Cardiac Valves in Patients with Q Fever Endocarditis: Microbiological, Molecular, and Histologic Studies

The pathologic features of Q fever endocarditis, which is caused by Coxiella burnetii were histologically evaluated in cardiac valves from 28 patients. We used quantitative image analysis to compare valvular fibrosis, calcifications, vegetations, inflammation, and vascularization due to Q fever endo...

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Bibliographic Details
Published in:The Journal of infectious diseases 2003-04, Vol.187 (7), p.1097-1106
Main Authors: Lepidi, Hubert, Houpikian, Pierre, Liang, Zhongxing, Raoult, Didier
Format: Article
Language:English
Subjects:
Adult
Aged
Bacterial diseases
Biological and medical sciences
Coxiella burnetii - genetics
Coxiella burnetii - immunology
Coxiella burnetii - isolation & purification
Endocarditis, Bacterial - microbiology
Endocarditis, Bacterial - pathology
Female
Heart Valve Prosthesis - microbiology
Heart Valves - microbiology
Heart Valves - pathology
Human bacterial diseases
Humans
Immunohistochemistry
Infectious diseases
Male
Medical sciences
Middle Aged
Q Fever - microbiology
Q Fever - pathology
Rickettsial diseases
Tropical bacterial diseases
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Summary:The pathologic features of Q fever endocarditis, which is caused by Coxiella burnetii were histologically evaluated in cardiac valves from 28 patients. We used quantitative image analysis to compare valvular fibrosis, calcifications, vegetations, inflammation, and vascularization due to Q fever endocarditis with that due to non–Q fever endocarditis and valvular degeneration. We also studied the presence of C. burnetii in valves by immunohistochemical analysis, culture, and polymerase chain reaction (PCR). Histologically, Q fever endocarditis was characterized by significant fibrosis and calcifications, slight inflammation and vascularization, and small or absent vegetations. Despite antibiotic treatment, non–statistically significant variations at the histologic level were observed. These pathologic features could be confused with noninfectious valvular degenerative damage. We found that the detection of C. burnetii in cardiac valves by immunohistochemical analysis, culture, and PCR decreased significantly only after 1 year of antibiotic treatment, which emphasizes the long persistence of this organism in valve tissues. Pathologic and immunohistochemical analyses may contribute to the diagnosis of Q fever endocarditis
ISSN:0022-1899
1537-6613
DOI:10.1086/368219