1Department of Paediatrics, Heraklion University Hospital, Medical School, University of Crete, Heraklion, Greece.
2Department of Radiology, Heraklion University Hospital, Medical School, University of Crete, Heraklion, Greece.
Am J Trop Med Hyg. 2020 Oct;103(4):1435-1438. doi: 10.4269/ajtmh.19-0932.
Acute Q fever is usually asymptomatic or is associated with a mild self-limited course and a favorable outcome. The occurrence of endocarditis during acute infection by is an emerging clinical entity observed in adults that has been attributed to an autoimmune complication of early infection. Herein, we report the first case of a previously healthy 2-year-old child with endocarditis complicated by septic embolic stroke, in which the identified microbiological evidence was suggestive of acute rather than chronic infection. The development of endocarditis in this case occurred in the absence of any autoimmune reaction, but in the context of a very mild form of congenital heart disease, a small ventricular septal defect, which might serve as a predisposing factor for endocarditis. This case suggests that acute Q fever endocarditis may affect children as well and can be attributed not only to autoimmune mechanisms but also to a potential effect of the infectious agent per se on the cardiac endothelium in patients with underlying heart defects, regardless of their severity.
急性 Q 热通常无症状，或与轻度自限性病程和良好结局相关。 由 引起的急性感染期间发生的心内膜炎是一种在成人中观察到的新兴临床实体，归因于早期感染的自身免疫并发症。 在此，我们报告首例先前健康的 2 岁儿童合并心内膜炎并发感染性栓子脑梗死，其中确定的微生物学证据提示为急性而非慢性 感染。 该病例的心内膜炎发展没有任何自身免疫反应，但存在一种非常轻微的先天性心脏病，即小室间隔缺损，这可能是心内膜炎的一个诱发因素。 该病例提示急性 Q 热心内膜炎也可能影响儿童，不仅归因于自身免疫机制，而且还归因于潜在感染因子本身对有基础心脏缺陷患者的心脏内皮的潜在影响，而与严重程度无关。
