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DISPATCHES Delayed Diagnosis of Chronic Q Fever and Cardiac Valve Surgery
BibTeX
@MISC{Kampschreur_dispatchesdelayed,
author = {Linda M. Kampschreur and Elske Hoornenborg and Nicole H. M. Renders and Jan Jelrik Oosterheert and Joost F. Haverman and Peter Elsman and Peter C. Wever},
title = {DISPATCHES Delayed Diagnosis of Chronic Q Fever and Cardiac Valve Surgery},
year = {}
}
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Abstract
Untreated chronic Q fever causes a high number of complications and deaths. We present cases of chronic Q fever that were not diagnosed until after the patients underwent cardiac valve surgery. In epidemic areas, Q fever screening of valve surgery patients secures early initiation of treatment and can prevent illness and death. fever, a zoonosis caused by the intracellular gram-neg-Q ative bacterium Coxiella burnetii, occurs in outbreaks and is prevalent worldwide. Q fever has acute and chronic stages (1). Acute Q fever is a self-limiting febrile disease occurring in 40%–50 % of C. burnetii–infected persons (1). Chronic Q fever can develop years after primary infection and occurs in 1%–5 % of C. burnetii–infected persons (1,2). The most critical manifestations of chronic Q fever are endocarditis and infections of vascular prosthesis and aortic aneurysms (3). Persons with pre-existing valvular cardiac disease have a reported 40 % risk of Q fever endocarditis when infected with C. burnetii (2,4). During 2007–2010, an outbreak of>4,000 cases of acute Q fever occurred in the Netherlands (5). To increase understanding of the role of Q fever in valvular cardiac disease, we present 3 cases of chronic Q fever and valvular cardiac disease requiring surgery in patients from the Netherlands. The diagnosis of chronic Q fever was not made until after the patients had elective cardiac valve surgery for progressive valvular dysfunction. Case 1 In 2004, aortic valve stenosis of a tricuspid valve was diagnosed in a 73-year-old man. Additional medical history
Keyphrases
chronic fever dispatch delayed diagnosis cardiac valve surgery valvular cardiac disease burnetii infected person acute fever additional medical history aortic valve stenosis epidemic area prevalent worldwide aortic aneurysm patient underwent cardiac valve surgery vascular prosthesis elective cardiac valve surgery primary infection pre-existing valvular cardiac disease 73-year-old man valve surgery patient high number critical manifestation progressive valvular dysfunction self-limiting febrile disease present case chronic stage early initiation fever endocarditis tricuspid valve
