Table 4. Characteristics and outcome of patients diagnosed with chronic Q fever using the Dutch consensus guideline* but without (definite) chronic Q fever according to alternative criteria†.
| Dutch consensus guideline |
Alternative criteria |
|
|---|---|---|
| Possible Q fever endocarditis or vascular infection, no. (%), n =14 |
No diagnosis, no. (%), n = 173 |
|
| Proven Q fever | 8 (57.1) | 46 (26.6) |
| Endocarditis | 8 (57.1) | 18 (10.4); |
| PCR positive for Coxiella burnetii in blood | 6 (42.9) | 18 (10.4) |
| Evidence of endocardial involvement | 2 (14.3) | 0 |
| Vascular infection | 0 | 24 (13.9)‡ |
| PCR positive in blood | 0 | 7 (4.0) |
| Vascular focus on imaging | 0 | 17 (9.8) |
| Other or no focus§ | 0 | 7 (4.1) |
| Deceased | 2 (14.3) | 8 (4.6) |
| Death probably due to Q fever |
2 (14.3) |
4 (2.3)¶ |
| Probable Q fever | 6 (42.9) | 58 (33.5) |
| Endocarditis | 4 (28.6) | 22 (12.7) |
| Vascular infection | 2 (14.3) | 16 (9.3) |
| Other or no focus | 0 | 20 (11.6) |
| Deceased | 2 (14.3) | 4 (2.3) |
| Death probably due to Q fever | 1 (7.1) | 0 |
| Possible Q fever | 0 | 69 (39.9) |
*Source (14). †Source (16). ‡In 3 patients with proven chronic Q fever, imaging studies showed that the focus of infection was in both the heart valves and the vascular structures. §All were PCR positive. ¶For 2 patients, PCR of vascular and heart valve tissue obtained at autopsy was positive for C. burnetii.