella burnetti infection diagnosed in a post‐transplant heart‐kidney recipient

Jandhyala

Farid

Mahmood

et al. 2018

Transplant Infectious Dis

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To the best of our knowledge, we report the first case of pre-transplant unrecognized disseminated Coxiella burnetii infection, unmasked in the post-transplant period leading to both heart and kidney allograft dysfunction. A 59 year old man with a history of simultaneous heart-kidney transplantation due to end stage heart failure from severe aortic regurgitation (AR) and cryoglobulinemic immune complex mediated concentric necrotizing glomerulonephritis (GN), presents with a history of intermittent fevers and fatigue. Prior to transplantation he was treated for multiple episodes of culture negative endocarditis requiring bio-prosthetic valve replacement. Evaluation of fever included a transesophageal echocardiogram (TEE) that revealed a large hyperechoic mass on the anterior mitral leaflet with perforation, severe mitral regurgitation and moderate AR. Blood cultures were negative at that time. Owing to development of allograft mitral and aortic valve insufficiency, he underwent allograft bio-prosthetic mitral valve (MV) replacement and aortic valvuloplasty 2 years following his transplantation. Pathologic examination of the allograft mitral valve demonstrated fibrinopurulent exudate with degenerating bacterial organisms, consistent with vegetation and myxoid degenerative changes. Due to a high suspicion for native heart C. burnetii prosthetic valve endocarditis prior to transplantation, we re-evaluated the native explanted heart histopathology, as well as the explanted allograft MV. Cardiac allograft and native MV were positive for C. burnetii by real-time PCR. C. burnetii serology was consistent with persistent infection as well.

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Section: Discussionmentioning

confidence: 69%

Unrecognized pre‐transplant disseminated Coxiella burnetti infection diagnosed in a post‐transplant heart‐kidney recipient

Jandhyala

Farid

Mahmood

et al. 2018

Transplant Infectious Dis

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“…Two‐thirds of patients who were classified as immunosuppressed experienced acute Q fever, though details of these patients are lacking. Of the specific cases of Q fever that have been described in the literature, only seven involve SOT recipients, though this is thought to be an underestimate of all cases . Our case speaks to the severity of acute Q fever in a SOT recipient and that Q fever should be considered in cases of atypical pneumonia in SOT recipients.…”

Section: Discussionmentioning

confidence: 99%

Severe acute Q fever pneumonia complicated by presumed persistent localized Q fever endocarditis in a renal transplant recipient: A case report and review of the literature

Budgin

Abidi

Bajrovic

et al. 2019

Transplant Infectious Dis

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“…Q fever has been rarely reported in SOT recipients . In a study of 84 cases of chronic Q fever in France, 17 (20%) patients were immunocompromised and only one of them was a transplant recipient .…”

Section: Discussionmentioning

confidence: 99%

“…Q fever caused by Coxiella burnetii has been rarely described in solid organ transplant (SOT) recipients . Here, we report an unusual presentation of Q fever in a kidney‐pancreas transplant recipient presenting as chronic granulomatous lung disease.…”

Section: Introductionmentioning

confidence: 94%