Volume 27, Number 7—July 2021
Dispatch
Polymicrobial Infections Among Patients with Vascular Q Fever, France, 2004–2020
Mathilde Puges
, 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
, 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
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 PCR |
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, AEF |
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.
Page created: April 21, 2021
Page updated: June 17, 2021
Page reviewed: June 17, 2021
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