{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T17:06:54Z","timestamp":1781975214437,"version":"3.54.5"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,10,24]],"date-time":"2019-10-24T00:00:00Z","timestamp":1571875200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,10,24]],"date-time":"2019-10-24T00:00:00Z","timestamp":1571875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006098","name":"Shaheed Rajaei Cardiovascular Medical and Research Center","doi-asserted-by":"publisher","award":["95066"],"award-info":[{"award-number":["95066"]}],"id":[{"id":"10.13039\/501100006098","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006098","name":"Shaheed Rajaei Cardiovascular Medical and Research Center","doi-asserted-by":"publisher","award":["95066"],"award-info":[{"award-number":["95066"]}],"id":[{"id":"10.13039\/501100006098","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010679","name":"Pasteur Institute of Iran","doi-asserted-by":"publisher","award":["1181"],"award-info":[{"award-number":["1181"]}],"id":[{"id":"10.13039\/501100010679","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010679","name":"Pasteur Institute of Iran","doi-asserted-by":"publisher","award":["810"],"award-info":[{"award-number":["810"]}],"id":[{"id":"10.13039\/501100010679","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Patients with the underlying valvular heart disease are at the high risk of developing sub-acute or chronic endocarditis secondary to <jats:italic>Coxiella burnetii<\/jats:italic>. Q fever endocarditis is the most common manifestation along with persistent the infection. There is some serologic and molecular evidence of <jats:italic>C<\/jats:italic>. <jats:italic>burnetii<\/jats:italic> infection in humans and livestock in Iran. As it is possible to observe chronic Q fever in Iran, it seems necessary to study the prevalence of Q fever endocarditis in this country. In the present study, Infective Endocarditis (IE) patients (possible or definite based on Duke Criteria) hospitalized in Rajaie Cardiovascular Medical and Research Center were enrolled from August 2016 to September 2018. Culture-negative endocarditis patients were evaluated by Raoult criteria for diagnosis Q fever endocarditis. The serological results for brucellosis were negative for all subjects. All blood and tissue samples including valve samples were tested for <jats:italic>C<\/jats:italic>. <jats:italic>burnetii<\/jats:italic> infection using serology and Polymerase Chain Reaction (PCR). In this study, 126 patients who were admitted to the hospital were enrolled; of which 52 subjects were culture-negative IE. Among the participants, 16 patients (30.77%) were diagnosed with Q fever IE and underwent medical treatment. The mean age of patients was 46.6 years ranging from 23 to 69 years and 75% of them were male. Considering the high prevalence of Q fever IE, evaluation of the patients with culture-negative IE for <jats:italic>C<\/jats:italic>. <jats:italic>burnetii<\/jats:italic> infections was highly recommended.<\/jats:p>","DOI":"10.1038\/s41598-019-51600-3","type":"journal-article","created":{"date-parts":[[2019,10,25]],"date-time":"2019-10-25T12:20:45Z","timestamp":1572006045000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Q Fever Endocarditis in Iran"],"prefix":"10.1038","volume":"9","author":[{"given":"Pardis","family":"Moradnejad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saber","family":"Esmaeili","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid","family":"Maleki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Sadeghpour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monireh","family":"Kamali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdi","family":"Rohani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Ghasemi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahimeh","family":"Bagheri Amiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid Reza","family":"Pasha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shabnam","family":"Boudagh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hooman","family":"Bakhshandeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasim","family":"Naderi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behshid","family":"Ghadrdoost","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Lotfian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyed Ali","family":"Dehghan Manshadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehsan","family":"Mostafavi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,10,24]]},"reference":[{"key":"51600_CR1","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1128\/CMR.00045-16","volume":"30","author":"C Eldin","year":"2017","unstructured":"Eldin, C. et al. From Q fever to Coxiella burnetii infection: a paradigm change. Clinical microbiology reviews 30, 115\u2013190 (2017).","journal-title":"Clinical microbiology reviews"},{"key":"51600_CR2","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.vetmic.2009.07.016","volume":"140","author":"E Angelakis","year":"2010","unstructured":"Angelakis, E. & Raoult Q fever. Veterinary Microbiology 140, 297\u2013309 (2010).","journal-title":"Veterinary Microbiology"},{"key":"51600_CR3","first-page":"1","volume":"62","author":"A Anderson","year":"2013","unstructured":"Anderson, A. et al. Diagnosis and management of Q fever\u2013United States, 2013. