@article{PAR00010930,
  title = {{E}volution from acute {Q} fever to endocarditis is associated with underlying valvulopathy and age and can be prevented by prolonged antibiotic treatment},
  author = {{M}illion, {M}. and {W}alter, {G}. and {T}huny, {F}. and {H}abib, {G}. and {R}aoult, {D}idier},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {T}he prevention of {Q} fever endocarditis through the use of systematic echocardiography and antibiotic prophylaxis in patients with acute {Q} fever and valvulopathy has never been validated in a cohort study. {M}ethods. {F}rom 2007 to 2012, all patients followed at the {F}rench {N}ational {R}eferral {C}enter for acute {Q} fever were included in a cohort study. {T}he prevention of endocarditis included a systematic transthoracic echocardiography ({TTE}) and a 12-month course of doxycycline and hydroxychloroquine prophylaxis in patients with significant valvulopathy. {T}ransesophageal echocardiography ({TEE}) was performed in patients with a negative {TTE} and a rapid rise of phase {I} immunoglobulin {G} titers. {R}esults. {S}eventy-two patients were included with a median follow-up time of 22 months. {A} valvulopathy was identified in 31 patients (43%), being previously unknown in 24 (33%) and diagnosed only upon {TEE} or a second {TTE} in 7 (10%). {T}he major determinants associated with endocarditis were age (hazard ratio [{HR}], 1.07; 95% confidence interval [{CI}], 1.006-1.13; {P} = .03), aortic regurgitation ({HR}, 10.2; 95% {CI}, 3.2-32.2; {P} < .001), and mitral regurgitation ({HR}, 4.78; 95% {CI}, 1.4-16.0; {P} = .01). {A}ntibiotic prophylaxis was highly effective ({HR}, 0.002; 95% {CI}, .00-.77; {P} = .04) for the 31 patients with valvulopathy. {C}onclusions. {A}cute {Q} fever could be associated with an increased prevalence of valvulopathy. {T}he evolution from acute {Q} fever to endocarditis is associated with age and valvulopathy and can be entirely prevented by antibiotic prophylaxis. {A}lthough the name "chronic {Q} fever" suggests otherwise, rapid evolution (< 1 month) was observed.},
  keywords = {{Q} fever endocarditis ; age ; heart valve disease ; prevention ; antibiotic ; prophylaxis},
  booktitle = {},
  journal = {{C}linical {I}nfectious {D}iseases},
  volume = {57},
  numero = {6},
  pages = {836--844},
  ISSN = {1058-4838},
  year = {2013},
  DOI = {10.1093/cid/cit419},
  URL = {https://www.documentation.ird.fr/hor/{PAR}00010930},
}