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Volume 27, Number 7—July 2021

Polymicrobial Infections Among Patients with Vascular Q Fever, France, 2004–2020

Mathilde PugesComments to Author , Xavier Bérard, Caroline Caradu, Maïlys Ducours, Carole Eldin, Mathilde Carrer, Noémie Sauvage, Marc-Olivier Vareil, Laure Alleman, Fatima M’Zali, Sabine Pereyre, and Charles Cazanave
Author affiliations: Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France (M. Puges, X. Bérard, C. Caradu, M. Ducours, M. Carrer, N. Sauvage, S. Pereyre, C. Cazanave); IHU-Méditerranée Infection, Marseille, France (C. Eldin); Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille (C. Eldin); Centre Hospitalier de la Côte Basque, Bayonne, France (M.-O. Vareil, L. Alleman); University of Bordeaux, Bordeaux (F. M’Zali, S. Pereyre, C. Cazanave)

Main Article

Table 1

Characteristics of patients with vascular Q fever complicated by polymicrobial infections, France, 2014–2020*

Patient no. Age, y Infection type Graft type (age, mo) Symptoms Computed tomography scan findings Phase I titer, IgG/IgM/IgA Coxiella burnetii
AEF Replacement graft type Co-infections Clinical outcome
1 64 Aortitis Not available Hemorrhagic shock caused by lower gastrointestinal bleeding Abdominal aortic aneurysm, psoas hematoma,
800/0/400 Aortic graft, + AD Bovine pericardium Aorta: Enterobacter cloacae, Enterococcus faecalis, Enterococcus durans, Streptococcus anginosus, S. salivarius, Klebsiella oxytoca, Gemella haemolysans, S. mitis, Escherichia coli, Haemophilus parainfluenzae;
blood culture, –
Survived; completed 18-mo Q fever treatment 28 d after symptom onset; has maintained
remission 5 y after diagnosis
2 78 Aortic endograft Polyester endograft (96) Chills, back pain, acute respiratory failure, fever Periprosthetic abscess and gas, AEF 100/0/0 Aortic graft, +;
serum, –
No, but AD close contact Silver and triclosan impregnated graft Graft: S. anginosus, Actinomyces odontolyticus, S. oralis; blood culture: S. anginosus Died 37 d after multiple organ failure caused by PVGI; did not receive Q fever treatment
3 63 Aortic endograft Polyester endograft (72) Skin infection, calf abscess, fever Close contact with duodenum Borderline Aortic graft, + AD Bovine pericardium Graft: E. cloacae, Candida albicans;
blood culture: E. cloacae
Died of unrelated causes; began Q fever treatment 11 d after symptom onset; attained remission at 18 mos; died at 19 mos.
4 80 Vascular endograft Polyester endograft (24) Abdominal pain, septic shock, fever Periprosthetic gas 1,600/0/800 Aortic graft, +;
serum, –
AD Silver and triclosan impregnated graft, stent Graft: A. odontolyticus, S. gordonii, S. oralis, Eikenella corrodens;
blood culture: Granulicatella adiacens, Veillonella parvula, S. gordonii
Died on day 27 of hemorrhagic shock on a recurrent AEF caused by PVGI; began Q fever treatment 20 d after symptom onset.
5 70 Aortic graft Silver polyester graft (36) Back pain, spondylodiscitis, lower gastrointestinal bleeding, fever Periprosthetic infiltration, spondylodiscitis 400/0/100 Vertebral biopsy, + AD Silver impregnated polyester graft Graft: Hafnia alvei, E. coli, nonhemolytic Streptococcus spp., Lactobacillus spp.;
blood culture, –
Died on day 173 after symptom onset, 12 d after hospitalization for multiple organ failure caused by PVGI; did not receive Q fever treatment.

*AD, aortoduodenal; AEF, aortoenteric fistula; PVGI, prosthetic vascular graft infection; +, positive; –, negative.

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Page created: April 21, 2021
Page updated: June 17, 2021
Page reviewed: June 17, 2021
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