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Coxiella burnetii infection of an aortic graft: surgical view and a word of caution

^a Department of Cardiothoracic Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
^b Department of Cardiology, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

^* Corresponding author. Tel.: +972-3-937 6701; fax: +972-3-924 0762
georgios{at}clalit.org.il

A 30-year-old-man presented with an aortic graft infection. Polymerase chain reaction study identified the infectious organism as Coxiella burnetii, a strictly intracellular pathogen that causes Q fever in humans. The patient was successfully treated by removal of the infected graft, implantation of homograft aortic tube, and specific antibiotic therapy. He is doing well after 6 months, with no evidence of recurrent homograft infection on transthoracic echocardiography. C. burnetii vascular graft infections may be underdiagnosed because of lack of recognition. We suggest that serologic tests for C. burnetii be routinely performed in the presence of unexplained febrile illness or pain in patients with a history of underlying vascular disease.

Key Words: Coxiella burnetii; Infection; Q fever; Aortic graft