title: Surgical and Antimicrobial Management of a Thoracic Aortic Aneurysm Due to Q Fever: A Case Report and Brief Review.
abstract: Coxiella burnetii, the etiologic agent of Q fever, has been associated with vascular infection and aneurysm formation. We report the case of a 36-year-old woman from Iraq who presented with long-standing malaise as well as vague chest and shoulder discomfort and was found to have a saccular aneurysm of the descending thoracic aorta. Serology assays were positive for chronic C burnetii infection. She was treated with successful aneurysm resection and aortic replacement with a rifampin-impregnated Maquet Hemashield (TM) Dacron interposition graft interposition graft in addition to 18 months of doxycycline and hydroxychloroquine. The patient is without evidence of recurrent infection on follow-up at 3 years. To our knowledge, this is the first case of aortic aneurysm secondary to Q fever reported in the United States. We review the diagnosis, surgical management, antibiotic therapy, and surveillance of a thoracic aortic aneurysm secondary to Q fever.
authors.affiliation: Division of Vascular and Endovascular Surgery, University of Massachusetts Medical School, Worcester, MA, USA wprobins3@gmail.com.
authors.forename: William P
authors.identifier: http://orcid.org/0000-0002-0150-0758
authors.initials: WP
authors.lastname: Robinson
authors.affiliation: Division of Vascular and Endovascular Surgery, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Manuela
authors.initials: M
authors.lastname: Schuksz
mesh_terms: D000328:Adult; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible; D000072226:Computed Tomography Angiography; D016997:Coxiella burnetii / Q000302:isolation & purification*; D004318:Doxycycline / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000008:administration & dosage*; D011474:Prosthesis Design; D011778:Q Fever / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D012293:Rifampin / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; D006886:Hydroxychloroquine; D004318:Doxycycline; D012293:Rifampin
keywords: Coxiella burnetii; Q fever; United States; thoracic aortic aneurysm; vascular infection