Q fever vaccine
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Lack of efficacy, leading to Q fever endocarditis: case report A 29-year-old man developed Q fever endocarditis despite vaccination with Q fever vaccine [Q-Vax]. During elective aortic and mitral valve replacement in April 2012, infective endocarditis was suspected due to the presence of healed aortic and mitral valve vegetations. The man had started work at an abattoir in March 2000, and a Q fever screen on 28 March was negative. Seven days later, he had received 0.5mL of Q fever vaccine containing 25µg of purified killed Coxiella burnetii suspension [route not stated]. He presented about 9 months later with fatigue and unexplained weight loss, and subsequently reported intermittent drenching night sweats. Aortic valve histopathology revealed aggregates of Gram-negative coccobacilliform bacteria in areas of active inflammation. Q fever serology was strongly positive, and specific PCR products for C. burnetii were detected on aortic and mitral valve tissue. Q fever endocarditis was diagnosed. The man was treated with doxycycline and hydroxychloroquine. After 3 months of follow-up, he was clinically well, with normal inflammatory markers and good valvular function; his night sweats had resolved. Author comment: "We consider that this case represents a unique occurrence of Q fever endocarditis in an at-risk individual, following vaccine failure." Trubiano JA, et al. Coxiella burnetii endocarditis after Q fever vaccination. Journal of Medical Microbiology 61: 1775-1779, No. 12, Dec 2012. Available from: URL: 803083339 http://dx.doi.org/10.1099/jmm.0.050880-0 - Australia
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Reactions 23 Feb 2013 No. 1440
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