BACKGROUND Q fever myocarditis is a rare disease manifestation of Q fever infection caused by Coxiella burnetii.It is associated with significant morbidity and mortality if left untreated.Prior studies have reported m...BACKGROUND Q fever myocarditis is a rare disease manifestation of Q fever infection caused by Coxiella burnetii.It is associated with significant morbidity and mortality if left untreated.Prior studies have reported myocarditis in patients with acute Q fever.We present the first case of chronic myocarditis in an end-stage heart failure patient with chronic Q fever infection.CASE SUMMARY A 69-year-old male was admitted with dyspnea on exertion,hypotension and bilateral lower extremity edema for a few months.He has a past medical history of ischemic cardiomyopathy with left ventricular ejection fraction of 25%,implantable cardioverter defibrillator in place,bioprosthetic aortic valve and mitral valve replacement.He continued to have shortness of breath despite diuresis along with low grade fevers.Initial infectious work up came back negative.On further questioning,the patient was found to have close contact with farm animals and the recurrent fevers prompted the work-up for Q fever.Q fever serologies and cardiac positron emission tomography confirmed the diagnosis of chronic Q fever myocarditis.He was then successfully treated with doxycycline and hydroxychloroquine for 18 mo.CONCLUSION Chronic Q fever myocarditis,if left untreated,carries a poor prognosis.It should be kept in differentials,especially in patients with recurrent fevers and contact with farm animals.展开更多
Objective:To determine the prevalence of Coxiella burnetii(C.burnetii) antibody positive randomly selected dairy herds in southeast Iran(Kerman).Methods:Bulk tank milk samples were collected randomly from 44 sufficien...Objective:To determine the prevalence of Coxiella burnetii(C.burnetii) antibody positive randomly selected dairy herds in southeast Iran(Kerman).Methods:Bulk tank milk samples were collected randomly from 44 sufficiently large commercial dairy herds,included near 12 000 dairy cattle,in Kerman(The largest province of Iran),southeast Iran.The samples were tested for antibodies against C.burnetii using the commercial CHEKIT(?) Q fever antibody ELISA Test Kit(Idexx,Liebefeld-Bern,Switzerland).Results:The prevalence of positive,negative and intermediate herds were 45.4%,43.2%and 11.4%,respectively.Conclusions:The result supports the hypothesis of high prevalence and endemic pattern of Q fever in Iran.This investigation highlights the importance of further studies on Q fever in Iran.展开更多
Q fever is a widespread zoonotic infection caused by Coxiella burnetii. During acute infection, three clinical patterns are commonly encountered—self limited, flu like disease, atypical pneumonia or hepatits. Chronic...Q fever is a widespread zoonotic infection caused by Coxiella burnetii. During acute infection, three clinical patterns are commonly encountered—self limited, flu like disease, atypical pneumonia or hepatits. Chronic infection almost always implies endocarditis. Acute infection during pregnancy may result in obstetrical complications, and predispose to chronic transformation. Treatment during pregnancy is more complex, and the duration of treatment was debatable up until recently. We describe a 31 years old patient with acute Q fever infection during pregnancy. We review the medical treatment, complications and follow up of acute and chronic Q fever during pregnancy.展开更多
Qfever is a worldwide zoonosis and its agent is Coxiella burnetii （C. burnetii）. There are two forms of Q fever： acute and chronic. Acute Q fever is caused by primary infection with C. burnetii and its main clinica...Qfever is a worldwide zoonosis and its agent is Coxiella burnetii （C. burnetii）. There are two forms of Q fever： acute and chronic. Acute Q fever is caused by primary infection with C. burnetii and its main clinical features are high fever, granulomatous hepatitis and atypical pneumonia. Acute Q fever is extremely prone to develop chronic infection if it is improperly treated. Endocarditis is the main characteristic of chronic Q fever and it accounts for 3% to 5% of all cases of endocarditis.展开更多
Background： Q fever endocarditis, a chronic illness caused by Coxiella burnetii, can be fatal ifmisdiagnosed or left untreated. Despite a relatively high positive rate of Q fever serology in healthy individuals in th...Background： Q fever endocarditis, a chronic illness caused by Coxiella burnetii, can be fatal ifmisdiagnosed or left untreated. Despite a relatively high positive rate of Q fever serology in healthy individuals in the mainland of China, very few cases of Q fever endocarditis have been reported. This study summarized cases of Q fever endocarditis among blood culture negative endocarditis （BCNE） patients and discussed factors attributing to the low diagnostic rate. Methods： We identified confirmed cases of Q fever endocarditis among 637 consecutive patients