Delayed diagnosis of Q fever endocarditis in a rheumatoid arthritis patient

Chronic Q fever caused by Coxiella burnetii is uncommon in the United States and is most often associated with infective endocarditis. We present a 52-year-old woman with a history of aortic valve replacement and rheumatoid arthritis treated with Etanercept with chronic Q fever manifesting as prosth...

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Bibliographic Details
Main Authors: Shailee Y. Shah, Christopher Kovacs, Carmela D. Tan, Gosta Pettersson, Nabin K. Shrestha, Larry Lutwick, Steven M. Gordon
Format: Article
Language:English
Published: Elsevier 2015-01-01
Series:IDCases
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214250915000244
Description
Summary:Chronic Q fever caused by Coxiella burnetii is uncommon in the United States and is most often associated with infective endocarditis. We present a 52-year-old woman with a history of aortic valve replacement and rheumatoid arthritis treated with Etanercept with chronic Q fever manifesting as prosthetic valve infective endocarditis. Explanted valve tissue showed organisms confirmed to be C. burnetii by PCR (polymerase chain reaction) sequencing. She subsequently reported consumption of unpasteurized cow milk which was the likely source of C. burnetii. She continues to do well 6 months after valve replacement on oral doxycycline and hydroxychloroquine.
ISSN:2214-2509