Abstract
Q fever is a zoonosis caused by Coxiella burnetii, presenting as acute and chronic illness and it has been reported worldwide. Acute Q fever is usually asymptomatic or mild and self-limiting, but infective endocarditis is one of the most serious complications of chronic Q fever and can be fatal. Known risk factors for Q fever endocarditis are valvular heart disease, immunocompromised hosts, and pregnancy. There have been some reports on Q fever in Korea but there exists no report on Q fever endocarditis. We have experienced 2 cases of Q fever with underlying valvular heart disease; both patients came to the hospital for evaluation of prolonged fever. Although Q fever and Q fever endocarditis are rare in Korea, Q fever endocarditis should be considered in the differential diagnosis of patient with infective endocarditis when causative microorganism cannot be identified.
References
2. Shin YJ, Yoo NC, Choi W, Yang DG, Lee HL, Cheon SH, Chang J, Kim SK, Lee WY. A case of Q fever. Korean J Med. 1992. 42:690–698.
3. Heo ST, Park MY, Choi YS, Oh WS, Ko KS, Peck KR, Song JH. Q fever as a cause of fever of unknown origin. Korean J Med. 2008. 74:100–105.
4. An SJ, Koo JW, Chung CY, Lee WY. A case of Q fever: person-to-person transmission. J Korean Pediatr Soc. 1998. 41:120–124.
5. Kim KS, Lee WY. Coxiella burnetii infection in patients with various diseases. J Korean Pediatr Soc. 1994. 37:356–367.
6. Park HS, Lee EG, Lee SY, Lyu CJ, Son YM, Kim DS, Kim KY, Lee WY. A case of Q fever: associated with pancytopenia, hepatitis, and myocarditis. Korean J Infect Dis. 1992. 24:45–54.
7. Park MS, Park MY, Shin YO. Distribution of antibidies to Coxiella burnetii in patients with unknown fever and atypical pneumonia. J Bacteriol Virol. 2003. 33:307–315.
9. Raoult D, Marrie T, Mege J. Natural history and pathophysiology of Q fever. Lancet Infect Dis. 2005. 5:219–226.
10. Hartzell JD, Wood-Morris RN, Martinez LJ, Trotta RF. Q fever: epidemiology, diagnosis, and treatment. Mayo Clin Proc. 2008. 83:574–579.
11. Kim WJ, Hahn TW, Kim DY, Lee MG, Jung KS, Ogawa M, Kishimoto T, Lee ME, Lee SJ. Seroprevalence of Coxiella burnetii infection in dairy cattle and non-symptomatic people for routine health screening in Korea. J Korean Med Sci. 2006. 21:823–826.
12. Calza L, Attard L, Manfredi R, Chiodo F. Doxycycline and chloroquine as treatment for chronic Q fever endocarditis. J Infect. 2002. 45:127–129.
13. Raoult D, Houpikian P, Tissot Dupont H, Riss JM, Arditi-Djiane J, Brouqui P. Treatment of Q fever endocarditis: comparison of 2 regimens containing doxycycline and ofloxacin or hydroxychloroquine. Arch Intern Med. 1999. 159:167–173.