title: Q fever endocarditis in Spain. Clinical characteristics and outcome.
abstract: OBJECTIVE
  To describe the clinical presentation of a large number of Q fever endocarditis (QFE) and its management considering the role of serology.
  
  
  METHODS
  Eighty-three patients with definite QFE (56 native and 27 prosthetic valve) with a long-term follow-up after stopping treatment (median: 48 months) were included. Final outcome (cure or relapse) was compared according with the serological titre at the end of therapy: less than 1:400 of phase I Ig G antibodies by indirect immunofluorescence (group 1, N=23) or more than 1:400 (group 2, N=30).
  
  
  RESULTS
  Eleven patients (13.2%) died from QFE and other 8 died for other reasons not related to endocarditis during follow-up. Surgery was performed in 61 (73.5%) patients and combined antimicrobial treatment was long (median: 23 months, IQR: 12 - 36). Seven relapses were observed, but five of them had received an initial incomplete antibiotic regimen. In patients who completed the programmed treatment (range: 12 - 89 months), serological titres at the end of therapy were not useful for predicting the final outcome: one relapse in each group.
  
  
  CONCLUSIONS
  QFE requires a prolonged antimicrobial treatment, but serological titres are not useful for determining its duration.
authors.affiliation: Servicios de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla.
authors.forename: Maria Victoria
authors.initials: MV
authors.lastname: Mogollón
authors.forename: Manuel P
authors.initials: MP
authors.lastname: Anguita
authors.forename: José María
authors.initials: JM
authors.lastname: Aguado
authors.forename: Pilar
authors.initials: P
authors.lastname: Tornos
authors.forename: José M
authors.initials: JM
authors.lastname: Miró
authors.forename: Juan
authors.initials: J
authors.lastname: Gálvez-Acebal
authors.forename: Agustín
authors.initials: A
authors.lastname: Muñoz-Sanz
authors.forename: Maria del Carmen
authors.initials: MC
authors.lastname: Fariñas
authors.forename: Manuel
authors.initials: M
authors.lastname: Fernández-Guerrero
authors.forename: Isidre
authors.initials: I
authors.lastname: Vilacosta
authors.forename: Patricia
authors.initials: P
authors.lastname: Muñoz
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Montejo-Baranda
authors.forename: Carmen
authors.initials: C
authors.lastname: Hidalgo-Tenorio
authors.forename: Vicenc
authors.initials: V
authors.lastname: Falcó
authors.forename: Ana
authors.initials: A
authors.lastname: del Río
authors.forename: Ana María
authors.initials: AM
authors.lastname: Arnaíz
authors.forename: Isabel
authors.initials: I
authors.lastname: San-Feliú
authors.forename: Arístides
authors.initials: A
authors.lastname: de Alarcón
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000382:Agricultural Workers' Diseases / Q000453:epidemiology / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D002648:Child; D003131:Combined Modality Therapy; D015897:Comorbidity; D016997:Coxiella burnetii / Q000276:immunology; D004198:Disease Susceptibility; D004359:Drug Therapy, Combination; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D005260:Female; D006331:Heart Diseases / Q000150:complications; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery; D011778:Q Fever / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D012008:Recurrence; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial