Hepatitis aislada como forma de presentación de la fiebre Q: características clínicas y epidemiológicas en 109 pacientes

Jiménez, Manuel Jesús Romero; Suárez-Lozano, Ignacio; Fajardo, José María; Benavente, Alberto; Menchero, A.; Iglesia, Alberto de la

doi:10.1016/s0213-005x(03)72916-4

Cited by 12 publications

(3 citation statements)

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“…Analysis of the clinical presentation of the cases included shows that the high percentage of pneumonia observed by us is consistent with the findings reported by other studies conducted in the north of Spain [ 8 , 17 , 39 ] but not with those reported by studies conducted in the south [ 8 , 14 , 19 ]. The reasons for this difference between northern and southern areas of the country are not completely understood.…”

Section: Discussionsupporting

confidence: 90%

“…This lack of association with traditional risk factors for Q fever was confirmed by our systematic review, which showed a higher percentage of patients from urban areas, and the presence of risk factors in only a third of all patients [ 7 , 8 , 13 ]. This same finding has been observed in studies conducted at different periods in different geographical areas [ 7 – 9 , 13 , 19 , 26 , 36 ]. The first explanation to be considered is the high percentage of missing data on risk factors in most of the studies analysed, something that could clearly lead to such factors being underestimated [ 10 , 18 , 24 , 27 ].…”

Section: Discussionsupporting

confidence: 88%

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Q fever in Spain: Description of a new series, and systematic review

Alende-Castro¹,

Macía-Rodríguez

Novo-Veleiro³

et al. 2018

PLoS Negl Trop Dis

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BackgroundForms of presentation of Q fever vary widely across Spain, with differences between the north and south. In the absence of reported case series from Galicia (north-west Spain), this study sought to describe a Q-fever case series in this region for the first time, and conduct a systematic review to analyse all available data on the disease in Spain.MethodsPatients with positive serum antibodies to Coxiella burnetii from a single institution over a 5-year period (January 2011-December 2015) were included. Patients with phase II titres above 1/128 (or documented seroconversion) and compatible clinical criterial were considered as having Q fever. Patients with clinical suspicion of chronic Q-fever and IgG antibodies to phase I-antigen of over 1/1024, or persistently high levels six months after treatment were considered to be cases of probable chronic Q-fever. Systematic review: We conducted a search of the Pubmed/Medline database using the terms: Q Fever OR Coxiella burnetii AND Spain. Our search yielded a total of 318 studies: 244 were excluded because they failed to match the main criteria, and 41 were discarded due to methodological problems, incomplete information or duplication. Finally, 33 studies were included.ResultsA total of 155 patients, all of them from Galicia, with positive serological determination were located during the study period; 116 (75%) were deemed to be serologically positive patients without Q fever and the remaining 39 (25%) were diagnosed with Q fever. A potential exposure risk was found in 2 patients (5%). The most frequent form of presentation was pneumonia (87%), followed by isolated fever (5%), diarrhoea (5%) and endocarditis (3%). The main symptoms were headache (100%), cough (77%) and fever (69%). A trend to a paucisymptomatic illness was observed in women. Hospital admission was required in 37 cases, and 6 patients died while in hospital. Only 2 patients developed chronic Q-fever. Systematic review: Most cases were sporadic, mainly presented during the winter and spring, as pneumonia in 37%, hepatitis in 31% and isolated fever in 29.6% of patients. In the north of Spain, 71% of patients had pneumonia, 13.2% isolated fever and 13% hepatitis. In the central and southern areas, isolated fever was the most frequent form of presentation (40%), followed by hepatitis (38.4%) and pneumonia (17.6%). Only 31.7% of patients reported risk factors, and an urban-environment was the most frequent place of origin. Overall mortality was 0.9%, and the percentage of patients with chronic forms of Q-fever was 2%.ConclusionsThis is the first study to report on a Q-fever case series in Galicia. It shows that in this region, the disease affects the elderly population -even in the absence of risk factors- and is linked to a higher mortality than reported by previous studies. While pneumonia is the most frequent form of presentation in the north of the country, isolated fever and hepatitis tend to be more frequent in the central and southern areas. In Spain, 32% of Q-fever cases do not report con...

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

Q fever in Spain: Description of a new series, and systematic review

Alende-Castro¹,

Macía-Rodríguez

Novo-Veleiro³

et al. 2018

PLoS Negl Trop Dis

View full text Add to dashboard Cite

show abstract

“…No se encontraron diferencias significativas entre los pacientes que desarrollaron hepatitis o no. Otras manifestaciones menos frecuentes fueron en forma de hepatitis infecciosa, fiebre prolongada o existencia de granulomas en la histología (1,8% cada una) 4 . En el estudio de Bolaños et al la manifestación clínica más frecuente fue el síndrome febril con elevación discreta de los enzimas hepáticos en un 87% (ya fuese citolisis o colestasis disociada).…”

Section: Discussionunclassified