[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.
Servicios de Medicina Interna, Hospital General Universitario de Alicante, Spain.
José
J
Murcia
Sergio
S
Reus
Vicente
V
Climent
María I
MI
Manso
Iñigo
I
López
Antonio
A
Tello
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