{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T14:02:16Z","timestamp":1773842536446,"version":"3.50.1"},"reference-count":12,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,7,23]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>Diagnosis of infective endocarditis can be challenging for clinicians, especially when involving prosthetic valves. Recent data suggest that <jats:sup>18<\/jats:sup>F-fluorodeoxyglucose positron emission tomography\/computed tomography (<jats:sup>18<\/jats:sup>F-FDG PET\/CT) could be a useful diagnostic tool in this setting. Here, we report a case of a patient with an aortic biological prosthesis who presented with a history of fever and fatigue. Echocardiograms were negative for vegetations. The <jats:sup>18<\/jats:sup>F-FDG PET\/CT revealed an infective process of the valve and serological tests were positive for chronic <jats:italic>Coxiella burnetii<\/jats:italic> infection. Specific treatment for chronic Q fever endocarditis was, therefore, started and the response was monitored using <jats:sup>18<\/jats:sup>F-FDG PET\/CT. This case highlights the challenges and pitfalls clinicians face when confronted with prosthetic valve endocarditis and the use of <jats:sup>18<\/jats:sup>F-FDG PET\/CT for diagnosis and follow-up.<\/jats:p>","DOI":"10.1136\/bcr-2021-243290","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T12:18:47Z","timestamp":1629461927000},"page":"e243290","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Challenging case of chronic Q fever endocarditis: usefulness of 18F-FDG PET\/CT in the diagnosis and follow-up"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7495-5809","authenticated-orcid":false,"given":"Anna Hermine","family":"Markowich","sequence":"first","affiliation":[{"name":"Immunology and Infectious Diseases Unit, Academic Department of Pediatrics, IRCCS Ospedale Pediatrico Bambino Ges\u00f9, Roma, Lazio, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenza","family":"Romani","sequence":"additional","affiliation":[{"name":"Immunology and Infectious Diseases Unit, Academic Department of Pediatrics, IRCCS Ospedale Pediatrico Bambino Ges\u00f9, Roma, Lazio, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6000-2898","authenticated-orcid":false,"given":"Lucia","family":"Leccisotti","sequence":"additional","affiliation":[{"name":"UOC di Medicina Nucleare, Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Roma, Lazio, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maia","family":"De Luca","sequence":"additional","affiliation":[{"name":"Immunology and Infectious Diseases Unit, Academic Department of Pediatrics, IRCCS Ospedale Pediatrico Bambino Ges\u00f9, Roma, Lazio, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,8,20]]},"reference":[{"key":"2025082709542711000_14.8.e243290.1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv319"},{"key":"2025082709542711000_14.8.e243290.2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-307021"},{"key":"2025082709542711000_14.8.e243290.3","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1093\/cid\/ciz267","article-title":"The role of 18F-fluorodeoxyglucose positron emission tomography\/computed tomography in the diagnosis of left-sided endocarditis: native vs prosthetic valves endocarditis","volume":"70","author":"de Camargo","year":"2020","journal-title":"Clin Infect 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