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports\/Centers for Disease Control 62, 1\u201330 (2013).","journal-title":"MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports\/Centers for Disease Control"},{"key":"51600_CR4","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/S1473-3099(05)70052-9","volume":"5","author":"D Raoult","year":"2005","unstructured":"Raoult, D., Marrie, T. & Mege, J. Natural history and pathophysiology of Q fever. The Lancet infectious diseases 5, 219\u2013226 (2005).","journal-title":"The Lancet infectious diseases"},{"key":"51600_CR5","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.jinf.2012.04.006","volume":"65","author":"D Raoult","year":"2012","unstructured":"Raoult, D. Chronic Q fever: expert opinion versus literature analysis and consensus. Journal of Infection 65, 102\u2013108 (2012).","journal-title":"Journal of Infection"},{"key":"51600_CR6","first-page":"735","volume":"23","author":"D Grisoli","year":"2014","unstructured":"Grisoli, D. et al. Latent Q fever endocarditis in patients undergoing routine valve surgery. The Journal of heart valve disease 23, 735\u2013743 (2014).","journal-title":"The Journal of heart valve disease"},{"key":"51600_CR7","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/j.jinf.2011.12.014","volume":"64","author":"MC Wegdam-Blans","year":"2012","unstructured":"Wegdam-Blans, M. C. et al. Chronic Q fever: review of the literature and a proposal of new diagnostic criteria. Journal of Infection 64, 247\u2013259 (2012).","journal-title":"Journal of Infection"},{"key":"51600_CR8","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1086\/500402","volume":"42","author":"F Fenollar","year":"2006","unstructured":"Fenollar, F., Thuny, F., Xeridat, B., Lepidi, H. & Raoult, D. Endocarditis after acute Q fever in patients with previously undiagnosed valvulopathies. Clinical infectious diseases 42, 818\u2013821 (2006).","journal-title":"Clinical infectious diseases"},{"key":"51600_CR9","doi-asserted-by":"publisher","first-page":"563","DOI":"10.3201\/eid1804.111478","volume":"18","author":"LM Kampschreur","year":"2012","unstructured":"Kampschreur, L. M. et al. Identification of risk factors for chronic Q fever, the Netherlands. Emerging infectious diseases 18, 563\u2013570 (2012).","journal-title":"Emerging infectious diseases"},{"key":"51600_CR10","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1093\/jac\/dkr450","volume":"67","author":"FK Gould","year":"2012","unstructured":"Gould, F. K. et al. Guidelines for the diagnosis and antibiotic treatment of endocarditis in adults: a report of the Working Party of the British Society for Antimicrobial Chemotherapy. Journal of antimicrobial chemotherapy 67, 269\u2013289 (2012).","journal-title":"Journal of antimicrobial chemotherapy"},{"key":"51600_CR11","first-page":"66","volume":"5","author":"E Mostafavi","year":"2012","unstructured":"Mostafavi, E., Rastad, H. & Khalili, M. Q. Fever: An emerging public health concern in Iran. Asian. Journal of Epidemiology 5, 66\u201374 (2012).","journal-title":"Journal of Epidemiology"},{"key":"51600_CR12","first-page":"66","volume":"1","author":"A Eghtedari","year":"1970","unstructured":"Eghtedari, A., Kohout, J. & Path, M. Q fever in Iran A report of clinical cases and serological studies in Shiraz. Pahlavi Med J 1, 66\u201373 (1970).","journal-title":"Pahlavi Med J"},{"key":"51600_CR13","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1089\/vbz.2013.1379","volume":"14","author":"S Esmaeili","year":"2014","unstructured":"Esmaeili, S., Pourhossein, B., Gouya, M. M., Amiri, F. B. & Mostafavi, E. Seroepidemiological survey of Q fever and brucellosis in Kurdistan Province, western Iran. Vector-Borne and Zoonotic Diseases 14, 41\u201345 (2014).","journal-title":"Vector-Borne and Zoonotic Diseases"},{"key":"51600_CR14","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1089\/vbz.2013.1382","volume":"14","author":"S Esmaeili","year":"2014","unstructured":"Esmaeili, S., Bagheri Amiri, F. & Mostafavi, E. Seroprevalence survey of Q fever among sheep in northwestern Iran. Vector-Borne and Zoonotic Diseases 14, 189\u2013192 (2014).","journal-title":"Vector-Borne and Zoonotic Diseases"},{"key":"51600_CR15","first-page":"708","volume":"20","author":"S Esmaeili","year":"2013","unstructured":"Esmaeili, S., Mostafavi, E., Shahdordizadeh, M. & Mahmoudi, H. A seroepidemiological survey of Q fever among sheep in Mazandaran province, northern Iran. Annals of agricultural and environmental medicine: AAEM 20, 708\u2013710 (2013).","journal-title":"Annals of agricultural and environmental medicine: AAEM"},{"key":"51600_CR16","first-page":"213","volume":"9","author":"MH Kayedi","year":"2017","unstructured":"Kayedi, M. H. et al. Seroepidemiological study of Q fever in Lorestan province, western Iran, 2014. Iranian journal of microbiology 