Journal Article

Risks Factors and Prevention of Q Fever Endocarditis

Florence Fenollar, Pierre-Edouard Fournier, M. Patrizia Carrieri, Gilbert Habib, Thierry Messana and Didier Raoult

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 3, pages 312-316
Published in print August 2001 | ISSN: 1058-4838
Published online August 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/321889
Risks Factors and Prevention of Q Fever Endocarditis

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Coxiella burnetii causes acute and chronic Q fever. To evaluate the risk factors of development of chronic endocarditis following Q fever and to assess the best preventive therapy, a retrospective study of patients diagnosed as having Q fever during 1985–2000 was conducted. Twelve patients with acute Q fever who developed endocarditis and 102 patients with Q fever endocarditis were included in the study. When compared to 200 control patients with acute Q fever, preexisting valvular disease (P < 10−7), especially a prosthetic valve (P = .01), were encountered more often among patients with endocarditis. Among patients with valvular defects, we estimate the risk of developing endocarditis to be 39%. A combination of doxycycline plus hydroxychloroquine was better at preventing the development of endocarditis than doxycycline alone (P = .009). Our results should encourage physicians to detect valvular lesions in patients with acute Q fever and to search for acute Q fever in patients with a valvulopathy and unexplained fever. A proper treatment for such patients and a scheduled follow-up should reduce the risk of developing endocarditis.

Journal Article.  3644 words.  Illustrated.

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

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