Diagnosis of Prosthetic Endocarditis Caused by Coxiella burnetii Using PET Scan and PCR: A Case Report of Chronic Q Fever

ABSTRACT Chronic blood culture‐negative endocarditis (BCNE) presents a significant challenge for early diagnosis and treatment, leading to increased morbidity and mortality. This report presents a 30‐year‐old man with a history of BCNE who presented with an intermittent fever lasting 3 months. His m...

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Main Authors: Sara Ghaderkhani, Maryam Moradi, Mahsa Azadbakhsh kanaf gorabi, Fereshteh Ghiasvand, Farnoosh Larti, Saber Esmaeili, Ensiyeh Rahimi
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Clinical Case Reports
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Online Access:https://doi.org/10.1002/ccr3.70289
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author Sara Ghaderkhani
Maryam Moradi
Mahsa Azadbakhsh kanaf gorabi
Fereshteh Ghiasvand
Farnoosh Larti
Saber Esmaeili
Ensiyeh Rahimi
author_facet Sara Ghaderkhani
Maryam Moradi
Mahsa Azadbakhsh kanaf gorabi
Fereshteh Ghiasvand
Farnoosh Larti
Saber Esmaeili
Ensiyeh Rahimi
author_sort Sara Ghaderkhani
collection DOAJ
description ABSTRACT Chronic blood culture‐negative endocarditis (BCNE) presents a significant challenge for early diagnosis and treatment, leading to increased morbidity and mortality. This report presents a 30‐year‐old man with a history of BCNE who presented with an intermittent fever lasting 3 months. His medical history was complex and characterized by tetralogy of Fallot (TOF), multiple cardiac surgeries, and previous positive pathological results for infection and endocarditis. A PET/CT scan revealed hypermetabolic lesions near the prosthetic valves and aortic grafts, prompting further investigation for potential causative organisms. Subsequent serological testing and PCR confirmed the presence of Coxiella burnetii, leading to a diagnosis of Q fever endocarditis. Treatment with doxycycline and hydroxychloroquine initiated significant improvement. Follow‐up after 3 months showed that the patient remained stable with significant improvements in serological tests and imaging. This case underscores the necessity of considering atypical pathogens like C. burnetii in patients with BCNE and chronic endocarditis, particularly those with complicated cardiac histories.
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spelling doaj-art-9aecf81e96174928913f32dc60009d5e2025-08-20T02:50:55ZengWileyClinical Case Reports2050-09042025-03-01133n/an/a10.1002/ccr3.70289Diagnosis of Prosthetic Endocarditis Caused by Coxiella burnetii Using PET Scan and PCR: A Case Report of Chronic Q FeverSara Ghaderkhani0Maryam Moradi1Mahsa Azadbakhsh kanaf gorabi2Fereshteh Ghiasvand3Farnoosh Larti4Saber Esmaeili5Ensiyeh Rahimi6Department of Infectious Diseases and Topical Medicine, School of Medicine, Imam Khomeini Hospital Complex Tehran University of Medical Sciences Tehran IranEye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital Iran University of Medical Sciences Tehran IranDepartment of Infectious Diseases and Topical Medicine, School of Medicine, Imam Khomeini Hospital Complex Tehran University of Medical Sciences Tehran IranLiver Transplantation Research Center, Department of Infectious Diseases, Imam Khomeini Hospital Complex Tehran University of Medical Sciences Tehran IranDepartment of Cardiology, School of Medicine, Prehospital and Hospital Emergency Research Center, Imam Khomeini Hospital Complex Tehran University of Medical Sciences Tehran IranDepartment of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases Pasteur Institute of Iran Tehran IranIranian Research Center for HIV/AIDS, School of Medicine, Imam Khomeini Hospital Complex Tehran University of Medical Sciences Tehran IranABSTRACT Chronic blood culture‐negative endocarditis (BCNE) presents a significant challenge for early diagnosis and treatment, leading to increased morbidity and mortality. This report presents a 30‐year‐old man with a history of BCNE who presented with an intermittent fever lasting 3 months. His medical history was complex and characterized by tetralogy of Fallot (TOF), multiple cardiac surgeries, and previous positive pathological results for infection and endocarditis. A PET/CT scan revealed hypermetabolic lesions near the prosthetic valves and aortic grafts, prompting further investigation for potential causative organisms. Subsequent serological testing and PCR confirmed the presence of Coxiella burnetii, leading to a diagnosis of Q fever endocarditis. Treatment with doxycycline and hydroxychloroquine initiated significant improvement. Follow‐up after 3 months showed that the patient remained stable with significant improvements in serological tests and imaging. This case underscores the necessity of considering atypical pathogens like C. burnetii in patients with BCNE and chronic endocarditis, particularly those with complicated cardiac histories.https://doi.org/10.1002/ccr3.70289blood culture‐negative endocarditischronic endocarditisCoxiella burnetiiQ fever
spellingShingle Sara Ghaderkhani
Maryam Moradi
Mahsa Azadbakhsh kanaf gorabi
Fereshteh Ghiasvand
Farnoosh Larti
Saber Esmaeili
Ensiyeh Rahimi
Diagnosis of Prosthetic Endocarditis Caused by Coxiella burnetii Using PET Scan and PCR: A Case Report of Chronic Q Fever
Clinical Case Reports
blood culture‐negative endocarditis
chronic endocarditis
Coxiella burnetii
Q fever
title Diagnosis of Prosthetic Endocarditis Caused by Coxiella burnetii Using PET Scan and PCR: A Case Report of Chronic Q Fever
title_full Diagnosis of Prosthetic Endocarditis Caused by Coxiella burnetii Using PET Scan and PCR: A Case Report of Chronic Q Fever
title_fullStr Diagnosis of Prosthetic Endocarditis Caused by Coxiella burnetii Using PET Scan and PCR: A Case Report of Chronic Q Fever
title_full_unstemmed Diagnosis of Prosthetic Endocarditis Caused by Coxiella burnetii Using PET Scan and PCR: A Case Report of Chronic Q Fever
title_short Diagnosis of Prosthetic Endocarditis Caused by Coxiella burnetii Using PET Scan and PCR: A Case Report of Chronic Q Fever
title_sort diagnosis of prosthetic endocarditis caused by coxiella burnetii using pet scan and pcr a case report of chronic q fever
topic blood culture‐negative endocarditis
chronic endocarditis
Coxiella burnetii
Q fever
url https://doi.org/10.1002/ccr3.70289
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