9, 213\u2013218 (2017).","journal-title":"Iranian journal of microbiology"},{"key":"51600_CR17","doi-asserted-by":"publisher","first-page":"e0005521","DOI":"10.1371\/journal.pntd.0005521","volume":"11","author":"AM Mobarez","year":"2017","unstructured":"Mobarez, A. M., Amiri, F. B. & Esmaeili, S. Seroprevalence of Q fever among human and animal in Iran; A systematic review and meta-analysis. PLoS neglected tropical diseases 11, e0005521 (2017).","journal-title":"PLoS neglected tropical diseases"},{"key":"51600_CR18","doi-asserted-by":"publisher","first-page":"e0144953","DOI":"10.1371\/journal.pone.0144953","volume":"11","author":"S Esmaeili","year":"2016","unstructured":"Esmaeili, S. et al. Seroprevalence of brucellosis, leptospirosis, and Q fever among butchers and slaughterhouse workers in south-eastern Iran. PloS one 11, e0144953 (2016).","journal-title":"PloS one"},{"key":"51600_CR19","doi-asserted-by":"publisher","first-page":"e0005535","DOI":"10.1371\/journal.pntd.0005535","volume":"11","author":"S Esmaeili","year":"2017","unstructured":"Esmaeili, S., Golzar, F., Ayubi, E., Naghili, B. & Mostafavi, E. Acute Q fever in febrile patients in northwestern of Iran. PLOS Neglected Tropical Diseases 11, e0005535 (2017).","journal-title":"PLOS Neglected Tropical Diseases"},{"key":"51600_CR20","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1177\/0049475515624855","volume":"46","author":"M Khalili","year":"2016","unstructured":"Khalili, M., Reza Naderi, H., Salehnia, N. & Abiri, Z. Detection of Coxiella burnetii in acute undifferentiated febrile illnesses (AUFIs) in Iran. Tropical doctor 46, 221\u2013224 (2016).","journal-title":"Tropical doctor"},{"key":"51600_CR21","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1016\/j.jiph.2014.12.004","volume":"8","author":"F Yaghmaie","year":"2015","unstructured":"Yaghmaie, F., Esmaeili, S., Francis, S. A. & Mostafavi, E. Q fever endocarditis in Iran: A case report. Journal of infection and public health 8, 498\u2013501 (2015).","journal-title":"Journal of infection and public health"},{"key":"51600_CR22","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1155\/2014\/863678","volume":"25","author":"I Das","year":"2014","unstructured":"Das, I., Steeds, R. & Hewins, P. Chronic Q fever: An ongoing challenge in diagnosis and management. Canadian Journal of Infectious Diseases and Medical Microbiology 25, 35\u201337 (2014).","journal-title":"Canadian Journal of Infectious Diseases and Medical Microbiology"},{"key":"51600_CR23","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/S0924-8579(96)00369-X","volume":"8","author":"TJ Marrie","year":"1997","unstructured":"Marrie, T. J. & Raoult, D. Q fever\u2014a review and issues for the next century. International journal of antimicrobial agents 8, 145\u2013161 (1997).","journal-title":"International journal of antimicrobial agents"},{"key":"51600_CR24","doi-asserted-by":"crossref","unstructured":"Astobiza, I. et al. A four-year evaluation of the effect of vaccination against Coxiella burnetii on reducing animal infection and environmental contamination in a naturally infected dairy sheep flock. Applied and environmental microbiology, AEM, 05530\u201305511 (2011).","DOI":"10.1128\/AEM.07181-11"},{"key":"51600_CR25","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1016\/S1473-3099(10)70135-3","volume":"10","author":"M Million","year":"2010","unstructured":"Million, M., Thuny, F., Richet, H. & Raoult, D. Long-term outcome of Q fever endocarditis: a 26-year personal survey. The Lancet infectious diseases 10, 527\u2013535 (2010).","journal-title":"The Lancet infectious diseases"},{"key":"51600_CR26","doi-asserted-by":"publisher","first-page":"1872","DOI":"10.1093\/cid\/cix702","volume":"65","author":"A Straily","year":"2017","unstructured":"Straily, A., Dahlgren, F. S., Peterson, A. & Paddock, C. D. Surveillance for Q Fever Endocarditis in the United States, 1999\u20132015. Clinical Infectious Diseases 65, 1872\u20131877 (2017).","journal-title":"Clinical Infectious Diseases"},{"key":"51600_CR27","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1086\/313753","volume":"30","author":"JS Li","year":"2000","unstructured":"Li, J. S. et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clinical infectious diseases 30, 633\u2013638 (2000).","journal-title":"Clinical infectious diseases"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-51600-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-51600-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-51600-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T14:54:59Z","timestamp":1671288899000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-51600-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,24]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["51600"],"URL":"https:\/\/doi.org\/10.1038\/s41598-019-51600-3","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,24]]},"assertion":[{"value":"5 March 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 October 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 October 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"15276"}}