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Habedank D, Bublak A, Habedank B. Q fever endocarditis of the tricuspid valve transmitted in an urban setting with no livestock exposure: Case report. BMC Infect Dis 2024; 24:766. [PMID: 39090536 PMCID: PMC11293036 DOI: 10.1186/s12879-024-09629-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 07/17/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Coxiella burnetii is a bacterium with extreme tenacity and contagiousness that is mainly transmitted by inhalation of contaminated aerosols. Nevertheless, a transmission by ticks is under discussion. We report a case of Q fever in an urban environment and far away from sheep breeding that caused a rare right-sided endocarditis. CASE PRESENTATION A 55-year-old man who was in good health before the event developed a C. burnetii -endocarditis of the tricuspid valve. He had no contact with sheep and no recent travel in a rural or even endemic area. The infection originated in a strictly urban environment, and the patient's occupation as a cemetery gardener in Berlin, coupled with the close temporal and local exposure to wild boar, made a transmission by these animals a plausible hypothesis. The infection was confirmed by the German Reference Laboratory, and the patient recovered completely after treatment with doxycycline and hydrochlorquine. CONCLUSIONS The specialities of this case report are the right-sided endocarditis and the transmission of C. burnetii in a metropolitan area without sheep contact. We think that this case should serve to increase awareness of the potential for Q fever infection even in non-rural areas.
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Affiliation(s)
- Dirk Habedank
- DRK Kliniken Berlin Köpenick, Clinical Medicine Department Cardiology, Berlin, Germany.
- Universität Greifswald, Klinik und Poliklinik für Innere Medizin B, Greifswald, Germany.
| | | | - Birgit Habedank
- German Environment Agency, Section Health Pests and their Control, Berlin, Germany
- Humboldt Universität zu Berlin, Institut für Biologie, Berlin, Germany
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Shaker R, Arabi M, Khafaja S, Fayad D, Casals AA, Lteif M, Shamseddine S, Taqa MA, Charafeddine F, Rassi IE, Al-Halees Z, Bitar F, Hanna-Wakim R, Dbaibo G. Placement of Labcor Pulmonary Conduit Results in a High Incidence of Postoperative Fever. World J Pediatr Congenit Heart Surg 2021; 12:55-60. [PMID: 33407033 DOI: 10.1177/2150135120956995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Fever in the postoperative period in cardiac patients is common. The purpose of this study is to recognize the risk factors for prolonged postoperative fever in cardiac patients with pulmonary conduit insertion. METHODS Patients were identified retrospectively by looking at the International Classification of Diseases, Ninth Revision, Clinical Modification procedure code for pulmonary conduit insertion between June 2009 and December 2015 at the American University of Beirut Medical Center. Data about preoperative, perioperative, and postoperative variables were collected. Data entry and analysis were performed using SPSS version 22. RESULTS The study identified 59 patients. The most common type of pulmonary conduit used was the Contegra type (57.6%) (n = 34), followed by the Labcor type (20.3%; n = 12). Postoperative fever occurred in 61% of patients (n = 36). Fourteen patients (38.8%) had a prolonged fever that lasted for more than seven days. Prolonged postoperative fever was significantly associated with the Labcor pulmonary conduit (P value < .001) and a longer duration of pacing wires (P value: .039). Significantly prolonged fever that lasted for more than 21 days occurred in five patients who all had inserted the Labcor pulmonary conduit. CONCLUSIONS The Labcor pulmonary conduit type is a risk factor for prolonged postoperative fever. The protracted use of pacing wires could be a consequence of the prolonged fever rather than a cause. In the absence of a demonstrable infectious etiology for prolonged postoperative fever in cardiac patients with pulmonary conduit insertion, the Labcor pulmonary conduit could be the underlying cause. Alternative management of such cases may lead to decreased antibiotic use and morbidity.
