{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:22:43Z","timestamp":1787775763299,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To describe a case of bilateral retinitis in a patient with endocarditis and a serologically confirmed Q fever.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A single case report documented with multimodal imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A 55-year-old patient with culture-negative endocarditis was referred to our department for an ocular examination. His visual acuity was 20\/20 in both eyes. Fundus examination showed white retinal infiltrates with few superficial retinal hemorrhages scattered in the posterior pole. There was no staining on fluorescein angiography. Swept-source optical coherence tomography (SS-OCT) revealed increased inner retinal reflectivity with a focal area of retinal thickening. Laboratory tests showed a high titer of antibodies against\n                      <jats:italic toggle=\"yes\">Coxiella burnetii<\/jats:italic>\n                      . The patient was treated with doxycycline. Two weeks later, fundus examination showed partial resolution of retinitis with inner retinal thinning in SS-OCT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Multifocal retinitis is an uncommon presentation of Q fever. The diagnosis should be considered, especially when associated with culture-negative infective endocarditis, highlighting the importance of routine ocular examination.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/joco.joco_81_23","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T15:58:26Z","timestamp":1725983906000},"page":"405-407","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Q Fever Endocarditis with Bilateral Multifocal Retinitis: A Case Report"],"prefix":"10.4103","volume":"35","author":[{"given":"Rym","family":"Maamouri","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Hospital Habib Thameur, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olfa","family":"Beizig","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Hospital Habib Thameur, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khadija","family":"Mzoughi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Habib Thameur, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monia","family":"Cheour","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Habib Thameur, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,8,10]]},"reference":[{"key":"R1-20240910","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1586\/eri.10.29","article-title":"Q fever: Clinical manifestations and treatment","volume":"8","author":"Gikas","year":"2010","journal-title":"Expert Rev Anti Infect Ther"},{"issue":"Suppl 1","key":"R2-20240910","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/S0213-005X(10)70005-7","article-title":"Infection by Coxiella burnetii (Q fever)","volume":"28","author":"Fari\u00f1as","year":"2010","journal-title":"Enferm Infecc Microbiol Clin"},{"key":"R3-20240910","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1016\/j.hlc.2021.04.022","article-title":"Q fever endocarditis: A review of local and all reported cases in the literature","volume":"30","author":"Jaltotage","year":"2021","journal-title":"Heart Lung Circ"},{"key":"R4-20240910","doi-asserted-by":"crossref","first-page":"2369","DOI":"10.1093\/eurheartj\/ehp285","article-title":"Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): The task force on the prevention, diagnosis, and treatment of infective endocarditis of the European society of cardiology (ESC). Endorsed by the European society of clinical microbiology and infectious diseases (ESCMID) and the international society of chemotherapy (ISC) for infection and cancer","volume":"30","author":"Habib","year":"2009","journal-title":"Eur Heart J"},{"key":"R5-20240910","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/S1473-3099(10)70135-3","article-title":"Long-term outcome of Q fever endocarditis: A 26-year personal survey","volume":"10","author":"Million","year":"2010","journal-title":"Lancet Infect Dis"},{"issue":"Suppl 3","key":"R6-20240910","doi-asserted-by":"crossref","first-page":"e269","DOI":"10.1016\/j.ijid.2009.11.010","article-title":"Optic neuritis associated with Q fever: Case report and literature review","volume":"14","author":"Ong","year":"2010","journal-title":"Int J Infect Dis"},{"key":"R7-20240910","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.2147\/OPTH.S18771","article-title":"Q fever: A new ocular manifestation","volume":"5","author":"Udaondo","year":"2011","journal-title":"Clin Ophthalmol"},{"key":"R8-20240910","doi-asserted-by":"crossref","first-page":"102215","DOI":"10.1016\/j.tmaid.2021.102215","article-title":"Retinitis as first clinical manifestation of Q fever infection in a patient returning from Mexico: A diagnostic challenge","volume":"45","author":"Espinosa-Encalada","year":"2022","journal-title":"Travel Med Infect Dis"},{"key":"R9-20240910","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s12348-022-00295-1","article-title":"Acute multifocal retinitis in a patient with Q fever (Coxiella Burnetii infection) with endocarditis","volume":"12","author":"Mahmoud","year":"2022","journal-title":"J Ophthalmic Inflamm Infect"},{"key":"R10-20240910","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.ophtha.2003.04.012","article-title":"Posterior segment manifestations of Rickettsia conorii infection","volume":"111","author":"Khairallah","year":"2004","journal-title":"Ophthalmology"},{"key":"R11-20240910","first-page":"123","article-title":"Efficiency of various serological techniques for diagnosing Coxiella burnetii infection","volume":"49","author":"Slab\u00e1","year":"2005","journal-title":"Acta Virol"}],"container-title":["Journal of Current Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/joco.joco_81_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:41:44Z","timestamp":1787773304000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/joco.joco_81_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/joco.joco_81_23","relation":{},"ISSN":["2452-2325"],"issn-type":[{"value":"2452-2325","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10]]},"assertion":[{"value":"2023-04-11","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-29","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}