title: Q fever endocarditis; not always expected.
abstract: Q fever endocarditis is a chronic disease with protean manifestations. The clinical and serological manifestations of nine patients diagnosed as having Q fever endocarditis during a 19-year period are reviewed. Four patients (44%) required valve replacement due to congestive heart failure. Three of these four patients were diagnosed as having Q fever endocarditis only after elective valve surgery, by histopathological examination of the valve and subsequent serological tests. Prior to surgery they were afebrile and had no other symptom or sign indicative of endocarditis. The antibiotic treatment and the decreasing titres of Q fever antibodies of all nine patients during several years of follow-up are summarized. Careful assessment of heart valves for histopathological evidence of inflammation is suggested, even after elective replacement. If found, clinical and laboratory evaluation should include determination of anti-Coxiella burnetti antibodies.
authors.affiliation: Infectious Disease Unit, Shaare Zedek Medical Centre, affiliated with the Hadassah-Hebrew University Medical School, Jerusalem, Israel. yonitw@zahav.net.il
authors.forename: Y
authors.initials: Y
authors.lastname: Wiener-Well
authors.forename: D
authors.initials: D
authors.lastname: Fink
authors.forename: Y
authors.initials: Y
authors.lastname: Schlesinger
authors.forename: D
authors.initials: D
authors.lastname: Raveh
authors.forename: B
authors.initials: B
authors.lastname: Rudensky
authors.forename: A M
authors.initials: AM
authors.lastname: Yinnon
mesh_terms: D000368:Aged; D000942:Antigens, Bacterial / Q000276:immunology; D016997:Coxiella burnetii / Q000276:immunology / Q000302:isolation & purification; D017558:Elective Surgical Procedures; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006350:Heart Valve Prosthesis; D006351:Heart Valves / Q000601:surgery; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011778:Q Fever / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D000942:Antigens, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M