Q Fever Endocarditis: Does Serology Predict Outcome?

Abstract

Q fever is an ubiquitous zoonosis caused by Coxiella burneti, an intracellular bacterium that can produce acute or chronic infections in humans. These forms are characterized by different evolution, serological profile and treatment that must be very long to achieve a cure in chronic forms. However, the serological profile for diagnosis and the real value of serology for predicting outcome are controversial, and management dilemmas for many patients with Q fever infection are continuously emerging. In this article, we describe in a comprehensive manner the different clinical presentations of the disease, making a critical overview of the evidence for serological predictions. We also take a broad view of new available diagnostic techniques and finally, we give recommendations for treatment.

Rapid molecular diagnosis of infective aortic valve endocarditis caused by Coxiella burnetii

“…Depending on risk for further relapse especially in this patient following valve replacement lifelong therapy could be considered [8]. Long-term clinical and serological follow-up is necessary and cessation of therapy depending on serological markers is possible although proof of a better outcome with this approach has not been shown so far [18].…”

Delayed diagnosis of Q fever endocarditis in a rheumatoid arthritis patient

“…Hence the use of serologic titers in distinguishing the stage of disease or outcome is problematic. They are also not a useful tool for deciding the duration of treatment [15] . Shortcomings of serologic testing and culture as well as prolonged turn around times for these tests highlights the potential benefit of PCR on pathologic specimens [2] , [5] .…”