Characteristics of Hospitalized Acute Q Fever Patients during a Large Epidemic, The Netherlands

Wielders, Cornelia C. H.; Wuister, Annemarie M. H.; Visser, Veerle L. de; Jager-Leclercq, Monique G. de; Groot, C. A. R.; Dijkstra, Frederika; Gageldonk-Lafeber, Arianne B van; Leuken, Jeroen P. G. van; Wever, Peter C.; Hoek, Wim van der; Schneeberger, Peter M.

doi:10.1371/journal.pone.0091764

Cited by 33 publications

(37 citation statements)

References 40 publications

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“…An epidemiologic explanation for this outbreak was the possible spatial link between dairy goat farms and human cases [50]. Wielders et al [51] described the epidemiological and clinical features of 183 hospitalized acute Q fever patients. Pneumonia was present in 86 % of patients, of which 4 % were admitted to the ICU; the mortality rate was 6 %.…”

Section: Coxiella Burnetiimentioning

confidence: 99%

Community-acquired pneumonia related to intracellular pathogens

Cillóniz¹,

Niederman

Eerden

et al. 2016

Intensive Care Med

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Community-acquired pneumonia (CAP) is associated with high rates of morbidity and mortality worldwide; the annual incidence of CAP among adults in Europe has ranged from 1.5 to 1.7 per 1000 population. Intracellular bacteria are common causes of CAP. However, there is considerable variation in the reported incidence between countries and change over time. The intracellular pathogens that are well established as causes of pneumonia are Legionella pneumophila, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Chlamydophila psittaci, and Coxiella burnetii. Since it is known that antibiotic treatment for severe CAP is empiric and includes coverage of typical and atypical pathogens, microbiological diagnosis bears an important relationship to prognosis of pneumonia. Factors such as adequacy of initial antibiotic or early de-escalation of therapy are important variables associated with outcomes, especially in severe cases. Intracellular pathogens sometimes appear to cause more severe disease with respiratory failure and multisystem dysfunction associated with fatal outcomes. The clinical relevance of intracellular pathogens in severe CAP has not been specifically investigated. We review the prevalence, general characteristics, and outcomes of severe CAP cases caused by intracellular pathogens.

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Section: Coxiella Burnetiimentioning

confidence: 99%

Community-acquired pneumonia related to intracellular pathogens

Cillóniz¹,

Niederman

Eerden

et al. 2016

Intensive Care Med

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“…In humans, the disease presents in an acute or chronic form; with the acute disease being characterized by fever, atypical pneumonia and hepatitis while the chronic form manifests with long‐term sequelae including fatigue, abortions and heart disease (Anderson et al., ; Wielders et al., ). Q fever associated mortality is usually low (1–2%) in treated patients (Tissot Dupont et al., ), but the mortality may be as high as 65% in infected persons who develop chronic disease (Raoult et al., ).…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence and Factors Associated with Coxiella burnetii Infection in Small Ruminants in Baringo County, Kenya

Muema

Thumbi

Obonyo

et al. 2017

Zoonoses and Public Health

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To improve estimates of C. burnetii epidemiology in Kenya, a survey was undertaken in small ruminants in Baringo County, where acute cases of Q fever in humans had been reported in 2014. From 140 household herds selected, 508 (60.5%) goats and 332 (39.5%) sheep were included and an indirect ELISA assay for C. burnetii IgG antibodies performed. In addition, epidemiological information at both herd and animal level was collected. Generalized mixed-effects multivariable logistic model using herd as the random effect was used to determine variables correlated to the outcome. Overall seroprevalence was 20.5% (95% CI: 17.8%, 23.3%). Goats had 26.0% (95% CI: 22.2%, 30.0%) compared to sheep 12.2% (95% CI: 8.7%, 16.0%). Nomadic pastoralism, goats and older animals (>1 year) were associated with greater risk of C. burnetii seropositivity (P = ≤0.05). Heterogeneity in C. burnetii seropositivity was observed across the sublocations (P = 0.028). Evidence of C. burnetii exposure in small ruminants revealed poses a potential risk of exposure to the people living in close proximity to the animals. We recommended integrated animal-human surveillance and socio-economic studies for C. burnetii, to aid our understanding of the risk of transmission between the animals and humans, and in the design of prevention and control strategies for the disease in the region.

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“…In contrast, pneumonia occurs in almost half of the patients with acute C. burnetii infection [14]. In some Q-fever outbreaks, even higher frequency of pneumonia was reported (86% in The Netherlands) [15]. The finding of a pulmonary infiltrate on chest radiograph in our patient suggested acute Q-fever.…”

Section: Discussionmentioning

confidence: 52%

Imported brucellosis and Q-fever coinfection in Croatia: a case report

Perić

Sabadi

Rubil

et al. 2018

J Infect Dev Ctries

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The brucellosis and Q-fever coinfection is very rarely reported. To our knowledge, this is the first case report of concomitant brucellosis and Q-fever, most likely imported in Croatia. A 30-year-old male agricultural worker was hospitalized on 22 April 2017 after a ten days fever up to 40°C with chills, shivering, excessive sweating, general weakness, loss of appetite and headache. A month and a half prior to the hospitalization he lost 18 kg of body weight. Three weeks before hospitalization the patient returned from Kupres (Bosnia and Herzegovina) where he was working for the past year on a sheep farm and consumed unpasteurized dairy products of sheep origin. At admission, his condition was moderately severe due to pronounced dehydration. Routine laboratory tests showed slightly elevated erythrocyte sedimentation rate, anemia, thrombocytopenia and elevated liver transaminases. The chest X-ray showed an inhomogeneous infiltrate of the lower right lung. Three sets of blood culture were cultivated. After 48 hours incubation, bacterial growth was detected in aerobic bottles. Gram-stained smear revealed small, gram-negative coccobacilli. Specimens were subcultured on blood and chocolate agar plates. Using a Vitek GN identification card, the isolated organism was identified as Brucella melitensis. 16S rRNA gene sequencing of the isolate confirmed it as a Brucella sp. Rose-Bengal test was positive, while Wright agglutination test showed a significant increase in antibody titer from 80 to 640 in paired sera. Using indirect immunofluorescence assay (IFA), Coxiella burnetii phase II IgM/IgG titers were 50 and 1024, respectively indicating acute Q-fever. The patient was treated with doxycycline and rifampicin. So far, there has been no relapse or signs of chronic infection.

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Characteristics of Hospitalized Acute Q Fever Patients during a Large Epidemic, The Netherlands

Cited by 33 publications

References 40 publications

Community-acquired pneumonia related to intracellular pathogens

Community-acquired pneumonia related to intracellular pathogens

Seroprevalence and Factors Associated with Coxiella burnetii Infection in Small Ruminants in Baringo County, Kenya

Imported brucellosis and Q-fever coinfection in Croatia: a case report

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