{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T10:13:42Z","timestamp":1777976022612,"version":"3.51.4"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T00:00:00Z","timestamp":1550620800000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"French government","award":["10-IAHU-03"],"award-info":[{"award-number":["10-IAHU-03"]}]},{"name":"R\u00e9gion Provence-Alpes-C\u00f4te d\u2019Azur"},{"DOI":"10.13039\/501100008530","name":"Fonds Europ\u00e9en de D\u00e9veloppement R\u00e9gional","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,13]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>As Q fever, caused by Coxiella burnetii, is a major health challenge due to its cardiovascular complications, we aimed to detect acute Q fever valvular injury to improve therapeutic management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In the French national reference center for Q fever, we prospectively collected data from patients with acute Q fever and valvular injury. We identified a new clinical entity, acute Q fever endocarditis, defined as valvular lesion potentially caused by C. burnetii: vegetation, valvular nodular thickening, rupture of chorda tendinae, and valve or chorda tendinae thickness. To determine whether or not the disease was superimposed on an underlying valvulopathy, patients\u2019 physicians were contacted. Aortic bicuspidy, valvular stenosis, and insufficiency were considered as underlying valvulopathies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 2434 patients treated in our center, 1797 had acute Q fever and 48 had acute Q fever endocarditis. In 35 cases (72%), transthoracic echocardiography (TTE) identified a valvular lesion of acute Q fever endocarditis without underlying valvulopathy. Positive anticardiolipin antibodies (&gt;22 immunoglobulin G-type phospholipid units [GPLU]) were independently associated with acute Q fever endocarditis (odds ratio [OR], 2.7 [95% confidence interval {CI}, 1.3\u20135.5]; P = .004). Acute Q fever endocarditis (OR, 5.2 [95% CI, 2.6\u201310.5]; P &lt; .001) and age (OR, 1.7 [95% CI, 1.1\u20131.9]; P = .02) were independent predictors of progression toward persistent C. burnetii endocarditis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Systematic TTE in acute Q fever patients offers a unique opportunity for early diagnosis of acute Q fever endocarditis and for the prevention of persistent endocarditis. Transesophageal echocardiography should be proposed in men, aged &gt;40 years, with anticardiolipin antibodies &gt;60 GPLU when TTE is inconclusive or negative.<\/jats:p><\/jats:sec>","DOI":"10.1093\/cid\/ciz120","type":"journal-article","created":{"date-parts":[[2019,2,4]],"date-time":"2019-02-04T20:26:54Z","timestamp":1549312014000},"page":"1987-1995","source":"Crossref","is-referenced-by-count":17,"title":["Acute Q Fever Endocarditis: A Paradigm Shift Following the Systematic Use of Transthoracic Echocardiography During Acute Q Fever"],"prefix":"10.1093","volume":"69","author":[{"given":"Cl\u00e9a","family":"Melenotte","sequence":"first","affiliation":[{"name":"Aix-Marseille Universit\u00e9, Institut de Recherche pour le D\u00e9veloppement, Assistance publique-H\u00f4pitaux de Marseille, Microbes Evolution Phylog\u00e9nie et Infections, Institut Hospitalo Universitaire-M\u00e9diterran\u00e9e Infection, Cayenne"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lo\u00efc","family":"Epelboin","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Maladies infectieuses et Tropicales, Centre Hospitalier Andr\u00e9 Rosemon, Cayenne"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthieu","family":"Million","sequence":"additional","affiliation":[{"name":"Aix-Marseille Universit\u00e9, Institut de Recherche pour le D\u00e9veloppement, Assistance publique-H\u00f4pitaux de Marseille, Microbes Evolution Phylog\u00e9nie et Infections, Institut Hospitalo Universitaire-M\u00e9diterran\u00e9e Infection, Cayenne"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandrine","family":"Hubert","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aix-Marseille Universit\u00e9, Marseille"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry","family":"Monsec","sequence":"additional","affiliation":[{"name":"Department of Cardiologie, Centre Hospitalier de Valence, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e9lix","family":"Djossou","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Maladies infectieuses et Tropicales, Centre Hospitalier Andr\u00e9 Rosemon, Cayenne"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Louis","family":"M\u00e8ge","sequence":"additional","affiliation":[{"name":"Aix-Marseille Universit\u00e9, Institut de Recherche pour le D\u00e9veloppement, Assistance publique-H\u00f4pitaux de Marseille, Microbes Evolution Phylog\u00e9nie et Infections, Institut Hospitalo Universitaire-M\u00e9diterran\u00e9e Infection, Cayenne"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilbert","family":"Habib","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Maladies infectieuses et Tropicales, Centre Hospitalier Andr\u00e9 Rosemon, Cayenne"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didier","family":"Raoult","sequence":"additional","affiliation":[{"name":"Aix-Marseille Universit\u00e9, Institut de Recherche pour le D\u00e9veloppement, Assistance publique-H\u00f4pitaux de Marseille, Microbes Evolution Phylog\u00e9nie et Infections, Institut Hospitalo Universitaire-M\u00e9diterran\u00e9e Infection, Cayenne"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,2,11]]},"reference":[{"key":"2019111315284148100_CIT0001","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1128\/CMR.00045-16","article-title":"From Q fever to Coxiella burnetii infection: a paradigm change","volume":"30","author":"Eldin","year":"2017","journal-title":"Clin Microbiol Rev"},{"key":"2019111315284148100_CIT0002","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1016\/S0140-6736(82)91341-1","article-title":"Q-fever endocarditis in England and Wales, 1975-81","volume":"2","author":"Palmer","year":"1982","journal-title":"Lancet"},{"key":"2019111315284148100_CIT0003","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/S0140-6736(59)91942-7","article-title":"Fatal endocarditis associated with Q fever","volume":"1","author":"Evans","year":"1959","journal-title":"Lancet"},{"key":"2019111315284148100_CIT0004","doi-asserted-by":"crossref","first-page":"E28","DOI":"10.1086\/338873","article-title":"Changing clinical presentation of Q fever endocarditis","volume":"34","author":"Houpikian","year":"2002","journal-title":"Clin Infect Dis"},{"key":"2019111315284148100_CIT0005","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1086\/321889","article-title":"Risk factors and prevention of Q fever endocarditis","volume":"33","author":"Fenollar","year":"2001","journal-title":"Clin Infect Dis"},{"key":"2019111315284148100_CIT0006","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1136\/bmj.2.5158.980","article-title":"Chronic Q fever. 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