title: Constrictive pericarditis due to Coxiella burnetii.
abstract: Q fever is characterized by its clinical polymorphism. Cardiac involvement in acute Q fever is rare. We report a case of pleuro-pericarditis that rapidly evolved to pericardial constriction during an acute episode of Coxiella burnetii infection. Constrictive pericarditis was confirmed by hemodynamic measurements, echocardiography, and magnetic resonance. Indirect immunofluorescence assay revealed positive serology for acute Q fever. The patient underwent a successful pericardiectomy and was given antibiotics. The histopathologic study of the excised pericardium showed C. burnetii in a large cluster of organisms. After a 6-month follow-up period, the individual was asymptomatic.
authors.affiliation: Regional Service of Cardiovascular Surgery, University Hospital Virgen de la Arrixaca, Murcia, Spain. vbautista-hernandez@hotmail.com
authors.forename: Víctor
authors.initials: V
authors.lastname: Bautista-Hernández
authors.forename: Francisco
authors.initials: F
authors.lastname: Gutierrez
authors.forename: Víctor G
authors.initials: VG
authors.lastname: Ray
authors.forename: José M
authors.initials: JM
authors.lastname: Arribas
authors.forename: Julio
authors.initials: J
authors.lastname: García-Puente
authors.forename: Norberto
authors.initials: N
authors.lastname: Casinello
authors.forename: Ramón
authors.initials: R
authors.lastname: Arcas
mesh_terms: D000907:Antibodies, Bacterial / Q000032:analysis; D006328:Cardiac Catheterization; D003131:Combined Modality Therapy; D016997:Coxiella burnetii / Q000276:immunology / Q000302:isolation & purification; D004318:Doxycycline / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010492:Pericardiectomy; D010494:Pericarditis, Constrictive / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D010496:Pericardium / Q000276:immunology / Q000382:microbiology; D010996:Pleural Effusion / Q000209:etiology / Q000276:immunology; D011778:Q Fever / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014463:Ultrasonography
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D004318:Doxycycline