scholarly journals Q Fever Endocarditis: A Diagnostic Dilemma

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Rebecca Angela Jeffery ◽  
Steve Walsh ◽  
Babar Haroon
Keyword(s):  
Aortic Valve ◽  
Q Fever ◽  
Clinical Manifestations ◽  
Zoonotic Disease ◽  
Blood Cultures ◽  
Positive Serology ◽  
Diagnostic Dilemma ◽  
Common Manifestation

Q fever is a zoonotic disease, typically spread by aerosol transmission from infected animals to humans. It can present with a variety of clinical manifestations, but endocarditis is the most common manifestation. We present a case of an 80-year-old man with a prior bioprosthetic aortic valve (AV) replacement who presented with chronic constitutional symptoms that acutely worsened over two days leading up to his presentation. An initial echocardiogram was equivocal for endocarditis, and bloodwork revealed a bicyotpenia, elevated ferritin, and negative blood cultures. He was diagnosed with Q fever endocarditis after positive serology for Coxiella burnetti. Treatment for this patient involved a 24-month course of doxycycline and hydroxychloroquine. Résumé Q la fièvre est une maladie zoonotique, généralement propagée par la transmission en aérosol des animaux infectés aux humains. Il peut présenter avec une variété de manifestations cliniques, mais l'endocardite est la manifestation la plus commune. Nous présentons un cas d'un homme de 80 ans avec une valve aortique antérieure de bioprothèse (AV) de remplacement qui a présenté des symptômes chroniques de la Constitution qui s'est aggravée de façon aiguë pendant deux jours menant à sa présentation. Un échocardiogramme initial a été équivoque pour l'endocardite, et analyses a révélé une bicyotpenia, une élévation de la ferritine et des cultures sanguines négatives. On lui a diagnostiqué une endocardite de fièvre Q après une sérologie positive pour Coxiella burnetti. Le traitement pour ce patient a impliqué un cours de 24 mois de doxycycline et de hydroxychloroquine.    

A One Health Perspective on Q Fever

2019 ◽  
pp. 195-216
Author(s):  
Rita Cruz ◽  
Carmen Vasconcelos-Nobrega ◽  
Fernando Esteves ◽  
Catarina Coelho ◽  
Ana Sofia Ferreira ◽  
...  
Keyword(s):  
Public Health ◽  
Disease Control ◽  
One Health ◽  
Q Fever ◽  
Clinical Manifestations ◽  
Zoonotic Disease ◽  
Diagnostic Methods ◽  
Veterinary Public Health

Q fever, a widespread zoonotic disease caused by Coxiella burnetiid, produces a complex and polymorphic disease in humans. As a zoonotic disease, control in animals will influence the level of disease seen in humans, thus resulting in interesting one health perspectives for disease control. Here the authors describe the clinical manifestations in animals and humans, as well as the current diagnostic methods available and the strategies for disease control. A review on the published information regarding Q fever as a disease with impact for veterinary public health and public health is presented.

scholarly journals INFECTIOUS ENDOCARDITIS WITH COXIELLA BURNETII

2017 ◽  
Vol 20 (4) ◽  
pp. 190-193
Keyword(s):  
Aortic Valve ◽  
Coxiella Burnetii ◽  
Q Fever ◽  
Clinical Manifestations ◽  
Cardiac Decompensation ◽  
Unpasteurized Milk ◽  
Appropriate Treatment ◽  
First Choice ◽  
Proper Diagnosis ◽  
Inflammatory Syndrome

Q fever is caused by an anthropozoonosis determined by the pathogen Coxiella burnetii, a gram-negative bacterium with intracellular growth. The occurrence of infection in the human species takes place through inhalation of contaminated aerosols or dust from infected domestic animals (cattle, sheep, goats) and more rarely through ingestion of unpasteurized milk, infected mite or inter-human transmission. The endocardium is one of the main infection sites, especially in the context of the long-term development of the disease, and cardiac decompensation often leads to death in absence of a proper diagnosis and appropriate treatment (1).We present the case of a patient of the male sex aged 37 years without personal pathologic history known admitted in “St. Parascheva” Clinical Hospital for Infectious Diseases Iasi complaining of productive cough, fatigue, shortness of breath with moderate effort and pain in the left scapulohumeral joint with irradiation in the left upper limb. Clinical examination objectified digital clubbing, systolic/diastolic murmurs throughout the precordium area and hepato-splenomegaly, while laboratory tests revealed the presence of inflammatory syndrome, cholestasis and hepatic cytolysis. Echocardiography shows a hyperechogenic entity at the level of the aortic valve, as well as a severe valve disorder. The diagnosis of infective endocarditis is established on aortic valve and therapy with first-choice antibiotics, consisting of triple combination of cefotaxime, amikacin and vancomycin, is initiated. Blood cultures taken upon admission were negative, while positive serological phase I and II tests for C. burnetii urged the indication of changing therapy with doxycycline and trimethoprim sulfamethoxazole (in the absence of hydroxychloroquine). Subsequently he underwent aortic valve replacement. The particularities of this case consisted in atypical clinical manifestations, the absence of fever and epidemiological context suggestive for Q fever.

