Fatal Endocarditis Associated With Q Fever

Evans, Alexandra; Powell, D. E. B.; Burrell, CJ

doi:10.1016/s0140-6736(59)91942-7

Cited by 42 publications

(13 citation statements)

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“…The infection could well have caused the death of the elderly woman with bronchitis and heart failure (Case B), if her low-titred antibody response from <8 to 20 is accepted as significant. Interest in non-bacterial forms of infective endocarditis has been aroused by recent descriptions of rickettsial endocarditis (Robson and Shimmin, 1959 ;Evans et al, 1959), but in the absence of post-mortem, histological, or cultural studies it is impossible to know whether the psittacosis antibody in the single tested serum of the woman with fatal endocarditis (Case I) was relevant to this disease or merely residual from infection some time before her final illness.…”

Section: Discussionmentioning

confidence: 99%

Infections by Organisms of Psittacosis/Lymphogranuloma Venereum Group in the West of Scotland

Grist¹,

McLean²

1964

BMJ

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Section: Discussionmentioning

confidence: 99%

Infections by Organisms of Psittacosis/Lymphogranuloma Venereum Group in the West of Scotland

Grist¹,

McLean²

1964

BMJ

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“…Chronic Q fever endocarditis has been described for decades [5][6][7] as a fatal chronic disease [6] lasting for >6 months [1], occurring mostly in male patients >50 years of age with a preexisting valvular heart disease (VHD) or immunosuppression [8]. Because fever and echocardiographic vegetations are frequently lacking, diagnosis may often be made only by systematically testing patients undergoing elective valve surgery [9,10] or in the context of a dual-pathogen endocarditis [11].…”

mentioning

confidence: 99%

Antiphospholipid Antibody Syndrome With Valvular Vegetations in Acute Q Fever

et al. 2015

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Background. Coxiella burnetii endocarditis is considered to be a late complication of Q fever in patients with preexisting valvular heart disease (VHD). We observed a large transient aortic vegetation in a patient with acute Q fever and high levels of IgG anticardiolipin antibodies (IgG aCL). Therefore, we sought to determine how commonly acute Q fever could cause valvular vegetations associated with antiphospholipid antibody syndrome, which would be a new clinical entity.Methods. We performed a consecutive case series between January 2007 and April 2014 at the French National Referral Center for Q fever. Age, sex, history of VHD, immunosuppression, and IgG aCL assessed by enzyme-linked immunosorbent assay were tested as potential predictors.Results. Of the 759 patients with acute Q fever and available echocardiographic results, 9 (1.2%) were considered to have acute Q fever endocarditis, none of whom had a previously known VHD. After multiple adjustment, very high IgG aCL levels (>100 immunoglobulin G-type phospholipid units; relative risk [RR], 24.9 [95% confidence interval {CI}, 4.5-140.2]; P = .002) and immunosuppression (RR, 10.1 [95% CI, 3.0-32.4]; P = .002) were independently associated with acute Q fever endocarditis.Conclusions. Antiphospholipid antibody syndrome with valvular vegetations in acute Q fever is a new clinical entity. This would suggest the value of systematically testing for C. burnetii in antiphospholipid-associated cardiac valve disease, and performing early echocardiography and antiphospholipid dosages in patients with acute Q fever.

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“…Libman suggested that the heart lesion was healing and had gone into a bacteria-free stage. Libman and Friedberg (1948) The description of endocarditis in Q fever (Evans et al, 1959) shows the importance of looking for evidence of infection by microbes other than bacteria.…”

Section: Discussionmentioning

confidence: 99%

“…Alternatively, the streptomycin given nine months before death could conceivably have destroyed the organisms. Evans et al (1959) have shown that Rickettsia burneti can cause infective carditis with negative blood cultures. This possibility, unknown to us at the time, has not been excluded.…”

Section: Prognosis In First Yearmentioning

confidence: 99%