{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:13:09Z","timestamp":1760235189279,"version":"build-2065373602"},"reference-count":54,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T00:00:00Z","timestamp":1627344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>A 57-year female patient diagnosed with Beh\u00e7et\u2019s disease, on azathioprine, was noticed to have at a routine examination antinuclear and antiphospholipid antibodies. An overlapping lupus-like syndrome was diagnosed; hydroxychloroquine and aspirin were added. Three years later, the patient presented with dyspnea and sweating, with no fever. A cardiac bruit was noted; a giant vegetation was detected by echocardiography. Laboratory revealed severe thrombocytopenia, antiphospholipid antibodies and low complement. Blood cultures were positive for Abiotrophia defectiva serology and also revealed a chronic Coxiella burnetii infection. Antibiotic therapy, low-dose anticoagulation and control of the underlying disease mildly improved the platelet count, which fully recovered only after cardiac valve replacement. However, the Beh\u00e7et\u2019s disease, initially quiescent, flared after the therapy of infections. We discuss potential links between Beh\u00e7et\u2019s disease and the occurrence of antinuclear and antiphospholipid antibodies and Coxiella endocarditis in this setting. We also highlight the differences between the endocarditis in Beh\u00e7et\u2019s disease, antiphospholipid syndrome, Coxiella burnetii and Abiotrophia defectiva infection, respectively. Intracellular infections may modify the presentation of autoimmune diseases. Confounding clinical features of Coxiella persistent infection and non-bacterial thrombotic endocarditis in Beh\u00e7et\u2019s disease warrant further insight.<\/jats:p>","DOI":"10.3390\/jpm11080728","type":"journal-article","created":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T12:18:31Z","timestamp":1627388311000},"page":"728","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Frenemies within: An Endocarditis Case in Beh\u00e7et\u2019s Disease"],"prefix":"10.3390","volume":"11","author":[{"given":"Diana","family":"Moro\u0219an","sequence":"first","affiliation":[{"name":"Department of Rheumatology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, 8 Victor Babe\u0219 St., 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adela","family":"\u0218erban","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, 8 Victor Babe\u0219 St., 400012 Cluj-Napoca, Romania"},{"name":"Department of Cardiology, \u201cNiculae Stancioiu\u201d Heart Institute Cluj-Napoca, 19-21, Calea Mo\u021bilor St., 400001 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u0103t\u0103lin","family":"Trifan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, \u201cNiculae Stancioiu\u201d Heart Institute Cluj-Napoca, 19-21, Calea Mo\u021bilor St., 400001 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svetlana","family":"Encica","sequence":"additional","affiliation":[{"name":"Department of Pathology, \u201cNiculae Stancioiu\u201d Heart Institute Cluj-Napoca, 19-21, Calea Mo\u021bilor St., 400001 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sorin","family":"Pop","sequence":"additional","affiliation":[{"name":"1st Internal Medicine Department, Emergency Clinical County Hospital Cluj, 3-5 Clinicilor St., 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tudor Costinel","family":"\u0218erban","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cNiculae Stancioiu\u201d Heart Institute Cluj-Napoca, 19-21, Calea Mo\u021bilor St., 400001 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Rednic","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, 8 Victor Babe\u0219 St., 400012 Cluj-Napoca, Romania"},{"name":"Department of Rheumatology, Centre for Rare Musculoskeletal Autoimmune and Autoinflammatory Diseases, Emergency Clinical County Hospital Cluj, 2-4 Clinicilor St., 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Damian","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Centre for Rare Musculoskeletal Autoimmune and Autoinflammatory Diseases, Emergency Clinical County Hospital Cluj, 2-4 Clinicilor St., 400006 Cluj-Napoca, Romania"},{"name":"CMI Reumatologie Dr. Damian, 6-8 P. Maior St., 400002 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e13180","DOI":"10.1111\/cmi.13180","article-title":"From neglected to dissected: How technological advances are leading the way to the study of Coxiella burnetii pathogenesis","volume":"22","author":"Burette","year":"2020","journal-title":"Cell Microbiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1093\/cid\/civ956","article-title":"Antiphospholipid Antibody Syndrome with Valvular Vegetations in Acute Q Fever","volume":"62","author":"Million","year":"2016","journal-title":"Clin. Infect. 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