Acute myocardial failure in a young man: Q-fever myocarditis

• Published in: Revista española de cardiologia Vol. 55; no. 8; pp. 875 - 877
• Main Authors: Murcia, José, Reus, Sergio, Climent, Vicente, Manso, María I, López, Iñigo, Tello, Antonio
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-08-2002
• Subjects: Acute Disease; Adult; Anti-Arrhythmia Agents - therapeutic use; Anti-Bacterial Agents - therapeutic use; Antibodies, Bacterial - analysis; Cardiomyopathy, Dilated - diagnosis; Cardiomyopathy, Dilated - drug therapy; Cardiomyopathy, Dilated - etiology; Clarithromycin - therapeutic use; Coxiella burnetii - immunology; Diuretics - therapeutic use; Echocardiography; Electrocardiography; Follow-Up Studies; Furosemide - therapeutic use; Humans; Losartan - therapeutic use; Male; Myocarditis - diagnosis; Myocarditis - drug therapy; Myocarditis - etiology; Q Fever - complications; Q Fever - diagnosis; Q Fever - drug therapy; Q Fever - immunology; Time Factors
• ISSN: 0300-8932
• DOI: 10.1016/S0300-8932(02)76719-5

Coxiella burnetii myocarditis is a rare but severe clinical form of acute Q fever. We report the case of a 40-year-old man hospitalized for acute febrile syndrome. Forty-eight hours later, he presented dyspnea, orthopnea, and paroxysmal nocturnal dyspnea; cardiac auscultation revealed a third sound and echocardiography showed a diffusely hypokinetic and dilated left ventricle (30% ejection fraction). Serological studies showed antibodies against phase-II C. burnetii antigens (IgG titer 1:320 and IgM 1:50). The patient was treated with losartan, furosemide, and clarithromycin, resulting in rapid improvement. Six months after admission, the echocardiographic changes had completely disappeared.