scholarly journals Non-tuberculous Mycobacterium Disease: Radiologic Manifestation in an Infant presenting with Respiratory Distress

2017 ◽  
Vol 5 (1-2) ◽  
pp. 13-20
Author(s):  
Rupesh Gautam ◽  
Maria Isabel Atienza ◽  
Maika Noda ◽  
Mariaem Andres
Keyword(s):  
Hypersensitivity Pneumonitis ◽  
Pulmonary Infection ◽  
Clinical Manifestations ◽  
Distinct Group ◽  
Middle Lobe ◽  
Air Trapping ◽  
Pulmonary Tb ◽  
Radiologic Findings ◽  
The Common ◽  
Common Manifestation

Non-tuberculous mycobacterium (NTM) comprises distinct group of organisms with lymphadenitis and pulmonary infection as the common manifestation. The diagnosis of pulmonary disease is based on clinical manifestations, radiologic findings and microbiologic culture. The classic NTM infection may be indistinguishable from pulmonary TB. Non-classic infection has predilection to the middle lobe and lingula unlike tuberculosis which is commonly seen in the upper lobes. The disease may also present as hypersensitivity pneumonitis with ground glass like opacities, centrilobular nodules and air trapping on imaging. The knowledge of imaging manifestations of NTM will aid in timely diagnosis and treatment of the disease.Nepal Journal of Radiology Vol.5(1-2) 2015: 13-20

scholarly journals De novoNAD synthesis is required for intracellular replication ofCoxiella burnetii, the causative agent of the neglected zoonotic disease Q fever

2018 ◽  
Vol 293 (48) ◽  
pp. 18636-18645 ◽  
Author(s):  
Mebratu A. Bitew ◽  
Chen Ai Khoo ◽  
Nitika Neha ◽  
David P. De Souza ◽  
Dedreia Tull ◽  
...  
Keyword(s):  
Causative Agent ◽  
Q Fever ◽  
Zoonotic Disease ◽  
Intracellular Replication

Cases of Q fever detected in residents of the novosibirsk region hospitalized with suspection of infections transmitted by ticks

2021 ◽  
Vol 66 (4) ◽  
pp. 229-236
Author(s):  
E. I. Bondarenko ◽  
E. S. Filimonova ◽  
E. I. Krasnova ◽  
E. V. Krinitsina ◽  
S. E. Tkachev
Keyword(s):  
Causative Agent ◽  
Q Fever ◽  
Clinical Manifestations ◽  
Test Methods ◽  
Pcr Analysis ◽  
Laboratory Diagnostics ◽  
Novosibirsk Region ◽  
Complex Approach ◽  
Wide Range ◽  
The Republic

Coxiella burnetii is the causative agent of Q fever (coxiellosis), which, in addition to acute manifestations, often occurs in a latent form, is prone to chronic course and, in the absence of antibiotic therapy, has a high risk of disability or death. As a result of the presence of a wide range of clinical manifestations specific to other infectious diseases, the use of laboratory test methods (LTM) is required to make a diagnosis. The presence of Q fever anthropurgic foci in the Novosibirsk region was described in the 90s of the last century, but due attention to its laboratory diagnostics is not paid in this region. The aim of the study was to identify genetic and serological markers of the causative agent, C. burnetii, in patients of the Novosibirsk region who were admitted for treatment with fever with suspected tick-borne infections (TBIs). DNA marker of the causative agent of Q fever was detected in blood samples by real time PCR in 9 out of 325 patients. In three patients, the presence of C. burnetii DNA was confirmed by sequencing of the IS1111 and htpB gene fragments. In ELISA tests, antibodies against the causative agent of coxiellosis were detected in the blood sera of 4 patients with positive results of PCR analysis. Contact with tick was registered in 7 out of 9 patients who had C. burnetii DNA and lacked markers of other TBIs. Six people were infected in the Novosibirsk region, two suffered from tick’s bite in Altai, and one case was from the Republic of Kyrgyzstan. Thus, a complex approach using both PCR analysis and ELISA provided the identification of markers of the Q fever causative agent in patients admitted with suspected TBIs, thereby differentiating it from other infections. Contact with ticks in most cases suggests that infection with C. burnetii had a transmissible pathway.

