Should Acute Q-Fever Patients be Screened for Valvulopathy to Prevent Endocarditis?
Abstract
Echocardiographic screening of acute Q-fever patients and antibiotic prophylaxis for patients with cardiac valvulopathy is considered an important approach to prevent chronic Q-fever-related endocarditis. During a large Q-fever epidemic in the Netherlands, routine screening echocardiography was discontinued, raising controversy in the international literature. We followed a cohort of acute Q-fever patients to estimate the risk for developing chronic Q-fever, and we evaluated the impact of screening in patients who were not yet known to have a valvulopathy. The study population consisted of patients diagnosed with acute Q-fever in 2007 and 2008. We retrospectively reviewed all screening echocardiographs and checked for development of chronic Q-fever 8 years after the acute episode. Risks of developing chronic Q-fever in relation to the presence or absence of valvulopathy were analyzed with logistic regression. The cohort included 509 patients, of whom 306 received echocardiographic screening. There was no significant difference (P-value = .22) in occurrence of chronic Q-fever between patients with a newly detected valvulopathy (2/84, 2.4%) and those with no valvulopathy (12/202, 5.9%). Two patients with a newly detected valvulop...Continue Reading
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