Infectious Diseases Unit, Bnai Zion Medical Center, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3104802, Israel.
Department of Cardiology, Bnai Zion Medical Center, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3104802, Israel.
Medicina (Kaunas). 2024 Jul 11;60(7):1122. doi: 10.3390/medicina60071122.
Polymicrobial endocarditis is uncommon, and polymicrobial endocarditis in combination with is very rare. We herein describe an extremely rare case of polymicrobial bivalvular endocarditis due to coinfection with and in a 62-year-old male patient, and extensively review the relevant medical literature. To the best of our knowledge, only three similar cases have been previously reported. Q fever is a worldwide endemic bacterial zoonosis, but it and its most common chronic complication, endocarditis, are still underestimated and underdiagnosed worldwide. This situation reflects the paucity of reported cases of polymicrobial endocarditis in combination with . Clinical presentation of Q fever endocarditis is highly nonspecific, and diagnosis may be delayed or missed, leading to severe and potentially fatal disease. Our case and the previously reported similar cases emphasize the need for further evaluation of infective endocarditis due to , in all cases of culture-negative endocarditis, and in prolonged oligo-symptomatic inflammatory syndrome, particularly in the presence of valvular heart disease. This approach should be applied even when typical pathogens are isolated, especially in endemic areas of Q fever, and with atypical presentation.
多微生物性心内膜炎并不常见，而与 合并的多微生物性心内膜炎则非常罕见。我们在此描述了一例非常罕见的 62 岁男性患者合并感染 和 引起的双瓣膜多微生物性心内膜炎的病例，并对相关医学文献进行了广泛回顾。据我们所知，之前仅报道过三例类似病例。Q 热是一种全球性流行的细菌性人畜共患病，但它及其最常见的慢性并发症——心内膜炎，在全球范围内仍被低估和漏诊。这种情况反映了与 合并的多微生物性心内膜炎报道病例较少。Q 热心内膜炎的临床表现高度非特异性，可能导致诊断延迟或漏诊，从而导致严重且可能致命的疾病。我们的病例和之前报道的类似病例强调，在所有培养阴性的心内膜炎病例中，以及在长时间的寡症状炎症综合征中，特别是在存在瓣膜性心脏病的情况下，需要进一步评估由于 引起的感染性心内膜炎。即使分离出了典型病原体，特别是在 Q 热流行地区和表现不典型的情况下，也应采用这种方法。
