[Acute myocardial failure in a young man: Q-fever myocarditis].
Coxiella burnetii myocarditis is a rare but severe clinical form of acute Q fever. We report the case of a 40-year-old man hospitalized for acute febrile syndrome. Forty-eight hours later, he presented dyspnea, orthopnea, and paroxysmal nocturnal dyspnea; cardiac auscultation revealed a third sound and echocardiography showed a diffusely hypokinetic and dilated left ventricle (30% ejection fraction). Serological studies showed antibodies against phase-II C. burnetii antigens (IgG titer 1:320 and IgM 1:50). The patient was treated with losartan, furosemide, and clarithromycin, resulting in rapid improvement. Six months after admission, the echocardiographic changes had completely disappeared.
Murcia
José
J
Servicios de Medicina Interna, Hospital General Universitario de Alicante, Spain.
Reus
Sergio
S
Climent
Vicente
V
Manso
María I
MI
López
Iñigo
I
Tello
Antonio
A
D000208:Acute Disease; D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000032:analysis; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D017291:Clarithromycin / Q000627:therapeutic use; D016997:Coxiella burnetii / Q000276:immunology; D004232:Diuretics / Q000627:therapeutic use; D004452:Echocardiography; D004562:Electrocardiography; D005500:Follow-Up Studies; D005665:Furosemide / Q000627:therapeutic use; D006801:Humans; D019808:Losartan / Q000627:therapeutic use; D008297:Male; D009205:Myocarditis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011778:Q Fever / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D013997:Time Factors
D000889:Anti-Arrhythmia Agents; D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D004232:Diuretics; D005665:Furosemide; D017291:Clarithromycin; D019808:Losartan