title: Delayed Diagnosis of Q Fever: Finally Diagnosed After Elective Cardiac Surgery.
abstract: Q fever is a bacterial infection caused by Coxiella burnetti. It can cause both acute and chronic illness. Chronic QF can present as a variety of clinical syndromes. A common and critical manifestation is endocarditis which can present atypically and is easily missed. This case describes a man who, after extensive investigation for splenomegaly and pancytopenia by several specialties, was finally diagnosed with Q fever endocarditis after unexpected aortic valve abnormalities found during elective cardiac surgery. Several factors contributed to diagnostic delay including aspects of clinical assessment and radiologic findings. Vigilance is essential for diagnosis and prompt initiation of effective treatment.
authors.affiliation: Department of Cardiothoracic Surgery, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, United Kingdom. Electronic address: robert.tyler@nhs.net.
authors.forename: Robert
authors.initials: R
authors.lastname: Tyler
authors.affiliation: Department of Cardiothoracic Surgery, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, United Kingdom.
authors.forename: Hannah
authors.initials: H
authors.lastname: Povey
authors.affiliation: Department of Clinical Microbiology, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, United Kingdom.
authors.forename: Sumita
authors.initials: S
authors.lastname: Pai
authors.affiliation: Department of Cardiothoracic Surgery, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, United Kingdom.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sudarshan
mesh_terms: D006348:Cardiac Surgical Procedures; D057210:Delayed Diagnosis; D017558:Elective Surgical Procedures; D006801:Humans; D008297:Male; D008875:Middle Aged; D011778:Q Fever / Q000175:diagnosis* / Q000601:surgery*