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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 17, Issue 6, Pages 341-344
http://dx.doi.org/10.1155/2006/152624
Case Report

Q Fever Presenting as Recurrent, Culture-Negative Endocarditis with Aortic Prosthetic Valve Failure: A Case Report and Review of the Literature

Abeer N AlShukairi,1 Muhammad G Morshed,2,3 and Neil E Reiner1,4,5

1Department of Medicine, Faculty of Medicine, University of British Columbia, Canada
2Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
3Laboratory Services, BC Centre for Disease Control, Canada
4Department of Microbiology and Immunology, Faculty of Science, University of British Columbia, Canada
5Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada

Received 11 January 2006; Accepted 27 June 2006

Copyright © 2006 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The present report describes a case of recurrent, culture-negative endocarditis presenting with aortic prosthetic valve dysfunction in a 62-year-old man who required four valve replacement surgeries. On each occasion, he presented with valve failure. Fever was only documented during his first presentation. Furthermore, no vegetations were detectable on his aortic valve at transesophageal echocardiography. On the occasion of his most recent presentation, a detailed history of animal exposure -- including hunting and skinning deer, moose and other large animals with his bare hands -- was the only clue to his diagnosis. Serum antibodies against Coxiella burnetii were strongly positive, and C burnetii DNA was detected by polymerase chain reaction from his resected aortic valve tissue. Q fever is a worldwide zoonotic infection with diverse reservoirs. This diagnosis should be considered when evaluating unexplained prosthetic valve dysfunction, particularly in the setting of animal exposure.