Coxiella burnetii Infection in Hemodialysis and Other Vascular Grafts

Abstract

Prosthetic arteriovenous (AV) graft infection is the principal cause of morbidity related to chronic hemodialysis AV graft fistula. Coxiella burnetii is a known pathogen that causes fever, pneumonia, and intravascular infections with the limitation of negative cultures. Herein, we report the first case of a patient who presented to the emergency department of our hospital with a prosthetic hemodialysis AV graft infection due to Coxiella burnetii. We also performed a literature search with PubMed to identify studies reporting cases of Coxiella burnetii vascular graft infection. Overall, we reviewed 15 cases of vascular graft infection, including ours. We found a high prevalence of male patients (87%); mean age ± standard deviation (SD) of the entire population was 60.4 ± 9.6 years. The dacron infrarenal aortic and the aortobifemoral bypass were the most common involved grafts. The early diagnosis of infection due to Coxiella burnetii was done by serology or with polymerase chain reaction (PCR), in 12 and 3 cases, respectively. All patients underwent partial or complete resection of the infected grafts; the most common antibiotic treatment for this entity was doxycycline and hydroxycloroquine.Although this is a relatively rare disease, Coxiella burnetii should be included in the differential diagnosis of all patients who present with infection of an endovascular graft of any nature with an inconclusive etiologic diagnosis.

Prevalence and Correlation of Infectious Agents in Hospitalized Children with Acute Respiratory Tract Infections in Central China

“…Coxiella burnetii ( C . burnetii ) is the etiologic agent of Q fever, a known pathogen that causes fever, pneumonia, and intravascular infections [ 5 , 6 ]. Studies of CAP have traditionally focused little on viral causes[ 2 ].…”

“…Currently, viral infections are also involved with 80% of episodes of CAP in children under 2 years old and over 40% of older children [ 6 – 11 ]. The existing studies have showed that respiratory syncytial virus (RSV) and influenza viruses (Flu) are important pathogens among the hospitalized and outpatient children presenting with ARTI [ 5 , 6 ].Adenovirus virus (ADV) and parainfluenza viruses (PIV) are also associated with a substantial proportion of ALRI in infants and young children [ 7 – 9 ].…”

Coxiella burnetii Femoro-Popliteal Bypass Infection: A Case Report

“…According to Hagenaars et al, PET-scan has a positive predictive value of 78% and a negative predictive value of 77% for the diagnosis of Q fever vascular infections [31]. In a retrospective study involving 167 patients with active C. burnetii infection, 18 F-FDG PET/CT changed the diagnosis for 62.6% of patients and revealed a previously unsuspected focus of infection in 38.7% of cases. This innovation was a strong argument for a paradigm change from chronic Q fever to C. burnetii persistent focalized infection.…”