Abstract Details

Title Speechless: Karius Testing in the Identification of Coxiella burnetii Infective Endocarditis Presenting with Acute Ischemic Stroke - A Case Report

Topic Infectious Disease

Presentation(s) P2 - Poster Session 2 (2:45 PM-3:45 PM)

Poster/Presentation
Number 080

Objective To report a case of Coxiella burnetii endocarditis presenting as aphasia and acute ischemic stroke in a 61-year-old male. This report highlights the identification of a rare infectious organism utilizing a newly developed microbial cell-free DNA (mcfDNA) test known as the Karius test in culture negative infective endocarditis (IE). Additionally, we discuss the importance of Neurology’s role in the multidisciplinary treatment approach of IE.

Background C. burnetii is a small obligate intracellular gram-negative bacterium most commonly known for causing Q fever. It is also a rare cause of culture negative IE. It occurs almost exclusively in patients who are immunocompromised or have previous valvular heart disease. Identifying C. burnetii remains challenging due to its obligate intracellular nature. Diagnostic modalities, such as the Karius test, use mcfDNA in the patient’s serum to assess for all potential infectious causes of valvular endocarditis, but it finds its greatest success in cases of culture negative endocarditis.

Design/Methods Not applicable.

Results Not applicable.

Conclusions C. burnetii is a rare, but important cause of IE in patients with previous valvular heart disease. Identification of the infectious agent may require specific diagnostic testing such as the newly developed Karius test. Additionally, multidisciplinary teams are required for complex cases presenting with ischemic or hemorrhagic stroke. In such cases, guiding brain imaging alongside collaborating with Cardiology and Cardiothoracic Surgery demonstrates the vital role of Neurology in surgical and treatment decision making.

Authors/Disclosures
Michael J. Smith, MD PRESENTER	Dr. Smith has nothing to disclose.
Connor D. Welsh, DO (Barrow Neurological Institute)	Dr. Welsh has nothing to disclose.
Daniel Gonzalez, MD (Barrow Neurological Institute)	Dr. Gonzalez has nothing to disclose.

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