Chronic Q Fever in the United States

Infections due to Coxiella burnetii, the causative agent of Q fever, are uncommon in the United States. Cases of chronic Q fever are extremely rare and most often manifest as culture-negative endocarditis in patients with underlying valvular heart disease. We describe a 31-year-old farmer from West...

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Bibliographic Details
Published in:Journal of Clinical Microbiology 2006-06, Vol.44 (6), p.2283-2287
Main Authors: Karakousis, Petros C, Trucksis, Michele, Dumler, J. Stephen
Format: Article
Language:English
Subjects:
Adult
Antibodies, Bacterial - blood
Case Reports
Chronic Disease
Coxiella burnetii
Coxiella burnetii - immunology
Coxiella burnetii - isolation & purification
Endocarditis, Bacterial - diagnosis
Endocarditis, Bacterial - epidemiology
Endocarditis, Bacterial - microbiology
Humans
Male
Q Fever - diagnosis
Q Fever - epidemiology
Q Fever - microbiology
United States - epidemiology
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Summary:Infections due to Coxiella burnetii, the causative agent of Q fever, are uncommon in the United States. Cases of chronic Q fever are extremely rare and most often manifest as culture-negative endocarditis in patients with underlying valvular heart disease. We describe a 31-year-old farmer from West Virginia with a history of congenital heart disease and recurrent fevers for 14 months who was diagnosed with Q fever endocarditis based on an extremely high antibody titer against Coxiella burnetii phase I antigen. Despite treatment with doxycycline, he continued to have markedly elevated Coxiella burnetii phase I antibody titers for 10 years after the initial diagnosis. To our knowledge, this case represents the longest follow-up period for a patient with chronic Q fever in the United States. We review all cases of chronic Q fever reported in the United States and discuss important issues pertaining to epidemiology, diagnosis, and management of this disease.
ISSN:0095-1137
1098-660X
1098-5530
DOI:10.1128/JCM.02365-05