Infect Chemother.  2009 Jun;41(3):199-204. 10.3947/ic.2009.41.3.199.

Two Cases of Q Fever Endocarditis

• Moon SY
• Choi YS
• Park MY
• Lee JA
• Chung MK
• Chung HS
• Jung DR
• Song JH
• Peck KR

• KMID: 1782325
• DOI: http://doi.org/10.3947/ic.2009.41.3.199

Abstract

Q fever is a zoonosis caused by Coxiella burnetii, presenting as acute and chronic illness and it has been reported worldwide. Acute Q fever is usually asymptomatic or mild and self-limiting, but infective endocarditis is one of the most serious complications of chronic Q fever and can be fatal. Known risk factors for Q fever endocarditis are valvular heart disease, immunocompromised hosts, and pregnancy. There have been some reports on Q fever in Korea but there exists no report on Q fever endocarditis. We have experienced 2 cases of Q fever with underlying valvular heart disease; both patients came to the hospital for evaluation of prolonged fever. Although Q fever and Q fever endocarditis are rare in Korea, Q fever endocarditis should be considered in the differential diagnosis of patient with infective endocarditis when causative microorganism cannot be identified.

Keyword

Q fever; Coxiella burnetii; Infective endocarditis

MeSH Terms

Chronic Disease
Coxiella burnetii
Diagnosis, Differential
Endocarditis
Fever
Heart
Heart Valve Diseases
Humans
Immunocompromised Host
Korea
Porphyrins
Pregnancy
Q Fever
Risk Factors
Porphyrins

Figure

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  Fig. 1 Transesophageal echocardiography of case-1 shows severe calcification of aortic valve.

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  Fig. 2 Liver biopsy of case-1 shows multifocal lymphocyte infiltration, moderate inflammation, and multifocal spotty hepatic necrosis (H & E stain, ×200).

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  Fig. 3 PCR for C. burnetii. A) Case-1 : 1-blood sample on May 3, 2007, 2-blood sample on May 22, 2008 and case 2, B) Case-2 : 1 and 2-blood sample on Jan. 22, 2008, 3-blood sample on Nov. 26, 2008, 4-blood sample on Dec. 3, 2008, 5-tissue from valve surgery. M: marker, P: positive control with DNA for C. burnetii, N: negative control.

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