Immunoglobulin responses to Coxiella burnetii (Q fever): single-serum diagnosis of acute infection, using an immunofluorescence technique.

Background. Q fever is an infection caused by Coxiella burnetii, an intracellular organism. Acute infection is most often a benign and asymptomatic process; however, some individuals may go on to develop subacute and persistent localized symptomatic Q fever. As such, the clinical and histopathologic findings of Q fever are widely variable and may be missed if clinical suspicion is not high. Case Presentation. Herein we report the first case of C. burnetii infection presenting as an isolated retroperitoneal mass. A 61-year-old male underwent axillary-bifemoral bypass surgery. His postoperative course was complicated by the discovery of a large retroperitoneal mass. Conclusion. Clinical and histopathologic findings of Coxiella burnetii infection are variable and can be deceiving. These are often nonspecific, especially in its persistent localized infectious stages.

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“Acute Q fever with dermatologic manifestations, molecular diagnosis, and no seroconversion”

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab458 ◽

2021 ◽

Author(s):

Natalí Uribe Pulido ◽

Clara Escorcia García ◽

Ruth Cabrera Orrego ◽

Lina Andrea Gutiérrez ◽

Carlos Andrés Agudelo

Keyword(s):

Incubation Period ◽

Coxiella Burnetii ◽

Real Time Pcr ◽

Peripheral Blood ◽

Genomic Dna ◽

Molecular Detection ◽

Q Fever ◽

Acute Infection ◽

Acute Q Fever ◽

Dermatologic Manifestations

Abstract We herein described a case of acute infection by Coxiella burnetii (acute Q fever) that started with a short incubation period and showed prominent dermatological manifestations and unusual serological behavior. The infection was confirmed by molecular detection through real-time PCR using genomic DNA collected from peripheral blood.

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One Health Approach: An Overview of Q Fever in Livestock, Wildlife and Humans in Asturias (Northwestern Spain)

Animals ◽

10.3390/ani11051395 ◽

2021 ◽

Vol 11 (5) ◽

pp. 1395

Author(s):

Alberto Espí ◽

Ana del Cerro ◽

Álvaro Oleaga ◽

Mercedes Rodríguez-Pérez ◽

Ceferino M. López ◽

...

Keyword(s):

One Health ◽

Roe Deer ◽

Q Fever ◽

Close Contact ◽

Acute Infection ◽

Pcr Analysis ◽

Wild Ungulates ◽

Domestic Ruminants ◽

Iberian Red Deer ◽

Northwestern Spain

This study aimed to investigate the seroprevalence of C. burnetii in domestic ruminants, wild ungulates, as well as the current situation of Q fever in humans in a small region in northwestern Spain where a close contact at the wildlife–livestock–human interface exists, and information on C. burnetii infection is scarce. Seroprevalence of C. burnetii was 8.4% in sheep, 18.4% in cattle, and 24.4% in goats. Real-time PCR analysis of environmental samples collected in 25 livestock farms detected Coxiella DNA in dust and/or aerosols collected in 20 of them. Analysis of sera from 327 wild ungulates revealed lower seroprevalence than that found in domestic ruminants, with 8.4% of Iberian red deer, 7.3% chamois, 6.9% fallow deer, 5.5% European wild boar and 3.5% of roe deer harboring antibodies to C. burnetii. Exposure to the pathogen in humans was determined by IFAT analysis of 1312 blood samples collected from patients admitted at healthcare centers with Q fever compatible symptoms, such as fever and/or pneumonia. Results showed that 15.9% of the patients had IFAT titers ≥ 1/128 suggestive of probable acute infection. This study is an example of a One Health approach with medical and veterinary institutions involved in investigating zoonotic diseases.

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Validation of a Novel Commercial ELISA Test for the Detection of Antibodies against Coxiella burnetii

Pathogens ◽

10.3390/pathogens9121075 ◽

2020 ◽

Vol 9 (12) ◽

pp. 1075

Author(s):

Salvatore Ledda ◽

Cinzia Santucciu ◽

Valentina Chisu ◽

Giovanna Masala

Keyword(s):

