Pancreatitis, hypereosinophilia and bilateral pulmonary infiltrates as presentation of 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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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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Pregnancy outcomes of Q fever : Prospective follow-up study on Reunion Island

10.21203/rs.2.13655/v2 ◽

2019 ◽

Author(s):

Yoan Mboussou ◽

Julien Jaubert ◽

Sophie Larrieu ◽

Laura Atiana ◽

Florence Naze ◽

...

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Q Fever ◽

Acute Infection ◽

Reunion Island ◽

Phase 2 ◽

Follow Up Study ◽

Réunion Island ◽

Acute Q Fever

Abstract Background Q fever has been associated with perinatal complications. We conducted a prospective follow-up study to assess both the incidence of adverse pregnancy outcomes (APOs) associated with Coxiella burnetii infection and the contribution of Q fever to APOs. Methods Between May 1 and October 31, 2013, within the regional perinatal health care centre of Saint Pierre, Reunion island, we investigated unexplained miscarriages, stillbirths, preterm births or small-for-gestational age children. Seropositivity for C. burnetii antibodies was defined using indirect immunofluorescence for a phase 2 IgG titre ≥1:64. Acute Q fever was defined for a high phase 2 IgG titre ≥1:256 (compatible with recent or active infection) or the detection of C. burnetii genome in miscarriage products and placentas. Incidence rate ratios (IRR) for Q fever related APOs (taken as a composite outcome or individually) were assessed using Poisson regression models for dichotomous outcomes controlling major confounders. Results Over a 6-month period, 179 pregnant women suspected or diagnosed with an APO were investigated for Q fever, of whom 118 met the definition for an APO. Of these, 19 were seropositive and 10 presented a profile indicative of an acute infection. For three women with an acute Q fever, the chronology between the onset of infection, the APO (2 miscarriages, 1 preterm birth) and the seroconversion suggested causality in the pathogenesis. The cumulative incidence of Q fever related APOs was estimated between 2.2‰ and 5.2‰, whether causality was required or not. Both C. burnetii exposure and acute Q fever were independently associated with APOs (IRR 1.55, 95% CI 1.31-1.84; IRR 1.47, 95% CI 1.15-1.89, respectively). Conclusions In the endemic context of Reunion island, acute Q fever may lead to APOs. To limit the burden of Q fever on reproduction, pregnant women should be kept away from farms and avoid direct contact with ruminants.

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