Q Fever Endocarditis with Bilateral Multifocal Retinitis: A Case Report

Purpose: To describe a case of bilateral retinitis in a patient with endocarditis and a serologically confirmed Q fever.Methods: A single case report documented with multimodal imaging.Results: A 55-year-old patient with culture-negative endocarditis was referred to our department for an ocular examination. His visual acuity was 20/20 in both eyes. Fundus examination showed white retinal infiltrates with few superficial retinal hemorrhages scattered in the posterior pole. There was no staining on fluorescein angiography. Swept-source optical coherence tomography (SS-OCT) revealed increased inner retinal reflectivity with a focal area of retinal thickening. Laboratory tests showed a high titer of antibodies against Coxiella burnetii. The patient was treated with doxycycline. Two weeks later, fundus examination showed partial resolution of retinitis with inner retinal thinning in SS-OCT.Conclusions: Multifocal retinitis is an uncommon presentation of Q fever. The diagnosis should be considered, especially when associated with culture-negative infective endocarditis, highlighting the importance of routine ocular examination.