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

2006 ◽  
Vol 48 (1) ◽  
pp. 5-9 ◽  
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.

scholarly journals Animals withCoxiella burnetiiInfection Demonstrate a Western Immunoblot Profile of Chronic Q Fever in Humans

1996 ◽  
Vol 7 (1) ◽  
pp. 45-48
Author(s):  
TJ Marrie ◽  
Linda Yates
Keyword(s):  
Immune Response ◽  
Phase I ◽  
Phase Ii ◽  
Coxiella Burnetii ◽  
Q Fever ◽  
Western Immunoblotting ◽  
Western Immunoblot ◽  
Chronic Q Fever

Western immunoblotting was used to compare the immune response toCoxiella burnetiiphase I and phase II antigens of humans with acute and chronic Q fever with that of infected cats, rabbits, cows and raccoons. The cats, rabbits, cows and raccoons had an immunoblot profile similar to that of the human with chronic Q fever.

scholarly journals Predominant Immunoglobulin A Response to Phase II Antigen of Coxiella burnetii in Acute Q Fever

1999 ◽  
Vol 6 (2) ◽  
pp. 173-177 ◽  
Author(s):  
Pierre-Edouard Fournier ◽  
Didier Raoult
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Rural Areas ◽  
Q Fever ◽  
Immunoglobulin A ◽  
Immunoglobulin M ◽  
Retrospective Case ◽  
Chronic Q Fever ◽  
Antibody Titers ◽  
Acute Q Fever

ABSTRACT Diagnosis of acute Q fever is usually confirmed by serology, on the basis of anti-phase II antigen immunoglobulin M (IgM) titers of ≥1:50 and IgG titers of ≥1:200. Phase I antibodies, especially IgG and IgA, are predominant in chronic forms of the disease. However, between January 1982 and June 1998, we observed anti-phase II antigen IgA titers of ≥1:200 as the sole or main antibody response in 10 of 1,034 (0.96%) patients with acute Q fever for whom information was available. In order to determine whether specific epidemiological or clinical factors were associated with these serological profiles, we conducted a retrospective case-control study that included completion of a standardized questionnaire, which was given to 40 matched controls who also suffered from acute Q fever. The mean age of patients with elevated phase II IgA titers was significantly higher than that usually observed for patients with acute Q fever (P = 0.026); the patients were also more likely than controls to live in rural areas (P = 0.026) and to have increased levels of transaminase in blood (P = 0.03). Elevated IgA titers are usually associated with chronic Q fever and are directed mainly at phase I antigens. Although the significance of our findings is unexplained, we herein emphasize the fact that IgA antibodies are not specific for chronic forms of Q fever and that they may occasionally be observed in patients with acute disease. Moreover, as such antibody profiles may not be determined by most laboratories, which test only for total antibody titers to phase I and II antigens, the three isotype-specific Ig titers should be determined as the first step in diagnosing Q fever.

The immune response in a cat-related outbreak of Q fever as measured by the indirect immunofluorescence test and the enzyme-linked immunosorbent assay

1990 ◽  
Vol 36 (4) ◽  
pp. 292-296 ◽  
Author(s):  
J. Embil ◽  
J. C. Williams ◽  
T. J. Marrie
Keyword(s):  
Immune Response ◽  
Phase I ◽  
Phase Ii ◽  
Q Fever ◽  
Elisa Test ◽  
Enzyme Linked Immunosorbent Assay ◽  
Whole Cells ◽  
Chronic Q Fever ◽  
Acute Q Fever ◽  
Indirect Immunofluorescent

The isotypic immune response of 16 individuals who developed Q fever pneumonia following exposure to an infected parturient cat was studied. The enzyme-linked immunosorbent (ELISA) test was used to detect IgM, IgA, and IgG antibodies to phase I and phase II Coxiella burnetii whole-cell antigens and to the phase I lipopolysaccharide. The indirect immunofluorescent antibody (IFA) test was also used to detect antibodies to phase I and phase II whole cells. None of the 16 subjects developed antibodies to the phase I lipopoly saccharide. The ELISA was more sensitive than the IFA test. IgM antibodies to phase II antigen were detectable by ELISA in 80% of the subjects at the time of onset of symptoms and were still present in 7 of the 8 tested at 32 weeks following the onset of symptoms. In all instances (ELISA: IgG, IgM; IFA: IgG, IgM) phase II antibodies developed earlier and reached higher levels than did phase I antibodies. The absence of antibodies to phase I lipopolysaccharide in acute Q fever combined with our unpublished findings of antibodies to phase I lipopoly saccharide in chronic Q fever suggests that this test may be used to distinguish acute from chronic Q fever. Key words: Q fever, immune response, ELISA.