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Affiliation(s)
- Rouba Shaker
- Department of Pediatrics and Adolescent Medicine, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Division of Pediatric Infectious Diseases, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Center for Infectious Diseases Research, 66984American University of Beirut Medical Center, Beirut, Lebanon
| | - Mariam Arabi
- Department of Pediatrics and Adolescent Medicine, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Division of Pediatric Cardiology, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Children's Heart Center, 66984American University of Beirut Medical Center, Beirut, Lebanon
| | - Sarah Khafaja
- Department of Pediatrics and Adolescent Medicine, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Center for Infectious Diseases Research, 66984American University of Beirut Medical Center, Beirut, Lebanon
| | - Danielle Fayad
- Department of Pediatrics and Adolescent Medicine, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Center for Infectious Diseases Research, 66984American University of Beirut Medical Center, Beirut, Lebanon
| | - Aia Assaf Casals
- Department of Pediatrics and Adolescent Medicine, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Division of Pediatric Infectious Diseases, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Center for Infectious Diseases Research, 66984American University of Beirut Medical Center, Beirut, Lebanon
| | - Mireille Lteif
- Department of Pediatrics and Adolescent Medicine, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Center for Infectious Diseases Research, 66984American University of Beirut Medical Center, Beirut, Lebanon
| | - Sarah Shamseddine
- Center for Infectious Diseases Research, 66984American University of Beirut Medical Center, Beirut, Lebanon
| | - Mohammad Abu Taqa
- Department of Pediatrics and Adolescent Medicine, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Division of Pediatric Cardiology, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Children's Heart Center, 66984American University of Beirut Medical Center, Beirut, Lebanon
| | - Fatmeh Charafeddine
- Department of Pediatrics and Adolescent Medicine, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Division of Pediatric Cardiology, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Children's Heart Center, 66984American University of Beirut Medical Center, Beirut, Lebanon
| | - Issam El Rassi
- Department of Pediatrics and Adolescent Medicine, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Division of Pediatric Cardiology, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Children's Heart Center, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Department of Surgery, 66984American University of Beirut Medical Center, Beirut, Lebanon
| | - Zoheir Al-Halees
- Division of Pediatric Cardiology, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Children's Heart Center, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Department of Surgery, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Heart Center, 37852King Faisal Specialist Hospital and Research center, Riyadh, Saudi Arabia
| | - Fadi Bitar
- Department of Pediatrics and Adolescent Medicine, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Division of Pediatric Cardiology, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Children's Heart Center, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Department of Biochemistry and Molecular Genetics, 66984American University of Beirut Medical Center, Beirut, Lebanon
| | - Rima Hanna-Wakim
- Department of Pediatrics and Adolescent Medicine, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Division of Pediatric Infectious Diseases, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Center for Infectious Diseases Research, 66984American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghassan Dbaibo
- Department of Pediatrics and Adolescent Medicine, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Division of Pediatric Infectious Diseases, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Center for Infectious Diseases Research, 66984American University of Beirut Medical Center, Beirut, Lebanon.,Department of Biochemistry and Molecular Genetics, 66984American University of Beirut Medical Center, Beirut, Lebanon
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Shmueli H, Thomas F, Flint N, Setia G, Janjic A, Siegel RJ. Right-Sided Infective Endocarditis 2020: Challenges and Updates in Diagnosis and Treatment. J Am Heart Assoc 2020; 9:e017293. [PMID: 32700630 PMCID: PMC7792231 DOI: 10.1161/jaha.120.017293] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Compared with the extensive data on left-sided infective endocarditis (IE), there is much less published information on the features and management of right-sided IE. Right-sided IE accounts for 5% to 10% of all IE cases, and compared with left-sided IE, it is more often associated with intravenous drug use, intracardiac devices, and central venous catheters, all of which has become more prevalent over the past 20 years. In this manuscript on right-sided IE we provide an up-to-date overview on the epidemiology, etiology, microbiology, potential locations of infection in the right heart, diagnosis, imaging, common complications, management, and prognosis. We present updated information on the treatment of pacemaker and device infections, infected fibrin sheaths that appear to be an easily missed source of infection after central line as well as pacemaker removal. We review current data on the AngioVac percutaneous aspiration device, which can obviate the need for surgery in patients with infected pacemaker leads and fibrin sheaths. We also focused on advanced diagnostic modalities, such as positron emission tomography/computed tomography. All of these are supported by specific case examples with detailed echocardiographic imaging from our experience.
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Affiliation(s)
- Hezzy Shmueli
- Smidt Heart Institute Cedars-Sinai Medical Center Los Angeles CA
| | - Felix Thomas
- Smidt Heart Institute Cedars-Sinai Medical Center Los Angeles CA
| | - Nir Flint
- Smidt Heart Institute Cedars-Sinai Medical Center Los Angeles CA.,Department of Cardiology Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Gayatri Setia
- Smidt Heart Institute Cedars-Sinai Medical Center Los Angeles CA
| | | | - Robert J Siegel
- Smidt Heart Institute Cedars-Sinai Medical Center Los Angeles CA
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