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Q-Fever Endocarditis and Treatment With the Fluoroquinolones

P. Cacoub, MD; B. Wechsler, MD; C. Chapelon, MD; M. Thibon, MD; P. Godeau, MD
Arch Intern Med. 1991;151(4):816-818. doi:10.1001/archinte.1991.00400040144041.
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To the Editor.—  Endocarditis is the most frequently reported manifestation of chronic infection with Coxiella burnetii. Many antibiotic regimens have been tried against Q-fever endocarditis with variable success. Recently, the fluoroquinolones have been suggested useful in the treatment of chronic Q-fever infection, such as endocarditis.1 We report a case of Q-fever endocarditis, in which the treatment with pefloxacine has failed.

Report of a Case.—  A 66-year-old man was admitted in March 1989 for persistent fever. This patient had a long history of rheumatic aortic stenosis for which a Björk's aortic valve replacement had been carried out in November 1975. He was well until November 1983, when intermittent episodes of fever began and persisted until November 1986. At this time, endocarditis was suspected and high titers of antibody to C burnetii suggested the diagnosis of Q fever. The associated treatment using rifampicine, 600 mg/d, and doxycycline, 200 mg/d was administered.

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