Q fever endocarditis associated with a cardiovascular implantable electronic device

Oteo, José A.; Pérez-Cortés, Salvador; Ez, Parsagashvili; Gutiérrez, E.; Portillo, Aránzazu; Blanco, José Ramón; Alarcón, Arı́stides de

doi:10.1111/j.1469-0691.2012.03992.x

Cited by 11 publications

(8 citation statements)

References 14 publications

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“…Regarding more severe valvulopathy, aortic regurgitation is at higher risk than mitral regurgitation and aortic stenosis (320). Also, three cases of C. burnetii infection of cardiovascular implantable electronic devices and a single case of C. burnetii infection of an intracardiac thrombus mimicking atrial myxoma have been reported to date (412,542,543).…”

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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Section: Clinical Manifestationsmentioning

confidence: 99%

From Q Fever to Coxiella burnetii Infection: a Paradigm Change

et al. 2017

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“…faecalis and H . parainfluenzae , respectively.For all these 24 patients, NGS results allowed us to retrospectively confirm the previous diagnosis.In addition, the 16S-NGS test data assessment, led us to corroborate mixed infections within the clinical and epidemiologic context when considering relatively low abundant microorganisms.Thus, for patient ID #1649, whose initial microbiologic diagnosis included Brucella melitensis (by BC and PCR) and Coxiella burnetii (by indirect immunofluorescence assays and specific PCR) (24), metagenomic results showed Brucellaceae as the most relative abundant taxa (99.7%) and, interestingly, C . burnetii was also detected at low relative abundance (<1%).For patient ID #1990, conventional methods (BC and PCR) led to an IE diagnosis due to E .…”

Section: Resultsmentioning

confidence: 99%

What does 16S rRNA gene-targeted next generation sequencing contribute to the study of infective endocarditis in valve tissue?

Santibáñez

Portillo

Santibáñez

et al. 2021

Preprint

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Infective endocarditis (IE) is a severe and life-threatening disease. Identification of infectious etiology is essential for establishing the appropriate antimicrobial treatment and decreasing mortality. The aim of this study was to explore potential utility of metagenomics for improving microbiological diagnosis of IE. In this work, next-generation sequencing (NGS) of V3-V4 region of the 16S rRNA gene was performed in 27 heart-valve tissues (18 natives, 5 intravascular devices, and 4 prosthetics) of patients diagnosed by IE. Initial microbiological diagnosis, blood culture (BC) and/or PCR, was compared with NGS-based diagnosis. Metagenomics matched with conventional techniques diagnosis in 24/27 cases (88.9%). The same bacterial family was assigned to 24 cases, the same genus to 23 cases, and the same specie for 13 cases. In 22 of them, the etiological agent was represented by percentages >99% of the reads and in two by ∼70%. Staphylococcus aureus was detected in a previously undiagnosed patient, making the microbiological diagnosis possible in one more sample than with previously used techniques. The remaining two patients showed no coincidence between traditional and NGS microbiological diagnoses. Minority records verified mixed infections in four cases and suggested confections in two cases, supported by clinical data. In conclusion: 16S rRNA gene-targeted NGS allowed to diagnose one case of IE without microbiological entity based on traditional techniques. However, the application of metagenomics to the study of IE in resected heart valves provides no benefits in comparison with BC and/or PCR. More studies are needed before implementation of NGS for the diagnosis of IE.

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“…In an attempt to secure a microbial diagnosis of CIED‐IE cases, an extensive evaluation, including serologic and antigen assays, similar to those recommended for CN endocarditis, was performed for five patients in our study cohort and was negative in all five. While there are published case reports of Brucella ‐ and Coxiella ‐related CIED infection, these organisms are extremely rare causes of device infection and should only be considered in patients with associated risk factors and relevant exposure history.…”

Section: Discussionmentioning

confidence: 99%