Coxiella burnetii endocarditis: Can positron emission tomography be an alternative to diagnosis?

Coxiella burnetii infective endocarditis (IE) represents a rarely reported zoonosis in Brazil. It is estimated that Coxiella burnetii is responsible for up to 5% of all IE cases worldwide. The disease affects mostly valvulopathy patients and immunocompromised subjects. Different from the classical acute and sub-acute endocarditis, the clinical picture is frustrating, and, because this is an obligate intracellular microorganism, hemocultures (HMC) are predominantly negative, which makes the clinical suspicion more difficult. This paper presents a rare endocarditis clinical case that manifested in an atypical manner, and was diagnosed with the help of specific Coxiella burnetii serology and of the positron emission tomography (PET). (author)