Vascular complications and surgical interventions after world's largest Q fever outbreak

P.P.H.L. Broos, J.C.J.P. Hagenaars, L.M. Kampschreur, P.C. Wever, C.P. Bleeker-Rovers, O.H.J. Koning, J.A.W. Teijink, M.C.A. Wegdam-Blans

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Abstract

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.
Original languageEnglish
Pages (from-to)1273-1280
JournalJournal of Vascular Surgery
Volume62
Issue number5
DOIs
Publication statusPublished - 1 Jan 2015

Cite this

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