{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:26:45Z","timestamp":1784042805090,"version":"3.55.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Q fever is a worldwide zoonotic disease caused by <jats:italic>Coxiella burnetii<\/jats:italic>. In humans, it can manifest clinically as an acute or chronic disease and endocarditis, the most frequent complication of chronic Q fever is associated with the greatest morbidity and mortality. We report a severe case of endocarditis in a 55-year-old man with a history of aortic valve replacement affected by monoclonal gammopathy of undetermined significance (MGUS), and living in a non-endemic area for <jats:italic>C. burnetii<\/jats:italic>. After two episodes of fever of unknown origin (FUO), occurring 2\u2009years apart and characterized by negative blood cultures, a serological diagnosis of Q fever endocarditis was performed even though the patient did not refer to possible past exposure to <jats:italic>C. burnetii<\/jats:italic>. Since people with preexisting valvular heart disease, when infected with <jats:italic>C. burnetii<\/jats:italic>, have reported a 40% risk of Q fever endocarditis, clinicians should maintain a high index of suspicion for infective endocarditis in all patients with FUO even when the exposure to <jats:italic>C. burnetii<\/jats:italic> appears to be unlikely.<\/jats:p>","DOI":"10.3389\/fmed.2023.1220205","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T08:09:57Z","timestamp":1691136597000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Case report: Coxiella burnetii endocarditis in the absence of evident exposure"],"prefix":"10.3389","volume":"10","author":[{"given":"Silvia","family":"Bozza","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Graziani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Borghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Marini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Duranti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Camilloni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,8,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1128\/CMR.12.4.518","article-title":"Q fever","volume":"12","author":"Maurin","year":"1999","journal-title":"Q Fever Clin Microbiol Rev"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"208","DOI":"10.21101\/cejph.a3754","article-title":"Influence of the environment and occupational exposure on the occurrence of Q fever","volume":"20","author":"Dorko","year":"2012","journal-title":"Cent Eur J Public Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e32108","DOI":"10.1371\/journal.pone.0032108","article-title":"Risk factors of Coxiella burnetii (Q fever) seropositivity in veterinary medicine students","volume":"7","author":"de Rooij","year":"2012","journal-title":"PLoS One"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1159\/000357107","article-title":"Coxiella burnetii - 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Scientific opinion on Q fever","volume":"8","year":"2010","journal-title":"EFSA J"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"273","DOI":"10.2903\/j.efsa.2022.7666","article-title":"The European Union one health 2021 zoonoses report","volume":"20","year":"2022","journal-title":"EFSA J"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e0131848","DOI":"10.1371\/journal.pone.0131848","article-title":"Long-term serological follow-up of acute Q-fever patients after a large epidemic","volume":"10","author":"Wielders","year":"2015","journal-title":"PLoS One"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e01595","DOI":"10.1016\/j.idcr.2022.e01595","article-title":"A zoonotic cause of blood culture-negative infective endocarditis in Belgium: case report and review of the literature on Q fever","volume":"29","author":"H\u00e9lo\u00efse","year":"2022","journal-title":"IDCases"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"3075","DOI":"10.1093\/eurheartj\/ehv319","article-title":"ESC guidelines for the management of infective endocarditis: the task force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). 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