Diagnostic Accuracy ◽

Phase Ii ◽

Coxiella Burnetii ◽

Q Fever ◽

Animal Health ◽

Elisa Test ◽

Clinical Diagnostics ◽

Complex Life Cycle ◽

Enzyme Linked Immunosorbent Assay ◽

Specificity And Sensitivity

Q fever is a zoonosis caused by Coxiella burnetii, a Gram-negative pathogen with a complex life cycle and a high impact on public and animal health all over the world. The symptoms are indistinguishable from those belonging to other diseases, and the disease could be symptomless. For these reasons, reliable laboratory tests are essential for an accurate diagnosis. The aim of this study was to validate a novel enzyme-linked immunosorbent assay (ELISA) test, named the Chorus Q Fever Phase II IgG and IgM Kit (DIESSE, Diagnostica Senese S.p.A), which is performed by an instrument named Chorus, a new device in medical diagnostics. This diagnostic test is employed for the detection of antibodies against C. burnetii Phase II antigens in acute disease. Our validation protocol was performed according to the Italian Accreditation Body (ACCREDIA) (Regulation UNI CEI EN ISO/IEC 17025:2018 and 17043:2010), OIE (World Organization for Animal Health), and Statement for Reporting Studies of Diagnostic Accuracy (STARD). Operator performance was evaluated along with the analytical specificity and sensitivity (ASp and ASe) and diagnostic accuracy of the kit, with parameters such as diagnostic specificity and sensitivity (DSp and DSe) and positive and negative predictive values (PPV and NPV), in addition to the repeatability. According to the evaluated parameters, the diagnostic ELISA test was shown to be suitable for validation and commercialization as a screening method in human sera and a valid support for clinical diagnostics.

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Contributions of lipopolysaccharide and the type IVB secretion system to Coxiella burnetii vaccine efficacy and reactogenicity

npj Vaccines ◽

10.1038/s41541-021-00296-6 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Carrie M. Long ◽

Paul A. Beare ◽

Diane C. Cockrell ◽

Jonathan Fintzi ◽

Mahelat Tesfamariam ◽

...

Keyword(s):

Phase I ◽

Coxiella Burnetii ◽

Vaccine Efficacy ◽

Q Fever ◽

Secretion System ◽

Cell Vaccine ◽

Post Vaccination ◽

Whole Cell Vaccine ◽

Type Ivb Secretion ◽

Type Ivb Secretion System

AbstractCoxiella burnetii is the bacterial causative agent of the zoonosis Q fever. The current human Q fever vaccine, Q-VAX®, is a fixed, whole cell vaccine (WCV) licensed solely for use in Australia. C. burnetii WCV administration is associated with a dermal hypersensitivity reaction in people with pre-existing immunity to C. burnetii, limiting wider use. Consequently, a less reactogenic vaccine is needed. Here, we investigated contributions of the C. burnetii Dot/Icm type IVB secretion system (T4BSS) and lipopolysaccharide (LPS) in protection and reactogenicity of fixed WCVs. A 32.5 kb region containing 23 dot/icm genes was deleted in the virulent Nine Mile phase I (NMI) strain and the resulting mutant was evaluated in guinea pig models of C. burnetii infection, vaccination-challenge, and post-vaccination hypersensitivity. The NMI ∆dot/icm strain was avirulent, protective as a WCV against a robust C. burnetii challenge, and displayed potentially altered reactogenicity compared to NMI. Nine Mile phase II (NMII) strains of C. burnetii that produce rough LPS, were similarly tested. NMI was significantly more protective than NMII as a WCV; however, both vaccines exhibited similar reactogenicity. Collectively, our results indicate that, like phase I LPS, the T4BSS is required for full virulence by C. burnetii. Conversely, unlike phase I LPS, the T4BSS is not required for vaccine-induced protection. LPS length does not appear to contribute to reactogenicity while the T4BSS may contribute to this response. NMI ∆dot/icm represents an avirulent phase I strain with full vaccine efficacy, illustrating the potential of genetically modified C. burnetii as improved WCVs.

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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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Human Q Fever on the Guiana Shield and Brazil: Recent Findings and Remaining Questions

Current Tropical Medicine Reports ◽

10.1007/s40475-021-00243-4 ◽

2021 ◽

Author(s):

Loïc Epelboin ◽

Carole Eldin ◽

Pauline Thill ◽

Vincent Pommier de Santi ◽

Philippe Abboud ◽

...

Keyword(s):

South America ◽

Geographical Distribution ◽

Coxiella Burnetii ◽

French Guiana ◽

Q Fever ◽

Guiana Shield ◽

Animal Reservoir ◽

The World ◽

Unique Strain ◽

Amazonian Region

Abstract Purpose of Review In this review, we report on the state of knowledge about human Q fever in Brazil and on the Guiana Shield, an Amazonian region located in northeastern South America. There is a contrast between French Guiana, where the incidence of this disease is the highest in the world, and other countries where this disease is practically non-existent. Recent Findings Recent findings are essentially in French Guiana where a unique strain MST17 has been identified; it is probably more virulent than those usually found with a particularly marked pulmonary tropism, a mysterious animal reservoir, a geographical distribution that raises questions. Summary Q fever is a bacterial zoonosis due to Coxiella burnetii that has been reported worldwide. On the Guiana Shield, a region mostly covered by Amazonian forest, which encompasses the Venezuelan State of Bolivar, Guyana, Suriname, French Guiana, and the Brazilian State of Amapá, the situation is very heterogeneous. While French Guiana is the region reporting the highest incidence of this disease in the world, with a single infecting clone (MST 117) and a unique epidemiological cycle, it has hardly ever been reported in other countries in the region. This absence of cases raises many questions and is probably due to massive under-diagnosis. Studies should estimate comprehensively the true burden of this disease in the region.