scholarly journals From Prolonged Febrile Illness to Fever of Unknown Origin

2003 ◽  
Vol 163 (9) ◽  
pp. 1033 ◽  
Author(s):  
Steven Vanderschueren ◽  
Daniël Knockaert ◽  
Tom Adriaenssens ◽  
Wim Demey ◽  
Anne Durnez ◽  
...  
Keyword(s):  
Fever Of Unknown Origin ◽  
Febrile Illness ◽  
Unknown Origin

scholarly journals Correlation between Ratio of Serum Doxycycline Concentration to MIC and Rapid Decline of Antibody Levels during Treatment of Q Fever Endocarditis

2005 ◽  
Vol 49 (7) ◽  
pp. 2673-2676 ◽  
Author(s):  
Jean-Marc Rolain ◽  
Areen Boulos ◽  
Marie-Noëlle Mallet ◽  
Didier Raoult
Keyword(s):  
Phase I ◽  
Q Fever ◽  
Serum Levels ◽  
Response To Treatment ◽  
Rapid Decline ◽  
Shell Vial ◽  
Real Time Quantitative Pcr ◽  
Chronic Q Fever ◽  
Antibody Levels ◽  
Quantitative Pcr Assay

ABSTRACT Endocarditis is the major clinical manifestation of chronic Q fever. Although doxycycline along with hydroxychloroquine remains the mainstay of medical therapy for Q fever endocarditis, there are wide variations in the rapidity of the patient's decline of antibody levels during such therapy. We undertook a retrospective examination of whether there was any correlation between the ratio of serum concentration to MIC of doxycycline and response to treatment in patients with Q fever endocarditis. Included herein are 16 patients from whom Coxiella burnetii was isolated from cardiac valve materials. Serology and measurement of doxycycline and hydroxychloroquine serum levels were performed and recorded after 1 year of treatment. The MIC of doxycycline for C. burnetii isolates was determined using the shell vial assay in a real-time quantitative PCR assay. At the completion of a yearlong therapy with doxycycline-hydroxychloroquine, all those that showed a low decline of antibody levels (n = 6) (i.e., <2-fold decrease in antibody titer to phase I C. burnetii antigen) had a ratio of serum doxycycline concentration to MIC between 0.5 and 1. In contrast, those having a ratio of ≥1 showed a rapid decline of phase I antibody levels (n = 9; P < 0.05). The only patient who died had a serum doxycycline-to-MIC ratio of <0.5, and the isolate of C. burnetii cultured from this patient was resistant to doxycycline (MIC = 8 μg/ml). The ratio of serum doxycycline concentration to MIC should be monitored during the course of therapy in patients with Q fever endocarditis.

National survey of childhood febrile illness cases with fever of unknown origin in Japan

2011 ◽  
Vol 53 (4) ◽  
pp. 421-425 ◽  
Author(s):  
Kazuko Kasai ◽  
Masaaki Mori ◽  
Ryoki Hara ◽  
Takako Miyamae ◽  
Tomoyuki Imagawa ◽  
...  
Keyword(s):  
National Survey ◽  
Fever Of Unknown Origin ◽  
Febrile Illness ◽  
Unknown Origin

scholarly journals Com1 as a Promising Protein for the Differential Diagnosis of the Two Forms of Q Fever

Pathogens ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 242 ◽  
Author(s):  
Vranakis ◽  
Mathioudaki ◽  
Kokkini ◽  
Psaroulaki
Keyword(s):  
Differential Diagnosis ◽  
Phase I ◽  
Clinical Diagnosis ◽  
Q Fever ◽  
Control Group ◽  
Virulence Potential ◽  
Chronic Q Fever ◽  
Candidate Protein ◽  
Immunogenic Proteins ◽  
Human Infections

