Since chronic Q fever often develops insidiously, and symptoms are not always recognized at an early stage, complications are often present at the time of diagnosis. We describe complications associated with vascular chronic Q fever as found in the largest cohort of chronic Q fever patients so far.Patients with proven or probable chronic Q fever with a focus of infection in an aortic aneurysm or vascular graft were included in this study, using the Dutch national chronic Q fever database.A total of 122 patients were diagnosed with vascular chronic Q fever between April 2008 and June 2012. The infection affected a vascular graft in 62 patients (50.8%) and an aneurysm in 53 patients (43.7%). Seven patients (5.7%) had a different vascular focus. Thirty-six patients (29.5%) presented with acute complications, and 35 of these patients (97.2%) underwent surgery. Following diagnosis and start of antibiotic treatment, 26 patients (21.3%) presented with a variety of complications requiring surgical treatment during a mean follow-up of 14.1? 9.1?months. The overall mortality rate was 23.7%. Among these patients, mortality was associated with chronic Q fever in 18 patients (62.1%).The management of vascular infections with C.?burnetii tends to be complicated. Diagnosis is often difficult due to asymptomatic presentation. Patients undergo challenging surgical corrections and long-term antibiotic treatment. Complication rates and mortality are high in this patient cohort. Society for Vascular Surgery.
Broos, P. P. H. L., Hagenaars, J. C. J. P., Kampschreur, L. M., Wever, P. C., Bleeker-Rovers, C. P., Koning, O. H. J., Teijink, J. A. W., & Wegdam-Blans, M. C. A. (2015). Vascular complications and surgical interventions after world's largest Q fever outbreak. Journal of Vascular Surgery, 62(5), 1273-1280. https://doi.org/10.1016/j.jvs.2015.06.217