Q fever endocarditis in Spain. Clinical characteristics and outcome. 2011

Maria Victoria Mogollón, and Manuel P Anguita, and José María Aguado, and Pilar Tornos, and José M Miró, and Juan Gálvez-Acebal, and Agustín Muñoz-Sanz, and Maria del Carmen Fariñas, and Manuel Fernández-Guerrero, and Isidre Vilacosta, and Patricia Muñoz, and José Miguel Montejo-Baranda, and Carmen Hidalgo-Tenorio, and Vicenc Falcó, and Ana del Río, and Ana María Arnaíz, and Isabel San-Feliú, and Arístides de Alarcón, and
Servicios de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla.

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.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011778 Q Fever An acute infectious disease caused by COXIELLA BURNETII. It is characterized by a sudden onset of FEVER; HEADACHE; malaise; and weakness. In humans, it is commonly contracted by inhalation of infected dusts derived from infected domestic animals (ANIMALS, DOMESTIC). Coxiella burnetii Fever,Query Fever,Acute Q Fever,Chronic Q Fever,Coxiella burnetii Infection,Coxiella burnetii Vector-Borne Disease,Acute Q Fevers,Chronic Q Fevers,Coxiella burnetii Fevers,Coxiella burnetii Infections,Coxiella burnetii Vector Borne Disease,Fever, Acute Q,Fever, Chronic Q,Fever, Coxiella burnetii,Fever, Q,Fever, Query,Fevers, Acute Q,Fevers, Chronic Q,Fevers, Coxiella burnetii,Fevers, Q,Fevers, Query,Infection, Coxiella burnetii,Infections, Coxiella burnetii,Q Fever, Acute,Q Fever, Chronic,Q Fevers,Q Fevers, Acute,Q Fevers, Chronic,Query Fevers
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D004198 Disease Susceptibility A constitution or condition of the body which makes the tissues react in special ways to certain extrinsic stimuli and thus tends to make the individual more than usually susceptible to certain diseases. Diathesis,Susceptibility, Disease,Diatheses,Disease Susceptibilities,Susceptibilities, Disease
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D004697 Endocarditis, Bacterial Inflammation of the ENDOCARDIUM caused by BACTERIA that entered the bloodstream. The strains of bacteria vary with predisposing factors, such as CONGENITAL HEART DEFECTS; HEART VALVE DISEASES; HEART VALVE PROSTHESIS IMPLANTATION; or intravenous drug use. Bacterial Endocarditides,Bacterial Endocarditis,Endocarditides, Bacterial
D005260 Female Females

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