{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T14:23:11Z","timestamp":1780582991638,"version":"3.54.1"},"reference-count":39,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2006,6,1]],"date-time":"2006-06-01T00:00:00Z","timestamp":1149120000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2006,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Infections due to\n            <jats:italic>Coxiella burnetii<\/jats:italic>\n            , the causative agent of Q fever, are uncommon in the United States. Cases of chronic Q fever are extremely rare and most often manifest as culture-negative endocarditis in patients with underlying valvular heart disease. We describe a 31-year-old farmer from West Virginia with a history of congenital heart disease and recurrent fevers for 14 months who was diagnosed with Q fever endocarditis based on an extremely high antibody titer against\n            <jats:italic>Coxiella burnetii<\/jats:italic>\n            phase I antigen. Despite treatment with doxycycline, he continued to have markedly elevated\n            <jats:italic>Coxiella burnetii<\/jats:italic>\n            phase I antibody titers for 10 years after the initial diagnosis. To our knowledge, this case represents the longest follow-up period for a patient with chronic Q fever in the United States. We review all cases of chronic Q fever reported in the United States and discuss important issues pertaining to epidemiology, diagnosis, and management of this disease.\n          <\/jats:p>","DOI":"10.1128\/jcm.02365-05","type":"journal-article","created":{"date-parts":[[2006,6,7]],"date-time":"2006-06-07T10:58:07Z","timestamp":1149677887000},"page":"2283-2287","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":61,"title":["Chronic Q Fever in the United States"],"prefix":"10.1128","volume":"44","author":[{"given":"Petros C.","family":"Karakousis","sequence":"first","affiliation":[{"name":"Departments of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Trucksis","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Stephen","family":"Dumler","sequence":"additional","affiliation":[{"name":"Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","first-page":"669","volume":"93","year":"1977","unstructured":"Applefeld, M. M., L. M. Billingsley, H. J. Tucker, and P. Fiset. 1977. Q fever endocarditis\u2014a case occurring in the United States. Am. Heart J.93:669-670.","journal-title":"Am. Heart J."},{"key":"e_1_3_2_3_2","first-page":"1577","volume":"35","year":"1974","unstructured":"Biberstein, E. L., D. E. Behymer, R. Bushnell, G. Crenshaw, H. P. Riemann, and C. E. Franti. 1974. A survey of Q fever (Coxiella burnetii) in California dairy cows. Am. J. Vet. Res.35:1577-1582.","journal-title":"Am. J. Vet. 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