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Review
, 44 (6), 2283-7

Chronic Q Fever in the United States

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Review

Chronic Q Fever in the United States

Petros C Karakousis et al. J Clin Microbiol.

Abstract

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.

Figures

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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