Coxiella burnetii endocarditis in a pediatric patient with a bovine jugular vein conduit diagnosed using metagenomic next-generation sequencing: a case report and review of the literature

Following a nearly one-year history of progressive nonspecific symptoms, a 16-year-old male with past medical history of tetralogy of Fallot with pulmonary atresia, status post Contegra® right ventricle to pulmonary artery conduit placement, developed intermittent fevers, weight loss, and chest discomfort. He was found to have globally depressed ejection fraction, focal conduit narrowing, and a small echogenic mobile mass in the conduit. Given negative blood culture results and exhaustive infectious evaluation, metagenomic next-generation sequencing (mNGS) was utilized to diagnose Coxiella burnetii endocarditis.