title: Rapid molecular diagnosis of infective aortic valve endocarditis caused by Coxiella burnetii.
abstract: We describe a case of Q-fever endocarditis with severe destruction of the aortic valve with perivalvular abscess formation and cardiac failure. The patient needed urgent operative treatment and postoperative critical care. All specimens sent for microbiological examination were negative. Molecular analysis, including fluorescence in situ hybridization of aortic valve tissue combined with PCR and sequencing, led to the correct diagnosis and to appropriate anti-infective treatment. The patient subsequently recovered from complex cardiovascular surgery. This is the first report on Q-fever endocarditis that was rapidly diagnosed using these methods.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany. oliver.kumpf@charite.de.
authors.forename: Oliver
authors.initials: O
authors.lastname: Kumpf
authors.affiliation: Department of Cardiovascular Surgery, Campus Charité Mitte, Charité-University Medicine Berlin, Berlin, Germany.|Department of Cardiothoracic Surgery, Faculty of Health Science, Free State University, Bloemfontein, South Africa.
authors.forename: Pascal
authors.initials: P
authors.lastname: Dohmen
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Ertmer
authors.affiliation: Department of Cardiology and Angiology, Campus Charité Mitte, Charité-University Medicine Berlin, Berlin, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Knebel
authors.affiliation: Biofilmcenter, German Heart Institute Berlin, Berlin, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Wiessner
authors.affiliation: Biofilmcenter, German Heart Institute Berlin, Berlin, Germany.|DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
authors.forename: Judith
authors.initials: J
authors.lastname: Kikhney
authors.affiliation: Biofilmcenter, German Heart Institute Berlin, Berlin, Germany.|DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Moter
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany.
authors.forename: Sascha
authors.initials: S
authors.lastname: Treskatsch
mesh_terms: D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000382:microbiology; D016997:Coxiella burnetii; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000382:microbiology; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000382:microbiology; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D011778:Q Fever / Q000175:diagnosis / Q000382:microbiology
keywords: Chronic infection; Coxiella burnetii; Culture negative; Endocarditis; Fluorescence in situ hybridization; Q-fever; Serology