Surgical and Antimicrobial Management of a Thoracic Aortic Aneurysm Due to Q Fever: A Case Report and Brief Review

Vasc Endovascular Surg. 2016 May;50(4):290-4. doi: 10.1177/1538574416642876. Epub 2016 Apr 12.


Coxiella burnetii, the etiologic agent of Q fever, has been associated with vascular infection and aneurysm formation. We report the case of a 36-year-old woman from Iraq who presented with long-standing malaise as well as vague chest and shoulder discomfort and was found to have a saccular aneurysm of the descending thoracic aorta. Serology assays were positive for chronic C burnetii infection. She was treated with successful aneurysm resection and aortic replacement with a rifampin-impregnated Maquet Hemashield (TM) Dacron interposition graft interposition graft in addition to 18 months of doxycycline and hydroxychloroquine. The patient is without evidence of recurrent infection on follow-up at 3 years. To our knowledge, this is the first case of aortic aneurysm secondary to Q fever reported in the United States. We review the diagnosis, surgical management, antibiotic therapy, and surveillance of a thoracic aortic aneurysm secondary to Q fever.

Keywords: Coxiella burnetii; Q fever; United States; thoracic aortic aneurysm; vascular infection.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aneurysm, Infected / diagnostic imaging
  • Aneurysm, Infected / microbiology
  • Aneurysm, Infected / surgery*
  • Anti-Bacterial Agents / administration & dosage*
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / microbiology
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Coated Materials, Biocompatible*
  • Computed Tomography Angiography
  • Coxiella burnetii / isolation & purification*
  • Doxycycline / administration & dosage*
  • Female
  • Humans
  • Hydroxychloroquine / administration & dosage*
  • Prosthesis Design
  • Q Fever / diagnosis
  • Q Fever / drug therapy*
  • Q Fever / microbiology
  • Rifampin / administration & dosage*
  • Time Factors
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Coated Materials, Biocompatible
  • Hydroxychloroquine
  • Doxycycline
  • Rifampin