with infective endocarditis （IE） in the Peking Union Medical College Hospital between 2006 and 2016. The clinical findings for each confirmed case were recorded. BCNE patients were also examined and each BCNE patient＇s Q fever risk factors were identified. The risk factors and presence of Q fever serologic testing between BCNE patients suspected and unsuspected of Q fever were compared using the Chi-squared or Chi-squared with Yates＇ correction for continuity. Results： Among the IE patients examined, there were 147 BCNE patients, of whom only 11 patients （7.5%） were suspected of Q fever and undergone serological testing for C. burnetii. Six out of 11 suspected cases were diagnosed as Q fever endocarditis. For the remaining 136 BCNE patients, none of them was suspected of Q fever nor underwent relevant testing. Risk factors for Q fever endocarditis were comparable between suspected and unsuspected patients, with the most common risk factors being valvulopathy in both groups. However, significantly more patients had consulted the Infectious Diseases Division and undergone comprehensive diagnostic tests in the suspected group than the unsuspected group （100% vs. 63%, P = 0.03）. Conclusions： Q fever endocarditis is a serious yet treatable condition. Lacking awareness of the disease may prevent BCNE patients from being identified, despite having Q fever risk factors. Increasing awareness and guideline adherence are crucial in avoiding misdiagnosing and missed diagnosing of the disease.展开更多
There are only a few case reports of Q fever caused by Coxiella burnetii in China,despite the nature as a ubiquitous zoonotic disease worldwide.In the northeast part of China,a 52-year-old male presented with fever,co...There are only a few case reports of Q fever caused by Coxiella burnetii in China,despite the nature as a ubiquitous zoonotic disease worldwide.In the northeast part of China,a 52-year-old male presented with fever,cough,shortness of breath,and sputum production,accompanied by headache,dizziness,chill,myalgia,and arthralgia.Chest computed tomography images showed pneumonia accompanied by bilateral scattered infiltrates and localized upper-lobe emphysema.The abnormal liver function was indicated by the increased levels of alanine aminotransferase and aspartate aminotransferase.Through high-throughput sequencing and molecular detection,Coxiella burnetii was positive in the patient's blood specimens.After treatment with moxifloxacin hydrochloride and vidarabine monophosphate for 12 days,the patient completely recovered.To our knowledge,this was the first reported case of Q fever with pneumonia and hepatitis in this country.展开更多
文摘BACKGROUND Q fever myocarditis is a rare disease manifestation of Q fever infection caused by Coxiella burnetii.It is associated with significant morbidity and mortality if left untreated.Prior studies have reported myocarditis in patients with acute Q fever.We present the first case of chronic myocarditis in an end-stage heart failure patient with chronic Q fever infection.CASE SUMMARY A 69-year-old male was admitted with dyspnea on exertion,hypotension and bilateral lower extremity edema for a few months.He has a past medical history of ischemic cardiomyopathy with left ventricular ejection fraction of 25%,implantable cardioverter defibrillator in place,bioprosthetic aortic valve and mitral valve replacement.He continued to have shortness of breath despite diuresis along with low grade fevers.Initial infectious work up came back negative.On further questioning,the patient was found to have close contact with farm animals and the recurrent fevers prompted the work-up for Q fever.Q fever serologies and cardiac positron emission tomography confirmed the diagnosis of chronic Q fever myocarditis.He was then successfully treated with doxycycline and hydroxychloroquine for 18 mo.CONCLUSION Chronic Q fever myocarditis,if left untreated,carries a poor prognosis.It should be kept in differentials,especially in patients with recurrent fevers and contact with farm animals.
基金financially supported by Research Center for Tropical and Infectious Diseases,Kerman University of Medical Sciences,Kerman,Iran and Shahid Bahonar University of Kerman,Iran
文摘Objective:To determine the prevalence of Coxiella burnetii(C.burnetii) antibody positive randomly selected dairy herds in southeast Iran(Kerman).Methods:Bulk tank milk samples were collected randomly from 44 sufficiently large commercial dairy herds,included near 12 000 dairy cattle,in Kerman(The largest province of Iran),southeast Iran.The samples were tested for antibodies against C.burnetii using the commercial CHEKIT(?) Q fever antibody ELISA Test Kit(Idexx,Liebefeld-Bern,Switzerland).Results:The prevalence of positive,negative and intermediate herds were 45.4%,43.2%and 11.4%,respectively.Conclusions:The result supports the hypothesis of high prevalence and endemic pattern of Q fever in Iran.This investigation highlights the importance of further studies on Q fever in Iran.
