Q fever endocarditis in Spain. Clinical characteristics and outcome

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• 作者：Maria Victoria Mogolló ; n^a ; Manuel P. Anguita^b ; José ; Marí ; a Aguado^c ; Pilar Tornos^d ; José ; M. Miró ; ^e ; Juan Gá ; lvez-Acebal^f ; Agustí ; n Muñ ; oz-Sanz^g ; Maria del Carmen Fariñ ; as^h ; Manuel Ferná ; ndez-Guerreroⁱ ; Isidre Vilacosta^j ; Patricia Muñ ; oz^k ; José ; Miguel Montejo-Baranda^l ; Carmen Hidalgo-Tenorio^m ; Vicenc Falcó ; ⁿ ; Ana del Rí ; o^e ; Ana Marí ; a Arnaí ; z^h ; Isabel San-Feliú ; ^o ; Arí ; stides de Alarcó ; n^p ; ^{aa2406ge@yahoo.es} ; on behalf of the Spanish Q Fever Endocarditis Group^&loz ;
• 关键词：Q fever ; Infective endocarditis ; Treatment ; Serological criteria
• 刊名：Enfermedades Infecciosas y Microbiolog铆a Cl铆nica
• 出版年：2011
• 期刊代码：pca153_0213005X
• 类别：med
• 出版时间：February 2011
• 卷：29
• 期：2
• 页码：109-116
• 文件大小：210 K

摘要

Objectives

To describe the clinical presentation of a large number of Q fever endocarditis (QFE) and its management considering the role of serology.

Patients and methods

Eighty-three patients with definite QFE (56 native and 27 prosthetic valve) with a long-term follow-up after stopping treatment (median: 48 months) were included. Final outcome (cure or relapse) was compared according with the serological titre at the end of therapy: less than 1:400 of phase I Ig G antibodies by indirect immunofluorescence (group 1, N = 23) or more than 1:400 (group 2, N = 30).

Results

Eleven patients (13.2%) died from QFE and other 8 died for other reasons not related to endocarditis during follow-up. Surgery was performed in 61 (73.5%) patients and combined antimicrobial treatment was long (median: 23 months, IQR: 12 鈥?36). Seven relapses were observed, but five of them had received an initial incomplete antibiotic regimen. In patients who completed the programmed treatment (range: 12 鈥?89 months), serological titres at the end of therapy were not useful for predicting the final outcome: one relapse in each group.

Conclusions

QFE requires a prolonged antimicrobial treatment, but serological titres are not useful for determining its duration.