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J Thorac Cardiovasc Surg 2003;125:217-218
© 2003 The American Association for Thoracic Surgery

Brief Communications

Q fever endocarditis: A surgical view and a word of caution

Thierry G. Mesana, MD, PhDa,b, Frederic Collart, MDb, Thierry Caus, MD, PhDb, Agnes Salamand, MDb Marseille, France,b and Ottawa, Ontario, Canadaa

From the Division of Adult Cardiac Surgery, University Hospital La Timone, Marseille, France.

Received for publication May 28, 2002. Accepted for publication June 13, 2002. Address for reprints: T. Mesana, MD, PhD, Chief, Division of Cardiac Surgery, University of Ottawa Heart Institute, 40, Ruskin Street, Ottawa, Ontario, Canada (E-mail: tmesana@ottawaheart.ca).

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  		Dr Mesana

 
Q fever endocarditis is caused by Coxiella burnetii, which is linked to the Rickettsia family. This is a lethal but widely underestimated disease because of insidiousness and lack of knowledge, whereas it occurs worldwide, including North America.Go Go 1-3 It is a highly resistant intracellular microorganism that is frequently involved in negative blood culture endocarditis,Go Go 1,4 although it is easily detectable with a simple, low-cost, and reliable serologic examination with immunofluorescence. Because of a close relationship with a Nationwide Referral Centre for Rickettsioses, we have been developing surgical strategies that enabled us to more frequently identify Q fever in patients referred for valvular interventions with or without initial suspicion for endocarditis. We therefore observed, over a 15-year period, a consecutive series of 20 patients, representing, to our knowledge, the world's largest single surgical experience.Go 5 This brief report aims to emphasize the role of the cardiac surgeon in this difficult-to-diagnose, difficult-to-treat endocarditis.

Clinical summary

Between May 1987 and October . . . [Full Text of this Article]




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