Psychomotor Epilepsy in Childhood

PEDIATRICS ◽  
1974 ◽  
Vol 53 (4) ◽  
pp. 540-542
Author(s):  
Arnold P. Gold
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Vascular Malformations ◽  
Craniocerebral Trauma ◽  
Clinical Manifestations ◽  
Focal Lesion ◽  
Etiologic Factor ◽  
Diagnostic Dilemma ◽  
Seizure State ◽  
Psychomotor Epilepsy

The most poorly understood and most frequently misdiagnosed seizure state of childhood is psychomotor epilepsy. Difficulties in diagnosis are related to the variety of possible clinical manifestations which characteristically differ from one child to another. In addition, psychomotor epilepsy can occur at any age, even during infancy. Therefore, the child's ability to verbalize the perceptive and affective sensations of this seizure state is obviously limited by his chronologic age. The diagnostic dilemma is further complicated as physicians tend to confuse psychomotor seizures and petit ma! epilepsy. INCIDENCE AND ETIOLOGY The terms psychomotor and temporal lobe epilepsy are often used synonymously and interchangeably. At times the seizure state may also be called uncinate epilepsy, epileptic automatisms or epileptic fuges. However, not all psychomotor seizures are associated with temporal lobe lesions, nor is temporal lobe pathology always productive of psychomotor epilepsy. Abnormalities and electrical foci from areas other than the temporal lobe can produce this seizure state. For these reasons, the term psychomotor epilepsy is preferred, and temporal lobe epilepsy, if used, should be restricted to those psychomotor seizures that result from primary temporal lobe pathology. Ten to 20% of children in most pediatric seizure clinics have psychomotor epilepsy. Focal lesions are often considered to be the responsible etiologic factor, but diffuse encephalopathies, above all in children, are more commonly encountered. Prolonged febrile convulsions, perinatal trauma and hypoxia, craniocerebral trauma or meningoencephalitis can be the specific etiologic condition. Expansive lesions including neoplasms, vascular malformations, cysts and abscesses must be considered, especially when there is clinical or electrical evidence of a focal lesion.

Infective endocarditis

2020 ◽  
pp. 163-176
Author(s):  
Salim Jivanji ◽  
Rubya Adamji ◽  
Michael Rigby
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Oral Hygiene ◽  
Aortic Valve Disease ◽  
Dental Hygiene ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Blood Cultures ◽  
Valve Disease ◽  
Symptoms And Signs

A young patient with previously repaired mixed aortic valve disease presented to his local hospital with symptoms and signs consistent with infective endocarditis. Following confirmation of Streptococcus viridans in his blood cultures, he underwent initial antibiotic treatment, followed by surgical resection of his right ventricular outflow tract vegetation. This chapter examines the difficulty in making a diagnosis of infective endocarditis, the devastating nature of its course, and the challenges in managing this condition. Finally, it explores the association of infective endocarditis with poor dental hygiene, the importance of promoting effective oral hygiene, and the evolving evidence in the use of antibiotic prophylaxis.

Lyme borreliosis

2013 ◽  
pp. 772-777
Author(s):  
Andreas Krause ◽  
Volker Fingerle
Keyword(s):  
Lyme Borreliosis ◽  
Erythema Migrans ◽  
Clinical Manifestations ◽  
Lyme Arthritis ◽  
Symptomatic Therapy ◽  
Positive Serology ◽  
Antibiotic Resistant ◽  
Acrodermatitis Chronica Atrophicans ◽  
Rapid Healing ◽  
The Central Nervous System

Lyme borreliosis (LB) is a multisystem infectious disease caused by the tick-borne spirochete Borrelia burgdorferi. The most frequent clinical manifestations include erythema migrans, meningoplyneuritis, and arthritis. Diagnosis of LB is made on clinical grounds and usually supported by a positive serology. Early diagnosis and treatment almost always leads to a rapid healing of the disease. However, in late manifestations gradual remission of symptoms may take several weeks to months. In rare cases, the pathogen can persist for many years or induce a persisting immunopathological response that may cause acrodermatitis chronica atrophicans, chronic neuroborreliosis of the central nervous system, or antibiotic resistant Lyme arthritis. However, even these chronic manifestations usually slowly regress after thorough antibiotic and symptomatic therapy, although in part with irreversible organ defects.

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