Coxiella burnetii is the causative agent of acute and chronic Q fever in humans. Although the isolates studied so far showed a difference in virulence potential between those causing the two forms of the disease, implying a difference in their proteomic profile, the methods used so far to diagnose the two forms of the disease do not provide sufficient discriminatory capability, and human infections may be often misdiagnosed. The aim of the current study was to identify the outer membrane Com1 (CBU_1910) as a candidate protein for serodiagnostics of Q fever. The protein was cloned, expressed, purified, and used as an antigen in ELISA. The protein was then used for the screening of sera from patients suffering from chronic Q fever endocarditis, patients whose samples were negative for phase I immunoglobulin G (IgG), patients for whom at least one sample was positive for phase I IgG, and patients suffering from any kind of rheumatoid disease. Blood donors were used as the control group. Following statistical analysis, 92.4% (122/132) of the samples tested agreed with the negative clinical diagnosis, and 72.2% (26/36) agreed with the positive clinical diagnosis. Moreover, a significant correlation to the presence of the disease (p = 0.00) was calculated. The results support the idea that a Com1 antigen-based serodiagnostic test may be useful for differential diagnosis of chronic Q fever. Further studies are required to compare more immunogenic proteins of the bacterium against samples originating from patients suffering from different forms of the disease.

scholarly journals Threat of scrub typhus in post-earthquake Nepal

2017 ◽  
Vol 6 (4) ◽  
pp. 1-6 ◽  
Author(s):  
S Thapa ◽  
L B Sapkota ◽  
P Hamal
Keyword(s):  
Fever Of Unknown Origin ◽  
Scrub Typhus ◽  
Febrile Illness ◽  
Unknown Origin ◽  
Serum Samples ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Recent Outbreak ◽  
High Index Of Suspicion ◽  
A Prospective Study

Scrub typhus is a potentially fatal zoonotic infection, reported from many parts of Asia including Nepal. There is in­creasing reports of outbreak of Scrub typhus, after the earthquake hit Nepal on April 25, 2015. The recent outbreak of Scrub typhus posed problems in diagnosis and treatment of the disease. It may be related to poor awareness of the disease or lack of suspicion for Scrub typhus which often presents with clinical features indistinguishable from typhoid fever. Since, various parts of Nepal appeared to be suitable hubs for Scrub typhus, the clinical suspicion of Scrub typhus in the differential diagnosis of fever of unknown origin (FUO) is of utmost importance to prevent mortality and morbidity. This is a prospective study conducted in Chitwan Medical College (CMC), Chitwan, Nepal. This study was carried out over a period of 4 months extending from June 2016 to September 2016. A total of 410 serum samples were collected from all patients visiting CMC, clinically suspected of having Scrub typhus infec­tion. The samples were processed for the detection of IgM antibodies for Scrub typhus by ELISA. Results: A total of 410 samples from patients suspected with Scrub typhus infection were processed which included 200 males and 210 females. Out of total 410 samples tested, 181 (44.1%) were seropositive for Scrub typhus. Seropositivity was highest 25.9% among the age group 11-20 years of age. Females were infected more than males. This study implies the re-emergence of Scrub typhus in different regions of Nepal. Although the disease is endemic in our country, it is grossly underdiagnosed owing to non-specific clinical presentation and lack of diagnostic facilities. It is thus suggested that high index of suspicion should be maintained for cases presenting with febrile illness. Infection with Scrub typhus was found high and this calls for an urgent need to introduce vaccine against Scrub typhus. 

scholarly journals Truckin' pneumonia—an outbreak of Q fever in a truck repair plant probably due to aerosols from clothing contaminated by contact with newborn kittens

1989 ◽  
Vol 102 (1) ◽  
pp. 119-127 ◽  
Author(s):  
Thomas J. Marrie ◽  
Donald Langille ◽  
Vasilia Papukna ◽  
Linda Yates
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Coxiella Burnetii ◽  
Attack Rate ◽  
Q Fever ◽  
The Other ◽  
High Antibody ◽  
First Case ◽  
The Family ◽  
Antibody Titres

SUMMARYWe describe an outbreak of Q fever affecting 16 of 32 employees at a truck repair plant. None of the cases were exposed to cattle, sheep or goats. the traditional reservoirs of Q fever. The cases did not work, live on, or visit farms or attend livestock auctions. One of the employees had a cat which gave birth to kittens 2 weeks prior to the first case of Q fever in the plant. The cat owner fed the kittens every day before coming to work as the cat would not let the kittens suckle. Serum from the cat had high antibody titres to phase I and phase IICoxiella burnetiiantigens. The attack rate among the employees where the cat owner worked. 13 of 19 (68%), was higher than that of employees elsewhere, 3 of 13 (28%) [P <0·01]. The cat owner's wife and son also developed Q fever. None of the family members of the other employees with Q fever was so affected.We conclude that this outbreak of Q fever probably resulted from exposure to the contaminated clothing of the cat owner.

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