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1 August 2001

Volume 33, Number 3
Clinical Infectious Diseases 2001;33:312–316
© 2001 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2001/3303-0007$03.00
DOI: 10.1086/321889
MAJOR ARTICLE

Risks Factors and Prevention of Q Fever Endocarditis

Florence Fenollar,1

Pierre‐Edouard Fournier,1

M. Patrizia Carrieri,2

Gilbert Habib,3

Thierry Messana,4 and

Didier Raoult1

1Unité des Rickettsies, Centre Nationale de Recherche Scientifique: Unité Mixte de Recherche 6020, Faculté de Médecine, Université de la Méditerranée, 2Institut Nationale de Santé et de Recherche Médicale Unité 379, and 3Service de Cardiologie and 4Service de Chirurgie Cardiaque, Hôpital de La Timone, Marseille, France

Coxiella burnetii causes acute and chronic Q fever. To evaluate the risk factors of development of chronic endocarditis following Q fever and to assess the best preventive therapy, a retrospective study of patients diagnosed as having Q fever during 1985–2000 was conducted. Twelve patients with acute Q fever who developed endocarditis and 102 patients with Q fever endocarditis were included in the study. When compared to 200 control patients with acute Q fever, preexisting valvular disease ( −7), especially a prosthetic valve ( ), were encountered more often among patients with endocarditis. Among patients with valvular defects, we estimate the risk of developing endocarditis to be 39%. A combination of doxycycline plus hydroxychloroquine was better at preventing the development of endocarditis than doxycycline alone ( ). Our results should encourage physicians to detect valvular lesions in patients with acute Q fever and to search for acute Q fever in patients with a valvulopathy and unexplained fever. A proper treatment for such patients and a scheduled follow‐up should reduce the risk of developing endocarditis.

Received 28 July 2000; revised 29 November 2000; electronically published 25 June 2001.

Reprints or correspondence: Dr. Didier Raoult, Unité des Rickettsies, CNRS:UPRESA 6020, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille cedex 05, France ().

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