Coxiella burnetii infection of aortic aneurysms or vascular grafts: report of 30 new cases and evaluation of outcome.
Q fever is a zoonotic disease caused by Coxiella burnetii. Polymorphic, the disease may present as an acute or chronic infection. Vascular infections are the second most common form of chronic Q fever, following endocarditis. Herein, we studied the outcome of 30 new cases of aortic infection caused by C. burnetii using uni- and multivariate analyses. The outcome of ten cases previously reported by our team was also updated. Of these 40 patients, 32 had a follow-up of >or=3 years. Among them, the overall mortality was of 25% (8/32). Vascular rupture was significantly and independently (multivariate P=0.03) associated with a lethal issue, whereas vascular surgery was significantly associated with recovery (uni- and multivariate P<0.01). Our findings demonstrate the critical importance of surgery in the management of C. burnetii vascular infections.
Botelho-Nevers
E
E
Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine, Université de la Méditerranée, 27 Blvd Jean Moulin, 13385 Marseille Cedex 5, France.
Fournier
P-E
PE
Richet
H
H
Fenollar
F
F
Lepidi
H
H
Foucault
C
C
Branchereau
A
A
Piquet
P
P
Maurin
M
M
Raoult
D
D
D000368:Aged; D000369:Aged, 80 and over; D000785:Aneurysm, Infected / Q000382:microbiology*; D001014:Aortic Aneurysm / Q000150:complications* / Q000401:mortality / Q000601:surgery; D001019:Aortic Rupture / Q000209:etiology; D001807:Blood Vessel Prosthesis / Q000382:microbiology*; D016997:Coxiella burnetii / Q000302:isolation & purification*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000382:microbiology*; D011778:Q Fever / Q000382:microbiology* / Q000401:mortality