PDF(Pubmed)
Abstract：
BACKGROUND: Coxiella burnetii is a bacterium with extreme tenacity and contagiousness that is mainly transmitted by inhalation of contaminated aerosols. Nevertheless, a transmission by ticks is under discussion. We report a case of Q fever in an urban environment and far away from sheep breeding that caused a rare right-sided endocarditis.
METHODS: A 55-year-old man who was in good health before the event developed a C. burnetii -endocarditis of the tricuspid valve. He had no contact with sheep and no recent travel in a rural or even endemic area. The infection originated in a strictly urban environment, and the patient\'s occupation as a cemetery gardener in Berlin, coupled with the close temporal and local exposure to wild boar, made a transmission by these animals a plausible hypothesis. The infection was confirmed by the German Reference Laboratory, and the patient recovered completely after treatment with doxycycline and hydrochlorquine.
CONCLUSIONS: The specialities of this case report are the right-sided endocarditis and the transmission of C. burnetii in a metropolitan area without sheep contact. We think that this case should serve to increase awareness of the potential for Q fever infection even in non-rural areas.
METHODS: A 55-year-old man who was in good health before the event developed a C. burnetii -endocarditis of the tricuspid valve. He had no contact with sheep and no recent travel in a rural or even endemic area. The infection originated in a strictly urban environment, and the patient\'s occupation as a cemetery gardener in Berlin, coupled with the close temporal and local exposure to wild boar, made a transmission by these animals a plausible hypothesis. The infection was confirmed by the German Reference Laboratory, and the patient recovered completely after treatment with doxycycline and hydrochlorquine.
CONCLUSIONS: The specialities of this case report are the right-sided endocarditis and the transmission of C. burnetii in a metropolitan area without sheep contact. We think that this case should serve to increase awareness of the potential for Q fever infection even in non-rural areas.
摘要：
背景：伯氏柯西氏菌是一种具有极端韧性和传染性的细菌，主要通过吸入污染的气溶胶传播。然而，正在讨论用蜱传递。我们报告了一例在城市环境中，远离绵羊繁殖的Q热引起的罕见右侧心内膜炎。
方法：一名55岁男子，在该事件发生前健康状况良好，出现了三尖瓣氏杆菌心内膜炎。他没有与绵羊接触，也没有最近在农村甚至流行地区旅行。感染起源于严格的城市环境，以及病人在柏林的墓地园丁，再加上对野猪的短暂和局部接触，使这些动物的传播成为一个合理的假设。德国参考实验室证实了感染，在使用多西环素和氢氯喹治疗后，患者完全康复。
结论：该病例报告的特点是右侧心内膜炎和在没有绵羊接触的大都市地区传播。我们认为，即使在非农村地区，这种情况也应有助于提高人们对Q热感染潜力的认识。
方法：一名55岁男子，在该事件发生前健康状况良好，出现了三尖瓣氏杆菌心内膜炎。他没有与绵羊接触，也没有最近在农村甚至流行地区旅行。感染起源于严格的城市环境，以及病人在柏林的墓地园丁，再加上对野猪的短暂和局部接触，使这些动物的传播成为一个合理的假设。德国参考实验室证实了感染，在使用多西环素和氢氯喹治疗后，患者完全康复。
结论：该病例报告的特点是右侧心内膜炎和在没有绵羊接触的大都市地区传播。我们认为，即使在非农村地区，这种情况也应有助于提高人们对Q热感染潜力的认识。
