Sheep tick - vector for Coxiella burnetii, the cause of the disease known as Q fever CDC image

Q Fever Patients Must Be Followed To Avoid Cardiac Complications Interview with:

Sheep tick - vector for Coxiella burnetii, the cause of the disease known as Q fever CDC image

Sheep tick – vector for Coxiella burnetii, the cause of the disease known as Q fever CDC image

Pr. Didier Raoult
Directeur de l’IHU Méditerranée-Infection
Marseille What is the background for this study? What are the main findings?

Response: This work represents the sum of data accumulated over several decades of studies on Q fever.

Our reference center contacts each of the physicians in charge and ensures patient follow-up, which allows obtaining data, that is not comparable to those used automatically in databanks. Four people exclusively dedicated their time to manage these specific data on Q fever.

The main data confirm the need to perform a cardiac ultrasound for all patients with Q fever and acute endocarditis (to detect valvulopathy) and to give a prophylactic treatment to avoid fixation on the heart in patients with valvulopathy.

This work helps clarify the evolution of Q fever by eliminating the term of chronic Q fever, which is based on non-clinical elements, and defining persistent Q fever for which there is an identifiable focus of infection.

Furthermore, this work makes it possible to recommend systematic detection of antiphospholipid antibodies in order to limit the risk of thrombosis and the risk of cardiac fixation. What should readers take away from your report?

Response: What the reader should keep in mind is that acute Q fever should be monitored for at least 6 months in order to avoid seeing the same patient again, a few months or years later, with a focused Q fever.

A cardiac ultrasound and the detection of antiphospholipid antibodies must immediately be performed in patients with acute Q fever in order to implement a treatment with doxycycline and OH-chloroquine in positive cases. What recommendations do you have for future research as a result of this work?

Response: For future research, the point remains unclear, especially the association of neurological forms with antiphospholipid antibodies, one may wonder if this is the consequence of vascular disorders.

To conclude, the question of a diagnosis of non-spontaneously resolving Q fever to prescribe OH-chloroquine immunity to avoid complications from anti-phospholipid antibodies is an issue that needs to be addressed in the future. 


Melenotte C, Protopopescu C, Million M, et al. Clinical Features and Complications of Coxiella burnetii Infections From the French National Reference Center for Q Fever. JAMA Network Open. 2018;1(4):e181580. doi:10.1001/jamanetworkopen.2018.1580

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Last Updated on August 27, 2018 by Marie Benz MD FAAD