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Chronic Q fever in the United States Karakousis PC; Trucksis M; Dumler JSJ Clin Microbiol 2006[Jun]; 44 (6): 2283-7Infections due to Coxiella burnetii, the causative agent of Q fever, are uncommon in the United States. Cases of chronic Q fever are extremely rare and most often manifest as culture-negative endocarditis in patients with underlying valvular heart disease. We describe a 31-year-old farmer from West Virginia with a history of congenital heart disease and recurrent fevers for 14 months who was diagnosed with Q fever endocarditis based on an extremely high antibody titer against Coxiella burnetii phase I antigen. Despite treatment with doxycycline, he continued to have markedly elevated Coxiella burnetii phase I antibody titers for 10 years after the initial diagnosis. To our knowledge, this case represents the longest follow-up period for a patient with chronic Q fever in the United States. We review all cases of chronic Q fever reported in the United States and discuss important issues pertaining to epidemiology, diagnosis, and management of this disease.|Adult[MESH]|Antibodies, Bacterial/blood[MESH]|Chronic Disease[MESH]|Coxiella burnetii/immunology/*isolation & purification[MESH]|Endocarditis, Bacterial/diagnosis/epidemiology/*microbiology[MESH]|Humans[MESH]|Male[MESH]|Q Fever/diagnosis/epidemiology/*microbiology[MESH]|United States/epidemiology[MESH] |