文摘Q fever is a widespread zoonotic infection caused by Coxiella burnetii. During acute infection, three clinical patterns are commonly encountered—self limited, flu like disease, atypical pneumonia or hepatits. Chronic infection almost always implies endocarditis. Acute infection during pregnancy may result in obstetrical complications, and predispose to chronic transformation. Treatment during pregnancy is more complex, and the duration of treatment was debatable up until recently. We describe a 31 years old patient with acute Q fever infection during pregnancy. We review the medical treatment, complications and follow up of acute and chronic Q fever during pregnancy.
文摘Qfever is a worldwide zoonosis and its agent is Coxiella burnetii （C. burnetii）. There are two forms of Q fever： acute and chronic. Acute Q fever is caused by primary infection with C. burnetii and its main clinical features are high fever, granulomatous hepatitis and atypical pneumonia. Acute Q fever is extremely prone to develop chronic infection if it is improperly treated. Endocarditis is the main characteristic of chronic Q fever and it accounts for 3% to 5% of all cases of endocarditis.
基金This work was supported by grants from the National Natural Science Foundation of China （No. 81470426）, the Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry （SRF for ROCS, and SEM）, Elite Class, and PUMCH Young and Middle-aged Investigation Fund, Key Project （No. PUMCH-2016-1.12）.
文摘Background： Q fever endocarditis, a chronic illness caused by Coxiella burnetii, can be fatal ifmisdiagnosed or left untreated. Despite a relatively high positive rate of Q fever serology in healthy individuals in the mainland of China, very few cases of Q fever endocarditis have been reported. This study summarized cases of Q fever endocarditis among blood culture negative endocarditis （BCNE） patients and discussed factors attributing to the low diagnostic rate. Methods： We identified confirmed cases of Q fever endocarditis among 637 consecutive patients with infective endocarditis （IE） in the Peking Union Medical College Hospital between 2006 and 2016. The clinical findings for each confirmed case were recorded. BCNE patients were also examined and each BCNE patient＇s Q fever risk factors were identified. The risk factors and presence of Q fever serologic testing between BCNE patients suspected and unsuspected of Q fever were compared using the Chi-squared or Chi-squared with Yates＇ correction for continuity. Results： Among the IE patients examined, there were 147 BCNE patients, of whom only 11 patients （7.5%） were suspected of Q fever and undergone serological testing for C. burnetii. Six out of 11 suspected cases were diagnosed as Q fever endocarditis. For the remaining 136 BCNE patients, none of them was suspected of Q fever nor underwent relevant testing. Risk factors for Q fever endocarditis were comparable between suspected and unsuspected patients, with the most common risk factors being valvulopathy in both groups. However, significantly more patients had consulted the Infectious Diseases Division and undergone comprehensive diagnostic tests in the suspected group than the unsuspected group （100% vs. 63%, P = 0.03）. Conclusions： Q fever endocarditis is a serious yet treatable condition. Lacking awareness of the disease may prevent BCNE patients from being identified, despite having Q fever risk factors. Increasing awareness and guideline adherence are crucial in avoiding misdiagnosing and missed diagnosing of the disease.
基金supported by the National Key R&D Program of China(2017YFD0501700)the Pearl River Talent Recruitment Program in Guangdong Province of China(2019CX01N111).
文摘There are only a few case reports of Q fever caused by Coxiella burnetii in China,despite the nature as a ubiquitous zoonotic disease worldwide.In the northeast part of China,a 52-year-old male presented with fever,cough,shortness of breath,and sputum production,accompanied by headache,dizziness,chill,myalgia,and arthralgia.Chest computed tomography images showed pneumonia accompanied by bilateral scattered infiltrates and localized upper-lobe emphysema.The abnormal liver function was indicated by the increased levels of alanine aminotransferase and aspartate aminotransferase.Through high-throughput sequencing and molecular detection,Coxiella burnetii was positive in the patient's blood specimens.After treatment with moxifloxacin hydrochloride and vidarabine monophosphate for 12 days,the patient completely recovered.To our knowledge,this was the first reported case of Q fever with pneumonia and hepatitis in this country.
