scholarly journals Coxiella burnetii infection of the spine requiring neurosurgical intervention

2019 ◽  
Vol 10 ◽  
pp. 182
Author(s):  
Paige Lundy ◽  
Paul Arnold ◽  
Kirk Hance

Background: Infections from Coxiella burnetii, resulting in what is known as Q fever, are relatively rare and difficult to diagnose. Very few reports of spinal infection from C. burnetii have been reported rarely have these cases required surgical intervention. Case Description: We report a patient with the previous vascular surgery and Q fever spinal osteomyelitis. Previously reported cases with spinal involvement have described initial infection of vascular grafts in proximity to the spine. Literature on spinal infection from C. burnetii reports only one case that required surgical intervention of the spine. We report a patient with L5-S1 diskitis who required surgical intervention and subsequent percutaneous drainage. Conclusion: Spinal infections from C. burnetii are rare; however, in the setting of a patient with osteodiscitis with negative cultures as well as a history of significant vascular disease with stents, the diagnosis of Q fever should be entertained. Operative and interventional procedures should also be considered in these patients to help alleviate pain and maintain neurologic function.

Infection ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 85-90
Author(s):  
Karol Borawski ◽  
Justyna Dunaj ◽  
Piotr Czupryna ◽  
Sławomir Pancewicz ◽  
Renata Świerzbińska ◽  
...  

Abstract Purpose The aim of the study is to assess anti-Coxiella burnetii antibodies presence in inhabitants of north-eastern Poland, to assess the risk of Q fever after tick bite and to assess the percentage of co-infection with other pathogens. Methods The serological study included 164 foresters and farmers with a history of tick bite. The molecular study included 540 patients, hospitalized because of various symptoms after tick bite. The control group consisted of 20 honorary blood donors. Anti-Coxiella burnetii antibodies titers were determined by Coxiella burnetii (Q fever) Phase 1 IgG ELISA (DRG International Inc. USA). PCR was performed to detect DNA of C. burnetii, Borrelia burgdorferi and Anaplasma phagocytophilum. Results Anti-C. burnetii IgG was detected in six foresters (7.3%). All foresters with the anti-C. burnetii IgG presence were positive toward anti-B. burgdorferi IgG and anti-TBE (tick-borne encephalitis). Anti-C. burnetii IgG was detected in five farmers (6%). Four farmers with anti-C. burnetii IgG presence were positive toward anti-B. burgdorferi IgG and two with anti-TBE. Among them one was co-infected with B. burgdorferi and TBEV. Correlations between anti-C. burnetii IgG and anti-B. burgdorferi IgG presence and between anti-C. burnetii IgG presence and symptoms of Lyme disease were observed. C. burnetii DNA was not detected in any of the 540 (0%) patients. Conclusions C. burnetii is rarely transmitted by ticks, but we proved that it is present in the environment, so it may be a danger to humans. The most common co-occurrence after tick bite concerns C. burnetii and B. burgdorferi.


2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Nataša Knap ◽  
Diana Žele ◽  
Urška Glinšek Biškup ◽  
Tatjana Avšič-Županc ◽  
Gorazd Vengušt

Abstract Background The obligate intracellular bacterium Coxiella burnetii causes globally distributed zoonotic Q fever. Ruminant livestock are common reservoirs of C. burnetii. Coxiella burnetii are shed in large numbers in the waste of infected animals and are transmitted by inhalation of contaminated aerosols. This study was conducted to evaluate the prevalence of C. burnetii infection in domestic animals and ticks in areas of Slovenia associated with a history of Q fever outbreaks. Results A total of 701 ticks were collected and identified from vegetation, domestic animals and wild animals. C. burnetii DNA was detected in 17 out of 701 (2.4%) ticks. No C. burnetii DNA was found in male ticks. Ticks that tested positive in the PCR-based assay were most commonly sampled from wild deer (5.09%), followed by ticks collected from domestic animals (1.16%) and ticks collected by flagging vegetation (0.79%). Additionally, 150 animal blood samples were investigated for the presence of C. burnetii-specific antibodies and pathogen DNA. The presence of pathogen DNA was confirmed in 14 out of 150 (9.3%) blood samples, while specific antibodies were detected in sera from 60 out of 150 (40.4%) animals. Conclusions Our results indicate that ticks, although not the primary source of the bacteria, are infected with C. burnetii and may represent a potential source of infection for humans and animals. Ticks collected from animals were most likely found to harbor C. burnetii DNA, and the infection was not lost during molting. The persistence and distribution of pathogens in cattle and sheep indicates that C. burnetii is constantly present in Slovenia.


