Abstract
Coxiella burnetii was isolated from the valve material of two patients who underwent valvectomy because of progressive congestive heart failure due to endocarditis. In each case antibiotic therapy was administered for several months prior to valvectomy. Classical histopathological examination of the valves did not reveal an etiology. However, coxiella-like organisms were demonstrated in valvular material with Köster, Stamp, and Giemsa stains, and the organisms were grown in cell culture. Antibody titers were consistent with the diagnosis of chronic C. burnetii infection. This report illustrates the advantage of simple and fast staining techniques and cell culture for the demonstration and isolation of C. burnetii in the heart valve tissue of patients with Q fever endocarditis.
Full Text
The Full Text of this article is available as a PDF (762.0 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- ANDREWS P. S., MARMION B. P. Chronic Q fever. 2. Morbid anatomical and bacteriological findings in a patient with endocarditis. Br Med J. 1959 Nov 14;2(5158):983–988. doi: 10.1136/bmj.2.5158.983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Aitken I. D., Bögel K., Cracea E., Edlinger E., Houwers D., Krauss H., Rády M., Rehácek J., Schiefer H. G., Schmeer N. Q fever in Europe: current aspects of aetiology, epidemiology, human infection, diagnosis and therapy. Infection. 1987;15(5):323–327. doi: 10.1007/BF01647731. [DOI] [PubMed] [Google Scholar]
- Akesson A., Macellaro A., Tüll P., Williams J. C., Norlander L. Epidemiology of Q fever in Sweden. Scand J Infect Dis. 1991;23(2):153–157. doi: 10.3109/00365549109023393. [DOI] [PubMed] [Google Scholar]
- Baumgärtner W., Dettinger H., Schmeer N., Hoffmeister E. Evaluation of different fixatives and treatments for immunohistochemical demonstration of Coxiella burnetti in paraffin-embedded tissues. J Clin Microbiol. 1988 Oct;26(10):2044–2047. doi: 10.1128/jcm.26.10.2044-2047.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dupuis G., Péter O., Mottiez M. C., Vouilloz M. Séro-prévalence de la fièvre Q humaine en Suisse. Schweiz Med Wochenschr. 1986 Apr 19;116(16):494–498. [PubMed] [Google Scholar]
- EVANS A. D., POWELL D. E., BURRELL C. D. Fatal endocarditis associated with Q fever. Lancet. 1959 Apr 25;1(7078):864–865. doi: 10.1016/s0140-6736(59)91942-7. [DOI] [PubMed] [Google Scholar]
- Fergusson R. J., Shaw T. R., Kitchin A. H., Matthews M. B., Inglis J. M., Peutherer J. F. Subclinical chronic Q fever. Q J Med. 1985 Oct;57(222):669–676. [PubMed] [Google Scholar]
- Fernández-Guerrero M. L., Muelas J. M., Aguado J. M., Renedo G., Fraile J., Soriano F., De Villalobos E. Q fever endocarditis on porcine bioprosthetic valves. Clinicopathologic features and microbiologic findings in three patients treated with doxycycline, cotrimoxazole, and valve replacement. Ann Intern Med. 1988 Feb;108(2):209–213. doi: 10.7326/0003-4819-108-2-209. [DOI] [PubMed] [Google Scholar]
- Frazier M. E., Mallavia L. P., Samuel J. E., Baca O. G. DNA probes for the identification of Coxiella burnetti strains. Ann N Y Acad Sci. 1990;590:445–458. doi: 10.1111/j.1749-6632.1990.tb42253.x. [DOI] [PubMed] [Google Scholar]
- GIMENEZ D. F. STAINING RICKETTSIAE IN YOLK-SAC CULTURES. Stain Technol. 1964 May;39:135–140. doi: 10.3109/10520296409061219. [DOI] [PubMed] [Google Scholar]
- Kelly P. J., Matthewman L. A., Mason P. R., Raoult D. Q fever in Zimbabwe. A review of the disease and the results of a serosurvey of humans, cattle, goats and dogs. S Afr Med J. 1993 Jan;83(1):21–25. [PubMed] [Google Scholar]
- Kimbrough R. C., 3rd, Ormsbee R. A., Peacock M., Rogers W. R., Bennetts R. W., Raaf J., Krause A., Gardner C. Q fever endocarditis in the United States. Ann Intern Med. 1979 Sep;91(3):400–402. doi: 10.7326/0003-4819-91-3-400. [DOI] [PubMed] [Google Scholar]
- Kristinsson A., Bentall H. H. Medical and surgical treatment of Q-fever endocarditis. Lancet. 1967 Sep 30;2(7518):693–697. doi: 10.1016/s0140-6736(67)90975-0. [DOI] [PubMed] [Google Scholar]
- Lev B. I., Shachar A., Segev S., Weiss P., Rubinstein E. Quiescent Q fever endocarditis exacerbated by cardiac surgery and corticosteroid therapy. Arch Intern Med. 1988 Jul;148(7):1531–1532. [PubMed] [Google Scholar]
- Palmer S. R., Young S. E. Q-fever endocarditis in England and Wales, 1975-81. Lancet. 1982 Dec 25;2(8313):1448–1449. doi: 10.1016/s0140-6736(82)91341-1. [DOI] [PubMed] [Google Scholar]
- Peacock M. G., Philip R. N., Williams J. C., Faulkner R. S. Serological evaluation of O fever in humans: enhanced phase I titers of immunoglobulins G and A are diagnostic for Q fever endocarditis. Infect Immun. 1983 Sep;41(3):1089–1098. doi: 10.1128/iai.41.3.1089-1098.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Raoult D., Levy P. Y., Harlé J. R., Etienne J., Massip P., Goldstein F., Micoud M., Beytout J., Gallais H., Remy G. Chronic Q fever: diagnosis and follow-up. Ann N Y Acad Sci. 1990;590:51–60. doi: 10.1111/j.1749-6632.1990.tb42206.x. [DOI] [PubMed] [Google Scholar]
- Reimer L. G. Q fever. Clin Microbiol Rev. 1993 Jul;6(3):193–198. doi: 10.1128/cmr.6.3.193. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Roberts W. C. The congenitally bicuspid aortic valve. A study of 85 autopsy cases. Am J Cardiol. 1970 Jul;26(1):72–83. doi: 10.1016/0002-9149(70)90761-7. [DOI] [PubMed] [Google Scholar]
- STAMP J. T., McEWEN A. D., WATT J. A. A., NISBET D. I. Enzootic abortion in ewes; transmission of the disease. Vet Rec. 1950 Apr 29;62(17):251–254. doi: 10.1136/vr.62.17.251. [DOI] [PubMed] [Google Scholar]
- Subramanya N. I., Wright J. S., Khan M. A. Failure of rifampicin and co-trimoxazole in Q fever endocarditis. Br Med J (Clin Res Ed) 1982 Jul 31;285(6338):343–344. doi: 10.1136/bmj.285.6338.343. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Turck W. P., Howitt G., Turnberg L. A., Fox H., Longson M., Matthews M. B., Das Gupta R. Chronic Q fever. Q J Med. 1976 Apr;45(178):193–217. [PubMed] [Google Scholar]