Endocarditis Due to Q Fever in Nova Scotia: Experience with Five Patients in 1981-1982

Haldane, E. V.; Marrie, Thomas J.; Faulkner, R. S.; Lee, S. H. S.; Cooper, Judy; MacPherson, D. D.; Montague, Terrence J.

doi:10.1093/infdis/148.6.978

Cited by 60 publications

(32 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our experience confirmed published data (9,10) (40) but is in accordance with the new model of infection that we described, which shows that these compounds are bacteriostatic (22 12 1 year after the first one, and the culture was again positive. Surgery must be accompanied by antibiotic therapy to prevent reinfection from a dormant site, including the other cardiac valves.…”

Section: Resultssupporting

confidence: 92%

“…Results obtained with combinations including co-trimoxazole are still controversial. Reports (6,7,9,29,34) show that nine patients required valve replacement, since viable C. burnetii were recovered from six patients after therapies of various durations. In our study, one patient was treated with cotrimoxazole combined with doxycycline and died 30 months after initiation of therapy.…”

Section: Resultsmentioning

confidence: 99%

“…Surgery must be accompanied by antibiotic therapy to prevent reinfection from a dormant site, including the other cardiac valves. In fact, C. burnetii has been observed in valves which were macroscopically unremarkable (9). The ideal duration of treatment is difficult to define since no criteria for a cure have been proposed at this time.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of different antibiotic regimens for therapy of 32 cases of Q fever endocarditis

Lévy¹,

Drancourt²,

Etienne³

et al. 1991

Antimicrob Agents Chemother

113

View full text Add to dashboard Cite

We studied 32 cases of Q fever endocarditis diagnosed in France between January 1985 and December 1989 to evaluate the efficacies of the different regimens of antibiotics used for treatment. Each patient was monitored during the treatment (range, 12 to 60 months), and clinical and biological information was computerized. Various treatments were prescribed, including doxycycline alone (9 cases) or in association with rifampin (4 cases), quinolones (16 cases), or sulfamethoxazole-trimethoprim (1 case). Two patients died before the beginning of the treatment. Nineteen patients had hemodynamic failure and subsequently underwent valve replacement. Nine valve tissue cultures were positive despite previous antibiotic treatment. In terms of their effects on mortality, the difference between doxycycline alone and doxycycline plus quinolones is statistically significant. We conclude that the addition of quinolones to doxycycline is beneficial. On the basis of clinical, serological, and valve tissue culture results, no treatment was able to cure Q fever endocarditis within 2 years, even with a combination of antibiotics. We advise a minimum duration of treatment of 3 years with therapy combining quinolones and doxycycline.

show abstract

Section: Resultssupporting

confidence: 92%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of different antibiotic regimens for therapy of 32 cases of Q fever endocarditis

Lévy¹,

Drancourt²,

Etienne³

et al. 1991

Antimicrob Agents Chemother

113

View full text Add to dashboard Cite

show abstract

“…The most common clinical presentation of acute Q fever in human is an influenza-like illness, often accompanied by pneumonia. The chronic Q fever form, particularly endocarditis, may appear several years after the primary episode (1,2,6,21). Because the clinical presentation of the infection is not specific, serological confirmation is required for the diagnosis of Q fever.…”

mentioning

confidence: 99%

New Criteria for Immunofluorescence Assay for Q Fever Diagnosis in Japan

Setiyono

Ogawa²,

Cai³

et al. 2005

J Clin Microbiol

View full text Add to dashboard Cite

A study was made to evaluate the cutoff value of indirect immunofluorescent-antibody (IFA) test for Q fever diagnosis in Japan. We used 346 sera, including 16 from confirmed Q fever cases, 304 from Japanese pneumonia patients, and 26 from negative cases. Thirteen sera from the confirmed Q fever cases with an immunoglobulin M (IgM) titer of >1:128 and/or IgG titer of >1:256 by the IFA test were positive by both enzyme-linked immunosorbent assay (ELISA) and Western blotting assay (WBA), whereas 298 sera from pneumonia patients and 26 negative sera with an IgM titer of <1:16 and an IgG titer of <1:32 by the IFA test were negative by both ELISA and WBA. In the proposed "equivocal area," with an IgM titer of >1:32 and <1:64 and/or an IgG titer of >1:64 and <1:128, we found 9 sera, 3 from confirmed Q fever cases and 6 from Japanese pneumonia patients, by the IFA test. Three sera from the confirmed Q fever cases and one of the sera from pneumonia patients were IgM and/or IgG positive by both ELISA and WBA. These results suggest that a single cutoff value for the IFA test may cause false-positive and false-negative results. In conclusion, this study showed that an "equivocal area" should be used for the IFA test rather than a single cutoff value and that sera in the equivocal area should be tested by additional serological assays for confirmation.

show abstract

“…More than 200 documented cases of this form have been described, and mortality rates can exceed 65% (1,3,6,10,31,32,36,38,43,44). Although various regimens have been proposed, tetracycline is the mainstay of treatment of Q fever endocarditis (6,41,44).…”

Section: Antibiotic and Surgical Treatment Of Chronic Q Fevermentioning

confidence: 99%