2004 ◽  
Vol 17 (6) ◽  
pp. 1-6 ◽  
Author(s):  
Max C. Lee ◽  
Michael Y. Wang ◽  
Richard G. Fessler ◽  
Jason Liauw ◽  
Daniel H. Kim

Object Placement of instrumentation in the setting of a spinal infection has always been controversial. Although the use of allograft and autograft bone has been accepted as safe, demonstrations of the effectiveness of titanium have been speculative, based on several retrospective reviews. The authors' goal in this study was to demonstrate the effectiveness of instrumentation in the setting of a spinal infection by retrospectively reviewing their cases over the last 4 years and searching the literature regarding instrumentation in patients with pyogenic spinal infections. Methods The authors conducted a retrospective review of their cumulative data on spinal infections. Diagnosis was based on subjective and objective clinical findings, along with radiographic and laboratory evaluation of infection and mechanical stability. Patients with medically managed disease and those who did not receive instrumentation were eliminated from this review. Of 105 patients with spinal infections who were admitted to the neurosurgical service between January 2000 and June 2004, 30 underwent surgical debridement necessitating spinal instrumentation. There were 17 women and 13 men in this group ranging from 28 to 86 years of age. Follow-up duration ranged from 3 to 54 months. There was one death, which occurred 3 months postsurgery. In three patients a deep wound infection developed, necessitating intervention, and two patients experienced a graft expulsion. Twenty-nine patients went on to demonstrate adequate fusion based on follow-up neuroimaging studies. Conclusions The goal of neurosurgical intervention in the setting of spinal infection is to obtain an organism culture and the debridement of infection while maintaining neurological and mechanical stability. The authors demonstrate the effectiveness of radical debridement of infected bone and placement of instrumentation in patients with spinal infections.


2016 ◽  
Vol 14 (1) ◽  
pp. 65-68 ◽  
Author(s):  
A. Chakrabartty ◽  
P. K. Bhattacharjee ◽  
R. R. Sarker ◽  
A. K. M. A. Rahman ◽  
K. Henning ◽  
...  

The objectives of this study were to determine the prevalence of Coxiella burnetii infection in domestic ruminants and to detect Coxiella burnetii DNA from ticks and serum samples. A total of 24 ticks, 91 goats and 81 cattle serum samples with the history of abortion and reproductive disorders were collected from the different areas in Bangladesh. The serum samples were tested by CHEKIT Q-Fever Antibody ELISA Test Kit and Coxiella burnetii DNA was detected by multiplex quantitative real- time PCR. The overall prevalence was 7.6% and 6.1% in goats and cattle, respectively. However, none of seropositive samples and tick samples was positive in quantitative real-time PCR.


Author(s):  
A. Chakrabartty ◽  
N. Nahar ◽  
M. S. Rahman ◽  
A. K. M. A. Rahman ◽  
A. S. Sarker ◽  
...  

Background: Q-fever is an important zoonotic disease caused by the bacterium Coxiella burnetii with wide host range of mammals, birds and arthropods worldwide. The prevalence of C. burnetii infection has been reported in domestic ruminants in Bangladesh with no attention on the ‘One Health’ approach for the epidemiological investigation associated with risk factors for prevention of the disease. Objective: This study aimed to investigate the sero-molecular prevalence of Coxiella burnetii infection and associated risk factors in domestic ruminants and humans based on ‘One Health’ approach in Bangladesh Materials and Methods: This study on C. burnetii infection was conducted in cattle, goats and humans of the four randomly selected districts (Kurigram, Sirajgonj, Pabna and Mymensingh) in Bangladesh during the period from 2018 to 2021. A total of 162 and 172 serum samples respectively from cattle and goats with the reproductive disorders, 159 serum samples from human patients with pyrexia of unknown origin lasting over a period of three weeks and who were in close contact with animal, 119 milk samples from cows with reproductive disorders and 6 aborted materials from goat were collected from these selected districts for the detection of C. burnetii antibody by ELISA and DNA by PCR assay. The research was performed with the collaboration of OIE reference laboratory for Q fever, Friedrich-Loeffler-Institute, Germany. Results: The overall sero-prevalence of C. burnetii infection by ELISA was 3.01% in cattle, 7.6 % in goats and 0.63% in humans. The highest sero-positivity was recorded in cattle in Mymensingh (4.5%) in comparison to Pabna (2.8%), Kurigram (2.5%) and Sirajgonj (2.4%) districts. Risk factors associated with higher sero-positivity of C. burnetii infection was recorded in cattle with  5 years (4.4%) than 3 to 5 years (2.1%), indigenous (4.2%) than cross-bred (2.6%), history of retention of placenta (5.6%) than abortion (2.3%) and natural service (5.9%) than artificial insemination (2.3%). The sero-positivity of C. burnetii infection in goat showed highest in Kurigram (10.0%), followed by Sirajgonj (9.5%) and Mymensingh (9.3%) with no positive reactors in Pabna district. Risk factors associated with sero-positivity of C. burnetii infection in goats showed higher in > 2 years (14.1%) than up to 2 years (2.1%) age group and higher with the history of abortion (10.0%) than retention of placenta (4.2%). Risk factors associated with positivity of C. burnetii infection detected in milk samples of cows by ELISA showed an overall 21.85% positivity associated with history of reproductive disorders, with highest positivity in anestrus (33.3%), followed by retention of placenta (24.4%), abortion (21.7%) and lowest with repeat breeding (8.3%). In addition, higher positivity was recorded in cross-bred (24.2%) than in indigenous (12.5%) cattle. In case of humans, only one human patient (0.63%) had positive for IgG phase-II ELISA. C. burnetii DNA was detected in two sero-positive milk samples but all of the intermediate positive milk samples by ELISA were negative by PCR assay and even none of the aborted material of goat was positive in PCR and cell culture. Conclusions: This study recorded the prevalence and risk factors associated with the zoonotic C. burnetii infection in both the domestic ruminants and humans but still it is unrecognized and underestimated in both human and animal health and research in Bangladesh. The findings of this study support the further research on C. burnetii in both human and veterinary medicine under ‘One Health’ approach particularly targeting epidemiology on the agent, host and environment for the control and prevention of the disease in Bangladesh. Keywords: C. burnetii, Ruminants, Humans, ELISA, PCR, Sera, Milk, Prevalence, Risk factors, ‘One Health’ approach


