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, 44 (6), 2283-7

Chronic Q Fever in the United States


Chronic Q Fever in the United States

Petros C Karakousis et al. J Clin Microbiol.


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.


FIG. 1.
FIG. 1.
Noncaseating granuloma in the bone marrow of a 31-year-old farmer with chronic Q fever (hematoxylin and eosin stain; original magnification, ×100).

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