Ten-year experience of Q fever endocarditis in a tertiary cardiac center in Saudi Arabia
Background: Q fever endocarditis (QFE) is considered rare in the Middle East, with only a few cases reported in Saudi Arabia. The aim of this study is to report on the experience of our centre on QFE. Methods: We searched the medical records for cases of QFE at our cardiac center from 2009–2018. Dem...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-11-01
|
| Series: | International Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971219303212 |
| _version_ | 1819071484992159744 |
|---|---|
| author | Fatehi E. Elzein Nisreen Alsherbeeni Khalid Alnajashi Eid Alsufyani M.Y. Akhtar Rashed Albalawi Ahmed M. Albarrag Naoufel Kaabia Syed Mehdi Ahmed Alzahrani Didier Raoult |
| author_facet | Fatehi E. Elzein Nisreen Alsherbeeni Khalid Alnajashi Eid Alsufyani M.Y. Akhtar Rashed Albalawi Ahmed M. Albarrag Naoufel Kaabia Syed Mehdi Ahmed Alzahrani Didier Raoult |
| author_sort | Fatehi E. Elzein |
| collection | DOAJ |
| description | Background: Q fever endocarditis (QFE) is considered rare in the Middle East, with only a few cases reported in Saudi Arabia. The aim of this study is to report on the experience of our centre on QFE. Methods: We searched the medical records for cases of QFE at our cardiac center from 2009–2018. Demographic data, clinical features, serology and echocardiography results, treatments, and outcomes were assessed. Results: Five hundred and two cases of infective endocarditis were detected over the 10 years period. Among the 234 patients with blood culture-negative endocarditis (BCNE), 19 (8.10%) had QFE. All patients had a previously diagnosed congenital heart disease except for one patient with rheumatic heart disease. Eleven patients had received a bovine jugular vein-related implant, e.g., a Melody valve (seven patients) or Contegra conduit (four patients). Coinfection was detected in three patients, and immunologic and embolic phenomena were observed in five patients. All patients received a combination of hydroxychloroquine and doxycycline, with good outcomes. Only two patients required surgery while on treatment. Two patients died several months after treatment; the cause of death was not identified. Conclusion: This study indicates that Q fever exists in our population. The majority of the patients had congenital heart disease (CHD) and underwent bovine jugular vein implants. Patients with CHD are at increased risk of infective endocarditis. Bovine jugular vein implants increase the risk of infective and possibly QFE. Proper exclusion of Q fever is warranted in all BCNE and possibly in culture-positive endocarditis cases in areas endemic to Q fever. Key points: We presented the largest series of Q fever endocarditis cases in Saudi Arabia. We showed that Q fever is not rare in the Middle East and suggest that it should be considered in all blood culture-negative endocarditis cases. Keywords: Q fever endocarditis, Congenital heart disease, Jugular vein, Middle East |
| first_indexed | 2024-12-21T17:22:34Z |
| format | Article |
| id | doaj.art-6e66f2fd941e4edb8540c94c465e79f5 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-21T17:22:34Z |
| publishDate | 2019-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-6e66f2fd941e4edb8540c94c465e79f52022-12-21T18:56:08ZengElsevierInternational Journal of Infectious Diseases1201-97122019-11-01882126Ten-year experience of Q fever endocarditis in a tertiary cardiac center in Saudi ArabiaFatehi E. Elzein0Nisreen Alsherbeeni1Khalid Alnajashi2Eid Alsufyani3M.Y. Akhtar4Rashed Albalawi5Ahmed M. Albarrag6Naoufel Kaabia7Syed Mehdi8Ahmed Alzahrani9Didier Raoult10Infectious Diseases Unit, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia; Corresponding author at: Infectious Diseases Unit, PSMMC, P.O. Box 7897, Riyadh 11159, Saudi Arabia.Infectious Diseases Unit, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi ArabiaPrince Sultan Cardiac Centre, Riyadh, Saudi ArabiaInfectious Diseases Unit, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi ArabiaPrince Sultan Cardiac Centre, Riyadh, Saudi ArabiaInfectious Diseases Unit, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi ArabiaKing Saud University, KKUH, Saudi ArabiaInfectious Diseases Unit, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi ArabiaPrince Sultan