Author(s):  
William Stokes ◽  
Jack Janvier ◽  
Stephen Vaughan

Chronic Q fever is a potentially life-threatening infection from the intracellular, Gram-negativeCoxiella burnetii. It presents most commonly as endocarditis or vascular infection in people with underlying cardiac or vascular disease. We discuss a case of a 67-year-old male withCoxiella burnetiivascular infection of a perirenal abdominal aortic graft. The patient had a history of an abdominal aortic aneurysm (AAA) repair 5 years earlier. He presented with a 12 × 6 × 8 cm perirenal pseudoaneurysm and concomitant L1, L2, and L3 vertebral body discitis. He underwent an open repair which revealed a grossly infected graft perioperatively. Q fever serology revealed phase I serological IgG titer of 1 : 2048 and phase II 1 : 1024 consistent with chronic Q fever. Polymerase chain reaction (PCR) on infected vascular tissue was positive forC. burnetii. The patient was started on doxycycline and hydroxychloroquine with good clinical response and decreasing serological titers. Recognizing chronic Q fever is a difficult task as symptoms are nonspecific, exposure risk is difficult to ascertain, and diagnosis is hidden from conventional microbiological investigations. Its recognition, however, is critical asC. burnetiiis inherently resistant to standard empiric therapies used in cardiovascular infections.


2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110253
Author(s):  
Jinwei Huang ◽  
Rui Wang ◽  
Can Gao ◽  
Yuankai Lü ◽  
Zhuo Cao ◽  
...  

Q fever is a zoonotic disease caused by Coxiella burnetii. Most patients have non-specific symptoms at onset. In addition, routine diagnostic tests for C. burnetii are not sensitive, and the bacterium cannot grow in general culture medium. The diagnosis of Q fever therefore poses a challenge. This case study describes a man with a clear history of tick bite who had recurrent fever, pneumonia, and liver damage. Routine tests and bacterial cultures failed to clarify the pathogeny, but laboratory and imaging data suggested infection. After routine tests were exhausted, we detected the presence of C. burnetii in a whole blood sample using next-generation sequencing (NGS). To our knowledge, this is the first report of Q fever associated with Coxiella burnetii detected directly from blood samples in Lishui, China. NGS has revolutionized the diagnosis of infectious diseases, especially those caused by rare or newly discovered pathogens, and patient responses have finally proved its substantial benefits. NGS has important clinical significance for the early diagnosis of chronic Q fever. This proof-of-concept study is worthy of promotion in clinical practice.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Zahra Soleimani ◽  
Amin Jaydari

Background: Q fever is caused by the bacterium Coxiella burnetii. To date, no studies have been conducted on the rate of Q fever infection among the veterinary staff in Lorestan province. Objectives: The present study aimed to investigate the seroprevalence of infection in the veterinary staff. Methods: This cross-sectional study was conducted from April to July 2019 on 92 samples collected randomly from Lorestan province on veterinary staff who had a history of contact with livestock and were tested via indirect immunofluorescence kit. Results: In this study, 77 (83/69%) samples were positive, and 15 (16/3%) samples were negative. There were no statistically significant relationships between residence, contact with livestock, and work experience. Conclusions: According to the results of this study, the high seroprevalence of a Q fever was observed among Veterinary staff, which further reveals the necessitates of diagnosis, treatment, and prevention of the disease in order to prevent unwanted complications in people in contact with livestock.


Pathogens ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 1075
Author(s):  
Salvatore Ledda ◽  
Cinzia Santucciu ◽  
Valentina Chisu ◽  
Giovanna Masala

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.


npj Vaccines ◽  
2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Carrie M. Long ◽  
Paul A. Beare ◽  
Diane C. Cockrell ◽  
Jonathan Fintzi ◽  
Mahelat Tesfamariam ◽  
...  

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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