Coxiella burnetii Endocarditis and Aortic Vascular Graft Infection: An Underrecognized Disease.

Abstract

BACKGROUND:

Q fever is considered endemic worldwide, and endocarditis, or aortic vascular infection, or both caused by Coxiella burnetii can be a fatal disease. The importance of surgical intervention has not yet been defined. We performed a descriptive retrospective study to assess indications for surgical treatment, timing of treatment, and outcome.

METHODS:

We studied all patients from the cardiac surgery department of a large tertiary hospital who underwent valve surgical procedure due to endocarditis or aortic surgical procedure due to graft infection.

RESULTS:

Throughout a 10-year period, we performed a total of 171 procedures due to valve endocarditis and/or vascular infection. In 16 patients (9.36%) Coxiella burnetii infection was diagnosed. Ten patients had previous cardiac surgical procedures, 3 had previous aortic surgical procedures, 2 had preexisting valvular disease, and 1 patient had no previous valve disorder. All patients received prolonged oral-specific antibiotic therapy under serologic guidance. In 9 patients antibiotic treatment (doxycycline and hydroxychloroquine) was started before the surgical procedure (12.4 ± 37.5 days), and in 7 patients after the surgical procedure (5.1 ± 13.5 days). We observed one in-hospital death (6.25%) and no long-term mortality. The mean follow-up period was 50.5 ± 34.7 months (range, 2 to 104 months).

CONCLUSIONS:

In this series surgical treatment yielded good results for both Q fever endocarditis and vascular graft infection. No association was found between timing of the surgical procedure and patients' outcomes.

• Authors: Yasmin Maor, Leonid Sternik, Boris Orlov, Galia Rahav, Nathan Keller, Ehud Raanani, Alexander Kogan
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 101 Issue 1 Pg. 141-5 (Jan 2016) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 26428692 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Chemical References

• Anti-Bacterial Agents

Topics

• Adolescent
• Adult
• Aged
• Anti-Bacterial Agents (therapeutic use)
• Child
• Coxiella burnetii (isolation & purification)
• Diagnostic Errors
• Echocardiography
• Endocarditis, Bacterial (complications, diagnosis, therapy)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Prosthesis-Related Infections (complications, diagnosis, therapy)
• Q Fever (complications, diagnosis, therapy)
• Reoperation
• Retrospective Studies
• Time Factors