Immunohistochemical detection of Coxiella burnetii in an aortic graft

Lépidi, Hubert; Fournier, Pierre‐Edouard; Karcher, Heiko; Schneider, Thomas; Raoult, Didier

doi:10.1111/j.1469-0691.2008.02213.x

Cited by 8 publications

(10 citation statements)

References 13 publications

(14 reference statements)

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“…A possible limitation of this study was that histological analyses were performed on a 3-m tissue sections, which contained a small tissue cell quantity or small inflammatory cell quantities. Coxiella burnetii infections can be localized in a small area of tissue (27,28), and it is possible that the analysis of more different biopsy sections could potentially increase the sensitivity of both FISH and immunohistochemical analyses.…”

Section: Discussionmentioning

confidence: 99%

Fluorescence In Situ Hybridization (FISH) and Peptide Nucleic Acid Probe-Based FISH for Diagnosis of Q Fever Endocarditis and Vascular Infections

et al. 2018

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Endocarditis and vascular infections are common manifestations of persistent localized infection due to , and recently, fluorescence hybridization (FISH) was proposed as an alternative tool for their diagnosis. In this study, we evaluated the efficiency of FISH in a series of valve and vascular samples infected by We tested 23-positive valves and thrombus samples obtained from patients with Q fever endocarditis. Seven aneurysms and thrombus specimens were retrieved from patients with Q fever vascular infections. Samples were analyzed by culture, immunochemistry, and FISH with oligonucleotide and PNA probes targeting -specific 16S rRNA sequences. The immunohistochemical analysis was positive for five (17%) samples with significantly more copies of DNA than the negative ones ( = 0.02). FISH was positive for 13 (43%) samples and presented 43% and 40% sensitivity compared to that for quantitative PCR (qPCR) and culture, respectively. PNA FISH detected in 18 (60%) samples and presented 60% and 55% sensitivity compared to that for qPCR and culture, respectively. Immunohistochemistry had 38% and 28% sensitivity compared to that for FISH and PNA FISH, respectively. Samples found positive by both immunohistochemistry and PNA FISH contained significantly more copies of DNA than the negative ones ( = 0.03). Finally, PNA FISH was more sensitive than FISH (60% versus 43%, respectively) for the detection of We provide evidence that PNA FISH and FISH are important assays for the diagnosis of endocarditis and vascular infections.

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Section: Discussionmentioning

confidence: 99%

Fluorescence In Situ Hybridization (FISH) and Peptide Nucleic Acid Probe-Based FISH for Diagnosis of Q Fever Endocarditis and Vascular Infections

et al. 2018

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“…Lepidi et al also developed a method called "autoimmunochemistry," using antibodies produced from the patient's own serum (370). IHC was used for detection of C. burnetii in aortic graft samples and hepatic and valvular biopsy specimens (328,371,372).…”

Section: Pathology and Immunohistochemistrymentioning

confidence: 99%

“…(ii) Vascular infections. An increasing number of reports of C. burnetii vascular infections have been published in the last decade, mainly due to the outbreak in the Netherlands (78,371,405,417,551,. At present, it is the most frequent form of persistent infection reported in the Netherlands (371,405,417,418,553,.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

From Q Fever to Coxiella burnetii Infection: a Paradigm Change

et al. 2017

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Coxiella burnetii is the agent of Q fever, or "query fever," a zoonosis first described in Australia in 1937. Since this first description, knowledge about this pathogen and its associated infections has increased dramatically. We review here all the progress made over the last 20 years on this topic. C. burnetii is classically a strict intracellular, Gram-negative bacterium. However, a major step in the characterization of this pathogen was achieved by the establishment of its axenic culture. C. burnetii infects a wide range of animals, from arthropods to humans. The genetic determinants of virulence are now better known, thanks to the achievement of determining the genome sequences of several strains of this species and comparative genomic analyses. Q fever can be found worldwide, but the epidemiological features of this disease vary according to the geographic area considered, including situations where it is endemic or hyperendemic, and the occurrence of large epidemic outbreaks. In recent years, a major breakthrough in the understanding of the natural history of human infection with C. burnetii was the breaking of the old dichotomy between "acute" and "chronic" Q fever. The clinical presentation of C. burnetii infection depends on both the virulence of the infecting C. burnetii strain and specific risks factors in the infected patient. Moreover, no persistent infection can exist without a focus of infection. This paradigm change should allow better diagnosis and management of primary infection and long-term complications in patients with C. burnetii infection.

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“…The PubMed search yielded 29 cases of Coxiella burnetii endovascular graft infection, all of them involving large vascular grafts. 2 , 3 , 7 , 10 , 11 , 15 , 18 , 22 , 26 , 28 , 32 , 36 , 42 , 43 However, 15 of these cases, all described in a single study, 3 could not be included because the patients’ treatment and clinical course were not individually described.…”

Section: Resultsmentioning

confidence: 99%

“…The mean time onset of chronic Q fever after graft placement was 4.6 years (range, 3 mo-15 yr) and in all previous cases the disease affected great vessels. The dacron aortobifemoral bypass 10 , 26 , 28 , 36 and infrarenal aortic graft 2 , 7 , 15 , 40 were the most common involved grafts (4 patients each), followed by thoracic aortic graft (3 patients), 11 , 42 , 43 PTFE subclavian-subclavian cross-over (1 patient), 32 aortobiiliac endoprosthesis (1 patient), 22 aortic endoprosthesis (1 patient), 18 and left humeral-axillary AV PTFE graft in our case. Fever and local pain were reported in 8 cases respectively, weight loss was reported in 4 cases, embolic phenomena in 3 cases, gastrointestinal symptoms (nausea, vomiting, and diarrhea) and respiratory symptoms (dyspnea and fatigue) in 2 cases, respectively, and other cases reported new symptoms like renal failure, hepatosplenomegaly, and purulent discharge, as was our case (see Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Coxiella burnetii Infection in Hemodialysis and Other Vascular Grafts

et al. 2014

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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.

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Immunohistochemical detection of Coxiella burnetii in an aortic graft

Cited by 8 publications

References 13 publications

Fluorescence In Situ Hybridization (FISH) and Peptide Nucleic Acid Probe-Based FISH for Diagnosis of Q Fever Endocarditis and Vascular Infections

Fluorescence In Situ Hybridization (FISH) and Peptide Nucleic Acid Probe-Based FISH for Diagnosis of Q Fever Endocarditis and Vascular Infections

From Q Fever to Coxiella burnetii Infection: a Paradigm Change

Coxiella burnetii Infection in Hemodialysis and Other Vascular Grafts

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