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European Heart Journal 1988 9(8):923-926;
Copyright © 1988 by the European Society of Cardiology.
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© 1988 The European Society of Cardiology

Acute heart failure due to Q fever endocarditis

J. ETIENNE*,, F. DELAHAYE*, R. RAOULT{dagger}, J.-P. FRIEH*, R. LOIRE* and J. DELAYE*

*Hôpital Cardiologique, BP Lyon Montchat 69394 Lyon, Cédex 3, France
{dagger}Centre National de Réferènce des Rickettsioses Hôpital de la Timone 13385 Marseille, Cédex 5, France

Received 11 November 1988; revised 2 February 1988; .

Address for reprints: J. Etienne, Hôpital Cardiologique, BP Lyon Montchat, 69394 Lyon, Cédex 3, France.

Abstract

We report a case of Q fever endocarditis in a patient who presented with a slight pyrexia and acute cardiac failure due to aortic incompetence. The diagnosis was made by detecting high titres of serum IgG and IgA antibody against Coxiella burnetii phase I antigens and confirmed by demonstrating C. burnetii on the excised aortic valve using immunofluorescene and electron microscopy. Aortic valve replacement was followed by initially successful antibiotic treatment for 15 months. Reappearance of Ig A anti-phase I antibodies 5 months later suggested continued presence of bacteria, although the patient's condition remained satisfactory. In endemic areas, such as rural southern France, Q fever endocarditis should be considered when there is evidence of acute heart valve damage but are few other features of infection.

Key Words: Endocarditis • Coxiella burnetii.


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