Περίληψη:
Background: The clinical manifestations of Q fever endocarditis are
protean in nature. Mixed cryoglobulinemia type II is rarely a facet of
the presenting clinical manifestations of Q fever endocarditis.
Case presentation: We report a case of a 65- year- old pensioner with
such an association and review the literature. As transesophageal
echocardiograms are usually normal and blood cultures are usually
negative in Q fever endocarditis, many of the manifestations ( fever,
rash, glomerulonephritis/ evidence of renal disease, low serum C4
complement component, presence of mixed type II cryoglobulin,
constitutional symptoms as arthralgias and fatigue) can be attributed to
Mixed cryoglobulinemia type II per se. The use of Classic Duke
Endocarditis Service criteria does not always suffice for the diagnosis
of Q fever.
Conclusion: The application of the modified criteria proposed by
Fournier et al for the improvement of the diagnosis of Q fever
endocarditis will help to reach the diagnosis earlier and thus reduce
the high mortality of the disease. We would like to stress the
importance of ruling out the diagnosis of Q fever endocarditis in cases
of mixed type II cryoglobulinemia.
Συγγραφείς:
Rafailidis, PI
Dourakis, SP
Fourlas, CA