Cardiac Centre, Riyadh, Saudi ArabiaPrince Sultan Cardiac Centre, Riyadh, Saudi ArabiaAix Marseille Université, MEPHI, IHU-Méditerranée Infection, Marseille, France; IHU-Méditerranée Infection, Marseille, FranceBackground: Q fever endocarditis (QFE) is considered rare in the Middle East, with only a few cases reported in Saudi Arabia. The aim of this study is to report on the experience of our centre on QFE. Methods: We searched the medical records for cases of QFE at our cardiac center from 2009–2018. Demographic data, clinical features, serology and echocardiography results, treatments, and outcomes were assessed. Results: Five hundred and two cases of infective endocarditis were detected over the 10 years period. Among the 234 patients with blood culture-negative endocarditis (BCNE), 19 (8.10%) had QFE. All patients had a previously diagnosed congenital heart disease except for one patient with rheumatic heart disease. Eleven patients had received a bovine jugular vein-related implant, e.g., a Melody valve (seven patients) or Contegra conduit (four patients). Coinfection was detected in three patients, and immunologic and embolic phenomena were observed in five patients. All patients received a combination of hydroxychloroquine and doxycycline, with good outcomes. Only two patients required surgery while on treatment. Two patients died several months after treatment; the cause of death was not identified. Conclusion: This study indicates that Q fever exists in our population. The majority of the patients had congenital heart disease (CHD) and underwent bovine jugular vein implants. Patients with CHD are at increased risk of infective endocarditis. Bovine jugular vein implants increase the risk of infective and possibly QFE. Proper exclusion of Q fever is warranted in all BCNE and possibly in culture-positive endocarditis cases in areas endemic to Q fever. Key points: We presented the largest series of Q fever endocarditis cases in Saudi Arabia. We showed that Q fever is not rare in the Middle East and suggest that it should be considered in all blood culture-negative endocarditis cases. Keywords: Q fever endocarditis, Congenital heart disease, Jugular vein, Middle Easthttp://www.sciencedirect.com/science/article/pii/S1201971219303212 |
| spellingShingle | Fatehi E. Elzein Nisreen Alsherbeeni Khalid Alnajashi Eid Alsufyani M.Y. Akhtar Rashed Albalawi Ahmed M. Albarrag Naoufel Kaabia Syed Mehdi Ahmed Alzahrani Didier Raoult Ten-year experience of Q fever endocarditis in a tertiary cardiac center in Saudi Arabia International Journal of Infectious Diseases |
| title | Ten-year experience of Q fever endocarditis in a tertiary cardiac center in Saudi Arabia |
| title_full | Ten-year experience of Q fever endocarditis in a tertiary cardiac center in Saudi Arabia |
| title_fullStr | Ten-year experience of Q fever endocarditis in a tertiary cardiac center in Saudi Arabia |
| title_full_unstemmed | Ten-year experience of Q fever endocarditis in a tertiary cardiac center in Saudi Arabia |
| title_short | Ten-year experience of Q fever endocarditis in a tertiary cardiac center in Saudi Arabia |
| title_sort | ten year experience of q fever endocarditis in a tertiary cardiac center in saudi arabia |
| url | http://www.sciencedirect.com/science/article/pii/S1201971219303212 |
| work_keys_str_mv | AT fatehieelzein tenyearexperienceofqfeverendocarditisinatertiarycardiaccenterinsaudiarabia AT nisreenalsherbeeni tenyearexperienceofqfeverendocarditisinatertiarycardiaccenterinsaudiarabia AT khalidalnajashi tenyearexperienceofqfeverendocarditisinatertiarycardiaccenterinsaudiarabia AT eidalsufyani tenyearexperienceofqfeverendocarditisinatertiarycardiaccenterinsaudiarabia AT myakhtar tenyearexperienceofqfeverendocarditisinatertiarycardiaccenterinsaudiarabia AT rashedalbalawi tenyearexperienceofqfeverendocarditisinatertiarycardiaccenterinsaudiarabia AT ahmedmalbarrag tenyearexperienceofqfeverendocarditisinatertiarycardiaccenterinsaudiarabia AT naoufelkaabia tenyearexperienceofqfeverendocarditisinatertiarycardiaccenterinsaudiarabia AT syedmehdi tenyearexperienceofqfeverendocarditisinatertiarycardiaccenterinsaudiarabia AT ahmedalzahrani tenyearexperienceofqfeverendocarditisinatertiarycardiaccenterinsaudiarabia AT didierraoult tenyearexperienceofqfeverendocarditisinatertiarycardiaccenterinsaudiarabia |