Epidemiologic features and clinical presentation of acute Q fever in hospitalized patients: 323 French cases

Q fever is a zoonotic disease caused by Coxiella burnetii. Its interest as a potential biological weapon stems from the fact that an aerosol of very few organisms could infect humans. Another route of transmission of C. burnetii could be through adding it to the food supply. Nevertheless, C. burnetii is considered to be one of the less suitable candidate agents for use in a bioterrorist attack; the incubation is long, many infections are inapparent and the mortality is low. In the case of an intentional release of C. burnetii by a terrorist, clinical presentation would be similar to naturally occurring disease. It may be asymptomatic, acute, normally accompanied by pneumonia or hepatitis, or chronic, usually manifested as endocarditis. Most cases of acute Q fever are asymptomatic and resolve spontaneously without specific treatment. Nevertheless, treatment can shorten the duration of illness and decrease the risk of complications such as endocarditis. Post-exposure prophylaxis is recommended after the exposure in the case of a bioterrorist attack.

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Tache Noire in a Patient with Acute Q Fever

Medical Principles and Practice ◽

10.1159/000486573 ◽

2018 ◽

Vol 27 (1) ◽

pp. 92-94

Author(s):

Vito Fiore ◽

Fabiola Mancini ◽

Alessandra Ciervo ◽

Paola Bagella ◽

Francesca Peruzzu ◽

...

Keyword(s):

Rare Case ◽

Clinical Presentation ◽

Q Fever ◽

Spotted Fever ◽

Mediterranean Area ◽

Clinical Feature ◽

Mediterranean Spotted Fever ◽

Acute Q Fever ◽

Pathognomonic Sign ◽

Rule Out

Objective: To describe a rare case of acute Q fever with tache noire. Clinical Presentation and Intervention: A 51-year-old man experienced acute Q fever showing tache noire, generally considered a pathognomonic sign of Mediterranean spotted fever (MSF) and MSF-like illness, but not a clinical feature of Q fever. The patient was treated with doxycycline 100 mg every 12 h. Conclusion: In the Mediterranean area, tache noire should be considered pathognomonic of MSF but it should not rule out Q fever. Clinical diagnosis should be supported by accurate laboratory diagnostic tests to guide proper management.

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Q fever: a rare but potentially life-threatening zoonotic disease

BMJ Case Reports ◽

10.1136/bcr-2020-237155 ◽

2021 ◽

Vol 14 (2) ◽

pp. e237155

Author(s):

Pranav Mahajan ◽

Kailash Pant ◽

Shirin Majdizadeh

Keyword(s):

Chronic Disease ◽

Cardiovascular System ◽

Q Fever ◽

Acute Infection ◽

Acute Illness ◽

Unknown Aetiology ◽

Severe Hepatitis ◽

The Usa ◽

Life Threatening ◽

Acute Q Fever

Q fever can present as a fever of unknown aetiology and can be challenging to diagnose because of the rare incidence. It can present as an acute illness with manifestations, including influenza-like symptoms, hepatitis, pneumonia or chronic disease involving the cardiovascular system. We present a case of a 39-year-old woman in the USA, who developed acute Q fever with associated sepsis and severe hepatitis. She received treatment with recovery from acute infection but currently has symptoms of post Q fever syndrome.

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Treatment of infant leukemias: challenge and promise

Hematology ◽

10.1182/asheducation-2013.1.596 ◽

2013 ◽

Vol 2013 (1) ◽

pp. 596-600 ◽

Cited By ~ 26

Author(s):

Patrick Brown

Keyword(s):

High Frequency ◽

Clinical Presentation ◽

State Of The Art ◽

Poor Response ◽

Cooperative Groups ◽

Therapeutic Approaches ◽

Unique Biology ◽

Current Therapies ◽

Epidemiologic Features ◽

Infant Leukemia

Abstract Leukemia in infants is rare but generates tremendous interest due to its aggressive clinical presentation in a uniquely vulnerable host, its poor response to current therapies, and its unique biology that is increasingly pointing the way toward novel therapeutic approaches. This review highlights the key clinical, pathologic, and epidemiologic features of infant leukemia, including the high frequency of mixed lineage leukemia (MLL) gene rearrangements. The state of the art with regard to current approaches to risk stratified treatment of infant leukemia in the major international cooperative groups is discussed. Finally, exciting recent discoveries elucidating the molecular biology of infant leukemia are reviewed and novel targeted therapeutic strategies, including FLT3 inhibition and modulation of aberrant epigenetic programs, are suggested.

