Coxiella burnetii Pericarditis: Report of 15 Cases and Review

Abstract

Q fever is characterized by its clinical polymorphism, and pericarditis associated with Q fever has occasionally been described. Herein we report 15 cases of Coxiella burnetii pericarditis, 9 from our data bank and 6 encountered within the past 12 months. Three patients presented with life-threatening tamponade. We compare our cases with the 18 previously reported and with 60 Q fever-matched controls at our center. This study showed that Q fever pericarditis can present as acute as well as chronic disease; we describe relapse after 6 months in association with a serological profile compatible with the chronic form of disease (phase I C. burnetii IgG titer of > or = 800). Discriminant factors among patients and controls are age of > 52 years (adjusted odds ratio [OR], 5.66), the occurrence of general symptoms such as arthralgias or myalgias (adjusted OR, 6.54), and a normal erythrocyte sedimentation rate (adjusted OR, 16.37). No specific symptoms or underlying cardiac predispositions are observed.

Acute Pericarditis due to Coxiellaburnetiiinfection, a case report

“…Q fever is a worldwide zoonosis. Humans infections are generally produced due to the inhalation of infected aerosols, usually associated with direct or indirect contact with infected animals, or by ingestion of unpasteurized milk from infected farm animals [1,2]. This disease is more frequently reported in spring and early summer.…”

“…Humans, ruminants (cattle, sheep, goats), and pets are the most frequently host observed, but in rare cases this microorganism may be observed in reptiles, birds, and ticks. Humans infections are generally produced due to the inhalation of infected aerosols, usually associated with direct or indirect contact with infected animals, or by ingestion of unpasteurized milk from infected farm animals [1,2]. Q fever is commonly divided into acute and chronic forms.…”

Changing Epidemiology of Q Fever in Germany, 1947-1999

“…Rare complications include myocarditis, pericarditis, or meningoencephalitis (1,13,19). The death rate among persons with Q fever pneumonia is 0.5% to 1.5% (14).…”

Q fever

“…22,29 Chronic granulomatous hepatitis, osteoarticular infection, pericarditis, and vascular complications have also been reported. 22,30,31 Persons with underlying heart valve abnormalities, prosthetic valves, or immune compromise are at increased risk for Q fever endocarditis. Chronic Q fever endocarditis can be life threatening, and patients may require excision and replacement of affected valves.…”