A zoonotic cause of blood culture-negative infective endocarditis in Belgium: Case report and review of the literature on Q fever
Q fever is a worldwide zoonotic infection caused by Coxiella burnetii. In Belgium, the disease must be notified, and the incidence is low. Human contamination is mostly due to sheep and goats. Herein, we report a case of chronic Q fever presenting as a prolonged fever in a patient with a history of...
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| Language: | English |
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Elsevier
2022-01-01
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| Series: | IDCases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214250922002232 |
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| author | Van Noten Héloïse Mori Marcella Morissens Marielle Maillart Evelyne Leemans Sophie Gvinda Doina Channan El Mehdi Clevenbergh Philippe |
| author_facet | Van Noten Héloïse Mori Marcella Morissens Marielle Maillart Evelyne Leemans Sophie Gvinda Doina Channan El Mehdi Clevenbergh Philippe |
| author_sort | Van Noten Héloïse |
| collection | DOAJ |
| description | Q fever is a worldwide zoonotic infection caused by Coxiella burnetii. In Belgium, the disease must be notified, and the incidence is low. Human contamination is mostly due to sheep and goats. Herein, we report a case of chronic Q fever presenting as a prolonged fever in a patient with a history of valve prosthesis. Blood culture-negative endocarditis was diagnosed through an assessment including echocardiography and systematic serological testing. Despite the absence of travel abroad or obvious contact with domestic or wildlife animals, C. burnetii phase I and phase II IgG antibody titers were > 1:8192, and polymerase chain reaction performed on blood was positive for C. burnetii. Genotypic single nucleotide polymorphism (SNP) analysis of the pathogen strain identified a SNP-type 1 genomic group, which is associated with small ruminants in Belgium. The epidemiological investigation did not confirm the presence of positive C. burnetii cattle or sheep herds in the vicinity of the patient’s workplace and home, nor in the pest animals surrounding the workplace. Patients with risk factors for chronic Q fever should be tested for C. burnetii infection in case of prolonged fever of unknown origin, osteomyelitis, abscess or blood culture-negative endocarditis, even in the absence of direct exposure to animals. |
| first_indexed | 2024-04-11T20:08:03Z |
| format | Article |
| id | doaj.art-611498b7aa1e4386bf952cfbea8fc75e |
| institution | Directory Open Access Journal |
| issn | 2214-2509 |
| language | English |
| last_indexed | 2024-04-11T20:08:03Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | IDCases |
| spelling | doaj.art-611498b7aa1e4386bf952cfbea8fc75e2022-12-22T04:05:15ZengElsevierIDCases2214-25092022-01-0129e01595A zoonotic cause of blood culture-negative infective endocarditis in Belgium: Case report and review of the literature on Q feverVan Noten Héloïse0Mori Marcella1Morissens Marielle2Maillart Evelyne3Leemans Sophie4Gvinda Doina5Channan El Mehdi6Clevenbergh Philippe7Infectious Diseases Department, CHU-Brugmann, Brussels, Belgium; Correspondence to: CHU Brugmann Victor Horta, Département de cardiologie, Place Arthur Van Gehuchten 4, 1020 Brussels, Belgium.National Reference Center for Coxiella burnetii and Bartonella, Zoonoses of Animals Unit, Sciensano, Brussels, BelgiumCardiology Department, CHU-Brugmann, Brussels, BelgiumInfectious Diseases Department, CHU-Brugmann, Brussels, BelgiumInfectious Diseases Department, CHU-Brugmann, Brussels, BelgiumCardiology Department, CHU-Brugmann, Brussels, BelgiumCardiology Department, CHU-Brugmann, Brussels, BelgiumInfectious Diseases Department, CHU-Brugmann, Brussels, BelgiumQ fever is a worldwide zoonotic infection caused by Coxiella burnetii. In Belgium, the disease must be notified, and the incidence is low. Human contamination is mostly due to sheep and goats. Herein, we report a case of chronic Q fever presenting as a prolonged fever in a patient with a history of valve prosthesis. Blood culture-negative endocarditis was diagnosed through an assessment including echocardiography and systematic serological testing. Despite the absence of travel abroad or obvious contact with domestic or wildlife animals, C. burnetii phase I and phase II IgG antibody titers were > 1:8192, and polymerase chain reaction performed on blood was positive for C. burnetii. Genotypic single nucleotide polymorphism (SNP) analysis of the pathogen strain identified a SNP-type 1 genomic group, which is associated with small ruminants in Belgium. The epidemiological investigation did not confirm the presence of positive C. burnetii cattle or sheep herds in the vicinity of the patient’s workplace and home, nor in the pest animals surrounding the workplace. Patients with risk factors for chronic Q fever should be tested for C. burnetii infection in case of prolonged fever of unknown origin, osteomyelitis, abscess or blood culture-negative endocarditis, even in the absence of direct exposure to animals.http://www.sciencedirect.com/science/article/pii/S2214250922002232Blood culture-negative infective endocarditisCoxiella burnetiiChronic Q feverBelgiumPulmonary homograft |
| spellingShingle | Van Noten Héloïse Mori Marcella Morissens Marielle Maillart Evelyne Leemans Sophie Gvinda Doina Channan El Mehdi Clevenbergh Philippe A zoonotic cause of blood culture-negative infective endocarditis in Belgium: Case report and review of the literature on Q fever IDCases Blood culture-negative infective endocarditis Coxiella burnetii Chronic Q fever Belgium Pulmonary homograft |
| title | A zoonotic cause of blood culture-negative infective endocarditis in Belgium: Case report and review of the literature on Q fever |
| title_full | A zoonotic cause of blood culture-negative infective endocarditis in Belgium: Case report and review of the literature on Q fever |
| title_fullStr | A zoonotic cause of blood culture-negative infective endocarditis in Belgium: Case report and review of the literature on Q fever |
| title_full_unstemmed | A zoonotic cause of blood culture-negative infective endocarditis in Belgium: Case report and review of the literature on Q fever |
| title_short | A zoonotic cause of blood culture-negative infective endocarditis in Belgium: Case report and review of the literature on Q fever |
| title_sort | zoonotic cause of blood culture negative infective endocarditis in belgium case report and review of the literature on q fever |
| topic | Blood culture-negative infective endocarditis Coxiella burnetii Chronic Q fever Belgium Pulmonary homograft |
| url | http://www.sciencedirect.com/science/article/pii/S2214250922002232 |
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