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Nordmann T, Wiemer D, Halfter M, Ramirez AV, Tappe D, Jordan S, Ramharter M, Jochum J. Q fever: a rare zoonotic disease as a cause of pneumonia in travellers. J Travel Med 2024; 31:taae001. [PMID: 38181394 DOI: 10.1093/jtm/taae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/27/2023] [Accepted: 12/31/2023] [Indexed: 01/07/2024]
Affiliation(s)
- Tamara Nordmann
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, University Medical Center Hamburg- Eppendorf, Martinistraße 52, 20251, Hamburg
- I.Department of Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg
- German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Lübeck, Riems
| | - Dorothea Wiemer
- Department of Infectious Diseases and Tropical Medicine, Bundeswehr Hospital Hamburg, Lesserstraße 180, 22049, Hamburg
| | - Matthias Halfter
- Department of Infectious Diseases and Tropical Medicine, Bundeswehr Hospital Hamburg, Lesserstraße 180, 22049, Hamburg
| | - Andrea Vanegas Ramirez
- Department of Dermatology, Bundeswehr Hospital Hamburg, Lesserstraße 180, 22049, Hamburg
| | - Dennis Tappe
- Bernhard-Nocht-Institute for Tropical Medicine, Bernhard-Nocht-Straße 74, 20359, Hamburg
| | - Sabine Jordan
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, University Medical Center Hamburg- Eppendorf, Martinistraße 52, 20251, Hamburg
- I.Department of Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg
- German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Lübeck, Riems
| | - Michael Ramharter
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, University Medical Center Hamburg- Eppendorf, Martinistraße 52, 20251, Hamburg
- I.Department of Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg
- German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Lübeck, Riems
| | - Johannes Jochum
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, University Medical Center Hamburg- Eppendorf, Martinistraße 52, 20251, Hamburg
- I.Department of Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg
- German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Lübeck, Riems
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Nieves Salceda JF, Lozano Cuesta P, Hermoso de Mendoza Aristegui S, Fernández-Suárez J, Madrid Carbajal C, García Clemente MM. Q fever, a rare cause of secondary hemophagocytic lymphohistiocytosis. GMS INFECTIOUS DISEASES 2023; 11:Doc05. [PMID: 38111807 PMCID: PMC10726720 DOI: 10.3205/id000085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome in which Coxiella burnetii is a very infrequent etiology. We present the case of a 62-year-old male with progressive pulmonary infiltrates, fever, hepatitis, and bicytopenia despite broad spectrum antibiotics. A thorough clinical evaluation led to a high suspicion of Coxiella burnetii infection, subsequently confirmed through a positive serum polymerase chain reaction (PCR) analysis. HLH diagnosis was established based on the fulfillment of 5/8 diagnostic criteria, obviating the need for a bone marrow biopsy. Targeted antibiotic treatment and dexamethasone led to full recovery within two weeks, eliminating the need for stronger immunosuppressive therapy.
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Affiliation(s)
| | - Pablo Lozano Cuesta
- Division of Respiratory Medicine, Hospital Universitario Central de Asturias, Spain
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von Ranke FM, Clemente Pessoa FM, Afonso FB, Gomes JB, Borghi DP, Alves de Melo AS, Marchiori E. Acute Q fever pneumonia: high-resolution computed tomographic findings in six patients. Br J Radiol 2019; 92:20180292. [PMID: 30608178 DOI: 10.1259/bjr.20180292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
METHODS: We analyzed high-resolution CT (HRCT) findings from six male patients (mean age, 22.6 years) with confirmed diagnoses of acute Q fever. Two chest radiologists analyzed the images and reached decisions by consensus. All patients presented fever, myalgia, prostation, headache, and dry cough. They also had common epidemiologic factors (recent travel for military service, where they had contact with sheep and capybara). Diagnoses were confirmed by the detection of C. burnetii DNA in clinical samples by polymerase chain reaction. RESULTS: The predominant HRCT findings were areas of consolidation (100%) and nodules (66.6%) with halos of ground-glass opacity, predominantly with segmental and peripheral distributions. Lesions affected all lobes, and predominated in the left upper and lower lobes. Involvement of more than one lobe was observed in four patients. No pleural effusion or lymph node enlargement was found. CONCLUSION: The predominant HRCT findings in patients with acute Q fever pneumonia were bilateral, peripheral areas of consolidation and nodules with irregular contours and halos of ground-glass opacity. ADVANCES IN KNOWLEDGE: Acute Q fever should be included in the differential diagnosis of lesions with the halo sign on HRCT.
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Affiliation(s)
| | | | | | - Josiani Bastos Gomes
- 1 Department of Radiology, Fluminense Federal University , Rio de Janeiro , Brazil
| | | | | | - Edson Marchiori
- 2 Department of Radiology, Federal University of Rio de Janeiro , Rio de Janeiro , Brazil
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Eldin C, Mélenotte C, Mediannikov O, Ghigo E, Million M, Edouard S, Mege JL, Maurin M, Raoult D. From Q Fever to Coxiella burnetii Infection: a Paradigm Change. Clin Microbiol Rev 2017; 30:115-190. [PMID: 27856520 PMCID: PMC5217791 DOI: 10.1128/cmr.00045-16] [Citation(s) in RCA: 550] [Impact Index Per Article: 78.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Coxiella burnetii is the agent of Q fever, or "query fever," a zoonosis first described in Australia in 1937. Since this first description, knowledge about this pathogen and its associated infections has increased dramatically. We review here all the progress made over the last 20 years on this topic. C. burnetii is classically a strict intracellular, Gram-negative bacterium. However, a major step in the characterization of this pathogen was achieved by the establishment of its axenic culture. C. burnetii infects a wide range of animals, from arthropods to humans. The genetic determinants of virulence are now better known, thanks to the achievement of determining the genome sequences of several strains of this species and comparative genomic analyses. Q fever can be found worldwide, but the epidemiological features of this disease vary according to the geographic area considered, including situations where it is endemic or hyperendemic, and the occurrence of large epidemic outbreaks. In recent years, a major breakthrough in the understanding of the natural history of human infection with C. burnetii was the breaking of the old dichotomy between "acute" and "chronic" Q fever. The clinical presentation of C. burnetii infection depends on both the virulence of the infecting C. burnetii strain and specific risks factors in the infected patient. Moreover, no persistent infection can exist without a focus of infection. This paradigm change should allow better diagnosis and management of primary infection and long-term complications in patients with C. burnetii infection.
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Affiliation(s)
- Carole Eldin
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Cléa Mélenotte
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Oleg Mediannikov
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Eric Ghigo
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Matthieu Million
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Sophie Edouard
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Jean-Louis Mege
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Max Maurin
- Institut de Biologie et de Pathologie, CHU de Grenoble, Grenoble, France
| | - Didier Raoult
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
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