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A Q fever outbreak in a psychiatric care institution in The Netherlands

Epidemiology and Infection ◽

10.1017/s095026881000021x ◽

2010 ◽

Vol 139 (1) ◽

pp. 13-18 ◽

Cited By ~ 13

Author(s):

R. P. M. KOENE ◽

B. SCHIMMER ◽

H. RENSEN ◽

M. BIESHEUVEL ◽

A. DE BRUIN ◽

...

Keyword(s):

Q Fever ◽

Atypical Pneumonia ◽

Fever Case ◽

Psychiatric Setting ◽

Psychiatric Institution ◽

Laboratory Confirmation ◽

Hygienic Measures ◽

Acute Q Fever ◽

Municipal Health

SUMMARYIn May 2008 the Nijmegen Municipal Health Service (MHS) was informed about an outbreak of atypical pneumonia in three in-patients of a long-term psychiatric institution. The patients had been hospitalized and had laboratory confirmation of acute Q fever infection. The MHS started active case finding among in-patients, employees of and visitors to the institution. In a small meadow on the institution premises a flock of sheep was present. One of the lambs in the flock had been abandoned by its mother and cuddled by the in-patients. Samples were taken of the flock. Forty-five clinical cases were identified in employees, in-patients and visitors; 28 were laboratory confirmed as Q fever. Laboratory screening of pregnant women and persons with valvular heart disease resulted in one confirmed Q fever case in a pregnant woman. Of 27 samples from animals, seven were positive and 15 suspect for Coxiella burnetii infection. This outbreak of Q fever in a unique psychiatric setting pointed to a small flock of sheep with newborn lambs as the most likely source of exposure. Care institutions that have vulnerable residents and keep flocks of sheep should be careful to take adequate hygienic measures during delivery of lambs and handling of birth products.

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A Serological Follow-Up Study of Acute Q Fever Infection

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2008.05.1209 ◽

2008 ◽

Vol 12 ◽

pp. e457

Author(s):

M.N. Hung ◽

P.Y. Shu ◽

M.Y. Hou ◽

P.S. Lin ◽

C.C. Lin ◽

...

Keyword(s):

Q Fever ◽

Follow Up Study ◽

Acute Q Fever

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A Mouse Model of Acute Q Fever Following Infection Via A Non-Invasive Intratracheal Inoculation Method

10.21203/rs.2.9192/v1 ◽

2019 ◽

Author(s):

Xueyuan Hu ◽

Yonghui Yu ◽

Junxia Feng ◽

Mengjiao Fu ◽

Lupeng Dai ◽

...

Keyword(s):

Mouse Model ◽

Low Dose ◽

Q Fever ◽

Pulmonary Delivery ◽

Delivery Device ◽

Inflammatory Infiltration ◽

Pathological Lesions ◽

Non Invasive ◽

Therapeutic Drugs ◽

Acute Q Fever

Abstract Background: Q fever is a worldwide zoonosis caused by Coxiella burnetii and mainly transmitted by aerosols. This study aims at establishing a systematic and efficient mouse model of acute Q fever via intratracheal (IT) inoculation of aerosolized C. burnetii. Methods: BALB/c mice were infected with C. burnetii via IT route using a non-invasive aerosol pulmonary delivery device to directly place the living C. burnetii organisms into their tracheas. The bacterial loads, pathological lesions, and serological responses were analyzed in mice, and compared with those of mice infected via intraperitoneal (IP) route. Results: As early as at day three post-infection (pi) with a low dose of C. burnetii (1×10⁴ per mouse), a large amount of C. burnetii organisms were determined in blood, lungs, hearts, livers, and spleens of the mice. The inflammatory infiltration was observed in hearts and lungs of mice. Compared with mice infected via IP route, the mice infected via IT route exhibited a higher level of bacterial loads and more severe pathological lesions in hearts and lungs at day 3 and day 7 pi. Conclusions: These data indicated that IT route is more efficient than IP route to cause acute C. burnetii infection in mice. Overall, we successfully established a mouse model of C. burnetii infection via IT route, which is useful for investigations of pathogenesis and immunity of acute C. burnetii infection as well as evaluation of therapeutic drugs and preventive vaccines of Q fever.

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