TY - JOUR
T1 - Coxiella burnetii Endocarditis and Aortic Vascular Graft Infection
T2 - An Underrecognized Disease
AU - Maor, Y
AU - Sternik, L
AU - Orlov, B
AU - Rahav, G
AU - Keller, N
AU - Raanani, E
AU - Kogan, A
N1 - Publisher Copyright:
© 2016 The Society of Thoracic Surgeons.
PY - 2016/1
Y1 - 2016/1
N2 - Background Q fever is considered endemic worldwide, and endocarditis, or aortic vascular infection, or both caused by Coxiella burnetii can be a fatal disease. The importance of surgical intervention has not yet been defined. We performed a descriptive retrospective study to assess indications for surgical treatment, timing of treatment, and outcome. Methods We studied all patients from the cardiac surgery department of a large tertiary hospital who underwent valve surgical procedure due to endocarditis or aortic surgical procedure due to graft infection. Results Throughout a 10-year period, we performed a total of 171 procedures due to valve endocarditis and/or vascular infection. In 16 patients (9.36%) Coxiella burnetii infection was diagnosed. Ten patients had previous cardiac surgical procedures, 3 had previous aortic surgical procedures, 2 had preexisting valvular disease, and 1 patient had no previous valve disorder. All patients received prolonged oral-specific antibiotic therapy under serologic guidance. In 9 patients antibiotic treatment (doxycycline and hydroxychloroquine) was started before the surgical procedure (12.4 ± 37.5 days), and in 7 patients after the surgical procedure (5.1 ± 13.5 days). We observed one in-hospital death (6.25%) and no long-term mortality. The mean follow-up period was 50.5 ± 34.7 months (range, 2 to 104 months). Conclusions In this series surgical treatment yielded good results for both Q fever endocarditis and vascular graft infection. No association was found between timing of the surgical procedure and patients' outcomes.
AB - Background Q fever is considered endemic worldwide, and endocarditis, or aortic vascular infection, or both caused by Coxiella burnetii can be a fatal disease. The importance of surgical intervention has not yet been defined. We performed a descriptive retrospective study to assess indications for surgical treatment, timing of treatment, and outcome. Methods We studied all patients from the cardiac surgery department of a large tertiary hospital who underwent valve surgical procedure due to endocarditis or aortic surgical procedure due to graft infection. Results Throughout a 10-year period, we performed a total of 171 procedures due to valve endocarditis and/or vascular infection. In 16 patients (9.36%) Coxiella burnetii infection was diagnosed. Ten patients had previous cardiac surgical procedures, 3 had previous aortic surgical procedures, 2 had preexisting valvular disease, and 1 patient had no previous valve disorder. All patients received prolonged oral-specific antibiotic therapy under serologic guidance. In 9 patients antibiotic treatment (doxycycline and hydroxychloroquine) was started before the surgical procedure (12.4 ± 37.5 days), and in 7 patients after the surgical procedure (5.1 ± 13.5 days). We observed one in-hospital death (6.25%) and no long-term mortality. The mean follow-up period was 50.5 ± 34.7 months (range, 2 to 104 months). Conclusions In this series surgical treatment yielded good results for both Q fever endocarditis and vascular graft infection. No association was found between timing of the surgical procedure and patients' outcomes.
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=barilanwos&SrcAuth=WosAPI&KeyUT=WOS:000368184300029&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1016/j.athoracsur.2015.06.075
DO - 10.1016/j.athoracsur.2015.06.075
M3 - Article
C2 - 26428692
SN - 0003-4975
VL - 101
SP - 141
EP - 145
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 1
ER -