Journal Article

Myocarditis, a Rare but Severe Manifestation of Q Fever: Report of 8 Cases and Review of the Literature

Pierre-Edouard Fournier, Jérôme Etienne, Jean-Robert Harle, Gilbert Habib and Didier Raoult

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 10, pages 1440-1447
Published in print May 2001 | ISSN: 1058-4838
Published online May 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/320159
Myocarditis, a Rare but Severe Manifestation of Q Fever: Report of 8 Cases and Review of the Literature

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Myocarditis has only rarely been described as a manifestation of acute Q fever. Among our series of 1276 patients in whom acute Q fever was diagnosed during 1985–1999, myocarditis was diagnosed in 8. Two patients (25.0%) developed cardiac symptoms during the course of interstitial pneumonia, 2 (25.0%) initially presented with unexplained fever, and 1 (12.5%) presented with febrile cutaneous rash. In 3 patients, cardiac symptoms were inaugural: 1 patient experienced heart failure, and 2 experienced precordial pain. Dilated cardiomyopathy was documented in 7 patients, and 2 (1 of whom had undergone heart transplantation) died despite therapy. In addition, 1 patient was scheduled for heart transplantation because of cardiac insufficiency. When the patients in this study were compared with 32 control patients with acute Q fever, no specific epidemiological or clinical features were associated with this disease except worse prognosis (P=.006). Moreover, among the 12 patients from our series who died as a result of acute Q fever, 2 patients, who were significantly younger than the other 9 patients (P=.03), had myocarditis. Our study highlights the severity of Coxiella burnetii myocarditis.

Journal Article.  5780 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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