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Coxiella burnetii Alters Cyclic AMP-Dependent Protein Kinase Signaling during Growth in Macrophages

Infection and Immunity ◽

10.1128/iai.00101-12 ◽

2012 ◽

Vol 80 (6) ◽

pp. 1980-1986 ◽

Cited By ~ 11

Author(s):

Laura J. MacDonald ◽

Richard C. Kurten ◽

Daniel E. Voth

Keyword(s):

Protein Kinase ◽

Cyclic Amp ◽

Coxiella Burnetii ◽

Alveolar Macrophages ◽

Q Fever ◽

Parasitophorous Vacuole ◽

Dependent Protein Kinase ◽

Content Type ◽

Bacterial Agent ◽

Dependent Protein

ABSTRACTCoxiella burnetiiis the bacterial agent of human Q fever, an acute, flu-like illness that can present as chronic endocarditis in immunocompromised individuals. Following aerosol-mediated transmission,C. burnetiireplicates in alveolar macrophages in a unique phagolysosome-like parasitophorous vacuole (PV) required for survival. The mechanisms ofC. burnetiiintracellular survival are poorly defined and a recent Q fever outbreak in the Netherlands emphasizes the need for better understanding this unique host-pathogen interaction. We recently demonstrated that inhibition of host cyclic AMP-dependent protein kinase (PKA) activity negatively impacts PV formation. In the current study, we confirmed PKA involvement in PV biogenesis and probed the role of PKA signaling duringC. burnetiiinfection of macrophages. Using PKA-specific inhibitors, we found the kinase was needed for biogenesis of prototypical PV andC. burnetiireplication. PKA and downstream targets were differentially phosphorylated throughout infection, suggesting prolonged regulation of the pathway. Importantly, the pathogen actively triggered PKA activation, which was also required for PV formation by virulentC. burnetiiisolates during infection of primary human alveolar macrophages. A subset of PKA-specific substrates were differentially phosphorylated duringC. burnetiiinfection, suggesting the pathogen uses PKA signaling to control distinct host cell responses. Collectively, the current results suggest a versatile role for PKA inC. burnetiiinfection and indicate virulent organisms usurp host kinase cascades for efficient intracellular growth.

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The Recent Evolution of a Maternally-Inherited Endosymbiont of Ticks Led to the Emergence of the Q Fever Pathogen, Coxiella burnetii

PLoS Pathogens ◽

10.1371/journal.ppat.1004892 ◽

2015 ◽

Vol 11 (5) ◽

pp. e1004892 ◽

Cited By ~ 117

Author(s):

Olivier Duron ◽

Valérie Noël ◽

Karen D. McCoy ◽

Matteo Bonazzi ◽

Karim Sidi-Boumedine ◽

...

Keyword(s):

Coxiella Burnetii ◽

Q Fever

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Questing one Brazilian query: reporting 16 cases of Q fever from Minas Gerais, Brazil

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652006000100002 ◽

2006 ◽

Vol 48 (1) ◽

pp. 5-9 ◽

Cited By ~ 18

Author(s):

Paulo Sérgio Gonçalves da Costa ◽

Marco Emilio Brigatte ◽

Dirceu Bartolomeu Greco

Keyword(s):

Phase I ◽

Phase Ii ◽

Fever Of Unknown Origin ◽

Q Fever ◽

Acute Infection ◽

Case Series ◽

Febrile Illness ◽

Unknown Origin ◽

Clinical Form ◽

Chronic Q Fever

Q fever has been considered non-existing in Brazil where reports of clinical cases still cannot be found. This case-series of 16 patients is a result of a systematic search for such illness by means of clinical and serologic criteria. Serologic testing was performed by the indirect microimmunofluorescence technique using phase I/II C. burnetii antigens. Influenza-like syndrome was the most frequent clinical form (eight cases - 50%), followed by pneumonia, FUO (fever of unknown origin), mono-like syndrome (two cases - 12.5% each), lymphadenitis (one case - 6.3%) and spondylodiscitis associated with osteomyelitis (one case - 6.3%). The ages varied from four to 67 years old with a median of 43.5. All but one patient had positive serologic tests for phase II IgG whether or not associated with IgM positivity compatible with acute infection. One patient had both phase I and phase II IgG antibodies compatible with chronic Q fever. Seroconvertion was detected in 10 patients. Despite the known limitations of serologic diagnosis, the cases here reported should encourage Brazilian doctors to include Q fever as an indigenous cause of febrile illness.

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