Case report of Acute Q fever with Hepatitis progressing to Chronic Q fever with Endocarditis

Abstract

A 35-year-old male greenhouse worker presented with myalgia, fatigue, and fever. Initially, he was thought to have an unspecified viral infection and was treated with conservative therapy. However, the patient’s symptoms persisted, and he reported additional symptoms of mild abdominal pain and headaches. Laboratory evaluation was significant for elevated liver enzymes. Due to concern for acute hepatitis and persistent fever the patient was hospitalized. During his hospital course, no infectious etiology was found to explain his symptoms. After discharge from the hospital, additional testing showed positive serology for Q fever IgG phase II antibody (1:8192) and phase II antibody IgM (>1:2048). He was treated with doxycycline and had a good clinical response. Upon follow-up, he had worsening Phase I IgG serologies. Transesophageal echo demonstrated vegetations consistent with endocarditis.

A case report of Vancomycin in the treatment of Q fever endocarditis

“…Doxycycline 0.1g bid is the preferred treatment option for acute Q fever, and fluoroquinolones and sulfamethoxazole are also available for a 14-day course. Doxycycline 0.1g bid coupled with hydroxychloroquine 0.2g tid is recommended for chronic Q fever for at least 18 months, particularly Q fever endocarditis ( Patil and Regunath, 2022 ; Jama et al., 2023 ). A recent case report showed that azithromycin can treat myocarditis in chronic Q fever infection ( Steffen et al., 2020 ).…”