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. 2024 Nov 29;12(12):e9635.
doi: 10.1002/ccr3.9635. eCollection 2024 Dec.

Q Fever Endocarditis: A Challenging Diagnosis in a Patient Referring Weight Loss and Anorexia, and With Granulomas in Gastric Biopsy Specimens

Ana Elena Lago-Rodriguez  1 , Pablo Arturo Fraile-Ribot  2 , Isabel Amengual-Antich  3 , Francisco Gual-Capllonch  1 , Mercedes Garcia-Gasalla  4
Affiliations

Q Fever Endocarditis: A Challenging Diagnosis in a Patient Referring Weight Loss and Anorexia, and With Granulomas in Gastric Biopsy Specimens

Ana Elena Lago-Rodriguez et al. Clin Case Rep. .

Abstract

Diagnosis of Q fever endocarditis is challenging since clinical findings are non-specific and diagnosis is mainly made by indirect methods such as serology. A progressive constitutional syndrome, severe asthenia, anorexia with no fever and histopathological findings of non-necrotizing gastric granulomas in a gastric biopsy were found preceding a cardiac failure in our case report. Prolonged treatment with doxycycline and hydroxychloroquine is mandatory, and cardiac valve surgery may be needed.

Keywords: Coxiella burnetii; Q fever; endocarditis; gastric granulomas; weight loss.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Histopathological image from a gastric biopsy specimen showing non‐necrotizing granulomas, round collection of lymphocytes, histiocytes and multinucleated giant cells (arrow).
FIGURE 2
FIGURE 2
Mitral valve reconstruction from a three‐dimensional (3D) transesophageal echocardiography suggestive of vegetation in the posterior leaflet.
FIGURE 3
FIGURE 3
Longitudinal plane of the mitral valve from a transesophageal two‐chamber view delineating the left atrium in the upper part, the left ventricle in the lower part, and the mitral valve separating the two chambers: transesophageal echocardiography image suggestive of a vegetation in the posterior velum.
See this image and copyright information in PMC

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