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Ann Thorac Surg 2004;78:326-328
© 2004 The Society of Thoracic Surgeons

Case report

Constrictive pericarditis due to Coxiella burnetii

Víctor Bautista-Hernández, MDa*, Francisco Gutierrez, MD, PhDa, Víctor G. Ray, MDa, José M. Arribas, MDa, Julio García-Puente, MDa, Norberto Casinello, MD, PhDa, Ramón Arcas, MD, PhDa

a Regional Service of Cardiovascular Surgery, University Hospital "Virgen de la Arrixaca," Murcia, Spain

Accepted for publication July 18, 2003.

* Address reprint requests to Dr Bautista-Hernández, Servicio Regional de Cirugía Cardiovascular, Hospital Universitario "Virgen de la Arrixaca," 30120 El Palmar, Murcia, Spain
e-mail: vbautista_hernandez{at}hotmail.com

Q fever is characterized by its clinical polymorphism. Cardiac involvement in acute Q fever is rare. We report a case of pleuro-pericarditis that rapidly evolved to pericardial constriction during an acute episode of Coxiella burnetii infection. Constrictive pericarditis was confirmed by hemodynamic measurements, echocardiography, and magnetic resonance. Indirect immunofluorescence assay revealed positive serology for acute Q fever. The patient underwent a successful pericardiectomy and was given antibiotics. The histopathologic study of the excised pericardium showed C. burnetii in a large cluster of organisms. After a 6-month follow-up period, the individual was asymptomatic.




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